Sistim Pencernaan Fisiologi (H.O KULIAH )

8/16/2019 Sistim Pencernaan Fisiologi (H.O KULIAH )

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FAAL SISTEM PENCERNAAN

Dr. H. SONNY P LAKSONO M.Kes



Overview of

GI Processes

Food

Secretion

Digestion

Absorption

Boo! "esses

Motiit#



Mo$t%

•on# p&rt in'o'e! in ingestion

•Or& c&'it#( b$cc& c&'it#

•Lips) c%ee*s) %&r! &n! so+t p&&te &n!

tong$e

•Most &cti'it# re&te! to &ccessor#

org&ns ,teet%) s&i'&r# g&n!s) &n!

tong$e-

•Foo! is c%ee!) /i0e! it% s&i'&

cont&ining en1#/es) begins s&oing



&ccessor# !igesti'e org&ns

•Organs

–teeth, tongue, gallbladder, glands

( salivary glands, liver, pancreas)•contribute to food breakdown



P%&r#n0

•orop%&r#n0 to &r#ngop%&r#n0

•,n&sop%&r#n0 not in'o'e! in !igestion-

•Co//on p&ss&ge&# +or +oo!) +$i!s &n!&ir

•No p%#sic& or /ec%&nic& !igestion

•Absorption2 none



Esop%&g$s

•/$sc$&r t$be &bo$t 34c/ ,56 inc%es- ong•Co&pse! %en not in $se•Ro$te! %ere &s epigottis coses o++ &r#n0 to+oo! entr#

•7oins sto/&c% &t c&r!i&c sp%incter •Secretes /ore /$c$s +or $bric&tion•No p%#sic& or /ec%&nic& !igestion•P%&r#n0 &n! esop%&g$s &re con!$its +ro//o$t% to sto/&c%

•Absorption2 none



Digestion



Cephalic Phase

• Anticipatory/Sensory

• Mediated via vags/Ach

! Chief cells secrete acid

! Parietal cells secrete pepsinogen

! G cells secrete gastrin

• "ags also #ediates via pancreas



Gastric Phase

• $egins with arrival of food in sto#ach

• Two sti#li%

! stretch receptors in sto#ach

! digested protein

• G cells in antr# sti#lated &y vags and

&y protein



Digesti'e process in'o'es 8 essenti& &cti'ities

5. ingestion2 t&*ing +oo! in – bo$s2 &n &/o$nt o+ +oo! p&ssing t%ro$g% tr&ct

3. prop$sion2 /o'es +oo! t%ro$g% tr&ct – s&oing2 'o$nt&r# – perist&sis2 in'o$nt&r# /$sc$&r &'es /o'es +oo! +or&r!

9. /ec%&nic& !igestion2 p%#sic& c%eing) /i0ing) c%$rning – seg/ent&tion2 r%#t%/ic oc& constrictions o+ intestine +or /i0ing

:. c%e/ic& !igestion2 c&t&bois/( bre&*!on o+ po#/ers into/ono/ers b# en1#/es – begins in /o$t%) essenti&# co/pete in s/& intestine

4. &bsorption2 p&ss&ge o+ !igeste! en! pro!$cts &cross & into boo!

– /ono/ers) 'it&/ins) /iner&s &n! &ter – p&ss t%ro$g% /$cos& ces ining tr&ct – s/& intestine /&;or &bsorption site

8. !e+ec&tion2 ei/in&tes in!igestibe s$bst&nces &n! ot%er &stes +ro/bo!# 'i& &n$s in +or/ o+ +eces



Sto/&c%

•<%o!ing t&n*= i/port&nt in protein

!igestion

•Foo! con'erte! into c%#/e•M&0i/$/ c&p&cit# &bo$t :L or 5 g&on

•L&rge ongit$!in& +o!s c&e! r$g&e

•P#oric sp%incter contros e/pt#ing



Microanato#y of the GtThe $asic Plan

• Mcosa

• S&#cosa

• Msclaris

• Serosa

• 'egional variations (



Secretion of )ater and *lectrolytes

Na+

+

!l"

Na+

+

!l"

Na+

#$O

L

>M

EN

%nterocyte

%nterocyte &ight 'unction

+



S/& Intestine

•/&;or !igesti'e org&n•Longest p&rt o+ &i/ent&r# c&n&

–,928 %o$r ;o$rne#-

•9 s$b!i'isions –5- !$o!en$/•s%ortest b$t ots going on•Hep&top&ncre&tic &/p$&2 bie !$ct &n! /&inp&ncre&tic !$ct enter

–3- ;e;$n$/•/i!!e portion

–9- ie$/•&st p&rt ;oins &rge intestine &t ieocec& '&'e



+, Secretion &y Parietal Cells

+

#+

%nterocyte

%nterocyte

L

>M

EN

!O$ + #$O

#!O" + #+

!l"

#!O"

CA

!O$



+CO-. Secretion &y Pancreatic Cells

%nterocyte

%nterocyte

+Na+

L

>M

EN

!l"

#!O"

CA

!O$ + #$O

#+

+ #!O

"

!O$



A&sorption



Pri#ary S&stances A&sor&ed

• Car&ohydrates

• Peptides

• ats



Motility



Two Types of Move#ent

• Peristaltic

! #oves food forward

• Seg#ental

! #i0ing



So#e Selected GI Disorders

• Disorders of the GI Tract

! #ala&sorption 1lactase deficiency2

! #otility 1G*'D2 ! constipation/diarrhea

! &leeding and pain

• Disorders of Accessory Organs ! Ascites



3actase Deficiency

• Deficiency of lactase

at &rsh &order

• Increased lactose provides car&on for

&acteria

• Presents as &loating4

cra#py pain4 os#oticdiarrhea Microvills

*n5y#es



Constipation

• Many Cases

! 7erogenic

• eg% +irschsprng8s

! Mscle wea9ness

• eg% post.srgery

! 3ow.reside diets• T#t(



Diarrhea . Three Mechanis#s• Os#otic

! os#oticant in intestine

• Secretory

! e0cessive #cosal secretion

! to0ins4 so#e t#ors

• Motility

! srgical

#$O



3a0atives )e :now and 3ove

• A; Irritants and Sti#lants

! Castor oil4 aloe4 phenophthalein

• $; $l9ing Agents ! Psylli#4 &ran4 #agnesi#

• Stool softeners

! Dcosate4 #ineral oil4 glycerin

Sistim Pencernaan Fisiologi (H.O KULIAH )

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