Anatomi GI Tract, 2012.ppt
Transcript of Anatomi GI Tract, 2012.ppt
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Anatomi & Fisiologi
Gastrointestinal System
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Sistem Pencernaan Gastrointestinal (Gl) tract (Alimentary
canal) Tube within a tube Berhubungan langsung atau sebagian
dengan organ-organ Structures
Mouth - Oral Cavity Pharynx Esophagus Stomach - DuodenumJejenum Ileum Caecum -
Ascending colon - Transverse colon -
Descending colon - Sigmoid colon Rectum - Anus11/22/2014 Padoli, GI Tract.
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Gastrointestinal System
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Processing of food Types :
Mechanical (physical) : Mengunyah ( Chew),melumasi (Tear), menggiling(Grind), menghaluskan(Mash), mencampur (Mix)
Chemical Catabolic reactions Enzymatic hydrolysis
Carbohydrate Protein Lipid
Phases : Ingestion Movement- Digestion- Absorption- Further digestion
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Accessory structures Organs : Teeth, Tongue, Salivary glands,
Liver, Gall bladder, PancreasBatas-Batas Mulut adalah : Atas : palatum mole dan palatum durum Bawah : mandibula, lidah dan struktur dasar
mulut Lateral :Pipi Belakang : osteum ke dalam faring. Di dasar mulut terdapat cekungan yang
dibawahnya terdapat kelenjar submandibulakanan dan kiri, kelenjar sublingual kanan kiriyang mensekresi saliva.
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Anatomy of the Mouth and Throat
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Dorsal Surface of the Tongue
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Deglutition (swallowing)
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Sequence Voluntary stage
Push food to back ofmouth
Pharyngeal stage Raise
Soft palate Larynx + hyoid
Tongue to soft palate Esophageal stage Contract pharyngeal
muscles Open esophagus
Start peristalsis
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Deglutition (swallowing)
Control Nerves
Glossopharyngeal Vagus Accessory
Brain stem Deglutition center
Medulla oblongata Pons
Disorders Dysphagia Aphagia
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The Major Salivary Glands
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Esophagus Faring merupakan tuba fibromuskuler yang
melekat pada dasar tulang tengkorak disebelahatas dan berlanjut dengan esofagus.
Faring terdiri dari nasofaring, orofaring danlaringofaring yang berlanjut pada esofagus.
Esofagus mrp tube muskuler dengan panjangsekitar 25 cm dan diameter 0,5 cm.
Esofagus dimulai dari bagian leher lanjutanfaring, menjalar ke bawah leher dan toraksmelewati persimpangan sebelah kiri diafragmadan masuk ke lambung.
Functions : Secrete mucousTransport food
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Stomach (Lambung) Lambung terdapat di kuadran kiri atas abdomen,
biasanya berbentuk J. terletak disebalah kirianterior limpa (spleen)
The wall of the stomach is lined with millions ofgastric glands , which together secrete 400 800ml of gastric juice at each meal.
Mucous membrane G cells make gastrin Goblet cells make mucous Gastric pit Oxyntic gland Parietal cells Make
HCl Chief cells Zymogenic cells :Pepsin, Gastric lipase
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Stomach (Lambung)
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The StomachMajor Function: Start of digestion by HCl & pepsin Storage of nutrients Controlled passage of bolus into duodenum
(*Also breakdown & absorption of Medications) Its walls layered with powerful muscles, your
stomach churns to break food into smaller andsmaller pieces. Gastric juices, produced by theglands that line your stomach, prepare the foodfor absorption
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3 muscle layers : Oblique, Circular, Longitudinal
Regions
Cardiac sphincter, Fundus, Antrum (pylorus),Pyloric sphincter Vascular Inner surface thrown into folds Rugae Contains enzymes that work best at pH 1-2
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Stomach
Functions Menyampur makanan Menampung makanan
(Reservoir)
Memulai pencernaan :Protein, Nucleic acids,Fats
Mengaktifkan bbrp enzym Menghancurkan bakteri Menghasilkan faktor
intrinsic u/ absorpsi B 12
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Absorbs:Alcohol, Water,Lipophilic acid,B 12
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Small Intestine
Usus halus terdiri dari 3 bagian,duodenum, jejunum dan ileum.Panjang usus halus 6 m (4,6-9m).Duodenum 25 cm (12 inchi), jejunum 2,5m atau 2/3 panjang usus halus, dan ileum3,5m atau 3/5 panjang usus halus.
