1. Principles of Anatomy and Physiology
Thirteenth Edition
Gerard J. Tortora • Bryan H. Derrickson
Chapter 24
The Digestive System
Copyright © 2012 by John Wiley & Sons, Inc.

2. Mouth (oral cavity)
contains teeth and tongue
Parotid gland
(salivary gland)
Sublingual gland
(salivary gland)
Submandibular gland
(salivary gland)
Pharynx
Esophagus
Stomach
Liver
Pancreas
Duodenum
Transverse colon
Gallbladder
Descending colon
Jejunum
Sigmoid colon
Ascending colon
Rectum
Ileum
Anal canal
Cecum
Anus
Appendix
(a) Right lateral view of head and neck and anterior view of trunk

3. SUPERIOR
Diaphragm
Falciform ligament
Stomach
Liver
Transverse colon
Gallbladder
Ascending colon
Descending colon
Cecum
Jejunum
Ileum
(b) Anterior view

4. Submucosal plexus (plexus of Meissner)
Mesentery
Duct of gland outside tract (such as pancreas)
Gland in mucosa
Vein
Glands in submucosa
Mucosa-associated lymphatic tissue (MALT)
Lumen
Artery
MUCOSA:
Nerve
Epithelium
Myenteric plexus (plexus of Auerbach)
Lamina propria
Muscularis
mucosae
SUBMUCOSA
MUSCULARIS:
SEROSA:
Circular muscle
Areolar connective tissue
Longitudinal muscle
Epithelium

5. (a) Midsagittal section showing the peritoneal folds
Diaphragm
Liver
LESSER OMENTUM
Pancreas
MESOCOLON
Stomach
Duodenum
MESENTERY
Transverse colon
GREATER OMENTUM
Jejunum
Ileum
PARIETAL PERITONEUM
Sigmoid colon
VISCERAL PERITONEUM
Uterus
PERITONEAL CAVITY
Urinary bladder
Rectum
Pubic symphysis
Midsagittal plane
POSTERIOR
ANTERIOR
(a) Midsagittal section showing the peritoneal folds

6. FALCIFORM LIGAMENT
Liver
Stomach
Transverse colon
GREATER OMENTUM
Urinary bladder
(b) Anterior view

7. Gallbladder (reflected upward)
LESSER OMENTUM
Liver
(reflected upward)
Stomach
Duodenum
Transverse colon
Descending colon
Ascending colon
Sigmoid colon
(c) Lesser omentum, anterior view
(liver and gallbladder lifted)

8. GREATER OMENTUM (reflected upward)
Transverse colon
Jejunum (pulled laterally)
MESENTERY
Descending colon
Ileum (pulled laterally)
Sigmoid colon
Urinary bladder
(d) Anterior view (greater omentum lifted and small intestine reflected to right side)

9. SUPERIOR
Lungs
Heart
Diaphragm
Right lobe of liver
FALCIFORM LIGAMENT
Left lobe of liver
Stomach
GREATER OMENTUM
(e) Anterior view

10. Hard palate Soft palate Uvula Cheek Molars Premolars Cuspid (canine)
Superior lip (lifted upward)
Superior labial frenulum
Gingivae (gums)
Palatoglossal arch
Hard palate
Fauces
Soft palate
Palatopharyngeal arch
Uvula
Palatine tonsil (between the arches)
Cheek
Tongue (lifted upward)
Molars
Lingual frenulum
Premolars
Opening of duct of submandibular gland
Cuspid (canine)
Gingivae (gums)
Incisors
Oral vestibule
Inferior labial frenulum
Inferior lip (pulled down)
Anterior view

11. (a) Location of salivary glands
Parotid duct
Zygomatic arch
PAROTID GLAND
Opening of parotid duct (near second maxillary molar)
Second maxillary molar tooth
Tongue (raised in mouth)
Lingual frenulum
Sublingual ducts
Lesser sublingual duct
Submandibular duct
SUBMANDIBULAR GLAND
Mylohyoid muscle
SUBLINGUAL GLAND
(a) Location of salivary glands

