Gastrointestinal System

Chapter 23
GI: Overview: Organ systems

 Gastrointestinal (GI) tract [Alimentary canal] a

continuous muscular digestive tube
 Digests:
 breaks food into smaller fragments
 Absorbs:
 digested material is moved through mucosa into the blood
 Eliminates:
 unabsorbed & secreted wastes.
Organ systems

 Includes:
 Mouth, pharynx &
esophagus
 Stomach
 Small intestine
 Large intestine
 Accessory digestive
organs: teeth, tongue,
gall bladder, salivary
glands, liver &
pancreas

Figure 23.1
Processes

 Ingestion
 Propulsion
 Mechanical digestion
 Chemical digestion
 Absorption
 Defecation
Processes

 Ingestion: obtaining food

 Propulsion: moves food along the GI tract by
peristalsis (wave-like muscular contraction)
 Mechanical digestion :
 chewing & mixing with saliva
 mixing in stomach
 segmentation (local constriction in intestine to mix food
& digestive juices)
Processes

 Chemical digestion: breaks down food to

molecular fragments (monomers) (Hydrolysis).
 Begins in the mouth with saliva & continues into the
small intestine.
 Absorption: movement of nutrients across the
mucosal membrane into blood/lymph
 Defecation: eliminates unused/indigestible &
secreted substances from the body
Functional Considerations :

 Substances in the GI tract lumen are outside of

the body.
 Multiple sensors & receptors line the GI tract to
monitor contents & respond to conditions.
 Controls: intrinsic (local control) & extrinsic
(CNS)
Peritoneum : serous membrane
 Visceral peritoneum: covers the external surfaces of
most digestive organs
 Parietal Peritoneum: lines the body wall
 Peritoneal Space: potential space containing fluid
that separates the visceral & parietal peritoneum

Figure 23.5a
 Peritoneum

 Mesentery: double layer of peritoneum fused together

that extends to the organs from the posterior body
wall.
 Provides support for the organs
 Provides support for vessels & nerves supplying the organs

Figure 23.5a
Peritoneum

 Retroperitoneal organs
 Organs that adhere to the posterior abdominal wall &
lose their peritoneum by resorption
 Parts of the large & small intestine & most of the
pancreas; (also kidneys)

Figure 23.5b
GI blood supply

 Blood supply: about 25% of cardiac output

 Arterial: Abdominal aorta g celiac trunk
 Celiac trunk g Hepatic, splenic & gastric branches
which serve the liver, spleen & stomach
 Celiac trunk g superior & inferior mesenteric
branches serve small & large intestine
Histology

 GI tract wall has 4 layers:

 Mucosa
 Submucosa
 Muscularis Externa
 Serosa or Adventitia
Histology of the Alimentary Canal

Figure 23.6
Histology

 Mucosa: The epithelial membrane that lines the GI

tract from mouth g anus.
 Secretes mucous, digestive enzymes & hormones
 Absorbs nutrients
 Protects from disease & from the GI contents
Histology

 Mucosa; 3 layers:
 Epidermis
 Lamina propria (loose ct : contain capillaries & some
elements of MALT)
 Muscularis mucosa
 Histology

 Submucosa: moderately dense CT with blood,

nerve, lymph vessels & lymphoid follicles; rich in
elastic fibers
 Muscularis externa: smooth muscle
 Responsible for peristalsis &
segmentation
 Circular layer
 Longitudinal layer
 Sphincters: in some areas
the circular layer thickens;
act as valves
Histology

 Serosa of intraperitoneal organs = visceral

peritoneum
 Esophagus has an outer covering of fibrous
connective tissue = adventitia
 Retroperitoneal organs: visceral serosa on the
surface facing the peritoneal cavity & adventitia
on the surface facing the body wall.
 Nerves

 Intrinsic: (Local): Short reflex

 Submucosal nerve plexus:
regulates glands & mucosal muscle
 Myenteric plexus: controls GI wall & GI motility
 Extrinsic: (CNS): Long reflex
 Parasympathetic NS: enhances gut motility &
secretion
 SNS: inhibits gut motility & secretion
 Nerves
Figure 23.4

 Intrinsic: (Local): Short reflex

 Submucosal nerve plexus: regulates glands & mucosal muscle
 Myenteric plexus: controls GI wall & GI motility
 Extrinsic: (CNS): Long reflex
 Parasympathetic NS: enhances gut motility & secretion
 SNS: inhibits gut motility & secretion
Functional Anatomy: Mouth