Memanjang dari pyloric sphincter ileocecal valve
Movements : Segmentation, Peristalsis
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Small Intestine
Absorbs 80% ingested water Electrolytes Vitamins
Minerals Carbonates Active/facilitated
transport Monosaccharides
Proteins Di-/tripeptides Amino acids
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Lipids:MonoglyceridesFatty acids
MicellesChylomicrons
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Small Intestine
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Small Intestine
Secretes digestive enzymes Peptidases : Amino-, Di-, Tri- Sucrases Maltase Lactase Saccharidases: Di-, Tri- Lipase Nucleases
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Sebelum nutrient diabsorbsi villi usus halus,nutrient harus dipecah menjadi manomer
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Large Intestine 5 feet long; 2 5/8 inch diameter Extends from the ileum to the anus Movement in the large intestine consists of
peristalsis, which is mild & slow, haustralchurning, & mass movements.
Regions Cecum Appendix Colon : Ascending, Transverse, Descending Rectum Anal canal
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Anatomy of the Large Intestine
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Large Intestine
Histology No villi No permanent circular folds
Smooth muscle Taeniae coli Haustra
Epiploic appendages Otherwise like rest of Gl tract
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Large Intestine ascending colon - lower right side of abdomen
becomes the transverse colon at the hepaticflexure, crosses the mid-abdomen , bends downat the splenic flexure on the left side & becomesthe descending colon
At the level of the iliac crest, colon curves like"S" (sigmoid) colon - terminates at the:
Rectum
Anal canal - 1" long Anal Sphincter (internal & external)-remain
closed x during defecation
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Feces Formation andDefecation
Chyme dehydrated to form feces Feces composition Water Inorganic salts
Epithelial cells Bacteria Byproducts of digestion
Defecation Peristalsis pushes feces into
rectum Rectal walls stretch
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Control :
ParasympatheticVoluntary
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Large Intestine The large intestine receives the liquid
residue after digestion and absorption arecomplete.
This residue consists mostly of water aswell as materials (e.g. cellulose) that werenot digested.
While the contents of the small intestineare normally sterile, the colon contains anenormous (~10 14 ) population ofmicroorganisms. (Our bodies consist of
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Large Intestine Most of the species live there perfectly
harmlessly; that is, they are commensals .Some are actually beneficial, e.g.,
by synthesizing vitamins and
by digesting polysaccharides for which wehave no enzymes (providing an estimated10% of the calories we acquire from ourfood).
Bacteria flourish to such an extent that asmuch as 50% of the dry weight of thefeces may consist of bacterial cells.
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Large Intestine Reabsorption of water is the chief function of the
large intestine. The large amounts of watersecreted into the stomach and small intestine bythe various digestive glands must be reclaimed
to avoid dehydration. If the large intestinebecomes irritated, it may discharge its contentsbefore water reabsorption is complete causingdiarrhea . On the other hand, if the colon retains
its contents too long, the fecal matter becomesdried out and compressed into hard massescausing constipation .
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Liver
Location R. Hypochondrium Epigastric region
4 Lobes Left Quadrate Caudate
Right Each lobe has lobules Contains hepatocytes
Surround sinusoids Feed into central vein
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Dual blood supply :1. Hepatic portal vein ;
Direct input from small
intestine2. Hepatic artery/vein;
Direct links to heart
B t li 1 36 kg (3
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Berat liver, 1,36 kg (3pons)
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Liver
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Liver Functions1. The liver secretes
bile Detergent emulsifies
fats Release promoted by:
Vagus n., CCK,Secretin
Contains : Water, Bilesalts, Bile pigments,Electrolytes,Cholesterol, Lecithin
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2. Detoxifies/removes:Drugs, Alcohol
3. Stores : Gycolgen,Vitamins (A, D, E, K), Feand other minerals,Cholesterol
4. Activates vitamin D5. Fetal RBC production6. Phagocytosis7. Metabolizes absorbed
food molecules :Carbohydrates, Proteins,Lipids
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The hepatic portal system
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The capillary beds of most tissues drain into veins that leaddirectly back to the heart. But blood draining the
intestines is an exception. The veins draining theintestine lead to a second set of capillary beds in theliver. Here the liver removes many of the materials thatwere absorbed by the intestine:
1. Glucose is removed and converted into glycogen .2. Other monosaccharides are removed and converted
into glucose.3. Excess amino acids are removed and deaminated .
