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Salivary glandsParotid glandSubmandibular glandSublingual glandPharynxTongueEsophagusPancreasPancreatic ductStomachIleumAnusRectumVermiform appendixCecumDescending colonAscending colonTransverse colonBile ductDuodenumGallbladderLiverOral cavityDigestive system diagram en
About this image

Upper and Lower gastrointestinal tract

Human gastrointestinal tract (Digestive System)
Stomach colon rectum diagram
Stomach colon rectum diagram
Latin Tractus digestorius (mouth to anus),
canalis alimentarius (esophagus to large Intestine),
canalis gastrointestinales (stomach to large Intestine)
Gray's subject #
System Digestive system
MeSH [2]
[[Image:|190px|center|]]

The human gastrointestinal tract is the stomach and intestine,[1] sometimes including all the structures from the mouth to the anus.[2] (The "digestive system" is a broader term that includes other structures, including the accessory organs of digestion).[3]

In an adult male human, the gastrointestinal (GI) tract is 5 metres long in a live subject, or up to 9 metres without the effect of muscle tone, and consists of the upper and lower GI tracts. The tract may also be divided into foregut, midgut, and hindgut, reflecting the embryological origin of each segment of the tract.

The GI tract always releases hormones to help regulate the digestive process. These hormones, including gastrin, secretin, cholecystokinin, and ghrelin, are mediated through either intracrine or autocrine mechanisms, indicating that the cells releasing these hormones are conserved structures throughout evolution.[4]

Upper gastrointestinal tract[]

Salivary glandsParotid glandSubmandibular glandSublingual glandPharynxTongueEsophagusPancreasPancreatic ductStomachIleumAnusRectumVermiform appendixCecumDescending colonAscending colonTransverse colonBile ductDuodenumGallbladderLiverOral cavityDigestive system diagram en
About this image

Upper and Lower gastrointestinal tract

The upper gastrointestinal tract consists of the esophagus, stomach, and duodenum.[5] The exact demarcation between "upper" and "lower" can vary. Upon dissection, the duodenum may appear to be a unified organ, but it is often divided into two parts based upon function, arterial supply, or embryology.

Lower gastrointestinal tract[]

The lower gastrointestinal tract includes most of the small intestine and all of the large intestine.[6] According to some sources, it also includes the anus.[citation needed]

  • Bowel or intestine
    • Small Intestine: Has three parts:
      • Duodenum: Here the digestive juices from the pancreas (digestive enzymes) and hormones and the gall bladder (bile) mix. The digestive enzymes break down proteins and bile and emulsify fats into micelles. The duodenum contains Brunner's glands which produce bicarbonate. In combination with bicarbonate from pancreatic juice, this neutralizes HCl of the stomach.
      • Jejunum: This is the midsection of the intestine, connecting the duodenum to the ileum. It contains the plicae circulares (also called circular folds or valves of Kerckring), and villi that increase the surface area of this part of the GI Tract. Products of digestion (sugars, amino acids, and fatty acids) are absorbed into the bloodstream here.
      • Ileum: Has villi similar to the jejunum, and absorbs mainly vitamin B12 and bile acids, as well as any other remaining nutrients.
    • Large Intestine: Has three parts:
      • Caecum: The Vermiform appendix is attached to the caecum.
      • Colon: Includes the ascending colon, transverse colon, descending colon and sigmoid Flexure: The main function of the Colon is to absorb water, but it also contains bacteria that produce beneficial vitamins like vitamin K.
      • Rectum
  • Anus: Passes fecal matter from the body.

The Ligament of Treitz is sometimes used to divide the upper and lower GI tracts.[7]

Embryology[]

The gut is an endoderm-derived structure. At approximately the sixteenth day of human development, the embryo begins to fold ventrally (with the embryo's ventral surface becoming concave) in two directions: the sides of the embryo fold in on each other and the head and tail fold toward one another. The result is that a piece of the yolk sac, an endoderm-lined structure in contact with the ventral aspect of the embryo, begins to be pinched off to become the primitive gut. The yolk sac remains connected to the gut tube via the vitelline duct. Usually this structure regresses during development; in cases where it does not, it is known as Meckel's diverticulum.

During fetal life, the primitive gut can be divided into three segments: foregut, midgut, and hindgut. Although these terms are often used in reference to segments of the primitive gut, they are also used regularly to describe components of the definitive gut as well.