 Mouth: lips, palate, &

tongue
 Mouth cavity = Buccal
cavity
Functional Anatomy: Mouth

 Lips: extend from inferior margin of the nose to

the superior margin of the chin. Red area = red
margin, is poorly keratinized & lacks sweat or
sebaceous glands.
 Palate:
 Hard palate: rigid surface against which food is
forced in chewing
 Soft palate: muscular structure that rises &
blocks off the nasopharynx during swallowing
Functional Anatomy: Mouth

 Tongue: muscular tentacle composed of

interlaced muscle fibers that grips & repositions
food, mixes food with saliva & compresses food
to form a food bolus, prior to swallowing.
Functional Anatomy: Mouth

 Filiform papillae: rough surface

 Fungiform papillae: house taste buds
 Circumvallate papillae: house taste buds,
 Foliate papillae: posterolateral; taste buds
 Functional Anatomy: Mouth
 Salivary Glands: intrinsic & extrinsic
 Intrinsic glands: scattered throughout the buccal
cavity mucosa
 Extrinsic glands: supply most of the saliva; outside
buccal cavity & supply secretions via ducts:
 Parotid
 Submandibular
 Sublingual
Functional Anatomy: Mouth
 Composition of saliva:
 97-99.5% H2O
 Electrolytes:
 pH 6.75-7.0
 Amylase: (digestive enzyme)
 Proteins: mucin, lysozyme, & IgA
 Protection from microbes by saliva:
 IgA: immunglobulins in secretions
 Lysozyme: bacteriostatic (inhibits bacterial growth)
 Cyanide
 Defensins: local antibiotic activity & when activated
promote chemotaxis by WBCs
 Normal flora: convert salivary components to nitrates
then to NO. NO is toxic & bacteriocidal
Functional Anatomy: Mouth

 Control of Salivation:
 Continuous baseline secretory activity
 With food ingestion, salivation increases dramatically
 Parasympathetic NS: chemoreceptors & pressoreceptors
stimulate salivatory nuclei to increase salivation
 Functional Anatomy:
Mouth, Pharynx

Figure 23.07
Figure 23.11

 Teeth:
 Primary: 2I 1C 2M x 2 = 20
2I 1C 2M
 Permanent: 2I 1C 2PM 3M x 2 = 32
2I 1C 2PM 3M
 Structures
 Crown: exposed above gingiva (gum)
 Root: anchored by periodontal ligament to the bone by a
fibrous joint (gomphosis)
Functional Anatomy: Throat &
Esophagus
 Pharynx: oropharynx & laryngopharynx;
muscular wall propels food to the esophagus
 Esophagus:
 Muscular 25cm tube from laryngopharynx to
stomach
 Passes through the diaphragm at the
esophageal hiatus
 Gastroesophageal (cardiac) sphincter: A
physiologic sphincter that helps keep
esophagus closed when empty
Functional Anatomy: Esophagus

 Esophagus (continued)
 Wall has all 4 GI tract tunics:
 Epithelial layer changes at the junction with
the stomach from stratified squamous
epithelium to simple columnar epithelium
 Esophageal mucous glands lubricate food bolus
 Muscularis externa
 Superior 1/3 of muscularis externa is skeletal muscle
 Middle 1/3 is mixed skeletal & smooth
 Lower 1/3 is smooth muscle
 Adventitia: external covering
Digestive Processes: Mouth, Pharynx &
Esophagus
 Ingestion
 Mechanical digestion: chewing
 Chemical digestion: mixing food with saliva
 Propulsion: swallowing & initiating peristalsis
Functional Anatomy: Stomach
 Cardiac region: narrow, receives food bolus
 Fundus: bulge that extends supero-laterally to the cardia,
reaches the diaphragm
 Body: mid-portion
 Pyloric antrum : funnel shaped portion narrows to form the;
 Pyloric canal
 Pylorous 
 Pyloric sphincter 
 small intestine
 Rugae
 longitudinal mucosal
folds
 volume about 4L

Figure 23.14a
Rugae
Microscopic Anatomy : Stomach

 Stomach: has the 4 tunics of the GI tract.

