a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

A biological process which converts sugars such as glucose, fructose, and sucrose into cellular energy, producing ethanol and carbon dioxide as by-products.

A substance that takes part in and undergoes change during a chemical reaction.

Image shows a female clinician dressed in scrubs listening to the heartbeat of a patient.

Image shows a diagram of the heart with all chambers and major vessels labelled. Arrows indicate blood flow. Deoxygenated blood is brought the the right atrium by the superior and inferior vena cava. The right atrium moves blood into the right ventricle, which then sends blood to the lungs via the pulmonary arteries. Oxygenated blood returns to the heart from the lungs via the pulmonary veins and enters the left atrium. From there, blood is pumped into the left ventricle and then into the aorta for distribution to the body.

Image shows a scanning electroflourescent pictomicrograph. It shows the villi of the small intestine, with a layer of mucus, and then a multitude of smaller bacterial cells above the mucous.

 

This man is on his way to coming in third in an international hot dog eating contest (Figure 15.3.1). It may look as though he is regurgitating his hot dogs, but in fact, he is trying to get them into his mouth and down his throat as quickly as he can. In order to eat as many hot dogs as possible in the allotted time, he pushes several into his mouth at once, and doesn’t bother doing much chewing. Chewing is normally the first step in the process of digestion.

Digestion of food is a form of catabolism, in which the food is broken down into small molecules that the body can absorb and use for energy, growth, and repair. Digestion occurs when food is moved through the digestive system. This process begins in the mouth and ends in the small intestine. The final products of digestion are absorbed from the digestive tract, primarily in the small intestine. There are two different types of digestion that occur in the digestive system: mechanical digestion and chemical digestion. Figure 15.3.2 summarizes the roles played by different digestive organs in mechanical and chemical digestion, both of which are described in detail below.

 

Mechanical digestion is a physical process in which food is broken into smaller pieces without becoming changed chemically. It begins with your first bite of food (see Figure 15.3.3) and continues as you chew food with your teeth into smaller pieces. The process of mechanical digestion continues in the stomach. This muscular organ churns and mixes the food it contains, an action that breaks any solid food into still smaller pieces.

Although some mechanical digestion also occurs in the small intestine, it is mostly completed by the time food leaves the stomach. At that stage, food in the GI tract has been changed to the thick semi-fluid called chyme. Mechanical digestion is necessary so that chemical digestion can be effective. Mechanical digestion tremendously increases the surface area of food particles so they can be acted upon more effectively by digestive enzymes.

Chemical Digestion

Chemical digestion is the biochemical process in which macromolecules in food are changed into smaller molecules that can be absorbed into body fluids and transported to cells throughout the body. Substances in food that must be chemically digested include carbohydrates, proteins, lipids, and nucleic acids. Carbohydrates must be broken down into simple sugars, proteins into amino acids, lipids into fatty acids and glycerol, and nucleic acids into nitrogen bases and sugars. Some chemical digestion takes place in the mouth and stomach, but most of it occurs in the first part of the small intestine (duodenum).

Digestive Enzymes

Chemical digestion could not occur without the help of many different digestive enzymes. Enzymes are proteins that catalyze, or speed up, biochemical reactions. Digestive enzymes are secreted by exocrine glands or by the mucosal layer of epithelium lining the gastrointestinal tract. In the mouth, digestive enzymes are secreted by salivary glands. The lining of the stomach secretes enzymes, as does the lining of the small intestine. Many more digestive enzymes are secreted by exocrine cells in the pancreas and carried by ducts to the small intestine. The following table lists several important digestive enzymes, the organs and/or glands that secrete them, the compounds they digest, and the pH necessary for optimal functioning. You can read more about them below.

Table 15.3.1: Digestive Enzymes

Digestive Enzyme	Source Organ	Site of Action	Reactant and Product	Optimal pH
Salivary Amylase	Salivary Glands	Mouth	starch + water ⇒ maltose	Neutral
Pepsin	Stomach	Stomach	protein + water ⇒ peptides	Acidic
Pancreatic Amylase	Pancreas	Duodenum	starch + water ⇒ maltose	Basic
Maltase	Small intestine	Small intestine	maltose + water ⇒ glucose	Basic
Sucrase	Small intestine	Small intestine	sucrose + water ⇒ glucose + fructose	Basic
Lactase	Small intestine	Small intestine	lactose + water ⇒  glucose + galactose	Basic
Lipase	Pancreas	Duodenum	fat droplet and water ⇒  glycerol and fatty acids	Basic
Trypsin	Pancreas	Duodenum	protein + water ⇒ peptides	Basic
Chymotrypsin	Pancreas	Duodenum	protein + water ⇒ peptides	Basic
Peptidases	Small intestine	Small intestine	peptides + water ⇒	Basic
Deoxyribonuclease	Pancreas	Duodenum	DNA + water ⇒ nucleotide fragments	Basic
Ribonuclease	Pancreas	Duodenum	RNA + water ⇒ nucleotide fragments	Basic
Nuclease	Small intestine	Small intestine	nucleic acids + water ⇒ nucleotide fragments	Basic
Nucleosidases	Small intestine	Small intestine	nucleotides + water ⇒ nitrogen base + phosphate sugar	Basic

Chemical Digestion of Carbohydrates

About 80% of digestible carbohydrates in a typical Western diet are in the form of the plant polysaccharide amylose, which consists mainly of long chains of glucose and is one of two major components of starch. Additional dietary carbohydrates include the animal polysaccharide glycogen, along with some sugars, which are mainly disaccharides.

The process of chemical digestion for some carbohydrates is illustrated Figure 15.3.4. To chemically digest amylose and glycogen, the enzyme amylase is required. The chemical digestion of these polysaccharides begins in the mouth, aided by amylase in saliva. Saliva also contains mucus — which lubricates the food — and hydrogen carbonate, which provides the ideal alkaline conditions for amylase to work. Carbohydrate digestion is completed in the small intestine, with the help of amylase secreted by the pancreas. In the digestive process, polysaccharides are reduced in length by the breaking of bonds between glucose monomers. The macromolecules are broken down to shorter polysaccharides and disaccharides, resulting in progressively shorter chains of glucose. The end result is molecules of the simple sugars glucose and maltose (which consists of two glucose molecules), both of which can be absorbed by the small intestine.

Other sugars are digested with the help of different enzymes produced by the small intestine. Sucrose (or table sugar), for example, is a disaccharide that is broken down by the enzyme sucrase to form glucose and fructose, which are readily absorbed by the small intestine. Digestion of the sugar lactose, which is found in milk, requires the enzyme lactase, which breaks down lactose into glucose and galactose. Glucose and galactose are then absorbed by the small intestine. Fewer than half of all adults produce sufficient lactase to be able to digest lactose. Those who cannot are said to be lactose intolerant.

Chemical Digestion of Proteins

Proteinsno post consist of polypeptides, which must be broken down into their constituent amino acids before they can be absorbed. An overview of this process is shown in Figure 15.3.5. Protein digestion occurs in the stomach and small intestine through the action of three primary enzymes: pepsin (secreted by the stomach), and trypsin and chymotrypsin (secreted by the pancreas). The stomach also secretes hydrochloric acid (HCl), making the contents highly acidic, which is a required condition for pepsin to work. Trypsin and chymotrypsin in the small intestine require an alkaline (basic) environment to work. Bile from the liver and bicarbonate from the pancreas neutralize the acidic chyme as it empties into the small intestine. After pepsin, trypsin, and chymotrypsin break down proteins into peptides, these are further broken down into amino acids by other enzymes called peptidases, also secreted by the pancreas.

Chemical Digestion of Lipids

The chemical digestion of lipids begins in the mouth. The salivary glands secrete the digestive enzyme lipase, which breaks down short-chain lipids into molecules consisting of two fatty acids. A tiny amount of lipid digestion may take place in the stomach, but most lipid digestion occurs in the small intestine.

Digestion of lipids in the small intestine occurs with the help of another lipase enzyme from the pancreas, as well as bile secreted by the liver. As shown in the diagram below (Figure 15.3.6), bile is required for the digestion of lipids, because lipids are oily and do not dissolve in the watery chyme. Bile emulsifies (or breaks up) large globules of food lipids into much smaller ones, called micelles, much as dish detergent breaks up grease. The micelles provide a great deal more surface area to be acted upon by lipase, and also point the hydrophilic (“water-loving”) heads of the fatty acids outward into the watery chyme. Lipase can then access and break down the micelles into individual fatty acid molecules.

Nucleic acids (DNA and RNA) in foods are digested in the small intestine with the help of both pancreatic enzymes and enzymes produced by the small intestine itself. Pancreatic enzymes called ribonuclease and deoxyribonuclease break down RNA and DNA, respectively, into smaller nucleic acids. These, in turn, are further broken down into nitrogen bases and sugars by small intestine enzymes called nucleases.

Bacteria in the Digestive System

Your large intestine is not just made up of cells. It is also an ecosystem, home to trillions of bacteria known as the "gut flora" (Figure 15.3.7). But don't worry, most of these bacteria are helpful. Friendly bacteria live mostly in the large intestine and part of the small intestine. The acidic environment of the stomach does not allow bacterial growth.

Gut bacteria have several roles in the body. For example, intestinal bacteria:

• Produce vitamin B12 and vitamin K.
• Control the growth of harmful bacteria.
• Break down poisons in the large intestine.
• Break down some substances in food that cannot be digested, such as fibre and some starches and sugars. Bacteria produce enzymes that digest carbohydrates in plant cell walls. Most of the nutritional value of plant material would be wasted without these bacteria. These help us digest plant foods like spinach.

A wide range of friendly bacteria live in the gut. Bacteria begin to populate the human digestive system right after birth. Gut bacteria include Lactobacillus, the bacteria commonly used in probiotic foods such as yogurt, and E. coli bacteria. About a third of all bacteria in the gut are members of the Bacteroides species. Bacteroides are key in helping us digest plant food.

It is estimated that 100 trillion bacteria live in the gut. This is more than the human cells that make up you. It has also been estimated that there are more bacteria in your mouth than people on the planet — there are over 7 billion people on the planet!

The bacteria in your digestive system are from anywhere between 300 and 1,000 species. As these bacteria are helpful, your body does not attack them. They actually appear to the body's immune system as cells of the digestive system, not foreign invaders. The bacteria actually cover themselves with sugar molecules removed from the actual cells of the digestive system. This disguises the bacteria and protects them from the immune system.

As the bacteria that live in the human gut are beneficial to us, and as the bacteria enjoy a safe environment to live, the relationship that we have with these tiny organisms is described as mutualism, a type of symbiotic relationship.

Lastly, keep in mind the small size of bacteria. Together, all the bacteria in your gut may weigh just about two pounds.

Control of the Digestive Process

The process of digestion is controlled by both hormones and nerves. Hormonal control is mainly by endocrine hormones secreted by cells in the lining of the stomach and small intestine. These hormones stimulate the production of digestive enzymes, bicarbonate, and bile. The hormone secretin, for example, is produced by endocrine cells lining the duodenum of the small intestine. Acidic chyme entering the duodenum from the stomach triggers the release of secretin into the bloodstream. When the secretin returns via the circulation to the digestive system, it signals the release of bicarbonate from the pancreas. The bicarbonate neutralizes the acidic chyme.  See Table 15.3.2 for a summary of the major hormones governing the process of chemical digestion.

Table 15.3.2: Major Hormones Governing Chemical Digestion

Hormone	Source Organ	Target Organ	Trigger	Result
Gastrin	Stomach walls	Stomach	High protein intake	HCL and pepsin release, stomach churning
Secretin	Duodenum	Pancreas Gallbladder	Acidic chyme entering the duodenum	Release sodium bicarbonate, release bile
Cholecystokinin (CCK)	Duodenum	Pancreas Gallbladder	Partially digested fat and protein in duodenum	Release lipase, trypsin, release bile

Nerves involved in digestion include those that connect digestive organs to the central nervous system, as well as nerves inside the walls of the digestive organs. Nerves connecting the digestive organs to the central nervous system cause smooth muscles in the walls of digestive organs to contract or relax as needed, depending on whether or not there is food to be digested. Nerves within digestive organs are stimulated when food enters the organs and stretches their walls. These nerves trigger the release of substances that speed up or slow down the movement of food through the GI tract and the secretion of digestive enzymes.

When digestion is finished, it results in many simple nutrient molecules that must go through the process of absorption from the lumen of the GI tract to blood or lymph vessels, so they can be transported to and used by cells throughout the body. A few substances are absorbed in the stomach and large intestine. Water is absorbed in both of these organs, and some minerals and vitamins are also absorbed in the large intestine, but about 95% of nutrient molecules are absorbed in the small intestine. Absorption of the majority of these molecules takes place in the second part of the small intestine, called the jejunum. There are, however, a few exceptions — for example, iron is absorbed in the duodenum, and vitamin B12 is absorbed in the last part of the small intestine, called the ileum. After being absorbed in the small intestine, nutrient molecules are transported to other parts of the body for storage or further chemical modification. Amino acids, for instance, are transported to the liver to be used for protein synthesis.

The epithelial tissue lining the small intestine is specialized for absorption. It is highly enfolded and is covered with villi and microvilli, creating an enormous surface area for absorption. As shown in Figure 15.3.8, each villus also has a network of blood capillaries and fine lymphatic vessels called lacteals close to its surface. The thin surface layer of epithelial cells of the villi transports nutrients from the lumen of the small intestine into these capillaries and lacteals. Blood in the capillaries absorbs most of the molecules, including simple sugars, amino acids, glycerol, salts, and water-soluble vitamins (vitamin C and the many B vitamins). Lymph in the lacteals absorbs fatty acids and fat-soluble vitamins (vitamins A, D, E, and K).

