TRACTUS GASTRO INTESTINALIS (histology)

TONGUE / LINGUAL Tdd: serabut otot rangka, longitudinal,

vertical & horizontal. Permukaan: dilapisi papillae yg b’bentuk

filiformis, fungiformis, circumvalate & Foliatae (pd man Rudimenter)

+ taste Buds (neurosensory bodies) pd epitel papillae.

PERSARAFAN : Ant: cab N. facialis ( N.VII) Post: cab N. Glossopharingeus (N.IX).

SALIVARY GLANDS• GLD.SUBLINGUALIS : kelenjar

seromukosa• GLD.SUBMANDIBULARIS : kelenjar

mukoserosa• GLD.PAROTIS: kelenjar serosa murni

STRUKTUR G.I.TRACT• TUNIKA MUKOSA :

1. Epitel 2. Lamina propia3. Muskularis mukosa

• TUNIKA SUBMUKOSA : Jar Peny pdt, PD & limf, pleksus Meissner, kelenjar, lymphoid tissuue

• TUNIKA MUSKULARIS : otot polos circular & longitudinal, Pleksus Aurbach

• TUNIKA ADVENTITIA ( SEROSA): jar penyambung jrg, P, limf, mesothel,

GANGLION AUTONOMIC NERVE :PLEXUS AURBACH &PLEXUS MEISSNER

GASTER• Tunika mukosa: Foveola Gastricae

Gastric Glands• Tdd:

a. Cardiab. Fundusc. Corpusd. Pylorus

• SEL KELENJAR REGIO FUNDUS-CORPUS :1. CHIEF CELLS : pepsinogen2. PARIETAL CELLS : HCL, factor

intrinsic (B12)3. MUCOUS NECK CELLS : glikoprotein 4. ENDOCRINE CELLS à

D cells : somatostatin, G cells : gastrinD1 cells : vasoactive intestinal peptide

Enterochromaffin cells : Serotonin

SMALL INTESTINE• DUODENUM ,JEJUNUM,ILEUM

T.MUKOSA : o Plika: circularis Kerkringio Villi intestinaliso Kripti Lieerkhun (memperluas

Permukaan mukosa).o Epitel selapis torak + absortive cells + sel

goblet + sel endokrin + paneth cells

ENDOCRINE CELLS BERISI : 1. IG CELLS : intestinal gastrin 2. D-CELLS : somatostatin3. S-CELLS : sekretiin4. L-CELLS : enteroglukagon 5. MO-CELLS : motilin6. N-CELLS : Neurotensin7. D1 CELLS : vasoactive Intestinal

peptide

SEL PANETH : f/ pertahanan thd bakteri (+ lisozim & phospholipase A2)

LAMINA PROPRIA : Solitary lymfoid nodules Aggregative lymfoid nodules (peyer

patches) + M-cells (skresi sist imun), Produksi IgA

T.SUBMUKOSA : Gld Brunner (pd duodenum):

- + alkalin mucin ( Ph.8,2-9,3)- + bikarbonat f/ penetralisir

+ Pleksus Meisner

HISTOFISIOLOGIo f/ mekanik y/ mencampur & transport

makanan dgn gerak peristaltic.o Kecepatan peristaltic: 0,5 – 5 cm/sco Secretory function:

Intestinal juice Enterokinase Amylase

Gastric ulcer

stressPsychosoma

tic factors aspirin nonsteroid

EtanolHelicobacter pylori

Lactase

LARGE INTESTINECECUM,COLON,APPENDIKS,RECTUM + ANAL CANAL• Pjg 1,5 m • f/ reabsorbsi air & garam inorgaik• hsl sekresi musin à f/ lubricant• Endocrine cells:

L- cells & EC1 cells à + serotonin & substance P

APPENDIKS• Lumen irregular• - vili• Kripti Lieberkhun <<• Nodule Limfatisi menembus lap mukosa

& submukosa

HEPAR• Kelenjar terbesar 1,5 kg • Dibungkus o/ kapsula Glisson• f/

o penyimpanan glikogeno sintesa prot, albumin, fibrinogen,

thrombin, factor 3o metabolism obat, alcohol,

detoksifikasi racuno sekresi empedu 500 – 1000 ml /hr

JENIS-JENIS SEL HATI:• SEL HEPATOSIT ( LIVER CELLS)• SEL KUPFFER ( PHAGOCYTIC CELLS)• SEGITIGA KIERNAN ( portal triad)

PORTAL TRIAD: CAB.VENA PORTA, CAB.ARTERI HEPATICA,DUKTUS BILIARIS

SENESCENT ERYTHROCYT à Degradasi Hb o/ sel Kupffer à pigemen hijau (bilirubin)à diambil o/ sel hepatosit berkonyugasi dgn glukoronide à disekresi ke dlm empedu. LIVER DISEASE à JAUNDICE

GALLBLADDER/ VESICA FELLEA• Epitel torak tinggi• Dinding tdd: mukosa, lamina propia, lap

fibromuskular, serosa• Sinus Rockytansky-Aschoff• F/ menyimpan & mengkonsentrasi

empedu mll penyerapan air.• Empedu berisi: Cholesterol,

Phospholipid, asam empedu, & pigmen.

PANCREAS• Kelenjar eksokrin & endokrin• EKSOKRIN : sekresi enzim ke dlm

duodenum u/ mencena prot, KH, lemak.• ENDOKRIN : pulau Langerhans, tdd

a. sel α àglucagon (hyperglycemic H) b. sel β à insulin (hypoglycemic H)c. Sel Dà Somatostatind. Sel F à Pancreatic Polipeptida

CLINICAL APPLICATION• GASTRO-ESOPHAGEAL REFLUX DISORDER• PEPTIC ULCER ( UPPER G.I.TRACT ULCER)• DUODENAL ULCER• HEPATITIS A• CHOLECYSTITIS• APPENDICITISCIRRHOSIS HEPATIS• CHOLELITHIASIS• ADENOCARCINOMA COLON• LACTASE DEFICIENCY• GASTRIC ULCER• GASTROESOPHAGEAL REFLUX DISORDER• DIABETES MELLITUS• ACUT PACREATITIS• MUMPS ( PAROTITIS EPIDEMICA)àPOST

PUBERTAL BECOME ORCHITIS • GASTRITIS• ATROPHIC GASTRITISàANEMIA

PERNICIOUS ( INTRINSIC FACT + VIT.B12)• PEPTIC ULCER ( UPPER G.I.TRACT ULCER)• DUODENAL ULCER• HIRSCHSPRUNG DISEASE ( CONGENITAL

MEGACOLON)