 Epithelium: Simple columnar epithelium
(goblet cells-mucous);
 Muscularis externa has an additional oblique
layer of muscle (allows another dimension of
contraction).
Microscopic
Anatomy : Stomach

 Gastric glands secrete

gastric juices
Figure 23.15
Microscopic Anatomy :
Stomach  Mucous neck cells: in
the duct portion

Figure 23.15
Microscopic Anatomy :
Stomach

 Gastric glands secrete

gastric juices
 Mucous neck cells: in
the duct portion
 Parietal cells: mid
portion secrete HCl &
intrinsic factor for B12
absorption

Figure 23.15
Microscopic Anatomy :
Stomach

 Gastric glands secrete

gastric juices
 Mucous neck cells: in
the duct portion
 Parietal cells: mid
portion of glands
secrete HCl & intrinsic
factor
 Chief cells: base of
gland; secretes
pepsinogen a precursor
molecule to pepsin (an Figure 23.15
enzyme that digests
protein)
Microscopic Anatomy :
Stomach

 Enteroendocrine cells:
secrete multiple
hormonal products;
 Gastrin, histamine,
endorphins, serotonin,
cholecystokinin, &
somatostatin, which
influence several
digestive system
organs
Figure 23.15
 Microscopic Anatomy : Stomach

 Mucosal barrier: protects the stomach from its own

secretions
 Viscous mucous overlies a thick coating of HCO3-
rich mucous
 Tight junctions between epithelial cell
PM of glandular cells are impermeable to HCl
 Epithelium is replaced every 3-6 days
Digestive Processes (Stomach)

 Acts as a holding vessel for ingested food

 Participates in mechanical & chemical digestion

 Propulsion: Delivers its product (chyme) to the small
intestine
Digestive Processes (Stomach)

 Protein digestion: HCl denatures protein

 HCl activates pepsinogen to pepsin
 Pepsin breaks peptide bonds of proteins
 Rennin: an enzyme that breaks down casein
(milk protein) secreted in infants
 Intrinsic factor: required for Vit. B12 absorption
(needed to mature RBC);
 Absence of B12 results in pernicious anemia
Regulation of gastric secretion (3 phases)

 Cephalic Phase
 Gastric Phase
 Intestinal Phase
Cephalic phase: Stimulation

 Cephalic phase: CNS response to presentation of

food; enhances gastric gland secretion

Cephalic phase: Inhibition

 Loss of appetite; satiety / depression
Gastric phase: Stimulation

 Gastric phase: food entering stomach;

 Stretch
 Change in pH (increase)
 Peptides

 All cause increased gastric gland secretion

Gastric phase: Stimulation

 Stretch: reflex arc causes increased Acetylcholine

release which then causes increased gastric gland
secretions

 Increased pH / polypeptides / caffeine

 All enhance Gastrin secretion by enteroendocrine G cells
Gastric phase: Stimulation

 3 chemicals: cause enhanced HCl secretion

through 2nd messenger systems
 Gastrin
 Acetylcholine
 Histamine
Gastric phase: Inhibition

 pH <2.0 inhibits Gastrin secretion

 SNS inhibits Gastrin (G cell) activity

Intestinal phase: Stimulation

 Excitatory: As chyme enters the duodenum the

mucosa secretes enteric gastrin which stimulates
secretion by gastric glands
Intestinal phase: Inhibition

 Inhibitory: As more chyme fills the small

intestine, the enterogastric reflex is triggered
 Inhibits CNS stimulation
 Inhibits local reflexes
 Controls gastric emptying
 Activates sympathetic fibers that tighten the
pyloric sphincter
Regulation of Gastric Activity

Figure 23.16
Small Intestine: Gross Anatomy

 6-7m long: from pyloric sphincter to the

ileocecal valve
 3 subdivisions:
 Duodenum
 Jejunum
 Ileum
Small Intestine: Gross
Fig 23.20
Anatomy

 Duodenum :
 Curves around the pancreatic head (~25cm long)
 Contains the hepatopancreatic ampulla : formed
by the merger of the bile duct & the pancreatic
duct.
 Hepatopancreatic sphincter controls admission of
bile & pancreatic enzymes to the duodenum
 Duodenum is retroperitoneal
Small Intestine; Regulatory Function

 Duodenenal regulation of gastric emptying:

Feedback mechanisms monitor the contents
being delivered from the stomach
 High fat content
 Low pH (high acidity)
 Hypertonicity (high osmolality)
 All result in decreased stomach emptying.
Regulation of Gastric Emptying