Feature: My Human Body

The process of digestion does not always go as it should. Many people suffer from indigestion, or dyspepsia, a condition of impaired digestion. Symptoms may include upper abdominal fullness or pain, heartburn, nausea, belching, or some combination of these symptoms. The majority of cases of indigestion occur without evidence of an organic disease that is likely to explain the symptoms. Anxiety or certain foods or medications (such as aspirin) may be contributing factors in these cases. In other cases, indigestion is a symptom of an organic disease, most often gastroesophageal reflux disease (GERD) or gastritis. In a small minority of cases, indigestion is a symptom of a peptic ulcer of the stomach or duodenum, usually caused by a bacterial infection. Very rarely, indigestion is a sign of cancer.

An occasional bout of indigestion is usually nothing to worry about, especially in people less than 55 years of age. However, if you suffer frequent or chronic indigestion, it’s a good idea to see a doctor. If an underlying disorder such as GERD or an ulcer is causing the indigestion, this can and should be treated. If no organic disease is discovered, the doctor can recommend lifestyle changes or treatments to help prevent or soothe the symptoms of acute indigestion. Lifestyle changes might include modifications in eating habits, such as eating more slowly, eating smaller meals, or avoiding fatty foods. You also might be advised to refrain from taking certain medications, especially on an empty stomach. The use of antacids or other medications to relieve symptoms may also be recommended.

 

Attributions

Figure 15.3.1

Patrick_Bertoletti_eating_hot_dogs by Michael on Wikimedia Commons is used under a CC BY 2.0 (https://creativecommons.org/licenses/by/2.0) license.

Figure 15.3.2

2426_Mechanical_and_Chemical_DigestionN by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 15.3.3

Eating tacos [photo] by DeMorris Byrd on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 15.3.4

Carbohydrate digestion by Nutritional Doublethink on Flickr is used under a CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0/) license.

Figure 15.3.5

Peptide Digestion by Nutritional Doublethink on Flickr is used under a CC BY 2.0 (https://creativecommons.org/licenses/by/2.0/) license.

Figure 15.3.6

Bile from the liver and lipase from the pancreas help digest lipids in small intestine by CK-12 Foundation is used under a CC BY NC 3.0 (https://creativecommons.org/licenses/by-nc/3.0/) license.

Figure 15.3.7

Gut Flora by NIH Image Gallery on Flickr by NIH Image Gallery on Flickr is used under a CC BY-NC-SA 2.0 (https://creativecommons.org/licenses/by-nc-sa/2.0/) license.

Figure 15.3.8

Figure_34_01_11f by CNX OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

References

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 23.28 Digestion and absorption [digital image].  In Anatomy and Physiology (Section 23.7). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/23-7-chemical-digestion-and-absorption-a-closer-look

Brainard, J/ CK-12 Foundation. (2016). Figure 6 Both bile from the liver and lipase from the pancreas help digest lipids in the small intestine [digital image]. In CK-12 College Human Biology (Section 17.3) [online Flexbook]. CK12.org. https://www.ck12.org/book/ck-12-college-human-biology/section/17.3/

OpenStax. (2016, May 27) Figure 11 Villi are folds on the small intestine lining that increase the surface area to facilitate the absorption of nutrients. [digital image]. In OpenStax, Biology (Section 34.1). OpenStax CNX.  https://cnx.org/contents/GFy_h8cu@10.53:Oestf0YE@6/Digestive-Systems

TED-Ed. (2017, March 23). How the food you eat affects your gut - Shilpa Ravella. YouTube. https://www.youtube.com/watch?v=1sISguPDlhY&feature=youtu.be

TED-Ed. (2018, November 1). What causes heartburn? - Rusha Modi. YouTube. https://www.youtube.com/watch?v=jP-9AD0wMOk&feature=youtu.be

TEDx Talks. (2015, December 7). Food for thought: How your belly controls your brain | Ruairi Robertson | TEDxFulbrightSantaMonica. YouTube. https://www.youtube.com/watch?v=awtmTJW9ic8&feature=youtu.be

 

Created by CK-12 Foundation/Adapted by Christine Miller

This man is on his way to coming in third in an international hot dog eating contest (Figure 15.3.1). It may look as though he is regurgitating his hot dogs, but in fact, he is trying to get them into his mouth and down his throat as quickly as he can. In order to eat as many hot dogs as possible in the allotted time, he pushes several into his mouth at once, and doesn’t bother doing much chewing. Chewing is normally the first step in the process of digestion.

Digestion of food is a form of catabolism, in which the food is broken down into small molecules that the body can absorb and use for energy, growth, and repair. Digestion occurs when food is moved through the digestive system. This process begins in the mouth and ends in the small intestine. The final products of digestion are absorbed from the digestive tract, primarily in the small intestine. There are two different types of digestion that occur in the digestive system: mechanical digestion and chemical digestion. Figure 15.3.2 summarizes the roles played by different digestive organs in mechanical and chemical digestion, both of which are described in detail below.

 

Mechanical digestion is a physical process in which food is broken into smaller pieces without becoming changed chemically. It begins with your first bite of food (see Figure 15.3.3) and continues as you chew food with your teeth into smaller pieces. The process of mechanical digestion continues in the stomach. This muscular organ churns and mixes the food it contains, an action that breaks any solid food into still smaller pieces.

Although some mechanical digestion also occurs in the small intestine, it is mostly completed by the time food leaves the stomach. At that stage, food in the GI tract has been changed to the thick semi-fluid called chyme. Mechanical digestion is necessary so that chemical digestion can be effective. Mechanical digestion tremendously increases the surface area of food particles so they can be acted upon more effectively by digestive enzymes.

Chemical Digestion

Chemical digestion is the biochemical process in which macromolecules in food are changed into smaller molecules that can be absorbed into body fluids and transported to cells throughout the body. Substances in food that must be chemically digested include carbohydrates, proteins, lipids, and nucleic acids. Carbohydrates must be broken down into simple sugars, proteins into amino acids, lipids into fatty acids and glycerol, and nucleic acids into nitrogen bases and sugars. Some chemical digestion takes place in the mouth and stomach, but most of it occurs in the first part of the small intestine (duodenum).

Digestive Enzymes

Chemical digestion could not occur without the help of many different digestive enzymes. Enzymes are proteins that catalyze, or speed up, biochemical reactions. Digestive enzymes are secreted by exocrine glands or by the mucosal layer of epithelium lining the gastrointestinal tract. In the mouth, digestive enzymes are secreted by salivary glands. The lining of the stomach secretes enzymes, as does the lining of the small intestine. Many more digestive enzymes are secreted by exocrine cells in the pancreas and carried by ducts to the small intestine. The following table lists several important digestive enzymes, the organs and/or glands that secrete them, the compounds they digest, and the pH necessary for optimal functioning. You can read more about them below.

Table 15.3.1: Digestive Enzymes

Digestive Enzyme	Source Organ	Site of Action	Reactant and Product	Optimal pH
Salivary Amylase	Salivary Glands	Mouth	starch + water ⇒ maltose	Neutral
Pepsin	Stomach	Stomach	protein + water ⇒ peptides	Acidic
Pancreatic Amylase	Pancreas	Duodenum	starch + water ⇒ maltose	Basic
Maltase	Small intestine	Small intestine	maltose + water ⇒ glucose	Basic
Sucrase	Small intestine	Small intestine	sucrose + water ⇒ glucose + fructose	Basic
Lactase	Small intestine	Small intestine	lactose + water ⇒  glucose + galactose	Basic
Lipase	Pancreas	Duodenum	fat droplet and water ⇒  glycerol and fatty acids	Basic
Trypsin	Pancreas	Duodenum	protein + water ⇒ peptides	Basic
Chymotrypsin	Pancreas	Duodenum	protein + water ⇒ peptides	Basic
Peptidases	Small intestine	Small intestine	peptides + water ⇒	Basic
Deoxyribonuclease	Pancreas	Duodenum	DNA + water ⇒ nucleotide fragments	Basic
Ribonuclease	Pancreas	Duodenum	RNA + water ⇒ nucleotide fragments	Basic
Nuclease	Small intestine	Small intestine	nucleic acids + water ⇒ nucleotide fragments	Basic
Nucleosidases	Small intestine	Small intestine	nucleotides + water ⇒ nitrogen base + phosphate sugar	Basic

Chemical Digestion of Carbohydrates

About 80% of digestible carbohydrates in a typical Western diet are in the form of the plant polysaccharide amylose, which consists mainly of long chains of glucose and is one of two major components of starchno post. Additional dietary carbohydrates include the animal polysaccharide glycogen, along with some sugars, which are mainly disaccharides.

The process of chemical digestion for some carbohydrates is illustrated Figure 15.3.4. To chemically digest amylose and glycogen, the enzyme amylase is required. The chemical digestion of these polysaccharides begins in the mouth, aided by amylase in saliva. Saliva also contains mucus — which lubricates the food — and hydrogen carbonate, which provides the ideal alkaline conditions for amylase to work. Carbohydrate digestion is completed in the small intestine, with the help of amylase secreted by the pancreas. In the digestive process, polysaccharides are reduced in length by the breaking of bonds between glucose monomers. The macromolecules are broken down to shorter polysaccharides and disaccharides, resulting in progressively shorter chains of glucose. The end result is molecules of the simple sugars glucose and maltose (which consists of two glucose molecules), both of which can be absorbed by the small intestine.

Other sugars are digested with the help of different enzymes produced by the small intestine. Sucrose (or table sugar), for example, is a disaccharide that is broken down by the enzyme sucrase to form glucose and fructose, which are readily absorbed by the small intestine. Digestion of the sugar lactose, which is found in milk, requires the enzyme lactase, which breaks down lactose into glucose and galactose. Glucose and galactose are then absorbed by the small intestine. Fewer than half of all adults produce sufficient lactase to be able to digest lactose. Those who cannot are said to be lactose intolerant.

Chemical Digestion of Proteins

Proteinsno post consist of polypeptides, which must be broken down into their constituent amino acids before they can be absorbed. An overview of this process is shown in Figure 15.3.5. Protein digestion occurs in the stomach and small intestine through the action of three primary enzymes: pepsin (secreted by the stomach), and trypsin and chymotrypsin (secreted by the pancreas). The stomach also secretes hydrochloric acid (HCl), making the contents highly acidic, which is a required condition for pepsin to work. Trypsin and chymotrypsin in the small intestine require an alkaline (basic) environment to work. Bile from the liver and bicarbonate from the pancreas neutralize the acidic chyme as it empties into the small intestine. After pepsin, trypsin, and chymotrypsin break down proteins into peptides, these are further broken down into amino acids by other enzymes called peptidases, also secreted by the pancreas.

Chemical Digestion of Lipids

The chemical digestion of lipids begins in the mouth. The salivary glands secrete the digestive enzyme lipase, which breaks down short-chain lipids into molecules consisting of two fatty acids. A tiny amount of lipid digestion may take place in the stomach, but most lipid digestion occurs in the small intestine.

Digestion of lipids in the small intestine occurs with the help of another lipase enzyme from the pancreas, as well as bile secreted by the liver. As shown in the diagram below (Figure 15.3.6), bile is required for the digestion of lipids, because lipids are oily and do not dissolve in the watery chyme. Bile emulsifies (or breaks up) large globules of food lipids into much smaller ones, called micelles, much as dish detergent breaks up grease. The micelles provide a great deal more surface area to be acted upon by lipase, and also point the hydrophilic (“water-loving”) heads of the fatty acids outward into the watery chyme. Lipase can then access and break down the micelles into individual fatty acid molecules.

Nucleic acids (DNA and RNA) in foods are digested in the small intestine with the help of both pancreatic enzymes and enzymes produced by the small intestine itself. Pancreatic enzymes called ribonuclease and deoxyribonuclease break down RNA and DNA, respectively, into smaller nucleic acids. These, in turn, are further broken down into nitrogen bases and sugars by small intestine enzymes called nucleases.

Bacteria in the Digestive System

Your large intestine is not just made up of cells. It is also an ecosystem, home to trillions of bacteria known as the "gut flora" (Figure 15.3.7). But don't worry, most of these bacteria are helpful. Friendly bacteria live mostly in the large intestine and part of the small intestine. The acidic environment of the stomach does not allow bacterial growth.

Gut bacteria have several roles in the body. For example, intestinal bacteria:

• Produce vitamin B12 and vitamin K.
• Control the growth of harmful bacteria.
• Break down poisons in the large intestine.
• Break down some substances in food that cannot be digested, such as fibre and some starches and sugars. Bacteria produce enzymes that digest carbohydrates in plant cell walls. Most of the nutritional value of plant material would be wasted without these bacteria. These help us digest plant foods like spinach.

A wide range of friendly bacteria live in the gut. Bacteria begin to populate the human digestive system right after birth. Gut bacteria include Lactobacillus, the bacteria commonly used in probiotic foods such as yogurt, and E. coli bacteria. About a third of all bacteria in the gut are members of the Bacteroides species. Bacteroides are key in helping us digest plant food.

It is estimated that 100 trillion bacteria live in the gut. This is more than the human cells that make up you. It has also been estimated that there are more bacteria in your mouth than people on the planet — there are over 7 billion people on the planet!

The bacteria in your digestive system are from anywhere between 300 and 1,000 species. As these bacteria are helpful, your body does not attack them. They actually appear to the body's immune system as cells of the digestive system, not foreign invaders. The bacteria actually cover themselves with sugar molecules removed from the actual cells of the digestive system. This disguises the bacteria and protects them from the immune system.

