The small intestine, or small bowel, is a hollow tube about 20 feet long that runs from the stomach to the beginning of the large intestine. The small intestine breaks down food from the stomach and absorbs much of the nutrients from the food. The small intestine has three parts:
After food is processed in the small intestine, it passes into the large intestine (also called the large bowel or colon). The large intestine, which is about 5 feet long, extracts most of the water from the food and distributes the liquid to the body; the remaining material passes through the colon and out of the body as feces (stool). Learn more about the intestine.
The small intestine (also referred to as the small bowel) is the specialized tubular structure between the stomach and the large intestine (also called the colon or large bowel) that absorbs the nutrition from your food. It is approximately 20-25 feet in length and is about as big around as your middle finger. It is divided into three parts: the duodenum, jejunum and ileum. The beginning portion of the small intestine (the duodenum) begins at the exit of the stomach (pylorus) and curves around the pancreas to end in the region of the left upper part of the abdominal cavity where it joins the jejunum. The duodenum has an important anatomical feature which is the ampulla of Vater. This is the site at which the bile duct and pancreatic duct empty their contents into the small intestine which helps with digestion. The jejunum is the upper part of the small intestine and the ileum the lower part, though there is no clear delineation between the jejunum and ileum.
The lining of the small intestinal mucosa is very highly specialized for maximizing digestion and absorption of nutrients. The lining is highly folded to form microscopic finger-like projections called villi which increase the surface area to help with absorption. The lining also contains specialized groups of cells that produce chemicals which help digestion, provide immune defenses, and hormones that help to control coordination of digestive process of the intestine, gallbladder, and pancreas. An important anatomic feature of the small intestine is also its highly integrated nervous system which lies within the wall of the intestine (this is called the enteric nervous system) The enteric nervous system plays a very important role in coordinating much of the activities of the small intestine including its muscular activity of propulsion (the moving of intestinal contents). Function & ControlThe small intestine is responsible for absorption of nutrients, salt, and water. On average, approximately nine liters of fluid enters the jejunum each day. The small intestine absorbs approximately seven liters, leaving only 1.5-2 liters to enter the large intestine. Significant abnormalities of the small intestine therefore, are manifested by malabsorption of nutrients, and diarrhea. The absorptive function of the small intestine is effected by an intricate array of cells within its lining that will absorb and secrete salts and nutrients as well as water in order to maintain normal salt and water balance within the body. The absorptive function is so efficient that in a normal adult with a normal diet, over 95% of ingested carbohydrates and proteins are absorbed. Specific regions are adapted to perform specific functions. For example, the duodenum plays an important role in coordinating how the stomach empties as well as the rate of emptying of bile duct juices into the intestine. The duodenum is also a major site for absorption of iron. The jejunum is a major site for absorption of the vitamin folic acid and the end of the ileum is the most important site for absorption for the vitamin B12, and bile salts. The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pancreatic duct to aid in digestion. The small intestine is about 18 feet (6.5 meters) long and folds many times to fit in the abdomen. Although it is longer than the large intestine, it is called the small intestine because it is narrower in diameter.
Diagram showing the small intestine and surrounding structures [edit on Wikidata] The small intestine has three distinct regions – the duodenum, jejunum, and ileum. The duodenum, the shortest, is where preparation for absorption through small finger-like protrusions called villi begins.[2] The jejunum is specialized for the absorption through its lining by enterocytes: small nutrient particles which have been previously digested by enzymes in the duodenum. The main function of the ileum is to absorb vitamin B12, bile salts, and whatever products of digestion that were not absorbed by the jejunum.
The length of the small intestine can vary greatly, from as short as 3.00 m (9.84 ft) to as long as 10.49 m (34.4 ft), also depending on the measuring technique used.[3] The typical length in a living person is 3m–5m.[4][5] The length depends both on how tall the person is and how the length is measured.[3] Taller people generally have a longer small intestine and measurements are generally longer after death and when the bowel is empty.[3]
It is approximately 1.5 cm in diameter in newborns after 35 weeks of gestational age,[7] and 2.5–3 cm (1 inch) in diameter in adults. On abdominal X-rays, the small intestine is considered to be abnormally dilated when the diameter exceeds 3 cm.[8][9] On CT scans, a diameter of over 2.5 cm is considered abnormally dilated.[8][10] The surface area of the human small intestinal mucosa, due to enlargement caused by folds, villi and microvilli, averages 30 square meters.[11] PartsThe small intestine is divided into three structural parts.
The jejunum and ileum are suspended in the abdominal cavity by mesentery. The mesentery is part of the peritoneum. Arteries, veins, lymph vessels and nerves travel within the mesentery.[13] Blood supplyThe small intestine receives a blood supply from the celiac trunk and the superior mesenteric artery. These are both branches of the aorta. The duodenum receives blood from the coeliac trunk via the superior pancreaticoduodenal artery and from the superior mesenteric artery via the inferior pancreaticoduodenal artery. These two arteries both have anterior and posterior branches that meet in the midline and anastomose. The jejunum and ileum receive blood from the superior mesenteric artery.[14] Branches of the superior mesenteric artery form a series of arches within the mesentery known as arterial arcades, which may be several layers deep. Straight blood vessels known as vasa recta travel from the arcades closest to the ileum and jejunum to the organs themselves.[14] MicroanatomyMicrograph of the small intestine mucosa showing the intestinal villi and crypts of Lieberkühn. 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: This cross section diagram shows the 4 layers of the small intestine wall.
