复旦大学：《内科学 Internal Medicine MBBS》课程教学资源（课件讲稿）消化系统_消化系统总论（英文）

Digestive System Introduction Prof. Ji yao Wang zhongshan hospital Fudan university Division of Gastroenterology

Digestive System Introduction Prof. Ji yao Wang

Common. Adults Saliva GERD: 79 Peptic ulcer: 10% Upper esophagealsphincte HP+:>50% FD:10% Lower esophageal IBS: 8%o Gastric cancer: 2nd Liver cancer: 3rd Gallbladder HBSAg+:10%(78%) CHB3500万 ylon Cirrhosis&HCC:100万 Pancreas IBD Carcinoma of colon Ileocecal valve Acute pancreatitis Carcinoma of pancreas Anal sphincters

Common, Adults GERD: 7% Peptic ulcer: 10% HP+: >50% FD:10% IBS: 8% Gastric cancer: 2nd Liver cancer:3rd HBsAg +: 10%(7.8%) CHB:3500万 Cirrhosis & HCC: 100万 IBD Carcinoma of colon Acute pancreatitis Carcinoma of pancreas

Structure and functions Assimilation of Lower nutrients Elimination of waste Pancrea Anal sphincters

Assimilation of nutrients Elimination of waste Structure and functions

Ingestion Structure and functions Mechanical digestion Ph pharynx Chewing(mouth) Esophagus Churning(stomach) The two activities Segmentation Propulsion (small intestine) Swallowing oropharynx) · Peristalsis under voluntary Chemical (esophagus, digestion stomach small intestine control are swallowing large intestine and defecation Stomach Absorption Small intestine Blood Large intestine 号 Mainly H2o Feces Defecation Anus

Structure and functions The two activities under voluntary control are swallowing and defecation

Characteristics of Digestive System Central Nervous System Many normal gi reflexes Central Autonomic Neural Network involve extrinsic vagus or Nodose DorsaLoot glia gangli splanchnic nerve (Sympathetic ganglia pathways. Nervous System Nervous System urase mpath gangla An active brain-gut axis Enteric Nervous System further alters function in (myenteric plexus, submucous plexus) regions Intermediate cells Effector Systems (musch, secretory epithe lium, endocrine cels, vasculature)

Characteristics of Digestive System Many normal GI reflexes involve extrinsic vagus or splanchnic nerve pathways. An active brain-gut axis further alters function in regions

Characteristics of Digestive System Immune organ Gastrointestinal-associated lymphoid tissue, GALT) Follicle Inductive site Villi 敌/ Lamina propria Submuco uscle follicle (terminal Peyers patch

 Immune organ Gastrointestinal-associated lymphoid tissue, (GALT) Characteristics of Digestive System

Characteristics of Digestive System Not only a digestive organ but also endocrine organ pancreas gastrin(胃泌素) glucagon(胰高糖素) somatostatin(生长抑素) VIP(血管活性肠肽) insulin(胰岛素)

• Not only a digestive organ but also endocrine organ pancreas gastrin (胃泌素) glucagon(胰高糖素) somatostatin( 生长抑素) VIP(血管活性肠肽) insulin(胰岛素) Characteristics of Digestive System

Structure /function and diseases The biggest organ Homeostasis Excretion Filter Hepatic Ducts LIVER Synthesis Defense Cystic Duct STOMACH Gallbladder LIVER Common Cirrhosis Bile Duct (Scarring and Nodule Formation) Small Intestine Pancreas (Duodenum Death)← symptoms SIgnS

Structure /function and diseases The biggest organ Homeostasis Synthesis Excretion Filter Defense symptoms signs Death

Common Lesions of Digestive System inflammation(炎症) e Ulcer(溃疡) ◆ bleeding出血) ◆ perforation(穿孔 ◆ neoplasm(肿瘤) o functional disturbances(功能失调)

inflammation(炎症) Ulcer (溃疡) bleeding(出血) perforation (穿孔) neoplasm (肿瘤) functional disturbances(功能失调 ) Common Lesions of Digestive System

Classification of Gl diseases Impaired Digestion and Absorption (Biliary obstruction, Chronic pancreatitis) Altered Secretion (Zollinger-Ellison syndrome duodenal ulcer Chronic pancreatitis) Altered ut Transit (Pylori/ bowel obstruction, Achalasia constipation, diarrhea)

Classification of GI Diseases • Impaired Digestion and Absorption (Biliary obstruction, Chronic pancreatitis) • Altered Secretion (Zollinger-Ellison syndrome, duodenal ulcer, Chronic pancreatitis) • Altered Gut Transit (Pylori/bowel obstruction, Achalasia, constipation, diarrhea)