The Mouth

The cheeks, tongue, and palate frame the mouth, which is also called the oral cavity (or buccal cavity). The structures of the mouth are illustrated in Figure 12.2.

When you are chewing, you do not find it difficult to breathe simultaneously. The next time you have food in your mouth, notice how the arched shape of the roof of your mouth allows you to handle both digestion and respiration at the same time. This arch is called the palate. The anterior region of the palate serves as a wall (or septum) between the oral and nasal cavities as well as a rigid shelf against which the tongue can push food. It is created by the maxillary and palatine bones of the skull and, given its bony structure, is known as the hard palate. If you run your tongue along the roof of your mouth, you’ll notice that the hard palate ends in the posterior oral cavity, and the tissue becomes fleshier. This part of the palate, known as the soft palate, is composed mainly of skeletal muscle. You can therefore manipulate, subconsciously, the soft palate—for instance, to yawn, swallow, or sing (see Figure 12.2).

A fleshy bead of tissue called the uvula drops down from the center of the posterior edge of the soft palate. Although some have suggested that the uvula is a vestigial organ, it serves an important purpose. When you swallow, the soft palate and uvula move upward, helping to keep foods and liquid from entering the nasal cavity. Unfortunately, it can also contribute to the sound produced by snoring.

Tongue

Perhaps you have heard it said that the tongue is the strongest muscle in the body. Although it is difficult to quantify the relative strength of different muscles, it remains indisputable that the tongue is a workhorse, facilitating ingestion, mechanical digestion, chemical digestion (lingual lipase), sensation (of taste, texture, and temperature of food), swallowing, and vocalization.

Salivary Glands

Many small salivary glands are housed within the mucous membranes of the mouth and tongue. These minor exocrine glands are constantly secreting saliva, either directly into the oral cavity or indirectly through ducts, even while you sleep. In fact, an average of 1 to 1.5 liters of saliva is secreted each day. Usually just enough saliva is present to moisten the mouth and teeth. Secretion increases when you eat, because saliva is essential to moisten food and initiate the chemical breakdown of carbohydrates.

Pharynx

The pharynx (throat) is involved in both digestion and respiration. It receives food and air from the mouth and air from the nasal cavities. When food enters the pharynx, involuntary muscle contractions close off the air passageways. A short tube of skeletal muscle lined with a mucous membrane, the pharynx runs from the posterior oral and nasal cavities to the opening of the esophagus and larynx. It has three subdivisions. The most superior, the nasopharynx, is involved only in breathing and speech. The other two subdivisions, the oropharynx and the laryngopharynx, are used for both breathing and digestion. The oropharynx begins inferior to the nasopharynx and is continuous below with the laryngopharynx. The inferior border of the laryngopharynx connects to the esophagus, whereas the anterior portion connects to the larynx, allowing air to flow into the bronchial tree.

Esophagus

The esophagus is a muscular tube that connects the pharynx to the stomach. It is approximately 25.4 cm (10 in) in length, located posterior to the trachea, and remains in a collapsed form when not engaged in swallowing. As you can see in Figure 12.3, the esophagus runs a mainly straight route through the mediastinum of the thorax. To enter the abdomen, the esophagus penetrates the diaphragm through an opening called the esophageal hiatus.

Stomach

There are four main regions in the stomach: the cardia, fundus, body, and pylorus (see Figure 12.4). The cardia (or cardiac region) is the point where the esophagus connects to the stomach and through which food passes into the stomach. Located inferior to the diaphragm, above and to the left of the cardia, is the dome-shaped fundus. Below the fundus is the body, the main part of the stomach. The funnel-shaped pylorus connects the stomach to the duodenum. The wider end of the funnel, the pyloric antrum, connects to the body of the stomach. The narrower end is called the pyloric canal, which connects to the duodenum. The smooth muscle pyloric sphincter is located at this latter point of connection and controls stomach emptying.