Each segment of the gut gives rise to specific gut and gut-related structures in later development. Components derived from the gut proper, including the stomach and colon, develop as swellings or dilatations of the primitive gut. In contrast, gut-related derivatives — that is, those structures that derive from the primitive gut but are not part of the gut proper, in general develop as out-pouchings of the primitive gut. The blood vessels supplying these structures remain constant throughout development.[8]

Part Part in adult Gives rise to Arterial supply
Foregut Esophagus to first 2 sections of the duodenum Esophagus, Stomach, Duodenum (1st and 2nd parts), Liver, Gallbladder, Pancreas, Superior portion of pancreas
(Note that though the Spleen is supplied by the celiac trunk, it is derived from dorsal mesentery and therefore not a foregut derivative)
celiac trunk
Midgut lower duodenum, to the first two-thirds of the transverse colon lower duodenum, jejunum, ileum, cecum, appendix, ascending colon, and first two-third of the transverse colon branches of the superior mesenteric artery
Hindgut last third of the transverse colon, to the upper part of the anal canal last third of the transverse colon, descending colon, rectum, and upper part of the anal canal branches of the inferior mesenteric artery

Transit time[]

The time taken for food or other ingested objects to transit through the gastrointestinal tract varies depending on many factors, but roughly, it takes less than an hour after a meal for 50% of stomach contents to empty into the intestines and total emptying of the stomach takes around 2 hours. Subsequently, 50% emptying of the small intestine takes 1 to 2 hours. Finally, transit through the colon takes 12 to 50 hours with wide variation between individuals.[9][10]

Pathology[]

Main article: Digestive disease

There are a number of diseases and conditions affecting the gastrointestinal system, including:

Immune function[]

The gastrointestinal tract is also a prominent part of the immune system.[11] The surface area of the digestive tract is estimated to be the surface area of a football field. With such a large exposure, the immune system must work hard to prevent pathogens from entering into blood and lymph.[12][WP:V]

The low pH (ranging from 1 to 4) of the stomach is fatal for many microorganisms that enter it. Similarly, mucus (containing IgA antibodies) neutralizes many of these microorganisms. Other factors in the GI tract help with immune function as well, including enzymes in saliva and bile. Enzymes such as Cyp3A4, along with the antiporter activities, also are instrumental in the intestine's role of detoxification of antigens and xenobiotics, such as drugs, involved in first pass metabolism.

Health-enhancing intestinal bacteria serve to prevent the overgrowth of potentially harmful bacteria in the gut. These two types of bacteria compete for space and "food," as there are limited resources within the intestinal tract. A ratio of 80-85% beneficial to 15-20% potentially harmful bacteria generally is considered normal within the intestines. Microorganisms also are kept at bay by an extensive immune system comprising the gut-associated lymphoid tissue (GALT).

Histology[]

File:Gut wall.svg

General structure of the gut wall

The gastrointestinal tract has a form of general histology with some differences that reflect the specialization in functional anatomy.[13] The GI tract can be divided into four concentric layers in the following order:

  • Mucosa
  • Submucosa
  • Muscularis externa (the external muscular layer)
  • Adventitia or serosa

Mucosa[]

The mucosa is the innermost layer of the gastrointestinal tract. that is surrounding the lumen, or open space within the tube. This layer comes in direct contact with digested food (chyme),

The mucosa is made up of three layers:

  • Epithelium - innermost layer. Responsible for most digestive, absorptive and secretory processes.
  • Lamina propria - a layer of connective tissue. Unusually cellular compared to most connective tissue
  • Muscularis mucosae - a thin layer of smooth muscle. Function is still under debate

The mucosae are highly specialized in each organ of the gastrointestinal tract to deal with the different conditions. The most variation is seen in the epithelium.

In the esophagus, the epithelium is stratified, squamous and non-keratinising, for protective purposes.

In the stomach it is simple columnar, and is organised into gastric pits and glands to deal with secretion. The gastro-oesophageal junction is extremely abrupt.

The small intestine epithelium (particularly the ileum) is specialised for absorption; it is organised into plicae circulares and villi, and the enterocytes have microvilli. This creates a brush border which greatly increases the surface area for absoption. The epithelium is simple columnar with microvilli. In the ileum there are occasionally Peyer's patches in the lamina propria.

The colon has simple columnar epithelium with no villi. There are goblet cells.

The appendix has a mucosa resembling the colon but is heavily infiltrated with lymphocytes.

The ano-rectal junction (at the pectinate line) is again very abrupt; there is a transition from simple columnar to stratified squamous non-keratinising epithelium (as in the esophagus) for protective purposes.