As the bacteria that live in the human gut are beneficial to us, and as the bacteria enjoy a safe environment to live, the relationship that we have with these tiny organisms is described as mutualism, a type of symbiotic relationship.

Lastly, keep in mind the small size of bacteria. Together, all the bacteria in your gut may weigh just about two pounds.

Control of the Digestive Process

The process of digestion is controlled by both hormones and nerves. Hormonal control is mainly by endocrine hormones secreted by cells in the lining of the stomach and small intestine. These hormones stimulate the production of digestive enzymes, bicarbonate, and bile. The hormone secretin, for example, is produced by endocrine cells lining the duodenum of the small intestine. Acidic chyme entering the duodenum from the stomach triggers the release of secretin into the bloodstream. When the secretin returns via the circulation to the digestive system, it signals the release of bicarbonate from the pancreas. The bicarbonate neutralizes the acidic chyme.  See Table 15.3.2 for a summary of the major hormones governing the process of chemical digestion.

Table 15.3.2: Major Hormones Governing Chemical Digestion

Hormone	Source Organ	Target Organ	Trigger	Result
Gastrin	Stomach walls	Stomach	High protein intake	HCL and pepsin release, stomach churning
Secretin	Duodenum	Pancreas Gallbladder	Acidic chyme entering the duodenum	Release sodium bicarbonate, release bile
Cholecystokinin (CCK)	Duodenum	Pancreas Gallbladder	Partially digested fat and protein in duodenum	Release lipase, trypsin, release bile

Nerves involved in digestion include those that connect digestive organs to the central nervous system, as well as nerves inside the walls of the digestive organs. Nerves connecting the digestive organs to the central nervous system cause smooth muscles in the walls of digestive organs to contract or relax as needed, depending on whether or not there is food to be digested. Nerves within digestive organs are stimulated when food enters the organs and stretches their walls. These nerves trigger the release of substances that speed up or slow down the movement of food through the GI tract and the secretion of digestive enzymes.

When digestion is finished, it results in many simple nutrient molecules that must go through the process of absorption from the lumen of the GI tract to blood or lymph vessels, so they can be transported to and used by cells throughout the body. A few substances are absorbed in the stomach and large intestine. Water is absorbed in both of these organs, and some minerals and vitamins are also absorbed in the large intestine, but about 95% of nutrient molecules are absorbed in the small intestine. Absorption of the majority of these molecules takes place in the second part of the small intestine, called the jejunum. There are, however, a few exceptions — for example, iron is absorbed in the duodenum, and vitamin B12 is absorbed in the last part of the small intestine, called the ileum. After being absorbed in the small intestine, nutrient molecules are transported to other parts of the body for storage or further chemical modification. Amino acids, for instance, are transported to the liver to be used for protein synthesis.

The epithelial tissue lining the small intestine is specialized for absorption. It is highly enfolded and is covered with villi and microvilli, creating an enormous surface area for absorption. As shown in Figure 15.3.8, each villus also has a network of blood capillaries and fine lymphatic vessels called lacteals close to its surface. The thin surface layer of epithelial cells of the villi transports nutrients from the lumen of the small intestine into these capillaries and lacteals. Blood in the capillaries absorbs most of the molecules, including simple sugars, amino acids, glycerol, salts, and water-soluble vitamins (vitamin C and the many B vitamins). Lymph in the lacteals absorbs fatty acids and fat-soluble vitamins (vitamins A, D, E, and K).

Feature: My Human Body

The process of digestion does not always go as it should. Many people suffer from indigestion, or dyspepsia, a condition of impaired digestion. Symptoms may include upper abdominal fullness or pain, heartburn, nausea, belching, or some combination of these symptoms. The majority of cases of indigestion occur without evidence of an organic disease that is likely to explain the symptoms. Anxiety or certain foods or medications (such as aspirin) may be contributing factors in these cases. In other cases, indigestion is a symptom of an organic disease, most often gastroesophageal reflux disease (GERD) or gastritis. In a small minority of cases, indigestion is a symptom of a peptic ulcer of the stomach or duodenum, usually caused by a bacterial infection. Very rarely, indigestion is a sign of cancer.

An occasional bout of indigestion is usually nothing to worry about, especially in people less than 55 years of age. However, if you suffer frequent or chronic indigestion, it’s a good idea to see a doctor. If an underlying disorder such as GERD or an ulcer is causing the indigestion, this can and should be treated. If no organic disease is discovered, the doctor can recommend lifestyle changes or treatments to help prevent or soothe the symptoms of acute indigestion. Lifestyle changes might include modifications in eating habits, such as eating more slowly, eating smaller meals, or avoiding fatty foods. You also might be advised to refrain from taking certain medications, especially on an empty stomach. The use of antacids or other medications to relieve symptoms may also be recommended.

 

Attributions

Figure 15.3.1

Patrick_Bertoletti_eating_hot_dogs by Michael on Wikimedia Commons is used under a CC BY 2.0 (https://creativecommons.org/licenses/by/2.0) license.

Figure 15.3.2

2426_Mechanical_and_Chemical_DigestionN by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 15.3.3

Eating tacos [photo] by DeMorris Byrd on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 15.3.4

Carbohydrate digestion by Nutritional Doublethink on Flickr is used under a CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0/) license.

Figure 15.3.5

Peptide Digestion by Nutritional Doublethink on Flickr is used under a CC BY 2.0 (https://creativecommons.org/licenses/by/2.0/) license.

Figure 15.3.6

Bile from the liver and lipase from the pancreas help digest lipids in small intestine by CK-12 Foundation is used under a CC BY NC 3.0 (https://creativecommons.org/licenses/by-nc/3.0/) license.

Figure 15.3.7

Gut Flora by NIH Image Gallery on Flickr by NIH Image Gallery on Flickr is used under a CC BY-NC-SA 2.0 (https://creativecommons.org/licenses/by-nc-sa/2.0/) license.

Figure 15.3.8

Figure_34_01_11f by CNX OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

References

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 23.28 Digestion and absorption [digital image].  In Anatomy and Physiology (Section 23.7). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/23-7-chemical-digestion-and-absorption-a-closer-look

Brainard, J/ CK-12 Foundation. (2016). Figure 6 Both bile from the liver and lipase from the pancreas help digest lipids in the small intestine [digital image]. In CK-12 College Human Biology (Section 17.3) [online Flexbook]. CK12.org. https://www.ck12.org/book/ck-12-college-human-biology/section/17.3/

OpenStax. (2016, May 27) Figure 11 Villi are folds on the small intestine lining that increase the surface area to facilitate the absorption of nutrients. [digital image]. In OpenStax, Biology (Section 34.1). OpenStax CNX.  https://cnx.org/contents/GFy_h8cu@10.53:Oestf0YE@6/Digestive-Systems

TED-Ed. (2017, March 23). How the food you eat affects your gut - Shilpa Ravella. YouTube. https://www.youtube.com/watch?v=1sISguPDlhY&feature=youtu.be

TED-Ed. (2018, November 1). What causes heartburn? - Rusha Modi. YouTube. https://www.youtube.com/watch?v=jP-9AD0wMOk&feature=youtu.be

TEDx Talks. (2015, December 7). Food for thought: How your belly controls your brain | Ruairi Robertson | TEDxFulbrightSantaMonica. YouTube. https://www.youtube.com/watch?v=awtmTJW9ic8&feature=youtu.be

 

Image shows a woman doing a handstand.

Image is a GIF of an xray of someone swallowing. You can see the bones of the head and neck from a side view. The liquid is swallowed and flows in through the mouth, down the pharynx and down the esophagus.

Medical artwork showing the anatomical composition of the stomach in a sectional view on white background. There are three layers of muscle in the stomach wall, each layer runs in a different direction: circular, longitudinal and oblique.

 

 

Head Stand

Did you ever wonder what would happen if you tried to swallow food while standing on your head like this person in Figure 15.4.1? Many people think that food travels down the gullet from the mouth by the force of gravity. If that were the case, then food you swallowed would stay in your throat while you were standing on your head. In reality, your position doesn’t have much to do with your ability to swallow. Food will travel from your mouth to your stomach whether you are standing upright or upside down. That’s because the tube the food travels through — the esophagus — moves the food along via muscular contractions known as peristalsis. The esophagus is one of several organs that make up the upper gastrointestinal tract.

Besides the esophagus, organs of the upper gastrointestinal (GI) tract include the mouth, pharynx, and stomach. These hollow organs are all connected to form a tube through which food passes during digestion. The only role in digestion played by the pharynx and esophagus is to move food through the GI tract. The mouth and stomach, in contrast, are organs where digestion — or the breakdown of food — also occurs. In both of these organs, food is broken into smaller pieces (mechanical digestion), as well as broken down chemically (chemical digestion). It should be noted that the first part of the small intestine (duodenum) is considered in some contexts to be part of the upper GI tract, but that practice is not followed here.

The mouth is the first organ of the GI tract. Most of the oral cavity is lined with mucous membrane. This tissue produces mucus, which helps moisten, soften, and lubricate food. Underlying the mucous membrane is a thin layer of smooth muscle to which the mucous membrane is only loosely connected. This gives the mucous membrane considerable ability to stretch as you eat food. The roof of the mouth, called the palate, separates the oral cavity from the nasal cavity. The front part is hard, consisting of mucous membrane covering a plate of bone. The back part of the palate is softer and more pliable, consisting of mucous membrane over muscle and connective tissue. The hard surface of the front of the palate allows for pressure needed in chewing and mixing food. The soft, pliable surface of the back of the palate can move to accommodate the passage of food while swallowing. Muscles at either side of the soft palate contract to create the swallowing action.

Several specific structures in the mouth are specialized for digestion. These include salivary glands, tongue, and teeth.

Salivary Glands

The mouth contains three pairs of major salivary glands, shown in Figure 15.4.2. These three pairs are all exocrine glands that secrete saliva into the mouth through ducts.

1. The largest of the three major pairs of salivary glands are the parotid glands, which are located on either side of the mouth in front of the ears.
2. The next largest pair is the submandibular glands, located beneath the lower jaw.
3. The third pair is the sublingual glands, located underneath the tongue.

In addition to these three pairs of major salivary glands, there are also hundreds of minor salivary glands in the oral mucosa lining the mouth and on the tongue. Along with the major glands, most of the minor glands secrete the digestive enzyme amylase, which begins the chemical digestion of starch and glycogen (polysaccharides). However, the minor salivary glands on the tongue secrete the fat-digesting enzyme lipase, which in the mouth is called lingual lipase (to distinguish it from pancreatic lipase secreted by the pancreas).

Saliva secreted by the salivary glands mainly helps digestion, but it also plays other roles. It helps maintain dental health by cleaning the teeth, and it contains antibodies that help protect against infection. By keeping the mouth lubricated, saliva also allows the mouth movements needed for speech.

Tongue

The tongue is a fleshy, muscular organ that is attached to the floor of the mouth by a band of ligaments that gives it great mobility. This is necessary so the tongue can manipulate food for chewing and swallowing. Movements of the tongue are also necessary for speaking. The upper surface of the tongue is covered with tiny projections called papillae, which contain taste buds. The latter are collections of chemoreceptor cells (shown in Figure 15.4.3). These sensory cells sense chemicals in food and send the information to the brain via cranial nerves, thus enabling the sense of taste.

There are five basic tastes detected by the chemoreceptor cells in taste buds: saltiness, sourness, bitterness, sweetness, and umami (often described as a meaty taste). Contrary to popular belief, taste buds for the five basic tastes are not located on different parts of the tongue. Why does taste matter? The taste of food helps to stimulate the secretion of saliva from the salivary glands. It also helps us to eat foods that are good for us, instead of rotten or toxic foods. The detection of saltiness, for example, enables the control of salt intake and salt balance in the body. The detection of sourness may help us avoid spoiled foods, which often taste sour due to fermentation by bacteria. The detection of bitterness warns of poisons, because many plants defend themselves with toxins that taste bitter. The detection of sweetness guides us to foods that supply quick energy. The detection of umami may signal protein-rich foods.

Teeth

The teeth are complex structures made of a bone-like material called dentin and covered with enamel, which is the hardest tissue in the body. Adults normally have a total of 32 teeth, with 16 in each jaw. The right and left sides of each jaw are mirror images in terms of the numbers and types of teeth they contain. Teeth have different shapes to suit them for different aspects of mastication (chewing). The different types of teeth are illustrated in Figure 15.4.4.

• Incisors are the sharp, blade-like teeth at the front of the mouth. They are used for cutting or biting off pieces of food. In adults, there are normally four incisors in each jaw, or eight in total.
• Canines are the pointed teeth on either side of the incisors. They are used for tearing foods that are tough or stringy. Adults normally have two canines in each jaw, or four altogether.
• Premolars and molars are cuboid teeth with cusps and grooves that are located on the sides and toward the back of the jaws. Premolars are closer to the front of the mouth. Molars are larger and have more cusps than premolars, but both are used for crushing and grinding food. Adults normally have two premolars and three molars on each side of each jaw, for a total of eight premolars and twelve molars.

The tube-like pharynx (see Figure 15.4.5 below) plays a dual role as an organ of both respiration and digestion. As part of the respiratory system, it conducts air between the nasal cavity and larynx. As part of the digestive system, it allows swallowed food to pass from the oral cavity to the esophagus. Anything swallowed has priority over inhaled air when passing through the pharynx. During swallowing, the backward motion of the tongue causes a flap of elastic cartilage — called the epiglottis — to close over the opening to the larynx. This prevents food or drink from entering the larynx.