Figure 23.19
 Small Intestine:
Gross Anatomy

 Jejunum: extends from duodenum

to ileum (~2.5m long)
 Ileum: from jejunum to ileocecal
valve (~3.6m long)

Figure 23.1
Small Intestine: Gross Anatomy

 Jejunum & Ileum function in absorption;

 Intraperitoneal
 Suspended from mesentery whose veins &
lymph vessels carry nutrients away from small
intestine
 Small Intestine: Microanatomy
Microvilli: PM
projections
forming “brush
border”; Hold
enzymes that
complete protein &
carbohydrate
digestion

Plicae circularis:
mucosal folds
cause chyme to
spiral slowly Villi
through the lumen

Villi: velvety mucosa of absorptive

epithelium containing capillaries &
lymph lacteals
Figure 23.21
Small intestine Wall

 Cell types:
 Mostly absorptive cells
 Goblet (mucous) cells increase in number as
the small intestine progresses
 Enteroendocrine cells
 T-Lymphocytes
Small intestine Wall

 Intestinal crypts with cells that secrete intestinal

juice & contain Paneth cells that secrete
protective lysozyme (antibacterial)
 Peyer’s Patches: lymphoid follicle in submucosa
Small intestine Wall

 Brunners glands (duodenum) secrete HCO3- rich

mucous to increase the pH of chyme
 Villus epithelium is replaced every 3-6 days
 Intestinal Juice : isotonic with blood plasma,
slightly alkaline, low enzyme content
Liver & Gall Bladder

 Liver produces bile (fat emulsifier) that is stored

in & concentrated by the gall bladder. (metabolic
role of the liver; Ch. 24)
 Liver: Gross Anatomy

 Largest gland
 4 Lobes
 Falciform ligament
 mesentery
supports liver
from diaphragm &
anterior body wall
 separates R & L
lobes
 Round ligament
Fig 23.23
fibrous remnant of
umbilical vein
Liver: Gross Anatomy
 Blood supply
 hepatic artery & hepatic
portal vein
 Bile
 drains from biliary ducts to
common hepatic duct
which fuses with cystic
duct from gallbladder to
form the bile duct
Fig 23.23
Liver: Microscopic Anatomy

 Liver lobule: hexagonal (Fig 23.24)

 Central vein: drains the lobule
 Hepatocytes form plates that radiate from the
central vein
Microanatomy of the Liver

Figure 23.24c, d
 Liver: Anatomy
 Portal triad at each corner of
the hexagonal system.
Consists of branches of:
 Hepatic Artery  delivers O2
 Hepatic portal vein  delivers
nutrients from small intestine
 Bile duct  receives bile from
the bile canaliculi that lie
between layers of hepatocytes
Figure 23.24c, d
Liver: Anatomy
 Liver (cont)
 Liver sinusoids  Large
leaky capillaries conduct
blood from the artery &
portal vein to the central
vein
 Hepatic macrophages 
Kupffer cells lie in Figure 23.24c, d
sinusoid walls
 Central veins flow into
hepatic veins then to the
inferior vena cava
Liver & Gall Bladder

 Composition of bile: Alkaline solution: Bile salts,

bile pigments, cholesterol, fats & phospholipids
 Bile salts & phospholipids participate in fat
absorption
Liver & Gall Bladder

 Bile salts are conserved by enterohepatic

circulation
 Reabsorbed in the ileum
 Return to Liver in hepatic portal blood
 Re-secreted by the Liver
 Bile pigments & bilirubin break down to urobilin
then stercobilin
Gall Bladder
 Gall Bladder = a muscular pouch that stores bile & expels bile
when needed via the cystic duct & the bile duct.

Figure 23.20
Regulation of Bile
Release
 Cholecystokinin (CCK) & secretin
released by the small intestine in
response to increased fats in
chyme
 CCK:
 Stimulates both Gall bladder &
pancreatic secretion
 Relaxes hepatopancreatic sphincter
 Secretin: stimulates bile secretion

Figure 23.25
Pancreas: Gross Anatomy

 Head encircled by duodenum

 Tail abuts the spleen
 Mostly retroperitoneal
Pancreatic Acini

 Large numbers of Acinar cells in

clusters around ducts; exocrine
(Acini)
 Acinar cells: Secrete
pancreatic digestive enzymes
 Endocrine cell clusters form the
pancreatic islets that produce
insulin & glucagon
Pancreatic Juice