Submucosa[]

The submucosa consists of a dense irregular layer of connective tissue with large blood vessels, lymphatics, and nerves branching into the mucosa and muscularis externa. It contains Meissner's plexus, an enteric nervous plexus, situated on the inner surface of the muscularis externa.

Muscularis externa[]

The muscularis externa consists of an inner circular layer and a longitudinal outer muscular layer. The circular muscle layer prevents food from traveling backward and the longitudinal layer shortens the tract. The layers are not truly longitudinal or circular, rather the layers of muscle are helical with different pitches. The inner circular is helical with a steep pitch and the outer longitudinal is helical with a much shallower pitch.

The coordinated contractions of these layers is called peristalsis and propels the food through the tract. Food in the GI tract is called a bolus (ball of food) from the mouth down to the stomach. After the stomach, the food is partially digested and semi-liquid, and is referred to as chyme. In the large intestine the remaining semi-solid substance is referred to as faeces.

Between the two muscle layers are the myenteric or Auerbach's plexus. This controls peristalsis. Activity is initiated by the pacemaker cells (interstitial cells of Cajal). The gut has intrinsic peristaltic activity (basal electrical rhythm) due to its self-contained enteric nervous system. The rate can of course be modulated by the rest of the autonomic nervous system.

The thickness of muscularis externa varies in each part of the tract. In the colon, for example, the muscularis externa is much thicker because the faeces are large and heavy, and require more force to push along. The outer longitudinal layer of the colon thins out into 3 discontinuous longitudinal bands, known as taeniae coli (bands of the colon). This is one of the 3 features helping to distinguish between the large and small intestine.

Occasionally in the large intestine (2-3 times a day) there will be mass contraction of certain segments, moving a lot of faeces along. This is generally when one gets the urge to defecate.

The pylorus of the stomach has a thickened portion of the inner circular layer: the pyloric sphincter. Alone among the GI tract, the stomach has a third layer of muscularis externa. This is the inner oblique layer, and helps churn the chyme in the stomach.

Adventitia/serosa[]

The outermost layer of the GI tract consists of several layers of connective tissue.

Intraperitoneal parts of the GI tract are covered with serosa. These include most of the stomach, first part of the duodenum, all of the small intestine, caecum and appendix, transverse colon, sigmoid colon and rectum. In these sections of the gut there is clear boundary between the gut and the surrounding tissue. These parts of the tract have a mesentery.

Retroperitoneal parts are covered with adventitia. They blend into the surrounding tissue and are fixed in position. For example, the retroperitoneal section of the duodenum usually passes through the transpyloric plane. These include the esophagus, pylorus of the stomach, distal duodenum, ascending colon, descending colon and anal canal. In addition, the oral cavity has adventitia.


See also[]

References[]

  1. Template:DorlandsDict
  2. MeSH Gastrointestinal+tract
  3. Template:DorlandsDict
  4. Nelson RJ. 2005. Introduction to Behavioral Endocrinology. Sinauer Associates: Massachusetts. p 57.
  5. MeSH Upper+Gastrointestinal+Tract
  6. Template:MeSH name
  7. David A. Warrell (2005). Oxford textbook of medicine: Sections 18-33, 511–, Oxford University Press. URL accessed 1 July 2010.
  8. Bruce M. Carlson (2004). Human Embryology and Developmental Biology, 3rd, Saint Louis: Mosby.
  9. Kim SK. Small intestine transit time in the normal small bowel study. American Journal of Roentgenology 1968; 104(3):522-524.
  10. [1] Uday C Ghoshal, Vikas Sengar, and Deepakshi Srivastava. Colonic Transit Study Technique and Interpretation: Can These Be Uniform Globally in Different Populations With Non-uniform Colon Transit Time? J Neurogastroenterol Motil. 2012 April; 18(2): 227–228.
  11. Richard Coico, Geoffrey Sunshine, Eli Benjamini (2003). Immunology: a short course, New York: Wiley-Liss.
  12. Animal Physiology textbook
  13. Abraham L. Kierszenbaum (2002). Histology and cell biology: an introduction to pathology, St. Louis: Mosby.