Esophagus

The esophagus (shown in Figure 15.4.6) is a muscular tube through which food is pushed from the pharynx to the stomach. The esophagus passes through an opening in the diaphragm (the large breathing muscle that separates the abdomen from the thorax) before reaching the stomach. In adults, the esophagus averages about 25 cm (about 9.8 inches) in length, depending on a person’s height. The inner lining of the esophagus consists of mucous membrane, which provides a smooth, slippery surface for the passage of food. The cells of this membrane are constantly being replaced as they are worn away from the frequent passage of food over them.

When food is not being swallowed, the esophagus is closed at both ends by upper and lower esophageal sphincters. Sphincters are rings of muscle that can contract to close off openings between structures. The upper esophageal sphincter is triggered to relax and open by the act of swallowing, allowing a bolus of food to enter the esophagus from the pharynx. Then, the esophageal sphincter closes again to prevent food from moving back into the pharynx from the esophagus.

Once in the esophagus, the food bolus travels down to the stomach, pushed along by the rhythmic contraction and relaxation of muscles (peristalsis). The lower esophageal sphincter is located at the junction between the esophagus and the stomach. This sphincter opens when the bolus reaches it, allowing the food to enter the stomach. The sphincter normally remains closed at other times to prevent the contents of the stomach from entering the esophagus. Failure of this sphincter to remain completely closed can lead to heartburn. If it happens chronically, it can lead to gastroesophageal reflux disease (GERD), in which the mucous membrane of the esophagus may become damaged by the highly acidic contents of the stomach.

See the video below to see how the parts of the upper GI tract work together to carry out swallowing:

https://youtu.be/pNcV6yAfq-g

Swallowing, uploaded by Alejandra Cork, 2012.

Stomach

The stomach is a J-shaped organ (shown in Figure 15.4.7) that is joined to the esophagus at its upper end, and to the first part of the small intestine (duodenum) at its lower end. When the stomach is empty of food, it normally has a volume of about 75 millilitres, but it can expand to hold up to about a litre of food. Waves of muscle contractions (peristalsis) passing through the muscular walls of the stomach cause the food inside to be mixed and churned. The wall of the stomach has an extra layer of muscle tissue not found in other organs of the GI tract that helps it squeeze and mix the food. These movements of the stomach wall contribute greatly to mechanical digestion by breaking the food into much smaller pieces. The churning also helps mix the food with stomach secretions that aid in its chemical digestion.

Secretions of the stomach include gastric acid, which consists mainly of hydrochloric acid (HCl). This makes the stomach contents highly acidic, which is necessary so that the enzyme pepsin — also secreted by the stomach — can begin the digestion of protein. Mucus is secreted by the lining of stomach to provide a slimy protective coating against the otherwise damaging effects of gastric acid. The fat-digesting enzyme lipase is secreted in small amounts in the stomach, but very little fat digestion occurs there.

By the time food has been in the stomach for about an hour, it has become the thick, semi-liquid chyme. When the small intestine is ready to receive chyme, a sphincter between the stomach and duodenum — called the pyloric sphincter — opens to allow the chyme to enter the small intestine for further digestion and absorption.

The ongoing epidemic of obesity in the wealthier nations of the world, including Canada, has led to the development of several different bariatric surgeries that modify the stomach to help obese patients reduce their food intake and lose weight. Go online to learn more about bariatric surgery. Find sources you judge to be reliable that answer the following questions:

1. Who qualifies for bariatric surgery?
2. Describe the bariatric surgeries commonly called stomach stapling, lap band, and gastric sleeve. How does each type of surgery modify the stomach? In terms of weight loss, how effective is each type?
3. What are the major potential risks of bariatric surgery?
4. Besides weight loss, what other benefits have been shown to result from bariatric surgery?

Attributions

Figure 15.4.1

Handstand, Pender Island, B.C. [photo] by Jasper Garratt on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 15.4.2

Blausen_0780_SalivaryGlands by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 15.4.3

1402_The_Tongue by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 15.4.4

1024px-3D_Medical_Animation_Still_Showing_Types_of_Teeth by http://www.scientificanimations.com on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0) license.

Figure 15.4.5

Illu01_head_neck by Arcadian from NCI/ SEER Training Modules on Wikimedia Common is in the public domain (https://en.wikipedia.org/wiki/public_domain).

Figure 15.4.6

ZenkerSchraeg by Bernd Brägelmann Braegel on Wikimedia Commons is used under a CC BY 3.0  (https://creativecommons.org/licenses/by/3.0) license.  (Courtesy of Dr. Martin Steinhoff. It is not known whether there is a possibly necessary approval from the patient.)

Figure 15.4.7

Anatomy stomach – white by www.medicalgraphics.de from MedicalGraphics is used under a  CC BY-ND 4.0 (https://creativecommons.org/licenses/by-nd/4.0/) license.

References

Alejandra Cork. (2012). Swallowing. YouTube. https://www.youtube.com/watch?v=pNcV6yAfq-g&t=4s

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 27). Figure 14.3 The tongue [digital image]. In Anatomy and Physiology (Section 14.1). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/14-1-sensory-perception

Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

Mayo Clinic. (2014, August 26). Gastric bypass surgery: One patient’s journey - Mayo Clinic. https://www.youtube.com/watch?v=twJBEypJDfU&feature=youtu.be

Mayo Clinic Staff. (n.d.). Gastroesophageal reflux disease (GERD) [online article]. MayoClinic.org. https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940

Tech Insider. (2018, March 20). Here's what happens in your body when you swallow gum | The human body. YouTube. https://www.youtube.com/watch?v=u_1sVri3b2w&feature=youtu.be

TED-Ed. (2020, April 9). How does alcohol make you drunk? - Judy Grisel. YouTube. https://www.youtube.com/watch?v=gCrmFbgT37I&feature=youtu.be

TED-Ed. (2016, October 17). What causes cavities? - Mel Rosenberg. YouTube. https://www.youtube.com/watch?v=zGoBFU1q4g0&feature=youtu.be

 

Image shows a diagram of the cross sectional layering of heart tissues. As described in the preceding paragraph, the endocardium is a thin layer on the inside of the heart chambers, and myocardium is an extremely thick layer of cardiac muscle, and the pericardium consists of two membranes separated by fluid. The visceral pericardium envelopes the myocardium and the parietal pericardium envelopes the entire heart structure.

Image shows a flowchart of the path of blood through the heart. Beginning at the lungs, oxygenated blood enters the pulmonary veins, then enters the left atrium. Blood then passes through the bicuspid AV valve to enter the left ventricle, which contracts to send blood through the aortic semilunar valve into the aorta. The aorta connects to arteries of the systemic circuit and ultimately deliver oxygen to body tissues. From here, blood is deoxygenated and returns to the heart via veins which merge to form the two vena cava. The vena cava delivers blood to the right atrium, which contracts to send blood through the tricuspid AV valve into the right ventricle, which contracts to send blood through the pulmonary semilunar valve into the pulmonary arteries and to the lungs for re-oxygenation.

Created by CK-12 Foundation/Adapted by Christine Miller

Case Study Conclusion: Cough That Won't Quit

Inhaling the moist air from a humidifier or steamy shower can feel particularly good if you have a respiratory system infection, such as bronchitis. The moist air helps to loosen and thin mucus in the respiratory system, allowing you to breathe easier.

In the beginning of this chapter, you learned about Erica, who developed acute bronchitis after getting a cold. She had a worsening cough, a sore throat due to coughing, and chest congestion. She was also coughing up thick mucus.

Acute bronchitis usually occurs after a cold or flu, usually due to the same viruses that cause cold or flu. Because bronchitis is not usually caused by bacteria (although it can be), in most cases, antibiotics are not an effective treatment.

Bronchitis affects the bronchial tubes, which, as you have learned, are air passages in the lower respiratory tract. The main bronchi branch off of the trachea and then branch into smaller bronchi, and then bronchioles. In bronchitis, the walls of the bronchi become inflamed, which makes them narrower. There is also excessive production of mucus in the bronchi, which further narrows the pathway where air can flow through. Figure 13.7.2, shows how bronchitis affects the bronchial tubes.

The treatment for most cases of bronchitis involves thinning and loosening the mucus so that it can be effectively coughed out of the airways. This can be done by drinking plenty of fluids, using humidifiers or steam, and — in some cases — using over-the-counter medications (such as expectorants). Dr. Choo recommended some of these treatments to Erica, and also warned against using cough suppressants. Cough suppressants work on the nervous system to suppress the cough reflex. When a patient has a “productive” cough (which means they are coughing up mucus), doctors generally advise them not to take cough suppressants, so that they can cough the mucus out of their bodies.

When Dr. Choo was examining Erica, she used a pulse oximeter to measure the oxygen level in her blood. Why did she do this? As you have learned, the bronchial tubes branch into bronchioles, which ultimately branch into the alveoli of the lungs. The alveoli are where gas exchange occurs between the air and the blood to take in oxygen and remove carbon dioxide and other wastes. By checking Erica’s blood oxygen level, Dr. Choo was making sure that her clogged airways were not impacting her level of much-needed oxygen.

Erica has acute bronchitis, but you may recall that chronic bronchitis was discussed earlier in this chapter (Section 13.5) as a term that describes the symptoms of chronic obstructive pulmonary disease (COPD). COPD is often due to tobacco smoking, and it causes damage to the walls of the alveoli. Acute bronchitis, on the other hand, typically occurs after a cold or flu, and involves inflammation and mucus build-up in the bronchial tubes. As implied by the difference in their names, chronic bronchitis is an ongoing, long-term condition, while acute bronchitis is likely to resolve relatively quickly with proper rest and treatment.

Erica uses e-cigarettes (vaping), so she is more likely to develop chronic respiratory conditions, such as COPD. As you have learned, smoking damages the respiratory system, along with many other systems of the body. Smoking and vaping increases the risk of respiratory infections, including bronchitis and flu, due to its damaging effects on the respiratory and immune systems. Dr. Choo strongly encouraged Erica to quit vaping, not only so that her acute bronchitis resolves, but so that she can avoid future infections and other negative health outcomes associated with vaping and smoking, including COPD and lung cancer.

As you have learned in this chapter, the respiratory system is critical to carry out the gas exchange necessary for life’s functions, and to protect the body from pathogens and other potentially harmful substances in the air. But this ability to interface with the outside air has a cost. The respiratory system is prone to infections, as well as damage and other negative effects from allergens, mold, air pollution, cigarette smoke and vaping. While exposure to most of these things cannot be avoided, not smoking is an important step you can take to protect this organ system — as well as many other systems of your body.

Attributions

Figure 13.7.1

Tags: Essential Oils Aroma Diffuser Diffuse Led by asundermeier on Pixabay is used under the Pixabay License (https://unsplash.com/license).

Figure 13.7.2

Bronchitis by National Heart Lung and Blood Institute on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain).

 

Created by CK-12 Foundation/Adapted by Christine Miller

Imagine the man in Figure 12.3.1 turns his eyes in your direction. This is a very small movement, considering the conspicuously large and strong external eye muscles that control eyeball movements. These muscles have been called the strongest muscles in the human body relative to the work they do. However, the external eye muscles actually do a surprising amount of work. Eye movements occur almost constantly during waking hours, especially when we are scanning faces or reading. Eye muscles are also exercised nightly during the phase of sleep called rapid eye movement sleep. External eye muscles can move the eyes because they are made mainly of muscle tissue.

Muscle tissue is a soft tissue that makes up most of the tissues in the muscles of the human muscular system. Other tissues in muscles are connective tissues, such as tendons that attach skeletal muscles to bones and sheaths of connective tissues that cover or line muscle tissues. Only muscle tissue per se, has cells with the ability to contract.

There are three major types of muscle tissues in the human body: skeletal, smooth, and cardiac muscle tissues. Figure 12.3.2 shows how the three types of muscle tissues appear under magnification. When you read about each type below, you will learn why the three types appear as they do.

Skeletal muscle is muscle tissue that is attached to bones by tendons, which are bundles of collagen fibres. Whether you are moving your eyes or running a marathon, you are using skeletal muscles. Contractions of skeletal muscles are voluntary, or under conscious control of the central nervous system via the somatic nervous system. Skeletal muscle tissue is the most common type of muscle tissue in the human body. By weight, an average adult male is about 42% skeletal muscles, and the average adult female is about 36% skeletal muscles. Some of the major skeletal muscles in the human body are labeled in Figure 12.3.3 below.

Skeletal Muscle Pairs

To move bones in opposite directions, skeletal muscles often consist of muscle pairs that work in opposition to one another, also called antagonistic muscle pairs.  For example, when the biceps muscle (on the front of the upper arm) contracts, it can cause the elbow joint to flex or bend the arm, as shown in Figure 12.3.4. When the triceps muscle (on the back of the upper arm) contracts, it can cause the elbow to extend or straighten the arm. The biceps and triceps muscles, also shown in Figure 12.3.4, are an example of a muscle pair where the muscles work in opposition to each other.

Skeletal Muscle Structure

Each skeletal muscle consists of hundreds — or even thousands — of skeletal muscle fibres, which are long, string-like cells. As shown in Figure 12.3.5 below, skeletal muscle fibres are individually wrapped in connective tissue called endomysium. The skeletal muscle fibres are bundled together in units called muscle fascicles, which are surrounded by sheaths of connective tissue called perimysium. Each fascicle contains between ten and 100 (or even more!) skeletal muscle fibres. Fascicles, in turn, are bundled together to form individual skeletal muscles, which are wrapped in connective tissue called epimysium. The connective tissues in skeletal muscles have a variety of functions. They support and protect muscle fibres, allowing them to withstand the forces of contraction by distributing the forces applied to the muscle. They also provide pathways for nerves and blood vessels to reach the muscles. In addition, the epimysium anchors the muscles to tendons.