12. Sagittal section of a mandibular (lower) molar
Sagittal plane
Enamel
Dentin
CROWN
Gingival sulcus
Gingiva (gum)
NECK
Pulp in pulp cavity
Cementum
Root canal
Alveolar bone
ROOT
Periodontal ligament
Apical foramen
Nerve
Blood supply
Sagittal section of a mandibular (lower) molar

13. Central incisor(8–12 mo.)
Lateral incisor(12–24 mo.)
Cuspid or canine (16–24 mo.) E F D G
First molar (12–16 mo.) C H
Second molar (24–32 mo.) B I A J
Upper Teeth
Lower Teeth
Second molar (24–32 mo.) T K
First molar (12–16 mo.) S L R M
Cuspid or canine (16–24 mo.) Q P O N
Lateral incisor(12–15 mo.)
Central incisor(6–8 mo.)
(a) Deciduous (primary) dentition; teeth are designated by letters (with times of eruption)

14. First premolar or bicuspid (9–10 yr.)
Central incisor (7–8 yr.)
Lateral incisor(8–9 yr.)
Cuspid or canine (11–12 yr.) 7 8 9 10 11 6
First premolar or bicuspid (9–10 yr.) 12 5 13 4
Second premolar or bicuspid
(10–12 yr.) 3 14 2 15
First molar (6–7 yr.) 1
Upper Teeth 16
Second molar (12–13 yr.)
Third molar or wisdom tooth
(17–21 yr.)
Lower Teeth 32 17
Third molar or wisdom tooth
(17–21 yr.) 31 18
Second molar (11–13 yr.) 30 19
First molar (6–7 yr.) 29 20 28 21
Second premolar or bicuspid
(11–12 yr.) 27 22 26 23 25 24
First premolar or bicuspid (9–10 yr.)
(b) Permanent (secondary) dentition; teeth are designated by numbers (with times of eruption)
Cuspid or canine (9–10 yr.)
Lateral incisor(7–8 yr.)
Central incisor(7–8 yr.)

15. Muscularis (circular layer)
Lumen of esophagus
Mucosa:
Nonkeratinized
stratified squamous
epithelium
Lamina propria
Muscularis mucosae
Transverse plane
Submucosa
Muscularis (circular layer)
Muscularis (longitudinal layer)
Adventitia
20x LM
Wall of the esophagus

16. (a) Position of structures before swallowing
Nasopharynx
Hard palate
Soft palate
Bolus
Uvula
Tongue
Oropharynx
Epiglottis
Laryngopharynx
Larynx
Esophagus
(a) Position of structures before swallowing
(b) During pharyngeal stage of swallowing

17. (c) Anterior view of frontal sections of peristalsis in esophagus
Relaxed muscularis
Circular muscles contract
Longitudinal muscles contract
Lower esophageal sphincter
Relaxed muscularis
Bolus
Stomach
(c) Anterior view of frontal sections of peristalsis in esophagus

18. Esophagus
Lower esophageal
sphincter
FUNDUS
Serosa
CARDIA
Muscularis:
Longitudinal layer
BODY
Circular layer
Lesser curvature
PYLORUS
Oblique layer
Greater curvature
Duodenum
Pyloric sphincter
Rugae of mucosa
PYLORIC ANTRUM
PYLORIC CANAL
(a) Anterior view of regions of stomach

19. (b) Anterior view of internal anatomy
Esophagus
Duodenum
PYLORUS
Pyloric sphincter
PYLORIC CANAL
FUNDUS
Lesser curvature
CARDIA
BODY
PYLORIC ANTRUM
Rugae of mucosa
Greater curvature
(b) Anterior view of internal anatomy

20. (a) Three-dimensional view of layers of stomach
Lumen of stomach
Gastric pits
Surface mucous cell
Lamina propria
MUCOSA
Mucous neck cell
Parietal cell
Chief cell
Gastric gland
Lymphatic nodule
G cell
SUBMUCOSA
Muscularis mucosae
Lymphatic vessel
Venule
MUSCULARIS
Arteriole
Oblique layer of muscle
Circular layer of muscle
SEROSA
Myenteric plexus
Longitudinal layer of muscle
(a) Three-dimensional view of layers of stomach

