GIT Physiology 1

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Gastrointestinal

Tract Physiology
By. Dr. Ayesha Fatima
GI
T
Function: The GI tract provides a continuous
supply of water, nutrients and electrolytes to
the body.
To achieve this target we need:
1. M ovement (Motility)
2. Secretion of glands
3. Absorption of nutrients
4. Circulation of blood (splanchnic circulation)
5. Control of all these functions (nervous and
hormonal)
Major Components of GIT
1.Mouth (oral cavity)

2.Pharynx (throat)
3.Esophagus (food pipe)
4.Stomach
5.Small intestine

Duodenum

jejunum ileum

5.
Large
intestine

Cecum appendix
colon

Rectum Anus
Typical cross section of Gut

A typical cross section
shows:
1. Serosa
2. Longitudinal smooth
Muscle layer
3. Circular smooth

muscle

4. Submucosa
5. Mucosa
Outer most Layer: Serosa (serous
layer)

Outer covering of the
tube.

Visceral peritoneum.

Secretes serous fluid to
keep the outside of
the organs lubricated
and moist, thus
performs a protective
function.
Peritoneum

 largest serous membrane of the body


 Protective barrier
 Two types:
Parietal peritoneum which lines abdominal
cavity
Visceral peritoneum which lines organs
Muscularis externa Layer

Provides the tube
movements
(peristalsis)

Has two coats of
smooth muscle tissue:
– Inner Circular fibers
(increase and decrease
tube diameter)
– Outer Longitudinal fibers
(lengthen and shorten
the tube)
Submucosal Layer

Contains loose
Connective Tissue.

Contains Glands, blood
vessels, lymphatics
and nerves.

Carries away absorbed
materials.
Mucosal Layer (innermost layer)
Mucosa= epithelium
and lamina propria

Small amount of
smooth muscle
(muscularis mucosae)
is also present

Lumen: passageway.

Epithelium may have
mucus secreting
glands (also secrete
digestive enzymes)

Secretes and absorbs.
Accessory Organs
Salivary glands (sublingual, submandibular and parotid
glands)
– Secrete saliva.

Pancreas:
– Secretes digestive enzymes.

Liver:
– Secretes bile.

Gallbladder:
– Stores and concentrates the bile.
Electrical activity in the Smooth Muscle of
GIT

Smooth muscle in the GIT is excitable.
Slow, intrinsic electrical activity takes place
along the membranes of this smooth muscle.


The GI smooth muscle acts as a functional
syncytium.
– Due to presence of Gap junctions.

Therefore, whenever an action potential is
generated within the muscle mass, it travels in all
directions.
Electrical activity in GIT

The RMP is -50 to -55
mV. This can be
changed to different
levels to control the
motor activity of the
gut.
There are two types of
electrical waves:
– Slow waves-
– Spike potentials.
Slow W aves
• Not true action
potential
• Function:
They lead the RMP to
threshold value so that

the spike potential can


take place. They range
from 5 to 15 mV.
• Stimulated by:
Interstitial cells of
Cajal
(electrical pacemaker
cells of smooth
muscles)
Cause of Slow W aves
– Pacemaker
cells/Interstitial cells
of Cajal:
– These pacemaker cells
undergo cyclic changes
in the membrane
potential due to unique
Na ion channels which
periodically open and
produce inward,
pacemaker currents
which in turn generate
slow waves.
Spike Potentials

These are true action potentials.

They occur whenever the RMP of the smooth muscle
becomes more positive than -40 mV (threshold)


Ionic basis of action potentials/spike potential:
– In GIT, the ion channels involved are slow Calcium-
Sodium channels.
– The slowness accounts for the long duration of the action
potential in the GI smooth muscle.
Neural Control of the GI
Function

Neural Controls:
– Extrinsic (3)
Parasympathetic.
Sympathetic.

– Intrinsic(2)
Myenteric plexus.
Submucosal plexus.

– SANS and PANS


modulate the enteric
nervous system as
opposed to directly
controlling the smooth
muscle of the bowel.
Extrinsic control
(Autonomic) Neural Pathways:
Parasympathetics

Upper/Cranial via Vagus nerve:

Lower/Sacral via Pelvic Splanchnic nerves (nervi erigentes)
– S2-S4 to the descending colon, rectum and anus.
.
– Neurotransmitter:
Acetylcholine.
– Function:
– Stimulates GI secretion, motor activity.
– Relaxes sphincters
Extrinsic control
Autonomic Neural Pathways:
Sympathetic
s

Fibers originate in the spinal cord between segments T-5 and L-2.

– Neurotransmitter:

Norepinephrine.

