内科学DisordersofDigestiveSysVIP免费

DisordersofDigestiveSystemBasicstructureofdigestivesystemGastrointestinaltractHistologicorganizationanatomyandphysiologyofSTOMACHzonationofstomach•cardia•fundus•body•antrumReceptorofparietalcellAcetylcholineReceptorsofhypersecretionGastrinHistamineProstaglandinsReceptorsofhyposecretionSomatostatinHistologicorganizationoftheGItractepitheliummucosalaminapropriamuscularismucosaewalloftheGIsubmucosamuscularisinnercircularlayerouterlongitudinallayerserosaDigestiveglands•liver:complexfunction•pancreas:endocrine:insulintwofunctionstrypsinexocrine:amylopsinsteapsin•biliarysystemeLIVERDoublebloodsupplyPortalvein75%Hepaticartery25%lobulesofliverfundamentalunitoftheliverOtherassociatedorgans•peritoneum•mesentery•omentumFunctionoftheDigestiveSystemDigestionAbsorptionMetabolismExcretionEndocrineDigestion:digestionreferstotheconversionofingestedfoodmoleculesintosmallercapableofbeingabsorbedintothebloodandlymph.Absorption:Absorptionreferstotheprocessofabsorbablemoleculesenteringthebloodorlymph.activetransportationabsorptivemechanismssimplediffusionfacilitateddiffusionendocytosislong-chainfattyacid→lymphmonoglyceridesothernutrients───→bloodMetabolismofliverbiochemicalprocessesabsorbednutrientsareprimarilymanagedtoxinsaredetoxicatedhormonesareinactivetedExcretion:bilirubin,cholesterineandsomedrugsareexcretedbytheliver.Endocrin:endocrinecellsinthestomach,intestine,andpancreas.Theycansecretalotofhormones.•Tillnow,mornthantwentyhormoneshavebeenfoundinthedigestivesystem.•Thenumberofhormoneproducedbythedigestivesystemisincreasing.•ThehormonesproducedbyGItractnotonlymodulatetheactivityofdigestivesystembutalsoplayanimportantroleintheregulationofalotofotherphysiologicalfunctions.•Inrecentyears,itisfoundthatGItractcanproduceanumberofpeptidehormones.•Thispeptidehormonespreviouslyfoundtobeproducedbythebrain.•Thesepeptidesarenamedas`brain-gutpeptides`DiagnosticmeasuresHistoryandsymptomsPhysicalexamination(sign)LaboratorysymptomsandcommondiseasesHistory:Historytakingcanprovideveryimportantinformation.Forsomedigestivediseasesonlybythesemeanscanbeestablishedaccuratediagnoses.AcutegastritisAcuteappendicitis1、esophagusHistoryandsymptomschestpaindysphagiaheartburnacidrefluxCommondiseaseesophagitis、GERD、esophagealcarcinoma、achalasiaofcardia2、stomachandduodenumHistoryandsymptomsepigastricpainanorexianausea、vomitingbelch、acidregurgitationCommondiseaseacuteandchronicgastritis、pepticulcer、gastriccarcinoma、functionaldyspepsia3、intestineHistoryandsymptomsabdominalpaindiarrheamalnutritionCommondiseasechordapsus、intestinaltuberculosis、Crohndisease4、colonandrectumHistoryandsymptomsabdominalpaindiarrhea、constipationrectaltenesmusCommondiseaseDysentery、ulcerativecolitis、irritablebowelsyndrome、carcinomaoflargeintestine5、liverHistoryandsymptomscomplaintorpainofhepaticregionhepatauxetendernessofhepaticregionportalhypertensionjaundicehepaticencephalopathynutritiondysmetabolismCommondiseaseviralhepatitis、cirrhosis、primaryhepaticcarcinoma。glucosecarbohydrate:fructosedigestiveenzyme(amylopsin)maltoseproteins:aminoacidsdigestion(trypsin)fats:fattyacids(steapsin)glycerolmovement6、billductHistoryandsymptomsabdominalpainjaundicemurphy’ssignCommondiseasecholelithiasis、cholecystitis、biliarytractroundworm、biliarytracttumor7、pancreasHistorya...