Documente Academic
Documente Profesional
Documente Cultură
BY ACHMAD AMINUDDIN
FUNCTIONS
INGESTION:
taking food into the mouth.
SECRETIO:
release of water,acid, buffer, and enzymes
into the lumen of the GI tract.
MIXING AND PROPULSION:
churning and propulsion of food through the
GI tract.
CONTINUATION
DIGESTIO:
mechanical and chemical breakdown of food
ABSORPTION:
passage of digested products from the GI
tract into the blood and lymph.
DEFECATION:
the elimination of feces from the GI tract.
ORAL REGION
INCLUDES :
THE ORAL CAVITY
TEETH
GINGIVAE
TONGUE
PALATE
THE REGION OF THE PALATINE
TONSILS
ORAL CAVITY
CONSIST OF
THE ORAL VESTIBULE
THE ORAL CAVITY PROPER
POSTERIOR
THE TERMIAL GROOVE OF THE TONGUE.
PALATOGLOSSAL ARCHES.
THE ROOF
THE PALATE.
ORAL VESTIBULE
CONTAIN
ORBICULARIS M.
SUPERIOR AND INFERIOR LABIAL M.
VESSELS AND NERVES.
ARE COVERED BY
SKIN.
MUCOUS MEMBRANE
PHILTRUM.
THE VERMILLION BORDER.
THE GINGIVAE
COMPOSED OF FIBROUS TISSUE COVE
RED WITH MUCOUS MEMBRANE.
FIRMLY ATTACH TO THE ALVEOLAR
PROCESSES OF THE JAWS AND THE
NECKS OF THE TEETH.
TEETH
SET IN THE ALVEOLI OF THE UPPER AND LOWER
JAWS.
CHILDREN HAVE 20 DECIDUOUS ( PRI MARY ) TEETH.
THE FIRST TOOTH USUALLY ERUPS AT 6 TO 8 MONTH
OF AGE AND THE LAST TOOTH BY 20 TO 24 MONTH
OF AGE.
THE PERMANENT TEETH NORMALLY 16 INEACH JAW,
3 MOLARS, 2 PREMOLARS,1 CA NINE AND 2
INCISORS, USUALLY IS COMPLE TE BY THE
MIDTEENS EXCEPT FOR THE 3rd MOLAR, WICH USUAL
LY ERUP DURING THE LATE TEENS OR EARLY
TWETIES
TEETH
CONSIST OF,
THE CROWN
PROJECTS FROM THE GINGIVA
THE NECK
THE PART OF THE TOOTH BETWEEN THE
CROWN AND ROOT.
THE ROOT
IS FIXED IN THE ALVEOLUS BY A FIBROUS
PERIODONTAL MEMBRANE.
DENTIN is covered by
ENAMEL over the crown
CEMENT over the root
PULP CAVITY, contain
CONNECTIVE TISSUE.
BLOOD VESSELS.
NERVES.
SALIVA
SALIVARY AMYLASE
source ; salivary glands.
substrates : starches ( polysacharides ).
products : maltose ( disaccharide ).
maltotriose ( trisaccharide ).
a-dextrins.
LINGUAL LIPASE
source : lingual glands in the tongue.
substrates : triglycerides ( fats and oils ) and
other lipids.
products : fatty acids and diglycerides.
PALATE
THE HARD PALATE
SEPARATES THE AMTERIOR PART OF THE
ORAL CAVITY FROM THE NASAL CAVITY.
PHARYNX
EXTENDS FROM THE CRANIAL BASE TO
THE INFERIOR BORDER OF THE CRICOID
CARTILAGE ANTERIORLY AND THE
INFERIOR BORDER OF THE C6
VERTEBRA POSTERIORLY.
INTERIOR OF THE PHARYNX
- NASOPHARYNX.
- OROPHARYNX.
- LARYNGOPHARYNX
ESOPHAGUS
A MUSCULAR TUBE THAT EXTENDS FROM
THE PHARYNX TO THE STOMACH
DESCENDS THROUGH THE POSTERIOR
MEDIASTINUM, ESOPHAGEAL HIATUS IN THE
DIAPHRAGM JUST JUST TO THE LEFT OF
MEDIAN PLANE AT THE LEVEL OF VT 10 ,
ENTER THE STOMACH THROGH CARDIAL
ORIFICE TO THE LEFT OF MID LINE AT THE
LEVEL OF THE 7 TH LEFT COSTAL CARTILAGE
AND VT 11
ESOPHAGUS
ESOPHAGUS
The esophagus descends in to the posterior
mediastinum from the superior mediastinum
passing posterior and to the right of the arch of the
aorta.
Passes through the esophageal hiatus in the
diaphragm at the level of the T10 vertebra anterior
to the aorta.
Three constrictions
- the arch of the aorta.
- the left main bronchus.
- the diaphragm.
NERVES OF THECERVICAL
ESOPHAGUS
Somatic motor and sensorik upper half.
Parasympathetic, sympathetic
and visceral sensory
-- lower half.
The cervical esiphagus receives
- somatic fibers via branches from the
recurrent laryngeal nerve.
- vasomotor fibers from the cervical
sympathetic trunk.
DEGLUTITION
THE MOVEMENT OF FOOD FROM THE MOUTH
INTO THE STOMACH.
FACILITATED BY THE SECRETION OF SALIVA
AND MUCUS AND INVOLVES THE
MOUTH,PHARYNX AND ESOPHAGU
THREE STAGES;
- the voluntary stage, the bolus is passed in
to the oropharynx.
- the pharyngeal stages.