Further reading[]

  • Abramets, I. I., Komissarov, I. V., & Samoilovich, I. M. (1968). On the action of serotonin on the D-receptors of smooth muscles: Byulleten' Eksperimental'Noi Biologii i Meditsiny 66(8) 1968, 62-66.
  • Adam, W. R., & Dawborn, J. K. (1972). Effect of potassium depletion on mineral appetite in the rat: Journal of Comparative and Physiological Psychology Vol 78(1) Jan 1972, 51-58.
  • Ader, R. (1970). Effects of early experience and differential housing on susceptibility to gastric erosions in lesion-susceptible rats: Psychosomatic Medicine Vol 32(6) Nov 1970, 569-580.
  • Akhobadze, R. A. (1968). On the influence of stimulation and extirpation of the limbic cortex on gastric secretory activity: Sak'art'velos SSR Mets'nierebat'a Akademiis Moambe 50(2) 1968, 493-498.
  • Akhobadze, R. A. (1968). On the influence of stimulation of several thalamic nonspecific structures on gastric secretory function in the chronic experiment: Sak'art'velos SSR Mets'nierebat'a Akademiis Moambe 50(1) 1968, 233-238.
  • Allison, J. (1971). Microbehavioral features of nutritive and nonnutritive drinking in rats: Journal of Comparative and Physiological Psychology Vol 76(3) Sep 1971, 408-417.
  • Almli, C. R. (1971). Hypervolemia at the polyethylene glycol induced onset of drinking: Physiology & Behavior Vol 7(3) Sep 1971, 369-373.
  • Almli, C. R. (1971). Thirst motivated behavior: Specification of the adequate internal stimulus: Dissertation Abstracts International Vol.
  • Altman, J., Das, G. D., Sudarshan, K., & Anderson, J. B. (1971). The influence of nutrition on neural and behavioral development: II. Growth of body and brain in infant rats using different techniques of undernutrition: Developmental Psychobiology Vol 4(1) 1971, 55-70.
  • Amiragova, M. G., & Berlina, M. A. (1970). Mechanisms whereby hormonal influences are conducted from the dorsal hypothalamus to the cerebral cortex: Doklady Akademii Nauk SSSR 191(5) 1970, 1186-1188.
  • Amit, Z., & Stern, M. H. (1970). Ambulatory behavior in the rat as a function of two methods of alcohol administration: Psychonomic Science Vol 18(5) 1970, 273-274.
  • Antin, J., Gibbs, J., & Smith, G. P. (1978). Cholecystokinin interacts with pregastric food stimulation to elicit satiety in the rat: Physiology & Behavior Vol 20(1) Jan 1978, 67-70.
  • Avakumov, V. M., & Batulin, Y. M. (1970). Comparative characteristics of the distribution of aminazine and chloracyzine in rats: Farmakologiya i Toksikologiya Vol 33(1) 1970, 14-17.
  • Badley, L. E., Spiro, H. M., & Senay, E. C. (1969). Effect of mental arithmetic on gastric secretion: Psychophysiology 5(6) 1969, 633-637.
  • Baichenko, P. I. (1969). On excitation of the abdominal muscles and diaphragm in the act of vomiting: Fiziologicheskii Zhurnal SSSR 55(5) 1969, 558-562.
  • Baile, C. A. (1971). Metabolites as feedbacks for control of feed intake and receptor sites in goats and sheep: Physiology & Behavior Vol 7(6) Dec 1971, 819-826.
  • Baile, C. A., Zinn, W., & Mayer, J. (1971). Feeding behavior of monkeys: Glucose utilization rate and site of glucose entry: Physiology & Behavior Vol 6(5) May 1971, 537-541.
  • Balagura, S., & Coscina, D. V. (1969). Influence of gastrointestinal loads on meal-eating patterns: Journal of Comparative and Physiological Psychology Vol 69(1) Sep 1969, 101-106.
  • Balinska, H. (1970). Influence of the type of reinforcement on the conditioned alimentary reaction in rats with lesions of the lateral hypothalamus: Acta Physiologica Polonica Vol 21(1) 1970, 63-70.
  • Banuazizi, A. (1969). Modification of an autonomic response by instrumental learning: Dissertation Abstracts International.
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  • Bulygin, I. A., & Malyukovich, G. F. (1969). Features typifying the changes of adrenaline-like substances in the blood, following exposure to intero- and exteroceptive influences: Fiziologicheskii Zhurnal SSSR Vol 55(10) Oct 1969, 1233-1241.
  • Bulygin, I. A., & Soltanov, V. V. (1969). New data on the features marking intero- and exteroceptive afferent impulsation: Fiziologicheskii Zhurnal SSSR Vol 55(8) Aug 1969, 995-1002.
  • Bulygin, I. A., & Syusyukina, V. A. (1968). Circular connections of the intestine with the central nervous system: Fiziologicheskii Zhurnal SSSR 54(2) 1968, 166-175.
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