 Pancreatic Juice: Alkaline, watery, contains

enzymes & electrolytes
Pancreatic Juice

 Proteolytic enzymes are released as inactive

forms then are activated in the duodenum
 Trypsinogen g Trypsin by the brush border
enzyme enterokinase
 Trypsin activates precursors to form
carboxypeptidase & chymotrypsin
 Amylase, lipase, & nuclease are released in their
active forms
Regulation of
pancreatic secretion
 Neural via PSNS
 Hormonal: Intestinal Hormones
 CCK: released in response to fats &
protein. Stimulates pancreatic Figure 23.28

secretion of enzymes
 Secretin: released in response to HCl.
Stimulates pancreatic duct cells to
release HCO3-
Digestive Processes : Small Intestine

 Optimal digestion requires adequate motility &

control of chemical composition
Digestive Processes : Small Intestine

 pH: acidic chyme must be buffered to allow

proper enzyme activity
 Osmolality: chyme is hypertonic & would pull H2O
out of circulation; thus chyme is released in small
amounts
 Liver & pancreatic function are required for
appropriate delivery of bile salts & enzymes to
the small intestine
Digestive Processes : Small Intestine

 Segmentation: moves intestinal contents back &

forth to mix
 Duodenal rhythm for segmentation is greater
than the rhythm in the ileum.
 Contents move toward the ileum.
Digestive Processes : Small Intestine

 After most digestion has occurred,

 Peristalsis begins sweeping from duodenum distally
 Occurs in series with each peristaltic wave, originating
more distally (migrating mobility complex)
 Ileocecal valve (sphincter) is relaxed by neural
(gastroileal reflex) impulses from the stomach &
hormonal (gastrin) secretion by the stomach
 Large Intestine:
Gross Anatomy

 Ileocecal valve to anus (~1.5m)

 Teniae coli: 3 ribbons of
longitudinal smooth muscle
Figure 23.29a
 Haustra: pocket-like segments
of large intestine
 Epiploic appendages: fat filled
pouches of visceral peritoneum
 Large Intestine:
Gross Anatomy

 Cecum: blind pouch (below ileocecal valve) Figure 23.29a

 Appendix: attached to cecum (lymphoid)

 Colon: ascending, transverse, descending, sigmoid
 Transverse colon & sigmoid colon are intraperitoneal;
anchored by mesentery. The rest of the colon is
retroperitoneal
 Rectum
 Anal canal
Large Intestine: Microscopic Anatomy

 All 4 layers present

 Mucosa: simple columnar epithelium until anal
canal (stratified squamous)
 No folds or villi. No significant enzyme secretions
 Crypts: invaginations of mucosa contain large numbers
of goblet cells that secrete mucous for protection &
lubrication
Large Intestine: Microscopic Anatomy

 Bacterial flora
 Ferment indigestible CHO: produces about 500ml of gas
per day
 Synthesize B complex vitamins & most vitamin K
Large Intestine: Digestive Processes

 Propulsion:
 Haustra contractions: stretch stimulate haustra to
contract moving (& mixing) contents to next haustra
 Mass peristalsis: long, slow contractile waves moving
contents toward rectum (3-4 per day)
 Gastrocolic reflex: food intake causes mass peristalsis
Large Intestine: Digestive Processes

 H2O reabsorption & vitamin absorption

 Defecation
 Empty rectum receives waste, causing stretch
 Stretch initiates reflex contraction of the rectum &
relaxation of both anal sphincters
 Voluntary control of the external anal sphincter can
postpone defecation
 If suppressed the contraction stops & is reinitiated later
 With defecation rectal muscle contractions are aided by
increased abdominal pressure (valsalva maneuver)
Structure of the Anal Canal

Figure 23.29b Figure 23.32

Chemical Digestion of Specific Food Groups

 Chemical Digestion: Mechanism

 Catabolic process: break down of food molecules to
monomeric form that can be absorbed
 Enzymes break molecules by hydrolysis (Adding H2O
into a molecular bond)
Chemical Digestion: Carbohydrates

 Carbohydrates (CHO): complex sugars are

broken down to simple sugars (monomers)
 Simple sugars (monosaccharides): glucose,
fructose, & galactose can be absorbed
 Disaccharides (not absorbed): sucrose,
maltose, & lactose are hydrolyzed by sucrase,
maltase, & lactase (brush border enzymes)
into monosaccharides
Chemical Digestion: Carbohydrates

