雙語醫(yī)學(xué)課件2-消化系統(tǒng)the digestive system

1、The Digestive System,The Digestive System,,Gastrointestinal tract 胃腸道Accessory organs輔助器官,(Para. 1),,,,The organization ofthe gastrointestinaltractWhat are the four layers?(Concentric layers)SublayersIntrins

2、ic nerves (內(nèi)神經(jīng)),The gastrointestinal tract胃腸道,,,,,,The submucosal plexus(Meissner plexus) 黏膜下層神經(jīng)叢（即邁斯納神經(jīng)叢） The myenteric plexus(Auerbach plexus) 腸肌神經(jīng)叢（即奧爾巴赫神經(jīng)叢) The subserosal plexus漿膜下神經(jīng)網(wǎng)叢,What are the t

3、hree nerve plexuses?,,,,,,唾液 saliva味蕾 taste buds嗅神經(jīng) olfactory nerves胃液的分泌 the secretion of gastric juice恒牙 permanent teeth咀嚼 mastication食管 esophagus蠕動 peristalsis外層縱向肌 outer longitudinal la

4、yers of muscles內(nèi)層環(huán)形肌 inner circular layers of muscles,Mouth and Esophagus口腔和食道,,,,1.Three pairs of salivary glands1 liter of saliva per day,salivation唾液分泌,,,,1.Three pairs of salivary glands1 liter of saliva per

5、day2. Autonomic nervous system (自主神經(jīng)系統(tǒng))controls salivation. (sympathetic and parasympathetic) (But not regulated by hormones),salivation唾液分泌,,,,食糜 chyme十二指腸 duodenum The stomach’s major anatomic

6、 boundaries:食管括約肌 賁門 胃大彎和胃小彎 幽門括約肌 十二指腸 What are the functional areas of the stomach?fundus, body, antrum,Stomach胃,,,,,,,,,,,胃壁 stomach wall 斜肌層 a layer of oblique muscle中環(huán)

7、層和外縱層在胃底最薄The circular and longitudinal layers of muscle are thinnest in the fundus.胃體和胃竇逐漸變厚The layers become progressively thicker in the body and antrum.胃粘膜 the mucosa of the stomach,Stomach胃,,,,1. 血液通過腹腔一支動脈輸

8、入胃中Blood is supplied to the stomach by a branch of the celiac artery.2. 主動脈沿胃大彎和胃小彎分布 Major arteries lie along the greater and lesser curvatures.3. 分叉深入漿膜和肌層 branch and penetrate the serosa and muscle layers4. 形成豐富

9、的側(cè)支循環(huán)form a rich collateral circulation,Stomach胃,,,Cardiovascular System: Major Vessels,1. renal artery 腎動脈 2.vertebral artery 脊椎動脈 3. subclavian artery 鎖骨下動脈 4. aorta 主動脈 5. coronary

10、artery 冠狀動脈 6. celiac artery 腹腔動脈 7. superior mesenteric artery 腸系膜上動脈 8. lumbar artery 腰動脈 9. inferior mesenteric artery 腸系膜下動脈 10. gonadal artery 生殖腺動脈,renal artery 腎動脈verte

11、bral artery 脊椎動脈3. subclavian artery 鎖骨下動脈4. aorta 主動脈 5. coronary artery 冠狀動脈6. celiac artery 腹腔動脈7. superior mesenteric artery 腸系膜上動8. lumbar artery 腰動脈9. inferior mesenteric artery 腸系膜

12、下動10. gonadal artery 生殖腺動脈,A rich circulation,stomach,,liver,Gastric Vein,Splenic Vein,靜止?fàn)顟B(tài)下沒有壁張力In resting state, no wall tension.吞咽動作致使底部松弛Swallowing causes the fundus to relax.食物存儲在垂直層或斜纖層Food is stored in ver

13、tical or oblique layers液體相對快速地流入胃竇Fluids flow relatively quickly down to the antrum.蠕動波使胃動力開始增強Gastric motility increases with peristaltic waves(蠕動收縮頻率)同時受神經(jīng)和激素活動影響。Influenced by neural and hormonal activity.,Gastr