- the esophageal stage.
STAGE I : VOLUNTARY
THE BOLUS IS COMPRESSED AGAINST
THE PALATE AND PUSHED FROM THE
MOUTH IN TO THE OROPHARYNX,
MAINLY BY MOVEMENTS OF THE
MUSCLES OF THE TONGUE AND SOFT
PALATE
Fig 8.39 A , B
STAGE 3 ; INVOLUNTARY
SEQUENTIAL CONTRACTION OF ALL
THREE CONSTRICTOR MUSCLES
FORCES THE FOOD BOLUS INFERIORLY
IN TO THE ESOPHAGUS
STOMACH
A FOOD BLENDER.
RESERVOIR.
CHIEF FUNCTION , ENZYMATIC DIGESTI
ON, GASTRIC JUICE CONVERTS A MASS
OF FOOD IN TO A LIQUID MIXTURE
CHYME THAT PASSES IN TO
DUODENUM.
STOMACH
HAS 4 PARTS AND 2 CURVATURES,
CARDIA.
FUNDUS.
BODY.
PYLORIC PART.
LESSER CURVATURE.
GREATER CURVATURE.
SMALL INTESTINE
EXTENDS FROM THE PYLORUS TO THE
ILEOCECAL JUNCTION.
THE PRIMARY SITE OF ABSORPTION OF
NUTRIEN FROM INGESTED MATERIAL.
CONSIST OF DUODENUM, JEJUNUM
AND ILEUM.
DUODENUM
SUPERIOR PART.
DESCENDING PART.
HORIZONTAL PART.
ASCENDING PART.
6 7 METERS.
JEJUNUM , two fifth.
ILEUM , three fifth.
THE MESENTERY
ATTACHES THE JEJUNUM AND ILEUM TO THE
POSTERIOR ABDOMINAL WALL.
THE ROOT OF THE MESENTERY, EXTENDS FROM
THE DUODENOJEJUNAL JUNCTION ON THE LEFT
DIDE OF V.L. 2 TO THE ILEOCOLIC JUNCTION AT
THE RIGHT SACROILIAC JOINT ( 15 CM LONG ).
LARGE INTESTINE
CONSIST OF
CECUM.
COLON
ASCENDING.
TRANSVERSE.
DESCENDING.
SIGMOID.
RECTUM.
ANAL CANAL.
COLON CAN BE
DISTINGUISED FROM SMALL
INTESTINE,
CECUM
THE FIRST PART OF THE LARGE
INTESTINE.
INTRA PERITONEALLY.
HAS NO MESENTERY.
THE ILEUM ENTER THE CECUM ,
ILEOCECAL ORIFICE.
ILEO CECAL VALVE.
APPENDIX
EXTENDS FROM THE POSTEROMEDIAL
ASPECT OF THE CECUM, INFERIOR TO
THE ILEOCECAL JUNCTION/
HAS THE MESOAPPENDIX.
USUALLY RETROCECAL.
ITS BASE MOST OFTENLIES DEEP TO
Mc. BURNEY POINT.
DESCENDING COLON
RETRO PERITONEALLY.
FROM THE LEFT COLIC FLEXURE IN TO
THE LEFT ILIAC FOSSA.
IN THE ILIAC FOSSA HAS A SHORT
MESENTERY ( 33 0/0 ).
RECTUM
fig 3.33
429
RECTUM
The rectosigmoid junction lies anterior to the S3
vertebra. At this point , the taenia of the sigmoid
colon spread out to form a continuous outer
longitudinal layer of smooth muscle, and the fatty
omental appendices are discontinued.
The sacral flexure of the rectum
The rectum ends anteroinferior to the tip of the
coccyx, immediately before the anorectal flexure of
the anal canal, that occur as the gut perforates the
pelvic diaphragm
fig 241
272
RECTUM
The roughly 80 the anorectal flexure is an
important mechanism for fecal continence,
being maintained during the resting stage
by the tonus of the puborectalis muscle and
by its contraction during peristaltic
contraction if defecation is not to occur.
The ampula of the rectum receives and
holds an accumulating fecal mass until it is
expelled during defcation
RECTUM
Peritonium covers the anterior and lateral
surface of the superior third of the rectum,
only the anterior surface of the middle third,
and no surface of the inferior third because
it is subperitoneal.
Rectovesical pouch.
Rectouterine pouch.
Pararectal fosae
fig 3.34
430
VENOUS DRAINAGE
The superior , middle and inferior rectal veins.
The superior rectal vein drains into the portal
venous system.
The middle and inferior rectal veins drains into
systemic system
The rectal venous plexus
- the internal rectal venous plexus.
- the externsl rectal venous plexus
LYMPHATIC DRAINAGE
From the superior half of the rectum pass to
the pararectal l.n , and then to the inferior
mesenteric l.n , -- lumbar l.n.
From the inferior half of the rectum drains
directly to sacral l.n.
From distal ampulla , drains into the internal
iliac l.n.
FIG 3,35
431
432
ANAL CANAL
Anal canal extends from the superior
aspect of the pelvic giaphragm to the anus.
Surrounded by internal and axternal anal
sphincters, descends posteroinferiorly
between the anococcygeal ligament and the
perineal body
FIG 3.42 B
FIG 3.43
ANAL CANAL
Extends from the superior aspect of the
pelvic diaphragm to the anus
Surroumded by internal and external anal
sphincter,descends posteroinferiorly between
the anococcygeal ligamentum and the
perineal body.
Anal column
- contain the terminal branches of the
superior rectal artery and vein
fig 3.45