 Polysaccharides: broken down to smaller &

smaller oligosaccharides
 Salivary amylase: breaks starch into 2-8 linked
monosaccharide
 Salivary amylase is denatured by HCl in the stomach
Chemical Digestion: Carbohydrates

 Polysaccharides (cont)
 Pancreatic amylase: continues breakdown (mostly to
maltose)
 Brush border enzymes act on oligosaccharides of more than
3 simple sugars (brush border)
 Sucrose, maltose & lactose are broken down by specific
brush border enzymes (sucrase, maltase, & lactase)
 Monosaccharides are absorbed.
 Chemical Digestion: Proteins

 Proteins: broken down to amino acid monomers.

Begins in the stomach.
 Pepsinogen is activated to pepsin by HCL
 Pepsin: cleaves peptide bonds associated with tyrosine &
phenylalanine forming polypeptides (+ a few amino acids).
 Pepsin is inactivated by increased pH in the duodenum

 Trypsin & chymotrypsin: pancreatic enzymes that further

breakdown polypeptides.
 Chemical Digestion: Proteins

 Proteins (cont):
 Carboxypeptidase (pancreatic & brush border
enzyme):
 Splits off single amino acid from the end of
polypeptide chain that contains the carboxyl group Figure 23.34

 Aminopeptidase & dipeptidase (brush border

enzymes) release final amino acid monomers
 Figure 23.34
Chemical
Digestion: Lipids

 Lipids: require emulsification to disperse

fats into microdroplets which enhances
enzyme activity
 Bile salts: surround fat droplets & keep them Figure 23.35

in suspension in the aqueous digestive juices

 Pancreatic lipase: cleaves off two fatty acid
chains from triglyceride molecules
 Yields a monoglyceride & 2 free fatty acids
Chemical Digestion: Nucleic acids

 Nucleic acids: small amounts occur in the diet

 Pancreatic nucleases: Hydrolyze nucleic acids to
nucleotide monomers
 Nucleosidases & phosphatases (brush border) break
down nucleotides
Absorption: Small Intestine

 Most nutrients are absorbed from chyme prior to the

ileum (ileum primarily reabsorbs bile salts)
 Most nutrients cross the mucosa by active transport.
 Some products of lipid digestion are absorbed by diffusion.
 CHO, amino acids & nucleic acid remnants are actively
transported into mucosal cells & then enter capillary blood
 Absorption: Small Intestine (Fats)

 Monoglycerides & free fatty acids are associated

with bile salts & lecithin (a phospholipid) to form
micelles
 Micelles diffuse between microvilli
 The lipid substances leave the micelles & diffuse across the
PM of microvilli
 Inside the intestinal epithelial cell, the components are
reassembled into triglycerides
 Absorption: Small Intestine (Fats)

 Monoglycerides (cont)
 Triglycerides are then packaged with cholesterol &
phospholipids into chylomicrons
 Chylomicrons are exocytosed & diffuse to lymphatic lacteals
to eventually be placed into blood by the lymphatic system
 Chylomicrons in the blood are hydrolyzed by lipoprotein lipase
to free fatty acids & glycerol prior to tissue absorption
 Fig. 23.36
Fatty Acid Absorption

Figure 23.36
Absorption: Small Intestine

 Vitamins
 Some Vit. K & B complex vitamins are absorbed in the
large intestine
 Dietary vitamins are absorbed in the small intestine
 Fat soluble vitamins (A, D, E, K) dissolve in dietary fats
& are absorbed after being incorporated into micelles
Absorption: Small Intestine

 Electrolytes: most ions are actively absorbed

throughout small intestine
 Na+ is coupled to absorption of glucose & amino acids
(cotransport)
 Cl- actively transported into cells; exchange for HCO3-
Absorption: Small Intestine

 K diffuses into the cells

 Iron is transported into cells & bound to ferritin
 Ca2+ absorption regulated by blood Ca2+ levels &
Vit D
 ( Vit D is a required cofactor for Ca2+ absorption)
Absorption: Small Intestine

 Water moves freely in both directions across the

mucosa
 Active transport of solutes create an osmotic gradient &
H2O follows
 H2O movement changes solute concentrations & effects
absorption of substances that move by diffusion
Absorption: Small Intestine

 Malabsorption: can result from

 Disruption of secretion
 Mucosal damage
 Reduction of absorptive surface area