Small Intestine

Chyme released from the stomach enters the small intestine, which is the primary digestive organ in the body. Not only is this where most digestion occurs, but it is also where practically all absorption occurs. The longest part of the alimentary canal, the small intestine is about 3.05 meters (10 feet) long in a living person (but about twice as long in a cadaver due to the loss of muscle tone). Since this makes it about five times longer than the large intestine, you might wonder why it is called “small.” In fact, its name derives from its relatively smaller diameter of only about 2.54 cm (1 in), compared with 7.62 cm (3 in) for the large intestine. As we’ll see shortly, in addition to its length, the folds and projections of the lining of the small intestine work to give it an enormous surface area, which is approximately 200 m², more than 100 times the surface area of your skin. This large surface area is necessary for complex processes of digestion and absorption that occur within it.

The coiled tube of the small intestine is subdivided into three regions. From proximal (at the stomach) to distal, these are the duodenum, jejunum, and ileum (see Figure 12.5).

Large Intestine

The large intestine is the terminal part of the alimentary canal. The primary function of this organ is to finish absorption of nutrients and water, synthesize certain vitamins, form feces, and eliminate feces from the body.

The large intestine runs from the appendix to the anus. It frames the small intestine on three sides. Despite its being about one-half as long as the small intestine, it is called large because it is more than twice the diameter of the small intestine, about 3 inches.

The large intestine is subdivided into four main regions: the cecum, the colon, the rectum, and the anus. The ileocecal valve, located at the opening between the ileum and the large intestine, controls the flow of chyme from the small intestine to the large intestine (see Figure 12.6).

Accessory Organs of Digestion

Chemical digestion in the small intestine relies on the activities of three accessory digestive organs: the liver, pancreas, and gallbladder. The digestive role of the liver is to produce bile and export it to the duodenum. The gallbladder primarily stores, concentrates, and releases bile. The pancreas produces pancreatic juice, which contains digestive enzymes and bicarbonate ions, and delivers it to the duodenum.

Liver

The liver is the largest gland in the body, weighing about three pounds in an adult. It is also one of the most important organs. In addition to being an accessory digestive organ, it plays a number of roles in metabolism and regulation. The liver lies inferior to the diaphragm in the right upper quadrant of the abdominal cavity and receives protection from the surrounding ribs. The liver is divided into two primary lobes: a large right lobe and a much smaller left lobe.

The porta hepatis (“gate to the liver”) is where the hepatic artery and hepatic portal vein enter the liver. These two vessels, along with the common hepatic duct, run behind the lateral border of the lesser omentum on the way to their destinations. The hepatic portal vein delivers partially deoxygenated blood containing nutrients absorbed from the small intestine and actually supplies more oxygen to the liver than do the much smaller hepatic arteries. In addition to nutrients, drugs and toxins are also absorbed. After processing the blood-borne nutrients and toxins, the liver releases nutrients needed by other cells back into the blood, which drains into the central vein and then through the hepatic vein to the inferior vena cava. With this hepatic portal circulation, all blood from the alimentary canal passes through the liver. This largely explains why the liver is the most common site for the metastasis of cancers that originate in the alimentary canal.

Bile produced by the liver is a mixture secreted by the liver to accomplish the emulsification of lipids in the small intestine.

Between meals, bile is produced but conserved. The valve-like hepatopancreatic ampulla closes, allowing bile to divert to the gallbladder, where it is concentrated and stored until the next meal.

Gallbladder

The gallbladder is 8–10 cm (~3–4 in) long and is nested in a shallow area on the posterior aspect of the right lobe of the liver. This muscular sac stores, concentrates, and, when stimulated, propels the bile into the duodenum via the common bile duct. The cystic duct is 1–2 cm (less than 1 in) long and turns inferiorly as it bridges the neck and hepatic duct.

Pancreas

The soft, oblong, glandular pancreas lies transversely in the retroperitoneum behind the stomach. It has a mix of exocrine (secreting digestive enzymes) and endocrine (releasing hormones into the blood) functions (Figure 12.8).

The exocrine part of the pancreas arises as little grapelike cell clusters, each called an acinus (plural = acini), located at the terminal ends of pancreatic ducts. These acinar cells secrete enzyme-rich pancreatic juice into tiny merging ducts that form two dominant ducts. The larger duct fuses with the common bile duct (carrying bile from the liver and gallbladder) just before entering the duodenum via a common opening (the hepatopancreatic ampulla). The smooth muscle sphincter of the hepatopancreatic ampulla controls the release of pancreatic juice and bile into the small intestine. The second and smaller pancreatic duct, the accessory duct (duct of Santorini), runs from the pancreas directly into the duodenum, approximately 1 inch above the hepatopancreatic ampulla.