1. The amino group is converted into urea .
2. The residue can then enter the pathways of cellular respiration and be oxidized for energy.
4. Many nonnutritive molecules, such as ingested drugs,are removed by the liver and, often, detoxified.
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Accessory Organs: Pancreas Pancreas terletak sebelah belakang
bagian atas duedenum. Pancreas dibagimenjadi kaput, kolum, korpos dan ekor.Panjang pankreas 6 dan lebar 1.
Sel-sel pancreas mensekresi cairanpankreas yang menghasilkan enzympencernaan : amylase - starch , lipase -fats , trypsin, chymotrypsin & otherproteases, which split proteases intopeptides
Endocrine functions - (insulin & glucagon)
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Pancreas
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The pancreas The pancreas consists of clusters if endocrine
cells ( the islets of Langerhans ) and exocrinecells whose secretions drain into theduodenum.
Pancreatic fluid contains:1. sodium bicarbonate (NaHCO3). This
neutralizes the acidity of the fluid arriving fromthe stomach raising its pH to about 8.
2. pancreatic amylase . This enzyme hydrolyzesstarch into a mixture of maltose and glucose.
3. pancreatic lipase . The enzyme hydrolyzesingested fats into a mixture of fatty acids andmonoglycerides . Its action is enhanced by thedetergent effect of bile
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The pancreas 4 "zymogens" proteins that are precursors to active
proteases. These are immediately converted into theactive proteolytic enzymes: trypsin. Trypsin cleaves peptide bonds on the C-terminal side of
arginines and lysines . chymotrypsin. Chymotrypsin cuts on the C-terminal side of
tyrosine , phenylalanine , and tryptophan residues (the samebonds as pepsin, whose action ceases when the NaHCO3 raisesthe pH of the intestinal contents).
elastase. Elastase cuts peptide bonds next to small, unchargedside chains such as those of alanine and serine.
carboxypeptidase. This enzyme removes, one by one, theamino acids at the C-terminal of peptides.
nucleases . These hydrolyze ingested nucleic acids(RNA and DNA) into their component nucleotides .
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The secretion of pancreatic fluid is controlledby two hormones:
secretin , which mainly affects the releaseof sodium bicarbonate, and
cholecystokinin (CCK ), which stimulatesthe release of the digestive enzymes.
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The Duodenum and Related
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The Duodenum and RelatedOrgans
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Topografi Abdomen 9 Area
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Topografi Abdomen
Abdomen divided into four quadrants bybody mid-line, horizontal plane throughumbilicus
Organs can be located by quadrant
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Topografi Abdomen :4 Area
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System 4 Quadrant
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RUQ LUQLiver,Gallbladder,
Kidney Duodenum,Ascending ColonTransverse Colon
SpleenStomach
PancreasLeft KidneyTransverse ColonDescending Colon
Splenic Flexure
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Topografi Abdomen :4 Area
Right LowerQuadrant
Left LowerQuadrant
Ascending Colon AppendixRight Ovary(female)
Right FallopianTube (female)
Descending ColonSigmoid colonLeft Ovary (female)Left Fallopian Tube
(female)
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Topografi Abdomen
Periumbilical area Located around (peri) the navel (umbilicus) Small bowel lies in all quadrants in
periumbilical area Suprapubic area
Located just above pubic bone
Urinary bladder, uterus lie in this area
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Peritoneum Peritoneum adalah membran tipis, halus
dan lembab yang terdapat pada ronggaabdomen dan menutupi organ abdomen.Peritoneum parietal : peritoneum yang
menutupi dinding abdomen; peritoneumvisceral menutupi organ-organ.Peritoneum parietalis berlanjut dengan
peritoneum visceralis. Mesenterika adalah lipatan ganda
peritoneum yang melekatkan yeyunum
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Omentum mayor adalah lipatan empatperitoneum menggantung ke bawah darikurvatura mayor lambung dan menutupi organabdomen ke arah anterior.
Cavum peritoneum mrp rongga potensial ygdapat terisi oleh udara atau cairan padakeadaan tertentu.
Fungsi peritoneum: tempat perlekatan organ-
organ ke dinding abdomen posterior;mempermudah organ saling bergerak diataslainnya; menutupi area terinfeksi denganomentum mayor, Memungkinkan pembuluhdarah dan persyarafan mencapai organ tanpa
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Topografi Abdomen
Peritoneal Spleen
Liver Stomach Gall bladder Bowel
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RetroperitonealPancreasKidneyUreterInferior vena cava Abdominal aortaUrinary bladderReproductive organs