14、ic Motility胃運動,,1. 胃液或胃分泌物gastric juices or gastric secretion2. 粘液、酸、酶、激素和內(nèi)因子Mucus, acid, enzymes, hormones, and intrinsic factor3.激素被分泌到血液里The hormones are secreted into the blood.4. 其他胃分泌物直接進(jìn)入胃腔。The other gastr

15、ic secretions into the stomach lumen,,Gastric Secretion胃分泌,,,粘液形成一道防護(hù)屏障來抵御酸和蛋白水解酶。Mucus forms a protective barrier against acid and proteolytic enzymes.,,Gastric Secretion胃分泌,,,1. 胃液的成分取決于其體積和流動速度The composition of g

16、astric juice depends on volume and flow rate2. 氫和氯, 鈉, 鉀 的濃度變化 The change of the concentrations of hydrogen and chloride, sodium , and potassium3. 分泌的速度和體積在早上為最小值，在下午和晚上達(dá)到最大值。The rate and volume of secretion are

17、 lowest in the morning and evening.,,Gastric Secretion胃分泌,,,What inhibits gastric secretion(胃分泌)? (L.95-96) Unpleasant odors and tastes; Rage, fear, painWhat causes increased secretions?分泌物增多與敵對心理或敵意厭惡感有關(guān).,,Gastri

18、c Secretion胃分泌,,,1. 功能上可分為三部分：十二指腸，空腸和回腸 Divided into 3 segments: the duodenum, jejunum, and ileum2. 腹膜是包裹在腹部器官和骨盆腔上的一層漿膜 The peritoneum is the serous membrane surrounding the organs of abdomen and pelvic cavity.,,Sm

19、all Intestine小腸,,,Small intestine,,Ileocecal valve,,,jejunum,A suspensory ligament,,duodenum,,,,,jejunum,A suspensory ligament,,,,,,腹膜,Peritoneum,,Peritoneum,,,,,Mesentery,,1. 十二指腸的動脈供應(yīng)主要由胃十二指腸動脈提供。 The arterial supply

20、 to the duodenum arises primarily from the gastroduodenal artery.2. 小腸平滑肌分布為兩層：外部的縱層和內(nèi)部較厚的環(huán)層。The smooth muscles of the small intestine are arranged in two layers.,,Small Intestine小腸,,,Arterial supply to small intestin

21、e,Gastroduodenal artery,,,,,,,,,,,,食物 氯化氫和胃蛋白酶的作用(分解食物纖維和蛋白 ) 食糜 胰腺酶，腸道酶和膽鹽的作用 碳水化合物/蛋白質(zhì)/脂肪分解 水/維生素/電解液通過傳輸，擴(kuò)散或易化擴(kuò)散 經(jīng)腸道黏膜 吸收。

22、,Intestinal Digestion and Asborption腸道消化與吸收,,,,,,,,,,小腸運動食糜刺激腸道運動 混合有來自肝臟，胰腺和腸腺的分泌物 攪拌運動 腔內(nèi)物接觸到絨毛吸收細(xì)胞 推進(jìn)使食糜進(jìn)入大腸 Chyme stimulates intestinal movements Mix in secretion fro

23、m the liver, pancreas, and intestinal glands a churning motion brings the luminal content into contact with the absorbing cells of the villi. Advance the chyme toward the large intestine.,,Intestinal Mo

24、tility腸道運動,,,,,,,,,腸道運動受兩種運動影響：結(jié)腸袋分節(jié)運動和蠕動。Intestinal motility is affected by two movements:Haustral segmentationperistalsis,,Intestinal Motility腸道運動,,,The large intestine consists of:cecum 盲腸

25、 a pouchappendix 闌尾 vermiform colon 結(jié)腸rectum 直腸anal canal 肛管,,Large Intestine大腸,,,,,,,,,,The four parts of the colonascending colon→ 升結(jié)腸transverse col