21. Surface mucous cell (secretes mucus)
Gastric pit
Surface mucous cell (secretes mucus)
Surface mucous cells
Gastric pit
Lamina propria
Mucous neck cell (secretes mucus)
40x
SEM
Stomach mucosa
Parietal cell (secretes hydrochloric acid and intrinsic factor)
Gastric glands
Chief cell (secretes pepsinogen and gastric lipase)
Muscularis mucosae
G cell (secretes the hormone gastrin)
Submucosa
(b) Sectional view of stomach mucosa showing gastric glands and cell types

22. Gastric pit Lamina propria Surface mucous cell Lumen of gastric gland
Mucous neck cell
Parietal cell
G cells
Chief cells
Lumen of gastric gland LM
180x
(c) Fundic mucosa

23. (a) Anterior view Falciform ligament Diaphragm Right lobe of liver
Coronary ligament
Left lobe of liver
Right hepatic duct
Left hepatic duct
Gallbladder:
Common hepatic duct
Neck
Round ligament
Cystic duct
Common bile duct
Body
Fundus
Tail
Pancreas
Body
Duodenum
Pancreatic duct (duct of Wirsung)
Head
Accessory duct
(duct of Santorini)
Jejunum
Hepatopancreatic ampulla
(ampulla of Vater)
Uncinate process
(a) Anterior view

24. (b) Details of hepatopancreatic ampulla
Common bile duct
Pancreatic duct (duct of Wirsung)
Hepatopancreatic ampulla (ampulla of Vater)
Mucosa of duodenum
Major duodenal papilla
Sphincter of the hepatopancreatic ampulla (sphincter of Oddi)
(b) Details of hepatopancreatic ampulla

25. Right hepatic duct
Left hepatic duct
Common hepatic duct from liver
Cystic duct from gallbladder
Common bile duct
Pancreatic duct from pancreas
Key:
Liver
Sphincter
Gallbladder
Pancreas
Duodenum
(c) Ducts carrying bile from liver and gallbladder and pancreatic juice from pancreas to duodenum

26. Falciform ligament
Liver
Diaphragm
Hepatic bile duct
Spleen
Cystic bile duct
Tail of pancreas
Gallbladder
Pancreatic duct (duct of Wirsung)
Common bile duct
Body of pancreas
Major duodenal papilla
Head of pancreas
Duodenum
(d) Anterior view

27. SUPERIOR MEDIAL LATERAL (e) Anterior view Duodenum Tail of pancreas
Common bile duct
Body of pancreas
Major
duodenal papilla
Pancreatic duct (duct of Wirsung)
Head of pancreas
Uncinate process
MEDIAL
LATERAL
(e) Anterior view

28. Liver
Inferior vena cava
Hepatic artery
Hepatic portal vein
Connective tissue
Hepatocyte
Portal triad:
Hepatic laminae
Bile duct
Branch of hepatic artery
Branch of
hepatic portal vein
Central vein
Hepatic sinusoids
(a) Overview of histological components of liver

29. (b) Details of histological components of liver
Hepatic sinusoids
Bile canaliculi
Central vein
To hepatic vein
Portal triad:
Bile duct
Branch of hepatic portal vein
Branch of hepatic artery
Hepatic laminae
Hepatocyte
Stellate
reticuloendothelial
(Kupffer) cell
Connective tissue
Hepatic sinusoid
(b) Details of histological components of liver

30. 1 2 3 4 5 6 Nutrient-rich, deoxygenated blood from hepatic portal vein
Oxygenated blood from hepatic artery 1 2
Liver sinusoids 3
Central vein 4
Hepatic vein 5
Inferior vena cava 6
Right atrium of heart

