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Large intestine

Large Intestine
Extends from ileocecal valve to anus Regions
Cecum Appendix Colon
Ascending Transverse Descending

Rectum Anal canal

Also called large bowel Is about 1.5 meters long and 7.5 cm wide 3 Parts of the Large Intestine:

1. Cecum: the pouchlike first portion -Stores materials and begins compaction 2. Colon: the largest portion, Has a larger diameter and thinner wall than small intestine The wall of the colon: forms a series of pouches (haustra) which permit expansion and elongation of colon 3. Rectum: the last 15 cm of digestive tract

The areas of the colon are:


Ascending Transverse Descending Sigmoid Rectum Anal canal

Large Intestine
The large intestine is wider than the small intestine and begins beyond the ileocecal sphincter and ends at the anus. The large intestine consists of the cecum; the ascending colon, transverse colon, descending colon, and sigmoid colon; the rectum; and the anal canal.

The longitudinal layer of smooth muscle is arranged in three discrete strips called teniae coli. Contractions of this discontinuous muscle layer cause the wall of the large intestine to form bulges known as haustra.

colon is lined with transporting epithelial cells called colonocytes, which absorb fluid and transport electrolytes but do not express digestive enzymes.

Large Intestine
Histology
No villi No permanent circular folds Smooth muscle
Taeniae coli Haustra

Epiploic appendages Otherwise like rest of Gl tract


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Microscopic Anatomy
Mucosa of large intestine = simple columnar epithelium except anal canal = nonkeratinized stratified squamous epithelium No circular folds No villi

Histology of the large intestine


Absence of villi Presence of goblet cells Deep intestinal glands

Mucosa and Glands of the Colon


Colon has a Lack of villi Abundance of goblet cells Presence distinctive intestinal glands

Figure 2424

Glands of the Large Intestine


Are deeper than glands of small intestine Are dominated by goblet cells Mucosa does not produce enzymes Provides lubrication for fecal material Physiology of the Large Intestine Less than 10% of nutrient absorption occurs in large intestine Prepares fecal material for ejection from the body

Functions of the large intestine


Reabsorb water and compact material into feces Absorb vitamins produced by bacteria Store fecal matter prior to defecation

Colonic Phase
Function
Final reabsorption of water and ions (proximal colon)
2 L enters 200 ml leaves

Propulsion Elimination of remaining waste products (rectum)

The main functions of the large intestine are completion of fluid absorption and the storage and elimination of fecal waste.

Reabsorption of bile salts:

Absorption in the Large Intestine Reabsorption of water


in the cecum transported in blood to liver

Absorption of vitamins produced by bacteriaorganic molecules Important as cofactors or coenzymes in metabolism Normal bacteria in colon make 3 vitamins that supplement diet Absorption of organic wastes

Physiology of the large intestine


Reabsorption in the large intestine includes: Water Vitamins K, biotin, and B5 Organic wastes urobilinogens and sterobilinogens Bile salts Toxins

3 Vitamins Produced in the Large Intestine


1. Vitamin K:
a fat-soluble vitamin required by liver for synthesizing 4 clotting factors, including prothrombin
a water-soluble vitamin important in glucose metabolism a water-soluble vitamin required in manufacture of steroid hormones and some neurotransmitters

2. Biotin:

3. Pantothenic acid:

Organic Wastes
Bacteria convert bilirubin to urobilinogens and stercobilinogens:
urobilinogens absorbed into bloodstream are excreted in urine urobilinogens and stercobilinogens in colon convert to urobilins and stercobilins by exposure to oxygen

Bacteria break down peptides in feces and generate:


ammonia:
as soluble ammonium ions

indole and skatole:


nitrogen compounds responsible for odor of feces

hydrogen sulfide:
gas that produces rotten egg odor

Bacterial flora & Intestinal Gas


Bacterial flora Ferment cellulose Synthesize vitamin B & K

Flatus 500 ml / day = gas N, CO2, H, methane, H2S, two amines indole & skatole

Gastroileal and gastroenteric reflexes:


move materials into cecum while you eat

Movements of the Large Intestine

Movement from cecum to transverse colon is very slow: allowing hours for water absorption Peristaltic waves move material along length of colon Segmentation movements (haustral churning) mix contents of adjacent haustra

Movements of the Large Intestine


Movement from transverse colon through rest of large intestine results from powerful peristaltic contractions (mass movements) Stimulus is distension of stomach and duodenum; relayed over intestinal nerve plexuses Distension of the rectal wall triggers defecation reflex:
2 positive feedback loops both loops triggered by stretch receptors in rectum

Elimination of Feces
Requires relaxation of internal and external anal sphincters Reflexes open internal sphincter, close external sphincter Opening external sphincter requires conscious effort

Sensory innervation and continence


Mechanoreceptors in the rectum detect distention and supply the ENS The anal canal in the region of the skin is innervated by somatosensory nerves that transmit signals to CNS This region has sensory receptors of pain, temperature and touch Contraction of internal anal sphincter and puborectalis muscle blocks the passage of feces and maintains continence

Defecation
Stretching of rectum stimulates defecation reflexes Intrinsic defecation reflex stretch signals Transmit impulses to spinal cord Spinal reflex causes contraction of rectum and relaxation of internal anal sphincter Relaxation of external anal sphincter is under voluntary control & can be suppressed With relaxation of the external anal sphincter, fecal material can pass to the outside

Neural Control of Defecation


1. Filling of the rectum 2. Reflex contraction of rectum & relaxation of internal anal sphincter

3. Voluntary relaxation of external sphincter

Feces Formation and Defecation


Chyme dehydrated to form feces Feces composition
Water Inorganic salts Epithelial cells Bacteria Byproducts of digestion

Control
Parasympathetic Voluntary

Defecation
Peristalsis pushes feces into rectum Rectal walls stretch
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Diarrhea too little water absorbed Constipation

too much water absorbed, causing difficulty in defecation

DIARRHEA
is defined as an increase in stool fluid volume of more than 200 mL within 24 hours In general terms, diarrhea may result from the delivery of more fluid to the colon than the colon can absorb, or it may result if feces move too rapidly through the colon to allow the colon to adequately absorb fluid. The general causes of diarrhea are:

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