26、on →橫結(jié)腸descending colon →降結(jié)腸sigmoid colon→ 乙狀結(jié)腸,,,,Large Intestine大腸,腸內(nèi)物通過盲腸和結(jié)腸受兩個括約肌控制： the ileocecal valve回盲瓣 控制食糜從回腸進(jìn)入盲腸 the O’Beirne sphincter奧貝恩括約肌控制廢物從乙狀結(jié)腸進(jìn)入直腸。2. anal sphincters 肛門括約肌 internal a

27、nal sphincter肛門括約肌 external anal sphincter肛門括約肌,,,Large Intestine大腸,What causes to kill pathogens (病原體) and bacteria throughout the gastrointestinal tract? Acid in the stomachBile acid secretionIntestinal motilit

28、yAntibody production Where are anaerobes mainly found? (L.196-197),,,Intestinal Bacteria腸道細(xì)菌,,,Accessory Organ of Digestion消化的輔助器官,What are the accessory organs of digestion?Liver →

29、produces bilegallbladder → stores bileexocrine pancreas →produces enzymes needed for the complete digestion of carbohydrates, proteins, and fats. Besides, produces an alkaline fluid.Liver →It also receives nutrient

30、s absorbed by the small intestine, metabolizing and synthesizing,,,Accessory Organ of Digestion消化的輔助器官,Liver---Secretion of BileWhere is the liver located? L.2162. The metabolic function of the liver

31、 require a large amount of blood hepatic artery( 肝動脈)provides oxygenated blood portal venous blood (門靜脈血) constitutes70% of the blood supply to

32、 the liver.,,,Accessory Organ of Digestion消化的輔助器官,Liver---Secretion of BileSecreting 700 to 1200ml bile per dayWhat does the bile contain? bile salts cholestrol bilirubin, electrolytes water膽鹽、膽固醇、膽紅素、電解液和

33、水 What is the function of bile salts? (L. 233-235),,,Accessory Organ of Digestion消化的輔助器官,Gallbladder (膽囊)Position and FunctionHow does the bile move? 膽汁從肝臟流出，經(jīng)由左或右肝導(dǎo)管進(jìn)入肝總管，并在此遇到奧迪括約肌的阻力。奧迪括約肌掌控膽汁流入

34、十二指腸。此后，膽汁經(jīng)由膽管進(jìn)入膽囊，并在此貯存、變濃。,,,Accessory Organ of Digestion消化的輔助器官,Gallbladder (膽囊) 3. How does Gallbladder work? 飯后30分鐘內(nèi)，膽囊開始收縮，奧迪括約肌松弛，迫使膽汁通過大的十二指腸乳突進(jìn)入十二指腸。在口腔和胃消化階段，迷走神經(jīng)的類膽堿分支控制膽囊的收縮。膽囊收縮的荷爾蒙調(diào)節(jié)源于縮膽囊

35、素和胃動素的釋放，縮膽囊素和胃動素是在脂肪環(huán)境下十二指腸黏膜分泌的。,,,Accessory Organ of Digestion消化的輔助器官,Exocrine Pancreas (外分泌胰腺)Location of PancreasWhy is the pancreas unique? It has both endocrine and exocrine functions.3. What does the e

36、ndocrine pancreas(內(nèi)分泌胰腺) do? secretes hormones: insulin (胰島素) glucagons (高血糖素),,,Accessory Organ of Digestion消化的輔助器官,4. What does the exocrine pancreas (外分泌胰腺) do? secrete enzymes(酶) and alkali

37、ne fluids (堿性流體),,,Accessory Organ of Digestion消化的輔助器官,Secretions drain into a system of ducts that leads to the pancreatic duct, which empties into the common bile duct at the ampulla of Vate. 分泌物流入導(dǎo)管系統(tǒng)，導(dǎo)管系統(tǒng)通

38、向胰導(dǎo)管，然后進(jìn)入法特壺腹處的總膽管。,,,Accessory Organ of Digestion消化的輔助器官,In some individuals an accessory duct branches off the pancreatic duct and drains directly into the duodenum at an opening called the minor duodenal papilla.