双语医学课件-消化系统

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,The Digestive System,The Digestive System,Gastrointestinal tract,胃肠道,Accessory organs,辅助器官,(Para. 1),The organization of,the gastrointestinal,tract,What are the four layers?,(Concentric layers),Sublayers,Intrinsic nerves (内神经),The gastrointestinal,tract,胃肠道,The submucosal plexus,(Meissner plexus),黏膜下层神经丛,（,即迈斯纳神经丛）,The myenteric plexus,(Auerbach plexus),肠肌神经丛,（即奥尔巴赫神经丛),The subserosal plexus,浆膜下神经网丛,What are the three,nerve plexuses?,唾液,saliva,味蕾,taste buds,嗅神经,olfactory nerves,胃液的分泌,the secretion of gastric juice,恒牙,permanent teeth,咀嚼,mastication,食管,esophagus,蠕动,peristalsis,外层纵向肌,outer longitudinal layers of muscles,内层环形肌,inner circular layers of muscles,Mouth and Esophagus,口腔和食道,1.Three pairs of salivary glands,1 liter of saliva per day,salivation,唾液分泌,1.Three pairs of salivary glands,1 liter of saliva per day,2. Autonomic nervous system,(自主神经系统),controls salivation.,(sympathetic and parasympathetic),(But not regulated by hormones),salivation,唾液分泌,食糜,chyme,十二指肠,duodenum,The stomachs major anatomic boundaries:,食管括约肌 贲门,胃大弯和胃小,弯,幽门括约肌,十二指肠,What are the functional areas of the stomach?,fundus, body, antrum,Stomach,胃,胃壁,stomach wall,斜肌层,a layer of oblique muscle,中环层,和,外纵层,在,胃底,最薄,The circular,and,longitudinal layers of muscle,are thinnest in the,fundus,.,胃体和,胃窦,逐渐变厚,The layers become progressively thicker in the body and,antrum,.,胃粘膜,the mucosa of the stomach,Stomach,胃,1. 血液通过,腹腔一支动脉,输入胃中,Blood is supplied to the stomach by,a branch of the celiac artery.,2. 主动脉沿,胃大弯,和,胃小弯,分布,Major arteries lie along,the greater and lesser curvatures.,3. 分叉深入,浆膜,和,肌层,branch and penetrate,the serosa,and,muscle layers,4. 形成丰富的,侧支循环,form a rich,collateral circulation,Stomach,胃,Cardiovascular System: Major Vessels,1. renal artery 肾动脉,2.vertebral artery 脊椎动脉,3. subclavian artery 锁骨下动脉,4. aorta 主动脉,5. coronary artery 冠状动脉,6. celiac artery 腹腔动脉,7. superior mesenteric artery 肠系膜上动脉,8. lumbar artery 腰动脉,9. inferior mesenteric artery 肠系膜下动脉,10. gonadal artery,生殖腺动脉,renal artery,肾动脉,vertebral artery,脊椎动脉,3. subclavian artery,锁骨下动脉,4. aorta,主动脉,5. coronary artery,冠状动脉,6. celiac artery,腹腔动脉,7. superior mesenteric artery,肠系膜上动,8. lumbar artery,腰动脉,9. inferior mesenteric artery,肠系膜下动,10. gonadal artery,生殖腺动脉,A rich circulation,stomach,liver,Gastric Vein,Splenic Vein,静止状态下没有,壁张力,In resting state, no,wall tension,.,吞咽动作致使,底部,松弛,Swallowing causes,the fundus,to relax.,食物存储在,垂直层或斜纤层,Food is stored in,vertical or oblique layers,液体相对快速地流入,胃窦,Fluids flow relatively quickly down to,the antrum,.,蠕动波,使胃动力开始增强,Gastric motility increases with,peristaltic waves,(蠕动收缩频率)同时受,神经和激素活动,影响。,Influenced by,neural and hormonal activity,.,Gastric Motility,胃运动,1.,胃液,或,胃分泌物,gastric juices,or,gastric secretion,2,.,粘液,、,酸,、,酶,、,激素,和,内因子,Mucus, acid, enzymes, hormones,and,intrinsic factor,3.,激素,被分泌到血液里,The hormones,are secreted into the blood.,4.,其他胃分泌物直接进入,胃腔,。