FILLING OF STOMACH

Food on entry into stomach arranges in different layers:

b. Ist eaten food arranges against greater curvature in
fundus & body of stomach
c. The successive layers of food lie near the lesser
curvature and the last eaten food lie at lesser
curvature near UES (cardiac sphincter)
d. The liquid remains near lesser curvature & flow
towards pylrus along with a V shaped groove.
e. The groove called magenstrasse is formed by stomach
muscle
 EMPTYING OF STOMACH

1.The food remains in stomach for 3 hrs.

2.Chyme is formed by its digestion.
3.With peristalsis contractions of stomach
& simultaneous relaxation of pyloric
sphincer slowly it is released into intestine.
4.The emptying is slow & takes 3-4 hrs.
5. Gastric emptying is influenced by
following factors:
a. Volume of gastric content: More the
volume of gastric contents more will be
gastric emptying into intestine.
 APPLIED PHYSIOLOGY
b. Consistency of gastric contents: liquids
leave the stomach rapidly as constricted pyloric
sphincter allow liquids to pass through but not
solids which are allowed to pass through only on
becoming semifluid.
c. Chemical Composition: Carbohydrates leave
stomach rapidly than proteins and proteins rapid
than fats. So fatty food remains in stomach for
long time.
d. pH of gastric Content: Gastric Chyme with
low pH leave the stomach slowly as it has to be
neutralised by the lkalineintestinal juices in
duodenum to prevent damage to small intestine.
e. Osmolar Concentration of gastric content:
 APPLIED PHYSIOLOGY
Regulation of Gastric Emptying:
2. Nervous factors: Enterogastric
reflex: When the chyme enters the
intestine the gastric muscle is inhibited
and motility deceases to stop gastric
emptying. This reflex is through vagus
nerve.
3. Hormonal factors: When acid chyme
enters dudenumthe duodenal mucosa
release some hormones which enters
blood and act on stomach to inhibit its
motility. The inhibitory hormones are
a. VasoactiveIntestinal Peptide (VIP) b.
 APPLIED PHYSIOLOGY of stomach

1. Gastric Dumping Syndrome:

Rapid gastric emptying into jejenum leading
to series of upper abdominal symptoms.
Occurs in those patients whose partial stomach
has been surgically removed (partial
gastrectomy) or have undergone gastric bypass
surgery (gastro-enterostomy).
The gastric emptying either occurs immediately
after meal (early dumping) or about few.hrs
after meal (late dumping).
Causes:
5. Gastric surgery
6. Zollinger Ellison Syndrome ( Severe peptic
 APPLIED PHYSIOLOGY of stomach
Symptoms of Dumping Syndrome:
2. Nausea, Vomiting
3. Feeling of abdominal fullness and
tightness after meal
4. Diarrhoea- as food is not fully digested
due to rapid transit in GIT.
5. Sweating & Weakness
6. Fatigue & Dizziness
7. Palpitation (feeling of heart beat).
 APPLIED PHYSIOLOGY of stomach

2. Gastroparesis:
A chronic disorder of delayed gastric
emptying in patients with :
c. Diabetes mellitus
d. Post surgery
e. Motility disorders
f. Gastric infection
g. Endocrine disorders
h. Decreased myentric plexus gangle
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Symptoms of Gastroparesis:
2. Early satiety (not satisfaction after
eating)
3. Nausea
4. Vomiting
5. Fullness in abdomen
6. Upper abdominal discomfort.
 Vomiting
Vomiting is abnormal emptying of stomach and upper part
of intestine via esophagus through mouth.
Causes:
3. Irritation in GIT
4. Mecahnical stimulation of pharynx
5. Pregnancy
6. Alcohal
7. Stimulation of labyrinth of ear eg sea sickeness,
mountain sickeness
8. Acute GI infection
9. Metabolic disorers
10.Increase Intracranial Pressure
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Mechanism of Vomitting
2. Nausea: It occurs before vomiting. It is an unpleasant
sensation and desire to do vomiting. In this a large
amount of salive collects in mouth.
3. Retching: Strong involuntary movements of GI tract start
even before actual vomiting called retching.
4. Act of Vomiting:
e. Beginning of reverse peristalsis (anti peristalsis) from
ileum towards mouth through intestine pushing the
intestine contents into stomach within few minutes.
f. Deep inspiration followed by temporary stoppage of
breathing
g. Closure of glottis
h. Upward & forward movement of larynx
i. Elevation of soft palate.
j. Contraction of diaphragm & abdominal muscles to
increase intra abdominal pressure.
k. Rise in intragastric pressure due to f ABOVE.
 APPLIED PHYSIOLOGY
Vomiting Reflex:
Vomiting is a reflex act.
Sensory impulses arise from irritated part of GIT.
Transmited to Vomiting centre in medulla oblongata
of brain via vagus nerve & sympathetic afferent fibres.
Efferent impulses (motor) arise from Vomiting centre
& transmited via V, VII, IX & X cranial nerves to upper
part of GIT and through spinal nerves to diaphgram and
abdominal muscles.

Centre for Vomiting during Motion Sickness or

vomiting induced by drugs like morphine:
It is in floor of 4th ventricle of brain called