The same bundles-within-bundles structure is replicated within each muscle fibre. As shown in Figure 12.3.6, a muscle fibre consists of a bundle of myofibrils, which are themselves bundles of protein filaments. These protein filaments consist of thin filaments of the protein actin, which are anchored to structures called Z discs, and thick filaments of the protein myosin. The filaments are arranged together within a myofibril in repeating units called sarcomeres, which run from one Z disc to the next. The sarcomere is the basic functional unit of skeletal and cardiac muscles. It contracts as actin and myosin filaments slide over one another. Skeletal muscle tissue is said to be striated, because it appears striped. It has this appearance because of the regular, alternating A (dark) and I (light) bands of filaments arranged in sarcomeres inside the muscle fibres. Other components of a skeletal muscle fibre include multiple nuclei and mitochondria.

Slow- and Fast-Twitch Skeletal Muscle Fibres

Skeletal muscle fibres can be divided into two types, called slow-twitch (or type I) muscle fibres and fast-twitch (or type II) muscle fibres.

• Slow-twitch muscle fibres are dense with capillaries and rich in mitochondria and myoglobin, which is a protein that stores oxygen until needed for muscle activity. Relative to fast-twitch fibres, slow-twitch fibres can carry more oxygen and sustain aerobic (oxygen-using) activity. Slow-twitch fibres can contract for long periods of time, but not with very much force. They are relied upon primarily in endurance events, such as distance running or cycling.
• Fast-twitch muscle fibres contain fewer capillaries and mitochondria and less myoglobin. This type of muscle fibre can contract rapidly and powerfully, but it fatigues very quickly. Fast-twitch fibres can sustain only short, anaerobic (non-oxygen-using) bursts of activity. Relative to slow-twitch fibres, fast-twitch fibres contribute more to muscle strength and have a greater potential for increasing in mass. They are relied upon primarily in short, strenuous events, such as sprinting or weightlifting.

Proportions of fibre types vary considerably from muscle to muscle and from person to person. Individuals may be genetically predisposed to have a larger percentage of one type of muscle fibre than the other. Generally, an individual who has more slow-twitch fibres is better suited for activities requiring endurance, whereas an individual who has more fast-twitch fibres is better suited for activities requiring short bursts of power.

Smooth muscle is muscle tissue in the walls of internal organs and other internal structures such as blood vessels. When smooth muscles contract, they help the organs and vessels carry out their functions. When smooth muscles in the stomach wall contract, for example, they squeeze the food inside the stomach, helping to mix and churn the food and break it into smaller pieces. This is an important part of digestion. Contractions of smooth muscles are involuntary, so they are not under conscious control. Instead, they are controlled by the autonomic nervous system, hormones, neurotransmitters, and other physiological factors.

Structure of Smooth Muscle

The cells that make up smooth muscle are generally called myocytes. Unlike the muscle fibres of striated muscle tissue, the myocytes of smooth muscle tissue do not have their filaments arranged in sarcomeres. Therefore, smooth tissue is not striated. However, the myocytes of smooth muscle do contain myofibrils, which in turn contain bundles of myosin and actin filaments. The filaments cause contractions when they slide over each other, as shown in Figure 12.3.7.

Unlike striated muscle, smooth muscle can sustain very long-term contractions. Smooth muscle can also stretch and still maintain its contractile function, which striated muscle cannot. The elasticity of smooth muscle is enhanced by an extracellular matrix secreted by myocytes. The matrix consists of elastin, collagen, and other stretchy fibres. The ability to stretch and still contract is an important attribute of smooth muscle in organs such as the stomach and uterus (see Figures 12.3.8 and 12.3.9), both of which must stretch considerably as they perform their normal functions.

The following list indicates where many smooth muscles are found, along with some of their specific functions.

• Walls of organs of the gastrointestinal tract (such as the esophagus, stomach, and intestines), moving food through the tract by peristalsis
• Walls of air passages of the respiratory tract (such as the bronchi), controlling the diameter of the passages and the volume of air that can pass through them
• Walls of organs of the male and female reproductive tracts; in the uterus, for example, pushing a baby out of the uterus and into the birth canal
• Walls of structures of the urinary system, including the urinary bladder, allowing the bladder to expand so it can hold more urine, and then contract as urine is released
• Walls of blood vessels, controlling the diameter of the vessels and thereby affecting blood flow and blood pressure
• Walls of lymphatic vessels, squeezing the fluid called lymph through the vessels
• Iris of the eyes, controlling the size of the pupils and thereby the amount of light entering the eyes
• Arrector pili in the skin, raising hairs in hair follicles in the dermis

Cardiac muscle is found only in the wall of the heart. It is also called myocardium. As shown in Figure 12.3.10, myocardium is enclosed within connective tissues, including the endocardium on the inside of the heart and pericardium on the outside of the heart. When cardiac muscle contracts, the heart beats and pumps blood. Contractions of cardiac muscle are involuntary, like those of smooth muscles. They are controlled by electrical impulses from specialized cardiac muscle cells in an area of the heart muscle called the sinoatrial node.

Like skeletal muscle, cardiac muscle is striated because its filaments are arranged in sarcomeres inside the muscle fibres. However, in cardiac muscle, the myofibrils are branched at irregular angles rather than arranged in parallel rows (as they are in skeletal muscle). This explains why cardiac and skeletal muscle tissues look different from one another.

The cells of cardiac muscle tissue are arranged in interconnected networks. This arrangement allows rapid transmission of electrical impulses, which stimulate virtually simultaneous contractions of the cells. This enables the cells to coordinate contractions of the heart muscle.

The heart is the muscle that performs the greatest amount of physical work in the course of a lifetime. Although the power output of the heart is much less than the maximum power output of some other muscles in the human body, the heart does its work continuously over an entire lifetime without rest. Cardiac muscle contains a great many mitochondria, which produce ATP for energy and help the heart resist fatigue.

Cardiomyopathy is a disease in which the muscles of the heart are no longer able to effectively pump blood to the body — extreme forms of this disease can lead to heart failure.  There are four main types of cardiomyopathy (also illustrated in Figure 12.3.11):

• Dilated (congestive) cardiomyopathy: the left ventricle (the chamber itself) of the heart becomes enlarged and can't pump blood our to the body.  This is normally related to coronary artery disease and/or heart attack
• Hypertrophic cardiomyopathy: abnormal thickening of the muscular walls of the left ventricle make the chamber less able to work properly.  This condition is more common in patients with a family history of the disease.
• Restrictive cardiomyopathy: the myocardium becomes abnormally rigid and inelastic and is unable to expand in between heartbeats to refill with blood.  Restrictive cardiomyopathy typically affects older people.
• Arrhythmogenic right ventricular cardiomyopathy: the right ventricular muscle is replaced by adipose or scar tissue, reducing elasticity and interfering with normal heartbeat and rhythm.  This disease is often caused by genetic mutations.

Cardiomyopathy is typically diagnosed with a physical exam supplemented by medical and family history, an angiogram, blood tests, chest x-rays and electrocardiograms.  In some cases your doctor would also requisition a CT scan and/or genetic testing.

When treating cardiomyopathy, the goal is to reduce symptoms that affect everyday life.  Certain medications can help regularize and slow heart rate, decrease chances of blood clots and cause vasodilation in the coronary arteries.  If medication is not sufficient to manage symptoms, a pacemaker or even a heart transplant may be the best option.  Lifestyle can also help manage the symptoms of cardiomyopathy — people living with this disease are encouraged to avoid drug and alcohol use, control high blood pressure, eat a healthy diet, get ample rest and exercise, as well as reduce stress levels.

 

Attributions

Figure 12.3.1

Look by ali-yahya-155huuQwGvA [photo] by Ali Yahya on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 12.3.2

Skeletal_Smooth_Cardiac by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.3

Anterior_and_Posterior_Views_of_Muscles by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.4

Antagonistic Muscle Pair by Laura Guerin at CK-12 Foundation on Wikimedia Commons is used under a CC BY-NC 3.0 (https://creativecommons.org/licenses/by-nc/3.0/) license. 

Figure 12.3.5

Muscle_Fibes_(large) by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.6

Muscle_Fibers_(small) by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.7

Smooth_Muscle_Contraction by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.8

Blausen_0747_Pregnancy by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.9

Size_of_Uterus_Throughout_Pregnancy-02 by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.10

1024px-Blausen_0470_HeartWall by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.11

Tipet_e_kardiomiopative by Npatchett at English Wikipedia on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) license. (Work derived from Blausen 0165 Cardiomyopathy Dilated by BruceBlaus)

References

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 4.18 Muscle tissue [digital image].  In Anatomy and Physiology (Section 4.4). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/4-4-muscle-tissue-and-motion

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 28.18 Size of uterus throughout pregnancy [digital image].  In Anatomy and Physiology (Section 28.4). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/28-4-maternal-changes-during-pregnancy-labor-and-birth

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 10.3 The three connective tissue layers [digital image].  In Anatomy and Physiology (Section 10.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-2-skeletal-muscle

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 10.4 Muscle fiber [digital image].  In Anatomy and Physiology (Section 10.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-2-skeletal-muscle

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 10.24 Muscle contraction [digital image].  In Anatomy and Physiology (Section 10.8). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-8-smooth-muscle

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 11.5 Overview of the muscular system [digital image].  In Anatomy and Physiology (Section 11.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/11-2-naming-skeletal-muscles

Blausen.com staff. (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

Brainard, J/ CK-12 Foundation. (2012). Figure 5 Triceps and biceps muscles in the upper arm are opposing muscles. [digital image]. In CK-12 Biology (Section 21.3) [online Flexbook]. CK12.org. https://www.ck12.org/book/ck-12-biology/section/21.3/ (Last modified August 11, 2017.)

khanacademymedicine. (2012, October 19). Three types of muscle | Circulatory system physiology | NCLEX-RN | Khan Academy. YouTube.

TED-Ed. (2017, February 14).  What happens during a heart attack? - Krishna Sudhir. YouTube. https://www.youtube.com/watch?v=3_PYnWVoUzM&feature=youtu.be

Image shows a diagram highlighting the different sections of the small intestine. The duodenum is the shortest portion and is the part of the small intestine that receives chyme directly from the stomch. Next, chyme would pass through the jejenum and then finally the ileum. The jejenum and ileum are a similar length (2.5-3 meters).

Image shows a diagram of the location of the sinoatrial and atrioventricular nodes. The SA node is located at the top right corner of the right atrium, and the AV node is in left wall of the right atrium, very close to the tricuspid AV valve.

Image shows a photograph of an Amish man. His hairstyle and beard with no mustache is evidence that he is married.

As per caption

What Are You Made of?

Your entire body is made of cells and cells are made of molecules.If you look at your hand, what do you see? Of course, you see skin, which consists of cells. But what are skin cells made of? Like all living cells, they are made of matter. In fact, all things are made of matter. Matter is anything that takes up space and has mass. Matter, in turn, is made up of chemical substances. A chemical substance is matter that has a definite composition that is consistent throughout. A chemical substance may be either an element or a compound.

Elements and Atoms

An element is a pure substance. It cannot be broken down into other types of substances. Each element is made up of just one type of atom.

Structure of an Atom

An atom is the smallest particle of an element that still has the properties of that element. Every substance is composed of atoms. Atoms are extremely small, typically about a ten-billionth of a metre in diametre. However, atoms do not have well-defined boundaries, as suggested by the atomic model shown below.

Protons have a positive electric charge and neutrons have no electric charge. Virtually all of an atom's mass is in the protons and neutrons in the nucleus. Electrons surrounding the nucleus have almost no mass, as well as a negative electric charge. If the number of protons and electrons in an atom are equal, then an atom is electrically neutral, because the positive and negative charges cancel each other out. If an atom has more or fewer electrons than protons, then it has an overall negative or positive charge, respectively, and it is called an ion.

The negatively-charged electrons of an atom are attracted to the positively-charged protons in the nucleus by a force called electromagnetic force, for which opposite charges attract. Electromagnetic force between protons in the nucleus causes these subatomic particles to repel each other, because they have the same charge. However, the protons and neutrons in the nucleus are attracted to each other by a different force, called nuclear force, which is usually stronger than the electromagnetic force. Nuclear force repels the positively-charged protons from each other.

Periodic Table of the Elements

There are almost 120 known elements. As you can see in the Periodic Table of the Elements shown below, the majority of elements are metals. Examples of metals are iron (Fe) and copper (Cu). Metals are shiny and good conductors of electricity and heat. Nonmetal elements are far fewer in number. They include hydrogen (H) and oxygen (O). They lack the properties of metals.

A compound is a unique substance that consists of two or more elements combined in fixed proportions. This means that the composition of a compound is always the same. The smallest particle of most compounds in living things is called a molecule.

Consider water as an example. A molecule of water always contains one atom of oxygen and two atoms of hydrogen. The composition of water is expressed by the chemical formula H₂O. A model of a water molecule is shown in Figure 3.2.4.

What causes the atoms of a water molecule to “stick” together? The answer is chemical bonds. A chemical bond is a force that holds together the atoms of molecules. Bonds in molecules involve the sharing of electrons among atoms. New chemical bonds form when substances react with one another. A chemical reaction is a process that changes some chemical substances into others. A chemical reaction is needed to form a compound, and another chemical reaction is needed to separate the substances in that compound.

