prof. barry campbell cellular & molecular physiologypcbjcampbl/lecture 1 - introduction to...
TRANSCRIPT
![Page 1: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/1.jpg)
Overview of digestion … introduction to the GI system
Prof. Barry Campbell
Cellular & Molecular Physiology
e-mail: [email protected]
http://pcwww.liv.ac.uk/~bjcampbl
Key concepts in Digestion….
![Page 2: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/2.jpg)
“The progressive breakdown of food into a form
suitable for absorption and the associated transport
processes”
Digestion therefore also includes: -
• The processes of secretion
• The processes of absorption
• Movement of the gut contents
• growth & differentiation
• The mechanisms protecting the gut from damage or attack, and
• the mechanisms controlling and integrating all of the above
DIGESTION
![Page 3: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/3.jpg)
SCHEMATIC REPRESENTATION OF
MAIN REGIONS OF THE GASTROINTESTINAL TRACT
Oesophagus
Stomach
duodenum
jejunum
ileum
Colon
rectum & anus
FUNCTION:
- fat, protein, carbohydrate
digestion & absorption, Ca2+/Fe2+
- water and electrolyte transport
- bile salt & vit B12 transport
REGION:
Small intestine
Large intestine
- Transit
- Storage
- water and electrolyte transport
- defaecation
- storage, H+/peptic digestion
& intrinsic factor
![Page 4: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/4.jpg)
Salivary glands -
synthesis/secretion:
amylase, mucus.
Water, electrolytes
Exocrine pancreas -
synthesis/secretion:
proteases,lipase,amylase.
HCO3- , water
Liver -
bile salt synthesis,
bile secretion.
Gall bladder -
storage and concentration of bile
SECRETIONS OF THE GUT
![Page 5: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/5.jpg)
• Endocrine - Gut hormones
• Paracrine - Local regulators
• Neural
Intrinsic - Myenteric & submucosal nerve plexuses
Extrinsic - Afferent & efferent nerves
vagal & splanchnic trunks (autonomic nervous system)
Physiological control systems in the gut
![Page 6: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/6.jpg)
Major hormones of the gut
STOMACH
Gastrin
Somatostatin
UPPER SMALL INTESTINE
Cholecystokinin (CCK)
Secretin
Gastric inhibitory peptide
Motilin
ILEUM AND COLON
Glucagon-like peptide 1 (GLP-1)
Peptide YY (PYY)
Neurotensin
![Page 7: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/7.jpg)
Overview of extrinsic innervation:
Voluntary (Conscious control)
Hypoglossal
nerve (XII)
Pudendal
nerve
Pelvic
splanchnic
nerve
Vagus
nerve (X) LOS
UOS
IAS EAS
Autonomic (non-perception)
Superior
cervical
ganglion
Paraspinal cord
![Page 8: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/8.jpg)
The autonomic nervous system Sympathetic system:
Noradrenaline
Gut secretions (+) e.g acid, enzymes
& electrolytes
Sp
inal c
ord
Pons/ medulla
Mid brain
Gut sphincters (-) reflex relaxation
Pancreas (+) exocrine &
endocrine secretion
ACTION
Rectum (+) defaecation
ACTION
Gut wall (+) increased
motility and tone
adrenaline
EFFECTS EFFECTS
Salivary glands (+) secretion of saliva
X IX
VII
Cranial
nerves
Parasympathetic system:
Acetylcholine (Ach)
(+) secretion of saliva salivary
glands
(+) vasoconstriction gut blood
2 (-) vasodilation vessels
1/2 (-) decrease motility gut wall,
(+) contraction sphincters
(+) secretion
Adrenal
medulla
![Page 9: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/9.jpg)
Organisation of the gut wall
epithelium
Lamina propria
Muscularis mucosa
SUBMUCOSA
Lumen
MUCOSA
Mesothelium (SEROSA)
Myenteric plexus
Longitudinal muscle
Circular muscle
MUSCULARIS
PROPRIA
![Page 10: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/10.jpg)
Intrinsic and extrinsic nerves of the digestive tract
Visceral
afferents
Parasympathetic
efferents
e.g. Stretch & chemosensitive
neurons
ABORAL ORAL e.g. secretory cell
e.g. post-ganglionic non-
adrenergic or cholinergic fibres
INTRINSIC
NERVES
EXTRINSIC
NERVES
Submucosal plexus
Myenteric plexus
![Page 11: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/11.jpg)
Action potentials
Mechanical recording 1.5g
25 mV
BER
Control of smooth muscle contraction –
Interstitial cells of Cajal are pacemakers of the gut
Basal electrical rhythm (BER) originates in ICC, but itself does not cause
contraction; when spike potentials occur at maximum depolarisation of BER due to
Ca2+entry, the result is contraction
ICC cell network
L type Ca2+ current & action potential mechanism
Slow wave conducted to smooth muscle
Slow wave mechanism
![Page 12: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/12.jpg)
~130 min
antrum
duodenum
Distal small intestine
Colon
Motility in the interdigestive period -
The Migrating Myoelectic Complex (MMC)
III – motilin, ghrelin
& vagus nerve
III – somatostatin,
Serotonin (5-HT)
and xenin
Feeding
disrupts the
cycle
71%
29%
Phases of MMC
I
II
III
IV
I - quiescence; II - random contractions; III - burst of contractions (max.
amplitude & duration); IV - rapid decrease of contractions.
![Page 13: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/13.jpg)
Alternate contraction and relaxation of adjacent
segments causes thorough mixing of contents
Intestinal movement - segmentation
![Page 14: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/14.jpg)
Intestinal movement - peristaltic reflex
Descending relaxation Ascending contraction
Orad Caudad
Circular smooth muscle
VIP/NO
Inhibitory motor
neurons
Ach = acetylcholine NO = nitric oxide TK = tachykinin VIP = vasoactive intestinal polypeptide 5-HT = 5-hydroxytryptamine (serotonin)
ACh/TK
ACh ACh Intrinsic primary afferent neurons (IPAN)
interneurons interneurons
Excitatory motor
neurons
TK/ACh >
>
>
>
> >
Distension (5-HT)
Animation at www.westga.edu/~lkral/peristalsis/
![Page 15: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/15.jpg)
Removing indigestible material –
reflexes in the colon and rectum
Mass movements +
+
Food in stomach
Food in
duodenum
Faeces
Defaecation reflex
Colon rectum
anus
Ach
Sp
inal c
ord
IAS
EAS
FAECES
+ Distention
-
VIP
ATP
+
- Pudendal
nerve
![Page 16: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/16.jpg)
Function & Dysfunction in the GI tract
Physiology Pathology
• Growth/development
• secretion
• absorption
• motility & signalling to
CNS
• surveillance (immuno/metabolic)
• co-ordination (neurons/hormones)
cancer
peptic ulcer, cystic fibrosis
malabsorption
oesophagitis, gastroparesis,
non-ulcer dyspepsia and
irritable bowel
ulcerative colitis, Crohn’s
disease, Coeliac disease
aganglionic colon
(Hirschsprung’s)
![Page 17: Prof. Barry Campbell Cellular & Molecular Physiologypcbjcampbl/Lecture 1 - Introduction to Digestion VITAL.pdf · Intrinsic and extrinsic nerves of the digestive tract Visceral afferents](https://reader031.vdocuments.site/reader031/viewer/2022011812/5e263425be1d73223b488bd7/html5/thumbnails/17.jpg)
GI system case-based learning (CBL)
1. A problem that’s difficult to swallow
2. Troubles with gastrin
3. No more fish and chips!
4. Gap year travels in India
Indigestion
Gallstone pancreatitis
Cholera
Achalasia