SMALL INTESTINE

In biology the 'small intestine' is the part of the gastrointestinal tract (gut) between the stomach and the large intestine and includes the duodenum, jejunum, and ileum. It is where the vast majority of digestion takes place.

Contents

Size and sections

Peristalsis

Extensions into lumen

Absorption

Digestion

Histology

Small intestine disorders

References

Notes

Additional images

Size and sections

In humans over 5 years old it is approximately 7 m (21 ft) long and can vary from 4-7 m (13.12-22.97 ft).
It is divided into three structural parts:

★ 'duodenum' 26 cm (9.84 in) in length

★ 'jejunum' 2.5 m (8.2 ft)

★ 'ileum' 3.5 m (11.5 ft)
Although the small intestine is much longer than the large intestine (typically 4-5 times longer), it is referred to as such due to its comparatively smaller diameter. On average, the diameter of the small intestine of an adult human measures approximately 2.5-3cm, and the large intestine measures about 7.6 cm in diameter.

Peristalsis

Food from the stomach is allowed into the duodenum by a muscle called the pylorus, or pyloric sphincter, and is then pushed through the small intestine by a process of muscular-wavelike contractions called peristalsis.

Extensions into lumen

The small intestine is the site where most of the nutrients from ingested food are absorbed and is covered in wrinkles or folds called plicae circulares. These are considered permanent features in the wall of the organ. They are distinct from rugae which are considered non-permanent or temporary allowing for distention and contraction. From the plicae circulares project microscopic finger-like pieces of tissue called villi. The small intestine is lined with simple columnar epithelial tissue. The epithelial cells also have finger-like projections known as microvilli. The function of the plicae circulares, the villi and the microvilli is to increase the amount of surface area available for secretion of enzymes and absorption of nutrients.

Absorption

The purpose of these wrinkles and projections is to increase surface area for absorption of nutrients. Each villus is covered in microvilli, which increase the surface area manyfold. Each villus contains a lacteal and capillaries. The lacteal absorbs the digested fat into the lymphatic system which will eventually drain into the circulatory system. The capillaries absorb all other digested nutrients.
The surface of the cells on the microvilli are covered with a brush border of proteins which helps to catch a molecule-thin layer of water within itself. This layer, called the "unstirred water layer," has a number of functions in absorption of nutrients.
Absorption of the majority of nutrients takes place in the jejunum, with the following notable exceptions:

★ Iron is absorbed in the duodenum

★ Vitamin B12 and bile salts are absorbed in the terminal ileum.

★ Water and lipids are absorbed by passive diffusion throughout

★ Sodium is absorbed by active transport and glucose and amino acid co-transport.

★ Fructose is absorbed by facilitated diffusion.

Digestion

The digestion of proteins into peptides and amino acids principally occurs in the stomach but some also occurs in the small intestine. The small intestine is where the most chemical digestion takes place:

★ peptides are degraded into amino acids. Chemical break down begins in the stomach and is further broken down in the small intestine. Proteolytic enzymes, trypsin and chymotrypsin, which are secreted by the pancreas cleave proteins into smaller peptides. Carboxypeptidase, which is a pancreatic brush border enzyme, splits one amino acid at a time. Aminopeptidase and dipeptidase free the end amino acid products.

★ lipids (fats) are degraded into fatty acids and glycerol. Lipid digestion is the sole responsibility of the small intestine. Pancreatic lipase is secreted here. Pancreatic lipase breaks down triglycerides into free fatty acids and monoglycerides. Pancreatic lipase preforms its job with the help of bile salts. Bile salts attach to triglycerides which aids in making them easier for pancreatic lipase to.

★ carbohydrates are degraded into simple sugars (e.g., glucose). In the small intestine pancreatic amylase breaks down carbohydrates into oligosaccharides. Brush border enzymes take over from there. The most important brush border enzymes are dextrinase and glucoamylase which further break down oligosaccharides. Other brush border enzymes are maltase, sucrase and lactase.

Histology

The three sections of the small intestine look similar to each other at a microscopic level, but there are some important differences.
The parts of the intestine are as follows:

'Layer'	'Duodenum'	'Jejunum'	'Ileum'
serosa	normal	normal	normal
muscularis externa	longitudinal and circular layers, with Auerbach's (myenteric) plexus in between	same as duodenum	same as duodenum
submucosa	Brunner's glands and Meissner's (submucosal) plexus	no BG	no BG
mucosa: muscularis mucosae	normal	normal	normal
mucosa: lamina propria	no PP	no PP	Peyer's patches
mucosa: epithelium	simple columnar. Contains goblet cells, Paneth cells	Similar to duodenum. Villi very long.	Similar to duodenum. Villi very short.

Small intestine disorders

★ Small intestine cancer

★ Small intestine obstruction ("high" mechanic ileus)

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★ Obstruction from external pressure

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★ Obstruction by masses in the lumen (foreign bodies, bezoar, gallstones)

★ Paralytic ileus

★ Maropthisis

★ Crohn's disease

★ Celiac disease

★ Carcinoid

★ Meckel's Diverticulum

★ Gastric dumping syndrome

★ Infectious diseases

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★ Giardiasis

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★ Scariasis

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★ Tropical sprue

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★ Tapeworm infection

★ Mesenteric ischemia

★ Short bowel syndrome

★ Inguinal hernia

References

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★ Solomon et al (2002) Biology Sixth Edition, Brooks-Cole/Thomson Learning ISBN 0-03-033503-5

★ Townsend et al (2004) Sabiston Textbook of Surgery, Elsevier ISBN 0-7216-0409-9

★ Small bowel review: Normal physiology, part 1., Thomson A, Drozdowski L, Iordache C, Thomson B, Vermeire S, Clandinin M, Wild G, , , Dig Dis Sci, 2003

★ Small bowel review: Normal physiology, part 2., Thomson A, Drozdowski L, Iordache C, Thomson B, Vermeire S, Clandinin M, Wild G, , , Dig Dis Sci, 2003

Notes

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Additional images