 

Attributions

Figure 3.2.1

Man Sitting, by Gregory Culmer, on Unsplash, is used under the Unsplash license (https://unsplash.com/license).

Figure 3.2.2

Lithium Atom diagram, by AG Caesar, is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en)

Figure 3.2.3

Periodic Table Armtuk3, by Armtuk, is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/) license.

Figure 3.2.4

Water molecule, by Sakurambo, is released into the public domain (https://en.wikipedia.org/wiki/Public_domain).

References

TED-Ed. (2012, April 16). Just how small is an atom. YouTube. https://www.youtube.com/watch?v=yQP4UJhNn0I&feature=youtu.be

 

 

 

Angela and Saloni are college students who met in physics class. They decide to study together for their upcoming midterm, but first, they want to grab some lunch. Angela says there is a particular restaurant she would like to go to, because they are able to accommodate her dietary restrictions. Saloni agrees and they head to the restaurant.

At lunch, Saloni asks Angela what is special about her diet. Angela tells her that she can’t eat gluten. Saloni says, “My cousin did that for a while because she heard that gluten is bad for you. But it was too hard for her to not eat bread and pasta, so she gave it up.” Angela tells Saloni that avoiding gluten isn’t optional for her — she has celiac disease. Eating even very small amounts of gluten could damage her digestive system.  It can be difficult for people living with celiac disease to find foods when eating out.

You have probably heard of gluten, but what is it, and why is it harmful to people with celiac disease? Gluten is a protein present in wheat and some other grains (such as barley, rye, and oats), so it is commonly found in foods like bread, pasta, baked goods, and many packaged foods, like the ones pictured in Figure 15.1.2.

Figure 15.1.2 Gluten is a protein present in foods like bread, pasta, and baked goods.

For people with celiac disease, eating gluten causes an autoimmune reaction that results in damage to the small, finger-like villi lining the small intestine, causing them to become inflamed and flattened (see Figure 15.1.3). This damage interferes with the digestive process, which can result in a wide variety of symptoms including diarrhea, anemia, skin rash, bone pain, depression, and anxiety, among others. The degree of damage to the villi can vary from mild to severe, with more severe damage generally resulting in more significant symptoms and complications. Celiac disease can have serious long-term consequences, such as osteoporosis, problems in the nervous and reproductive systems, and the development of certain types of cancers.

 

Why does celiac disease cause so many different types of symptoms and have such significant negative health consequences? As you read this chapter and learn about how the digestive system works, you will see just how important the villi of the small intestine are to the body as a whole. At the end of the chapter, you will learn more about celiac disease, why it can be so serious, and whether it is worth avoiding gluten for people who do not have a diagnosed medical issue with it.

Attributions

Figure 15.1.1

Bread [photo] by Sergio Arze on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 15.1.2

• Paste cu sos de roșii by Sestrjevitovschii Ina on Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Cookies and More by Sarah Shaffer on Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Raspberry waffles by Izabelle Acheson on Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Homemade croissant & pain au chocolat by Cristiano Pinto on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 15.1.3

Inflammed_mucous_layer_of_the_intestinal_villi_depicting_Celiac_disease by www.scientificanimations.com (image 140/191) on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0) license.

 

Image shows systole and diastole of the heart. In diastole, the ventricles of the heart are relaxed and are able to receive blood from the atria. In systole, both ventricles contract, squeezing the blood out and into the pulmonary trunk and aorta.

As described in the caption.

Image shows a diagram of the vessels going into and out of the liver. The hepatic artery bring blood from the heart to the liver and the hepatic vein returns this blood to the heart. The portal vein brings blood from the lower GI tract to the liver.

As per caption

The space occurring between two or more membranes. In cell biology, it's most commonly described as the region between the inner membrane and the outer membrane of a mitochondrion or a chloroplast.

 

Did you ever hear of a person looking at something or someone with a “jaundiced eye”? It means to take a negative view, such as envy, maliciousness, or ill will. The expression may be based on the antiquated idea that liver bile is associated with such negative emotions as these, as well as the fact that excessive liver bile causes jaundice, or yellowing of the eyes and skin. Jaundice is likely a sign of a liver disorder or blockage of the duct that carries bile away from the liver. Bile contains waste products, making the liver an organ of excretion. Bile has an important role in digestion, which makes the liver an accessory organ of digestion, too.

Accessory organs of digestion are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. Besides the liver, the major accessory organs of digestion are the gallbladder and pancreas. These organs secrete or store substances that are needed for digestion in the first part of the small intestine — the duodenum — where most chemical digestion takes place. You can see the three organs and their locations in Figure 15.6.2.

Liver

The liver is a vital organ located in the upper right part of the abdomen. It lies just below the diaphragm, to the right of the stomach. The liver plays an important role in digestion by secreting bile, but the liver has a wide range of additional functions unrelated to digestion. In fact, some estimates put the number of functions of the liver at about 500! A few of them are described below.

Structure of the Liver

The liver is a reddish brown, wedge-shaped structure. In adults, the liver normally weighs about 1.5 kg (about 3.3 lb). It is both the heaviest internal organ and the largest gland in the human body. The liver is divided into four lobes of unequal size and shape. Each lobe, in turn, is made up of lobules, which are the functional units of the liver. Each lobule consists of millions of liver cells, called hepatic cells (or hepatocytes). They are the basic metabolic cells that carry out the various functions of the liver.

As shown in Figure 15.6.3, the liver is connected to two large blood vessels: the hepatic artery and the portal vein. The hepatic artery carries oxygen-rich blood from the aorta, whereas the portal vein carries blood that is rich in digested nutrients from the GI tract and wastes filtered from the blood by the spleen. The blood vessels subdivide into smaller arteries and capillaries, which lead into the liver lobules. The nutrients from the GI tract are used to build many vital biochemical compounds, and the wastes from the spleen are degraded and excreted.

Functions of the Liver

The main digestive function of the liver is the production of bile. Bile is a yellowish alkaline liquid that consists of water, electrolytes, bile salts, and cholesterol, among other substances, many of which are waste products. Some of the components of bile are synthesized by hepatocytes. The rest are extracted from the blood.

As shown in Figure 15.6.4, bile is secreted into small ducts that join together to form larger ducts, with just one large duct carrying bile out of the liver. If bile is needed to digest a meal, it goes directly to the duodenum through the common bile duct. In the duodenum, the bile neutralizes acidic chyme from the stomach and emulsifies fat globules into smaller particles (called micelles) that are easier to digest chemically by the enzyme lipase. Bile also aids with the absorption of vitamin K. Bile that is secreted when digestion is not taking place goes to the gallbladder for storage until the next meal. In either case, the bile enters the duodenum through the common bile duct.

Besides its roles in digestion, the liver has many other vital functions:

• The liver synthesizes glycogen from glucose and stores the glycogen as required to help regulate blood sugar levels. It also breaks down the stored glycogen to glucose and releases it back into the blood as needed.
• The liver stores many substances in addition to glycogen, including vitamins A, D, B12, and K. It also stores the minerals iron and copper.
• The liver synthesizes numerous proteins and many of the amino acids needed to make them. These proteins have a wide range of functions. They include fibrinogen, which is needed for blood clotting; insulin-like growth factor (IGF-1), which is important for childhood growth; and albumen, which is the most abundant protein in blood serum and functions to transport fatty acids and steroid hormones in the blood.
• The liver synthesizes many important lipids, including cholesterol, triglycerides, and lipoproteins.
• The liver is responsible for the breakdown of many waste products and toxic substances. The wastes are excreted in bile or travel to the kidneys, which excrete them in urine.

The liver is clearly a vital organ that supports almost every other organ in the body. Because of its strategic location and diversity of functions, the liver is also prone to many diseases, some of which cause loss of liver function. There is currently no way to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. An artificial liver has not yet been developed, so liver transplantation may be the only option for people with liver failure.

The gallbladder is a small, hollow, pouch-like organ that lies just under the right side of the liver (see Figure 15.6.5). It is about 8 cm (about 3 in) long and shaped like a tapered sac, with the open end continuous with the cystic duct. The gallbladder stores and concentrates bile from the liver until it is needed in the duodenum to help digest lipids. After the bile leaves the liver, it reaches the gallbladder through the cystic duct. At any given time, the gallbladder may store between 30 to 60 mL (1 to 2 oz) of bile. A hormone stimulated by the presence of fat in the duodenum signals the gallbladder to contract and force its contents back through the cystic duct and into the common bile duct to drain into the duodenum.

Pancreas

The pancreas is a glandular organ that is part of both the digestive system and the endocrine system. As shown in Figure 15.6.6, it is located in the abdomen behind the stomach, with the head of the pancreas surrounded by the duodenum of the small intestine. The pancreas is about 15 cm (almost 6 in) long, and it has two major ducts: the main pancreatic duct and the accessory pancreatic duct. Both of these ducts drain into the duodenum.

As an endocrine gland, the pancreas secretes several hormones, including insulin and glucagon, which circulate in the blood. The endocrine hormones are secreted by clusters of cells called pancreatic islets (or islets of Langerhans). As a digestive organ, the pancreas secretes many digestive enzymes and also bicarbonate, which helps neutralize acidic chyme after it enters the duodenum. The pancreas is stimulated to secrete its digestive substances when food in the stomach and duodenum triggers the release of endocrine hormones into the blood that reach the pancreas via the bloodstream. The pancreatic digestive enzymes are secreted by clusters of cells called acini, and they travel through the pancreatic ducts to the duodenum. In the duodenum, they help to chemically break down carbohydrates, proteins, lipids, and nucleic acids in chyme. The pancreatic digestive enzymes include:

• Amylase, which helps digest starch and other carbohydrates.
• Trypsin and chymotrypsin, which help digest proteins.
• Lipase, which helps digest lipids.
• Deoxyribonucleases and ribonucleases, which help digest nucleic acids.

 

Attributions

Figure 15.6.1

Scleral_Icterus by Sheila J. Toro on Wikimedia Commons is used under a  CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 15.6.2

Blausen_0428_Gallbladder-Liver-Pancreas_Location by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 15.6.3

Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg by Cancer Research UK on Wikimedia Commons is used under a CC BY-SA 4.0  (https://creativecommons.org/licenses/by-sa/4.0) license.

Figure 15.6.4

Gallbladder by NIH Image Gallery on Flickr is used CC BY-NC 2.0 (https://creativecommons.org/licenses/by-nc/2.0/) license.

Figure 15.6.5

Gallbladder_(organ) (1) by BruceBlaus on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0) license. (See a full animation of this medical topic at blausen.com.)

Figure 15.6.6

Blausen_0698_PancreasAnatomy by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

References

Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

nature video. (2018, December 19). Scar wars: Repairing the liver. YouTube. https://www.youtube.com/watch?v=a0d1yvGcfzQ&feature=youtu.be

TED-Ed. (2014, November 25). What does the liver do? - Emma Bryce. YouTube. https://www.youtube.com/watch?v=wbh3SjzydnQ&feature=youtu.be

TED-Ed. (2015, February 19). What does the pancreas do? - Emma Bryce. YouTube. https://www.youtube.com/watch?v=8dgoeYPoE-0&feature=youtu.be

Created by CK-12 Foundation/Adapted by Christine Miller

Did you ever hear of a person looking at something or someone with a “jaundiced eye”? It means to take a negative view, such as envy, maliciousness, or ill will. The expression may be based on the antiquated idea that liver bile is associated with such negative emotions as these, as well as the fact that excessive liver bile causes jaundice, or yellowing of the eyes and skin. Jaundice is likely a sign of a liver disorder or blockage of the duct that carries bile away from the liver. Bile contains waste products, making the liver an organ of excretion. Bile has an important role in digestion, which makes the liver an accessory organ of digestion, too.

Accessory organs of digestion are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. Besides the liver, the major accessory organs of digestion are the gallbladder and pancreas. These organs secrete or store substances that are needed for digestion in the first part of the small intestine — the duodenum — where most chemical digestion takes place. You can see the three organs and their locations in Figure 15.6.2.

Liver

The liver is a vital organ located in the upper right part of the abdomen. It lies just below the diaphragm, to the right of the stomach. The liver plays an important role in digestion by secreting bile, but the liver has a wide range of additional functions unrelated to digestion. In fact, some estimates put the number of functions of the liver at about 500! A few of them are described below.

Structure of the Liver

The liver is a reddish brown, wedge-shaped structure. In adults, the liver normally weighs about 1.5 kg (about 3.3 lb). It is both the heaviest internal organ and the largest gland in the human body. The liver is divided into four lobes of unequal size and shape. Each lobe, in turn, is made up of lobules, which are the functional units of the liver. Each lobule consists of millions of liver cells, called hepatic cells (or hepatocytes). They are the basic metabolic cells that carry out the various functions of the liver.

As shown in Figure 15.6.3, the liver is connected to two large blood vessels: the hepatic artery and the portal vein. The hepatic artery carries oxygen-rich blood from the aorta, whereas the portal vein carries blood that is rich in digested nutrients from the GI tract and wastes filtered from the blood by the spleen. The blood vessels subdivide into smaller arteries and capillaries, which lead into the liver lobules. The nutrients from the GI tract are used to build many vital biochemical compounds, and the wastes from the spleen are degraded and excreted.

Functions of the Liver

The main digestive function of the liver is the production of bile. Bile is a yellowish alkaline liquid that consists of water, electrolytes, bile salts, and cholesterol, among other substances, many of which are waste products. Some of the components of bile are synthesized by hepatocytes. The rest are extracted from the blood.