Some amounts of Epinephrine


.
– Function:
Inhibition of GI secretion, motor activity.
Contraction of GI sphincters and blood
vessels.
Intrinsic/ Enteric Nervous System:

Submucosal (Meissner’s)
plexus.

Myenteric (Auerbach’s)
plexus.
Enteric Nervous System
Myenteric plexus (AuerbaCh’s plexus):

– Located between the


longitudinal and circular
layers of muscle in the wall
of the GIT.

Controls tonic and rhythmic
contractions.

Exerts control
primarily over
digestive tract
motility.

Myenteric plexus

Principal effects:

Increased tone.

Increased intensity of
contractions.

Increased rate of contractions.

Increased velocity of conduction.
Enteric Nervous System
Submucosal plexus
(M e i s s n e r ’ s plexus)
– Buried in the
Submucosa.

– Controls epithelial
cell function (local
intestinal secretion
and absorption).
– May be sparse or
missing in some parts of
GI tract.
Types of Enteric Neurotransmitters in enteric
neurons
– Acetylcholine:
Excitatory
– Stimulates smooth muscle contraction.
– Increases intestinal secretions.
– Releases enteric hormones.
– Dilates the blood vessels.
– Norepinephrine:
Derived from extrinsic sympathetic neurons.

Inhibits the GI activity.
Causes vasoconstriction
– Others (some are
excitatory some are
inhibitory)

Adenosine tri phosphate (ATP), Serotonin,
Dopamine, Cholecystokinin, VIP, Somatostatin,
Factors that increase depolarization
of membrane (more excitable)

 Stretching of the muscle


 Acetylcholine action
 Parasympathetic stimulation
 Gastrointestinal hormones
Factors that increase Hyperpolarization
of Membrane (less excitable)

 Sympathetic stimulation
 Effect of epinephrine and nor epinephrine
Hormonal Control of the GI M otility

Following hormones affect the motility of the
gut in addition to their digestive functions:
1. Gastrin.
2. Cholecystokinin (CCK)
3. Secretin.
4. Gastric Inhibitory Peptide (GIP)
5. Motilin.
1. GASTRIN:

Secretion: By G cells in gastric pits of the


mucosa.
Stimulus: Stomach distention , the products of
proteins and Gastrin releasing peptide.

Actions:
– 1. Increases HCl production in stomach.
– 2. Increases gastric motility.
– 3. Stimulates growth of gastric mucosa.
– 4. Contracts lower esophageal sphincter.
– 5. Relaxes pyloric sphincter.
2. CHOLECYSTOKININ
(CCK):
Secretion: By I cells in the mucosa of the
duodenum
and jejunum.
Stimulus: Chyme rich in digestive products of
triglycerides and fatty acids and monoglycerides
and amino acids.
Actions:
– Contracts the gallbladder.
– Opens the Sphincter of Oddi.
– Increases secretion of pancreatic juice rich in digestive
enzymes.
– Inhibits gastric secretion and motility.

3.
SECRETIN
Secretion: By S cells in the mucosa of the
duodenum.
Stimulus: Acid chyme (H+), fatty acids in the
small intestine causes secretion of Secretin.
Actions:
– Stimulates the watery secretion of pancreatic juice and
bile that is rich in bicarbonate ions. MCQ
– Inhibit production of HCl in stomach.
– Promotes growth and maintenance of the pancreas.
– Enhances the effects of Cholecystokinin (CCK)
4. Gastric Inhibitory Peptide (GIP)/Glucose
dependent insulinotropic peptide

Secretion: By mucosa of the upper


small intestine.
Stimulus: Chyme rich in fatty acids and
amino acids, glucose
Actions:
– Inhibits gastric secretion and motility.
– Stimulates release of Insulin by beta cells.
5. Motilin

Secretion: By the cells of the


upper duodenum.
Stimulus: It is released during
fasting.
Actions:
Increases the gastrointestinal motility.
Functional Types of M ovements in the GIT

1. Propulsive movements/peristalsis
2. M ixing movements.


Both are brought about by the Enteric nervous system, but
are influenced by the Extrinsic nervous system, especially
the Parasympathetic nervous system.
Propulsive movements/peristalsis

It is an inherent property of many syncitial smooth


muscle tubes.
Occurs in the gut, bile ducts, glandular ducts and
ureters.


Controlled by:
– Actual peristalsis is brought about by the Myenteric
nervous system.
– But it is influenced by the Parasympathetic nervous
system.
Mixing Movements

Differ in most parts of the gut.


Segmentations in small
intestines


Haustrations in large
intestines


They bring about chopping
and shearing of food.

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