31. Stomach
DUODENUM
Large intestine
JEJUNUM
ILEUM
(a) Anterior view of external anatomy

32. Circular folds (plicae circulares)
(b) Internal anatomy of jejunum

33. Circular folds (plicae circulares)
Villi
Submucosa
Circular layer of muscle
(a) Relationship of villi to circular folds
Longitudinal layer of muscle
Serosa

34. Lumen of small intestine
Blood capillary
Lacteal
Villi
Opening of intestinal gland
Absorptive cell
Goblet cell
Lacteal
MUCOSA
Lamina propria
Enteroendocrine cell
Paneth cell
Lymphatic nodule
Muscularis mucosae
SUBMUCOSA
Arteriole
Venule
MUSCULARIS
Lymphatic vessel
Circular layer of muscle
Myenteric plexus
SEROSA
Longitudinal layer of muscle
(b) Three-dimensional view of layers of the small intestine showing villi

35. Microvilli
Absorptive cell (absorbs nutrients)
Blood capillary
Lacteal
Goblet cell (secretes mucus)
Lamina propria
Mucosa
Intestinal gland
Enteroendocrine cell (secretes the hormones secretin, cholecystokinin, or GIP)
Muscularis mucosae
Arteriol
Venule
Submucosa
Paneth cell (secretes lysozyme and is capable of phagocytosis)
Lymphatic vessel
Muscularis
(c) Enlarged villus showing lacteal, capillaries, intestinal glands, and cell type

36. (d) Several microvilli from duodenum
Brush border
Simple columnar epithelial cell
TEM
46,800x
(d) Several microvilli from duodenum

37. (b) Movement of absorbed nutrients into blood and lymph
Left subclavian vein
Villus (greatly enlarged)
Chylomicron
Small short-chain fatty acid
Heart
Blood capillary
Liver
Hepatic portal vein
Amino acid
Lacteal
Thoracic duct
Monosaccharide
Arteriole
Venule
Blood
Lymphatic vessel
Lymph
(b) Movement of absorbed nutrients into blood and lymph

38. INGESTED AND SECRETED ABSORBED Saliva (1 liter) Ingestion of liquids
(2.3 liters)
Gastric juice
(2 liters)
Bile (1 liter)
Pancreatic juice
(2 liters)
Intestinal juice
(1 liter)
Small intestine (8.3 liters)
Total ingested and secreted
Large intestine (0.9 liters)
= 9.3 liters
Total absorbed = 9.2 liters
Excreted in feces (0.1 liter)
Fluid balance in GI tract

39. (a) Anterior view of large intestine showing major regions
TRANSVERSE COLON
Left colic (splenic) flexure
Right colic (hepatic) flexure
Teniae coli
ASCENDING COLON
DESCENDING COLON
Teniae coli
Omental appendices
Ileum
Mesoappendix
Haustra
Ileocecal sphincter (valve)
SIGMOID COLON
CECUM
RECTUM
VERMIFORM APPENDIX
ANAL CANAL
ANUS
(a) Anterior view of large intestine showing major regions

40. (b) Frontal section of anal canal
Rectum
Anal canal
Internal anal sphincter (involuntary)
External anal sphincter (voluntary)
Anus
Anal column
(b) Frontal section of anal canal

41. (a) Three-dimensional view of layers of large intestine
Lumen of large intestine
Openings
of intestinal glands
Absorptive cell
MUCOSA
Goblet cell
Intestinal gland
Lamina propria
Lymphatic nodule
SUBMUCOSA
Muscularis mucosae
Lymphatic vessel
MUSCULARIS
Arteriole
Venule
Circular layer of muscle
Myenteric plexus
SEROSA
Longitudinal layer of muscle
(a) Three-dimensional view of layers of large intestine

42. (b) Sectional view of intestinal glands and cell types
Openings of intestinal glands
Lamina propria
Microvilli
Intestinal gland
Absorptive cell (absorbs water)
Goblet cell (secretes mucus)
Muscularis mucosae
Lymphatic nodule
Submucosa
(b) Sectional view of intestinal glands and cell types