As shown in Figure 15.6.4, bile is secreted into small ducts that join together to form larger ducts, with just one large duct carrying bile out of the liver. If bile is needed to digest a meal, it goes directly to the duodenum through the common bile duct. In the duodenum, the bile neutralizes acidic chyme from the stomach and emulsifies fat globules into smaller particles (called micelles) that are easier to digest chemically by the enzyme lipase. Bile also aids with the absorption of vitamin K. Bile that is secreted when digestion is not taking place goes to the gallbladder for storage until the next meal. In either case, the bile enters the duodenum through the common bile duct.

Besides its roles in digestion, the liver has many other vital functions:

• The liver synthesizes glycogen from glucose and stores the glycogen as required to help regulate blood sugar levels. It also breaks down the stored glycogen to glucose and releases it back into the blood as needed.
• The liver stores many substances in addition to glycogen, including vitamins A, D, B12, and K. It also stores the minerals iron and copper.
• The liver synthesizes numerous proteins and many of the amino acids needed to make them. These proteins have a wide range of functions. They include fibrinogen, which is needed for blood clotting; insulin-like growth factor (IGF-1), which is important for childhood growth; and albumen, which is the most abundant protein in blood serum and functions to transport fatty acids and steroid hormones in the blood.
• The liver synthesizes many important lipids, including cholesterol, triglycerides, and lipoproteins.
• The liver is responsible for the breakdown of many waste products and toxic substances. The wastes are excreted in bile or travel to the kidneys, which excrete them in urine.

The liver is clearly a vital organ that supports almost every other organ in the body. Because of its strategic location and diversity of functions, the liver is also prone to many diseases, some of which cause loss of liver function. There is currently no way to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. An artificial liver has not yet been developed, so liver transplantation may be the only option for people with liver failure.

The gallbladder is a small, hollow, pouch-like organ that lies just under the right side of the liver (see Figure 15.6.5). It is about 8 cm (about 3 in) long and shaped like a tapered sac, with the open end continuous with the cystic duct. The gallbladder stores and concentrates bile from the liver until it is needed in the duodenum to help digest lipids. After the bile leaves the liver, it reaches the gallbladder through the cystic duct. At any given time, the gallbladder may store between 30 to 60 mL (1 to 2 oz) of bile. A hormone stimulated by the presence of fat in the duodenum signals the gallbladder to contract and force its contents back through the cystic duct and into the common bile duct to drain into the duodenum.

Pancreas

The pancreas is a glandular organ that is part of both the digestive system and the endocrine system. As shown in Figure 15.6.6, it is located in the abdomen behind the stomach, with the head of the pancreas surrounded by the duodenum of the small intestine. The pancreas is about 15 cm (almost 6 in) long, and it has two major ducts: the main pancreatic duct and the accessory pancreatic duct. Both of these ducts drain into the duodenum.

As an endocrine gland, the pancreas secretes several hormones, including insulin and glucagon, which circulate in the blood. The endocrine hormones are secreted by clusters of cells called pancreatic islets (or islets of Langerhans). As a digestive organ, the pancreas secretes many digestive enzymes and also bicarbonate, which helps neutralize acidic chyme after it enters the duodenum. The pancreas is stimulated to secrete its digestive substances when food in the stomach and duodenum triggers the release of endocrine hormones into the blood that reach the pancreas via the bloodstream. The pancreatic digestive enzymes are secreted by clusters of cells called acini, and they travel through the pancreatic ducts to the duodenum. In the duodenum, they help to chemically break down carbohydrates, proteins, lipids, and nucleic acids in chyme. The pancreatic digestive enzymes include:

• Amylase, which helps digest starch and other carbohydrates.
• Trypsin and chymotrypsin, which help digest proteins.
• Lipase, which helps digest lipids.
• Deoxyribonucleases and ribonucleases, which help digest nucleic acids.

 

Attributions

Figure 15.6.1

Scleral_Icterus by Sheila J. Toro on Wikimedia Commons is used under a  CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 15.6.2

Blausen_0428_Gallbladder-Liver-Pancreas_Location by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 15.6.3

Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg by Cancer Research UK on Wikimedia Commons is used under a CC BY-SA 4.0  (https://creativecommons.org/licenses/by-sa/4.0) license.

Figure 15.6.4

Gallbladder by NIH Image Gallery on Flickr is used CC BY-NC 2.0 (https://creativecommons.org/licenses/by-nc/2.0/) license.

Figure 15.6.5

Gallbladder_(organ) (1) by BruceBlaus on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0) license. (See a full animation of this medical topic at blausen.com.)

Figure 15.6.6

Blausen_0698_PancreasAnatomy by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

References

Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

nature video. (2018, December 19). Scar wars: Repairing the liver. YouTube. https://www.youtube.com/watch?v=a0d1yvGcfzQ&feature=youtu.be

TED-Ed. (2014, November 25). What does the liver do? - Emma Bryce. YouTube. https://www.youtube.com/watch?v=wbh3SjzydnQ&feature=youtu.be

TED-Ed. (2015, February 19). What does the pancreas do? - Emma Bryce. YouTube. https://www.youtube.com/watch?v=8dgoeYPoE-0&feature=youtu.be

Image shows a person's elbows with a rash that has caused redness and scabbing.

Image shows a diagram of the large intestine. There are multiple abnormal little pouches on the exterior of the colon.

We stay alive because millions of different chemical reactions are taking place inside our bodies all the time. Each of our cells is like the busy auto assembly line pictured in Figure 3.10.1. Raw materials, half-finished products, and waste materials are constantly being used, produced, transported, and excreted. The "workers" on the cellular assembly line are mainly enzymes. These are the proteins that make biochemical reactions happen.

Chemical reactions that take place inside living things are called biochemical reactions. The sum of all the biochemical reactions in an organism is called metabolism. Metabolism includes both exothermic (energy-releasing) chemical reactions and endothermic (energy-absorbing) chemical reactions.

Catabolic Reactions

Exothermic reactions in organisms are called catabolic reactions. These reactions break down molecules into smaller units and release energy. An example of a catabolic reaction is the breakdown of glucose during cellular respiration, which releases energy that cells need to carry out life processes.

Anabolic Reactions

Endothermic reactions in organisms are called anabolic reactions. These reactions build up bigger molecules from smaller ones and absorb energy. An example of an anabolic reaction is the joining of amino acids to form a protein. Which type of reactions — catabolic or anabolic — do you think occur when your body digests food?

Most of the biochemical reactions that happen inside of living organisms require help. Why is this the case? For one thing, temperatures inside living things are usually too low for biochemical reactions to occur quickly enough to maintain life. The concentrations of reactants may also be too low for them to come together and react. Where do the biochemical reactions get the help they need to proceed? From the enzymes.

An enzyme is a protein that speeds up a biochemical reaction. It is a biological catalyst. An enzyme generally works by reducing the amount of activation energy needed to start the reaction. The graph in Figure 3.10.2 shows the activation energy needed for glucose to combine with oxygen. Less activation energy is needed when the correct enzyme is present than when it is not present.

How Well Enzymes Work

Enzymes are involved in most biochemical reactions, and they do their jobs extremely well. A typical biochemical reaction that would take several days or even several centuries to happen without an enzyme is likely to occur in just a split second with the proper enzyme! Without enzymes to speed up biochemical reactions, most organisms could not survive.

Enzymes are substrate-specific. The substrate of an enzyme is the specific substance it affects. Each enzyme works only with a particular substrate, which explains why there are so many different enzymes. In addition, for an enzyme to work, it requires specific conditions, such as the right temperature and pH. Some enzymes work best under acidic conditions, for example, while others work best in neutral environments.

Enzyme-Deficiency Disorders

There are hundreds of known inherited metabolic disorders in humans. In most of them, a single enzyme is either not produced by the body at all, or is otherwise produced in a form that doesn't work. The missing or defective enzyme is like an absentee worker on the cell's assembly line. Imagine the auto assembly line from the image at the start of this section.  What if the worker who installed the steering wheel was absent?  How would this impact the overall functioning of the vehicle?  When an enzyme is missing, toxic chemicals build up, or an essential product isn't made. Generally, the normal enzyme is missing because the individual with the disorder inherited two copies of a gene mutation, which may have originated many generations previously.

Any given inherited metabolic disorder is generally quite rare in the general population. However, there are so many different metabolic disorders that a total of one in 1,000 to 2,500 newborns can be expected to have one.

Figure 3.10.1

Auto Assembly line by Brian Snelson on Wikimedia Commons is used under a CC BY 2.0 (https://creativecommons.org/licenses/by/2.0) license.

Figure 3.10.2

Enzyme_activation_energy by G. Andruk [IMeowbot at the English language Wikipedia], is used under a CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0/) license.

References

Amoeba Sisters. (2016, August 28). Enzymes (updated). YouTube. https://www.youtube.com/watch?v=qgVFkRn8f10&feature=youtu.be

TED-Ed. (2015, January 15). What triggers a chemical reaction? - Kareem Jarrah. YouTube. https://www.youtube.com/watch?v=8m6RtOpqvtU&feature=youtu.be

A type of disease in which cells of the central nervous system stop working or die. Neurodegenerative disorders usually get worse over time and have no cure. They may be genetic or be caused by a tumor or stroke.

Groups of connected cells form tissues. The cells in a tissue may all be the same type, or they may be of multiple types. In either case, the cells in the tissue work together to carry out a specific function, and they are always specialized to be able to carry out that function better than any other type of tissue.  There are four main types of human tissues: connective, epithelial, muscle, and nervous tissues. We use tissues to build organs and organ systems.  The 200 types of cells that the body can produce based on our single set of DNA can create all the types of tissue in the body.

Epithelial Tissue

Epithelial tissue is made up of cells that line inner and outer body surfaces, such as the skin and the inner surface of the digestive tract. Epithelial tissue that lines inner body surfaces and body openings is called mucous membrane. This type of epithelial tissue produces mucus, a slimy substance that coats mucous membranes and traps pathogens, particles, and debris. Epithelial tissue protects the body and its internal organs, secretes substances (such as hormones) in addition to mucus, and absorbs substances (such as nutrients).

The key identifying feature of epithelial tissue is that it contains a free surface and a basement membrane.  The free surface is not attached to any other cells and is either open to the outside of the body, or is open to the inside of a hollow organ or body tube.  The basement membrane anchors the epithelial tissue to underlying cells.

Epithelial tissue is identified and named by shape and layering.  Epithelial cells exist in three main shapes: squamous, cuboidal, and columnar.  These specifically shaped cells can, depending on function, be layered several different ways: simple, stratified, pseudostratified, and transitional.

Epithelial tissue forms coverings and linings and is responsible for a range of functions including diffusion, absorption, secretion and protection.  The shape of an epithelial cell can maximize its ability to perform a certain function.  The thinner an epithelial cell is, the easier it is for substances to move through it to carry out diffusion and/or absorption.  The larger an epithelial cell is, the more room it has in its cytoplasm to be able to make products for secretion, and the more protection it can provide for underlying tissues. Their are three main shapes of epithelial cells: squamous (which is shaped like a pancake- flat and oval), cuboidal (cube shaped), and columnar (tall and rectangular).

Figure 7.4.2 The shape of epithelial tissues is important.  

Epithelial tissue will also organize into different layerings depending on their function.  For example, multiple layers of cells provide excellent protection, but would no longer be efficient for diffusion, whereas a single layer would work very well for diffusion, but no longer be as protective; a special type of layering called transitional is needed for organs that stretch, like your bladder.  Your tissues exhibit the layering that makes them most efficient for the function they are supposed to perform. There are four main layerings found in epithelial tissue: simple (one layer of cells), stratified (many layers of cells), pseudostratified (appears stratified, but upon closer inspection is actually simple), and transitional (can stretch, going from many layers to fewer layers).

Figure 7.4.3 The layerings found in epithelial tissues is important.  

See Table 7.4.1 for a summary of the different layering types and shapes epithelial cells can form and their related functions and locations.

Table 7.4.1

Summary of Epithelial Tissue Cells

So far, we have identified epithelial tissue based on shape and layering.  The representative diagrams we have seen so far are helpful for visualizing the tissue structures, but it is important to look at real examples of these cells.  Since cells are too tiny to see with the naked eye, we rely on microscopes to help us study them.  Histology is the study of the microscopic anatomy and cells and tissues.  See Table 7.4.2 to see some examples of slides of epithelial tissues prepared for the purpose of histology.

Table 7.4.2

Epithelial Tissues and Histological Samples

 

Epithelial Tissue Type	Tissue Diagram	Histological Sample
Stratified squamous (from skin)
Simple cuboidal (from kidney tubules)
Pseudostratified ciliated columnar (from trachea)

Connective Tissue

Bone and blood are examples of connective tissue. Connective tissue is very diverse. In general, it forms a framework and support structure for body tissues and organs. It's made up of living cells separated by non-living material, called extracellular matrix, which can be solid or liquid. The extracellular matrix of bone, for example, is a rigid mineral framework. The extracellular matrix of blood is liquid plasma.

The key identifying feature of connective tissue is that is is composed of a scattering of cells in a non-cellular matrix. There are three main categories of connective tissue, based on the nature of the matrix. They  look very different from one another, which is a reflection of their different functions:

1. Fibrous connective tissue: is characterized by a matrix which is flexible and is made of protein fibres including collagen, elastin and possibly reticular fibres.  These tissues are found making up tendons, ligaments, and body membranes.
2. Supportive connective tissue: is characterized by a solid matrix and is what is used to make bone and cartilage.  These tissues are used for support and protection.
3. Fluid connective tissue: is characterized by a fluid matrix and includes both blood and lymph.

