Anatomi GI Tract, 2012.ppt

8/10/2019 Anatomi GI Tract, 2012.ppt

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Anatomi & Fisiologi

Gastrointestinal System

11/22/2014 Padoli, GI Tract.


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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)


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


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


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


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

only ~10 13 cells!)11/22/2014 Padoli, GI Tract.


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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


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


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)

& Exocrine functions - high Bicarbonate11/22/2014 Padoli, GI Tract.


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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

11/ 22/2014 Padoli, GI Tract.
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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.


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


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

dan ileum pada dinding abdomen posterior11/22/2014 Padoli, GI Tract.


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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

11/22/2014 P d li GI T t

RetroperitonealPancreasKidneyUreterInferior vena cava Abdominal aortaUrinary bladderReproductive organs

Anatomi GI Tract, 2012.ppt

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