Scattered through the sea of exocrine acini are small islands of endocrine cells, the islets of Langerhans. These vital cells produce the hormones pancreatic polypeptide, insulin, glucagon, and somatostatin.

Image Descriptions

Figure 12.1 image description: This diagram shows the digestive system of a human being, with the major organs labeled. Labels read (clockwise, from top): salivary glands: parotid gland, sublingual gland, submandibular gland; pharynx, stomach, spleen, pancreas, large intestine: transverse colon, ascending colon, descending colon, cecum, sigmoid colon, appendix, rectum, anal canal, anus; small intestine: duodenum, jejunum, ileum, gallbladder, liver, esophagus, tongue, mouth. [Return to Figure 12.1].

Figure 12.2 image description: This diagram shows an anterior view of the structure of the mouth. The teeth, lips, tongue, gums, and many other parts are labeled. Labels read (clockwise from top): superior lip, superior labial frenulum, gingivae, palatoglossal arch, fauces, palatopharyngeal arch, palatine tonsil, tongue, lingual frenulum, opening duct of submandibular gland, gingivae, inferior labial frenulum, inferior lip, oral vestibule, incisors, cuspid, premolars, molars, cheek, uvula, soft palate, hard palate. [Return to Figure 12.2].

Figure 12.3 image description: This diagram shows the esophagus, going from the mouth to the stomach. The upper and the lower esophageal sphincter are labeled. Labels read (from top): upper esophageal sphincter, trachea, esophagus, lower esophageal sphincter, stomach. [Return to Figure 12.3].

Figure 12.4 image description: This image shows a cross section of the stomach, and the major parts: the cardia, fundus, body, and pylorus are labeled. Labels read (from top of stomach): esophagus, muscular externa (longitudinal layer, circular layer, oblique layer), cardia, fundus, serosa, lesser and greater curvatures, lumen, rugae of mucosa, pyloric antrum, pyloric canal, pyloric sphincter valve at pylorus, duodenum. [Return to Figure 12.4].

Figure 12.5 image description: This diagram shows the small intestine. The different parts of the small intestine are labeled. Labels read (from top of small intestine): duodenum, jejunum, ileum, large intestine, rectum. [Return to Figure 12.5].

Figure 12.6 image description: This image shows the large intestine; the major parts of the large intestine are labeled. Labels read (from start of large intestinal tract): vermiform complex, cecum, ileum, ascending colon, transverse colon, right colic hepatic flexure, left colic splenic flexure, descending colon, sigmoid colon, rectum, anal canal. [Return to Figure 12.6].

Figure 12.7 image description: This diagram shows the accessory organs of the digestive system. The liver, spleen, pancreas, gallbladder, and their major parts are shown. Labels read: liver (right lobe, quadrate lobe, left lobe, caudate lobe), spleen, pancreas, pancreatic duct, gallbladder right hepatic duct, cystic duct, common hepatic duct, common bile duct, left hepatic duct. [Return to Figure 12.7].

Figure 12.8 image description: This figure shows the gallbladder and its major parts are labeled. Labels read (starting in gallbladder): body, fundus, neck, cystic duct, common hepatic duct, common bile duct, left and right hepatic ducts, liver. [Return to Figure 12.8].

Figure 12.9 image description: This image shows the different processes involved in digestion. The image shows how food travels from the mouth through the major organs. Associated textboxes list the various digestive processes: Absorption (nutrients and water to blood vessels and lymph vessels (small intestine), water to blood vessels (large intestine)), propulsion (swallowing (oropharynx), peristalsis (esophagus, stomach, small intestine, large intestine)), chemical digestion, mechanical digestion (chewing (mouth), churning (stomach), segmentation (small intestine)). Parts of the digestive tract are labeled: ingestion of food, pharynx, esophagus, stomach, small intestine, large intestine, feces, anus, defecation. [Return to Figure 12.9].