Fibrous Connective Tissue

Fibrous connective tissue contains cells called fibroblasts.  These cells produce fibres of collagen, elastin, or reticular fibre which makes up the matrix of this type of connective tissue.  Based on how tightly packed these fibres are and how they are oriented changes the properties, and therefore the function of the fibrous connective tissue.

 

• Loose fibrous connective tissue:  composed of a loose and disorganized weave of collagen and elastin fibres, creating a tissue that is thin and flexible, yet still tough.  This tissue, which is also sometimes referred to as "areolar tissue", is found in membranes and surrounding blood vessels and most body organs.  As you can see from the diagram in Figure 7.4.4, loose fibrous connective tissue fulfills the definition of connectives tissue since it is a scattering of cells (fibroblasts) in a non-cellular matrix (a mesh of collagen and elastin fibres).  There are two types of specialized loose fibrous connective tissue: reticular and adipose.  Adipose tissue stores fat and reticular tissue forms the spleen and lymph nodes.
  
• Dense Fibrous Connective Tissue: composed of a dense mat of parallel collagen fibres and a scattering of fibroblasts, creating a tissue that is very strong.  Dense fibrous connective tissue forms tendons and ligaments, which connect bones to muscles and/or bones to neighbouring bones.
  

Supportive Connective Tissue

Supportive connective tissue exhibits the defining feature of connective tissue in that it is a scattering of cells in a non-cellular matrix; what sets it apart from other connective tissues is its solid matrix.  In this tissue group, the matrix is solid- either bone or cartilage.  While fibrous connective tissue contained cells called fibroblasts which produced fibres, supportive connective tissue contains cells that either create bone (osteocytes) or cells that create cartilage (chondrocytes).

Cartilage

Chondrocytes produce the cartilage matrix in which they reside.  Cartilage is made up of protein fibres and chondrocytes in lacunae.  This is tissue is strong yet flexible and is used many places in the body for protection and support.  Cartilage is one of the few tissues that is not vascular (doesn't have a direct blood supply) meaning it relies on diffusion to obtain nutrients and gases; this is the cause of slow healing rates in injuries involving cartilage.  There are three main types of cartilage:

• Hyaline cartilage: a smooth, strong and flexible tissue.  Found at the ends of ribs and long bones, in the nose, and comprising the entire fetal skeleton.
• Fibrocartilage: a very strong tissue containing thick bundles of collagen.  Found in joints that need cushioning from high impact (knees, jaw).
• Elastic cartilage: contains elastic fibres in addition to collagen,  giving support with the benefit of elasticity.  Found in earlobes and the epiglottis.
  

  

Bone

Osteocytes produce the bone matrix in which they reside.  Since bone is very solid, these cells reside in small spaces called lacunae.  This bone tissue is composed of collagen fibres embedded in calcium phosphate giving it strength without brittleness.  There are two types of bone: compact and spongy.

• Compact bone: has a dense matrix organized into cylindrical units called osteons.  Each osteon contains a central canal (sometimes called a Harversian Canal) which allows for space for blood vessels and nerves, as well as concentric rings of bone matrix and osteocytes in lacunae, as per the diagram here.  Compact bone is found in long bones and forms a shell around spongy bone.

• Spongy bone: a very porous type of bone which most often contains bone marrow.  It is found at the end of long bones, and makes up the majority of the ribs, shoulder blades and flat bones of the cranium.

Fluid Connective Tissue

Fluid connective tissue has a matrix that is fluid; unlike the other two categories of connective tissue, the cells that reside in the matrix do not actually produce the matrix. Fibroblasts make the fibrous matrix, chondrocytes make the cartilaginous matrix, osteocytes make the bony matrix, yet blood cells do not make the fluid matrix of either lymph or plasma.  This tissue still fits the definition of connective tissue in that it is still a scattering of cells in a non-cellular matrix.

There are two types of fluid connective tissue:

• Blood: blood contains three types of cells suspended in plasma, and is contained in the cardiovascular system.
  • Eryththrocytes, more commonly called red blood cells, are present in high numbers (roughly 5 million cells per mL) and are responsible for delivering oxygen from to the lungs to all the other areas of the body. These cells are relatively small in size with a diameter of around 7 micrometres and live no longer than 120 days.
  • Leukocytes, often referred to as white blood cells, are present in lower numbers (approximately 5 thousand cells per mL) are responsible for various immune functions.  They are typically larger than erythrocytes, but can live much longer, particularly white blood cells responsible for long term immunity.  The number of leukocytes in your blood can go up or down based on whether or not you are fighting an infection.
  • Thrombocytes, also known as platelets, are very small cells responsible for blood clotting.  Thrombocytes are not actually true cells, they are fragments of a much larger cell called a megakaryocyte.
• Lymph: contains a liquid matrix and white blood cells and is contained in the lymphatic system, which ultimately drains into the cardiovascular system.

Figure 7.4.11 A stained lymphocyte surrounded by red blood cells viewed using a light microscope. 

Muscular Tissue

Muscular tissue is made up of cells  that have the unique ability to contract- which is the defining feature of muscular tissue.  There are three major types of muscle tissue, as pictured in Figure 7.4.12 skeletal, smooth, and cardiac muscle tissues.

Skeletal Muscle

Skeletal muscles are voluntary muscles, meaning that you exercise conscious control over them.  Skeletal muscles are attached to bones by tendons, a type of connective tissue. When these muscles shorten to pull on the bones to which they are attached, they enable the body to move. When you are exercising, reading a book, or making dinner, you are using skeletal muscles to move your body to carry out these tasks.

Under the microscope, skeletal muscles are striated (or striped) in appearance, because of their internal structure which contains alternating protein fibres of actin and myosin.  Skeletal muscle is described as multinucleated, meaning one "cell" has many nuclei.  This is because in utero, individual cells destined to become skeletal muscle fused, forming muscle fibres in a process known as myogenesis.  You will learn more about skeletal muscle and how it contracts in the Muscular System.

Smooth Muscle

Smooth muscles are nonstriated muscles- they still contain the muscle fibres actin and myosin, but not in the same alternating arrangement seen in skeletal muscle.   Smooth muscle is found in the tubes of the body - in the walls of blood vessels and in the reproductive, gastrointestinal, and respiratory tracts. Smooth muscles are not under voluntary control meaning that they operate unconsciously, via the autonomic nervous system.  Smooth muscles move substances through a wave of contraction which cascades down the length of a tube, a process termed peristalsis. 

Watch the YouTube video "What is Peristalsis" by Mister Science to see peristalsis in action.

https://www.youtube.com/watch?v=kVjeNZA5pi4

What is Peristalsis, Mister Science, 2018.

 

 

Cardiac Muscle

Cardiac muscles work involuntarily, meaning they are regulated by the autonomic nervous system.  This is probably a good thing, since you wouldn't want to have to consciously concentrate on keeping your heart beating all the time! Cardiac muscle, which is found only in the heart, is mononucleated and striated (due to alternating bands of myosin and actin). Their contractions cause the heart to pump blood. In order to make sure entire sections of the heart contract in unison, cardiac muscle tissue contains special cell junctions called intercalated discs, which conduct the electrical signals used to "tell" the chambers of the heart when to contract.

Nervous Tissue

Nervous tissue is made up of neurons and a group of cells called neuroglia (also known as glial cells).  Nervous tissue makes up the central nervous system (mainly the brain and spinal cord) and peripheral nervous system (the network of nerves that runs throughout the rest of the body).  The defining feature of nervous tissue is that it is specialized to be able to generate and conduct nerve impulses.  This function is carried out by neurons, and the purpose of neuroglia is to support neurons.

A neuron has several parts to its structure:

• Dendrites which collect incoming nerve impulses
• A cell body, or soma, which contains the majority of the neuron's organelles, including the nucleus
• An axon, which carries nerve impulses away from the soma, to the next neuron in the chain
• A myelin sheath, which encases the axon and increases that rate at which nerve impulses can be conducted
• Axon terminals, which maintain physical contact with the dendrites of neighbouring neurons

 

Attributions

Figure 7.4.1

• Construction man kneeling in front of wall by Charles Deluvio on Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Beige wooden frame by Charles Deluvio on Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Tambour on green by Pierre Châtel-Innocention Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Tags: Construction Studs Plumbing Wiring by JWahl on Pixabay is used under the Pixabay License (https://pixabay.com/es/service/license/).

Figure 7.4.2 and Figure 7.4.3

• Simple columnar epithelium tissue by Kamil Danak on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license. 
• Simple cuboidal epithelium by Kamil Danak on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.
• Simple squamous epithelium by Kamil Danak on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license. 

Figure 7.4.4

Loose fibrous connective tissue by CNX OpenStax. Biology. on Wikimedial Commons is used under a CC BY 4.0. (https://creativecommons.org/licenses/by/4.0) license.

Figure 7.4.5

Connective Tissue: Loose Aerolar by Berkshire Community College Bioscience Image Library on Flickr is used under a CC0 1.0 Universal public domain dedication (https://creativecommons.org/publicdomain/zero/1.0/) license.

Figure 7.4.6

Dense Fibrous Connective Tissue by by CNX OpenStax. Biology. on Wikimedial Commons is used under a CC BY 4.0. (https://creativecommons.org/licenses/by/4.0) license.

Figure 7.4.7

Dense_connective_tissue-400x by J Jana on Wikimedia Commons is used under a  CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en) license.

Figure 7.4.8

Types_of_Cartilage-new by OpenStax College on Wikipedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license. 

Figure 7.4.9

Compact_bone_histology_2014 by Athikhun.suw on Wikimedia Commons is used under a  CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en) license.

Figure 7.4.10

Bone_normal_and_degraded_micro_structure by Gtirouflet on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.

Figure 7.4.11

Lymphocyte2 by NicolasGrandjean on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.  [No machine-readable author provided. NicolasGrandjean is assumed, based on copyright claims.]

Figure 7.4.12

Skeletal_muscle_横纹肌1 by 乌拉跨氪 on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en) license.

Figure 7.4.13

Smooth_Muscle_new by OpenStax on Wikimedia Commons is used under a CC BY 4.0  (https://creativecommons.org/licenses/by/4.0/deed.en) license.

Figure 7.4.14

Peristalsis by OpenStax on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0/deed.en) license.

Figure 7.4.15

400x Cardiac Muscle by Jessy731 on Flickr is used and adapted by Christine Miller under a CC BY-NC 2.0 (https://creativecommons.org/licenses/by-nc/2.0/) license.

Figure 7.4.16

Neuron.svg by User:Dhp1080 on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.

Figure 7.4.17

400x Nervous Tissue  by Jessy731 on Flickr is used under a CC BY-NC 2.0 (https://creativecommons.org/licenses/by-nc/2.0/) license.

Table 7.4.1

Summary of Epithelial Tissue Cells, by OpenStax College on Wikipedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license. 

Table 7.4.2

• Epithelial_Tissues_Stratified_Squamous_Epithelium_(40230842160) by
  Berkshire Community College Bioscience Image Library on Wikimedia Commons is used under a  CC0 1.0 Universal Public Domain Dedication (https://creativecommons.org/publicdomain/zero/1.0/) license.
• Simple cuboidal epithelial tissue histology by Berkshire Community College on Flickr is used under a  CC0 1.0 Universal Public Domain Dedication (https://creativecommons.org/publicdomain/zero/1.0/) license.
• Pseudostratified_Epithelium by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

References

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 4.8 Summary of epithelial tissue cells [digital image].  In Anatomy and Physiology (Section 4.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/4-2-epithelial-tissue

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 4.16 Types of cartilage [digital image].  In Anatomy and Physiology (Section 4.3). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/4-3-connective-tissue-supports-and-protects

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 10.23 Smooth muscle [digital micrograph].  In Anatomy and Physiology (Section 10.8). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-8-smooth-muscle (Micrograph provided by the Regents of University of Michigan Medical School © 2012)

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 22.5 Pseudostratified ciliated columnar epithelium [digital micrograph].  In Anatomy and Physiology (Section 22.1). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/22-1-organs-and-structures-of-the-respiratory-system

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 23.5 Peristalsis [diagram]. In Anatomy and Physiology (Section 23.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/23-2-digestive-system-processes-and-regulation

Mister Science. (2018). What is peristalsis? YouTube. https://www.youtube.com/watch?v=kVjeNZA5pi4

MoomooMath and Science. (2017, May 18). Types of human body tissue. YouTube. https://www.youtube.com/watch?v=O0ZvbPak4ck&feature=youtu.be

Open Stax. (2016, May 27). Figure 6 Loose connective tissue [digital image]. In OpenStax Biology (Section 33.2). OpenStax CNX. https://cnx.org/contents/GFy_h8cu@10.53:-LfhWRES@4/Animal-Primary-Tissues

Open Stax. (2016, May 27). Figure 7 Fibrous connective tissue from the tendon [digital image]. In OpenStax Biology (Section 33.2). OpenStax CNX. https://cnx.org/contents/GFy_h8cu@10.53:-LfhWRES@4/Animal-Primary-Tissues

TED-Ed. (2019, October 17). How to 3D print human tissue - Taneka Jones. YouTube. https://www.youtube.com/watch?v=uHbn7wLN_3k&feature=youtu.be

TED-Ed. (2020, January 27). How bones make blood - Melody Smith. YouTube. https://www.youtube.com/watch?v=1Qfmkd6C8u8&feature=youtu.be

 

 

Image shows a diagram illustrating how peristalsis pushes food through the digestive tract by squeezing just behind the food, pushing it forward.