Gene and protein expressionAbout 20,000 protein coding genes are expressed in human cells and 70% of these genes are expressed in the normal duodenum.[15][16] Some 300 of these genes are more specifically expressed in the duodenum with very few genes expressed only in the small intestine. The corresponding specific proteins are expressed in glandular cells of the mucosa, such as fatty acid binding protein FABP6. Most of the more specifically expressed genes in the small intestine are also expressed in the duodenum, for example FABP2 and the DEFA6 protein expressed in secretory granules of Paneth cells.[17] DevelopmentThe small intestine develops from the midgut of the primitive gut tube.[18] By the fifth week of embryological life, the ileum begins to grow longer at a very fast rate, forming a U-shaped fold called the primary intestinal loop. The loop grows so fast in length that it outgrows the abdomen and protrudes through the umbilicus. By week 10, the loop retracts back into the abdomen. Between weeks six and ten the small intestine rotates anticlockwise, as viewed from the front of the embryo. It rotates a further 180 degrees after it has moved back into the abdomen. This process creates the twisted shape of the large intestine.[18]
Food from the stomach is allowed into the duodenum through the pylorus by a muscle called the pyloric sphincter. DigestionThe small intestine is where most chemical digestion takes place. Many of the digestive enzymes that act in the small intestine are secreted by the pancreas and liver and enter the small intestine via the pancreatic duct. Pancreatic enzymes and bile from the gallbladder enter the small intestine in response to the Hormone cholecystokinin, which is produced in the response to the presence of nutrients. Secretin, another hormone produced in the small intestine, causes additional effects on the pancreas, where it promotes the release of bicarbonate into the duodenum in order to neutralize the potentially harmful acid coming from the stomach. The three major classes of nutrients that undergo digestion are proteins, lipids (fats) and carbohydrates:
AbsorptionDigested food is now able to pass into the blood vessels in the wall of the intestine through either diffusion or active transport. The small intestine is the site where most of the nutrients from ingested food are absorbed. The inner wall, or mucosa, of the small intestine, is lined with simple columnar epithelial tissue. Structurally, the mucosa is covered in wrinkles or flaps called circular folds, which are considered permanent features in the mucosa. They are distinct from rugae which are considered non-permanent or temporary allowing for distention and contraction. From the circular folds project microscopic finger-like pieces of tissue called villi (Latin for "shaggy hair"). The individual epithelial cells also have finger-like projections known as microvilli. The functions of the circular folds, the villi, and the microvilli are to increase the amount of surface area available for the absorption of nutrients, and to limit the loss of said nutrients to intestinal fauna. Each villus has a network of capillaries and fine lymphatic vessels called lacteals close to its surface. The epithelial cells of the villi transport nutrients from the lumen of the intestine into these capillaries (amino acids and carbohydrates) and lacteals (lipids). The absorbed substances are transported via the blood vessels to different organs of the body where they are used to build complex substances such as the proteins required by our body. The material that remains undigested and unabsorbed passes into the large intestine. Absorption of glucose in the small intestine Absorption of the majority of nutrients takes place in the jejunum, with the following notable exceptions:
ImmunologicalThe small intestine supports the body's immune system.[20] The presence of gut flora appears to contribute positively to the host's immune system. Peyer's patches, located within the ileum of the small intestine, are an important part of the digestive tract's local immune system. They are part of the lymphatic system, and provide a site for antigens from potentially harmful bacteria or other microorganisms in the digestive tract to be sampled, and subsequently presented to the immune system.[21] The small intestine is a complex organ, and as such, there are a very large number of possible conditions that may affect the function of the small bowel. A few of them are listed below, some of which are common, with up to 10% of people being affected at some time in their lives, while others are vanishingly rare.
The small intestine is found in all tetrapods and also in teleosts, although its form and length vary enormously between species. In teleosts, it is relatively short, typically around one and a half times the length of the fish's body. It commonly has a number of pyloric caeca, small pouch-like structures along its length that help to increase the overall surface area of the organ for digesting food. There is no ileocaecal valve in teleosts, with the boundary between the small intestine and the rectum being marked only by the end of the digestive epithelium.[22] In tetrapods, the ileocaecal valve is always present, opening into the colon. The length of the small intestine is typically longer in tetrapods than in teleosts, but is especially so in herbivores, as well as in mammals and birds, which have a higher metabolic rate than amphibians or reptiles. The lining of the small intestine includes microscopic folds to increase its surface area in all vertebrates, but only in mammals do these develop into true villi.[22] The boundaries between the duodenum, jejunum, and ileum are somewhat vague even in humans, and such distinctions are either ignored when discussing the anatomy of other animals, or are essentially arbitrary.[22] There is no small intestine as such in non-teleost fish, such as sharks, sturgeons, and lungfish. Instead, the digestive part of the gut forms a spiral intestine, connecting the stomach to the rectum. In this type of gut, the intestine itself is relatively straight but has a long fold running along the inner surface in a spiral fashion, sometimes for dozens of turns. This valve greatly increases both the surface area and the effective length of the intestine. The lining of the spiral intestine is similar to that of the small intestine in teleosts and non-mammalian tetrapods.[22] In lampreys, the spiral valve is extremely small, possibly because their diet requires little digestion. Hagfish have no spiral valve at all, with digestion occurring for almost the entire length of the intestine, which is not subdivided into different regions.[22] In traditional Chinese medicine, the small intestine is a yang organ.[23]
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