内科学DisordersofDigestiveSysVIP专享VIP免费

第1页共28页编号：时间：2021年x月x日书山有路勤为径，学海无涯苦作舟页码：第1页共28页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、intestineHistoryandsymptomsabdominalpaindiarrheaglucosecarbohydrate:fructosedigestiveenzyme(amylopsin)maltoseproteins:aminoacidsdigestion(trypsin)fats:fattyacids(steapsin)glycerolmovement第2页共28页第1页共28页编号：时间：2021年x月x日书山有路勤为径，学海无涯苦作舟页码：第2页共28页malnutritionCommondiseasechordapsus、intestinaltuberculosis、Crohndisease4、colonandrectumHistoryandsymptomsabdominalpaindiarrhea、constipationrectaltenesmusCommondiseaseDysentery、ulcerativecolitis、irritablebowelsyndrome、carcinomaoflargeintestine5、liverHistoryandsymptomscomplaintorpainofhepaticregionhepatauxetendernessofhepaticregionportalhypertensionjaundicehepaticencephalopathynutritiondysmetabolismCommondiseaseviralhepatitis、cirrhosis、primaryhepaticca...