,The other gastric secretions into,the stomach lumen,Gastric Secretion,胃分泌,粘液,形成一道防护屏障来抵御,酸,和,蛋白水解酶,。,Mucus,forms a protective barrier against,acid,and,proteolytic enzymes,.,Gastric Secretion,胃分泌,1. 胃液的成分取决于其,体积,和,流动速度,The composition of gastric juice depends on,volume,and,flow rate,2.,氢和氯, 钠, 钾,的浓度变化,The change of the concentrations of,hydrogen and chloride, sodium ,and,potassium,3. 分泌的速度和体积在早上为最小值，在下午和晚上达到最大值。,The rate and volume of secretion are 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, pain,What causes increased secretions?,分泌物增多与敌对心理或敌意厌恶感有关.,Gastric Secretion,胃分泌,1.,功能上可分为三部分：十二指肠，空肠和回肠,Divided into 3 segments:,the duodenum, jejunum, and ileum,2.,腹膜,是包裹在腹部器官和,骨盆腔,上的一层,浆膜,The peritoneum,is the,serous membrane,surrounding the organs of abdomen and,pelvic cavity.,Small Intestine,小肠,Small intestine,Ileocecal valve,jejunum,A suspensory ligament,duodenum,jejunum,A suspensory ligament,腹膜,Peritoneum,Peritoneum,Mesentery,1. 十二指肠的动脉供应主要由,胃十二指肠动脉,提供,。,The arterial supply to the duodenum arises primarily from,the gastroduodenal artery.,2.,小肠平滑肌,分布为两层：外部的纵层和内部较厚的环层。,The smooth muscles of the small intestine,are arranged in two layers.,Small Intestine,小肠,Arterial supply to small intestine,Gastroduodenal artery,食物 氯化氢和胃蛋白酶,的作用(分解食物纤维和蛋白,),食糜 胰腺酶，肠,道酶和胆盐的作用 碳水,化合物/蛋白质/脂肪分解,水/维生素/电解液通过传输，,扩散或易化扩散 经肠,道黏膜 吸收。,Intestinal Digestion and Asborption,肠道消化与吸收,小肠运动,食糜,刺激肠道运动 混合有来自,肝脏,，,胰腺,和,肠腺,的分泌物 搅拌运动,腔内物,接触到,绒毛吸收细胞,推进,使食糜进入大肠,Chyme,stimulates intestinal movements,Mix in secretion from 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 Motility,肠道运动,肠道运动受两种运动影响：结肠袋分节运动和蠕动。,Intestinal motility is affected by two movements:,Haustral segmentation,peristalsis,Intestinal Motility,肠道运动,The,large intestine,consists of:,cecum 盲肠 a pouch,appendix 阑尾 vermiform,colon 结肠,rectum 直肠,anal canal 肛管,Large Intestine,大肠,The four parts of the colon,ascending colon, 升结肠,transverse colon,横结肠,descending colon,降结肠,sigmoid colon,乙状结肠,Large Intestine,大肠,肠内物通过盲肠和结肠受,两个括约肌,控制：,the,ileocecal,valve,回盲瓣,控制食糜从回肠进入盲肠,the,OBeirne,sphincter,奥贝恩括约肌,控制废物从乙状结肠进入直肠。,2.,anal sphincters,肛门括约肌,internal anal sphincter,肛门括约肌,external anal sphincter,肛门括约肌,Large Intestine,大肠,What causes to kill pathogens (病原体) and bacteria throughout the gastrointestinal tract?,Acid in the stomach,Bile acid secretion,Intestinal motility,Antibody production,Where are anaerobes mainly found?,(L.196-197),Intestinal Bacteria,肠道细菌,Accessory Organ of Digestion,消化的辅助器官,What are the accessory organs of digestion?,Liver,produces,bile,gallbladder, stores,bile,exocrine pancreas,produces,enzymes,needed for the complete digestion of carbohydrates, proteins,and fats. Besides, produces an,alkaline fluid,.,Liver,It also receives nutrients absorbed by the small intestine, metabolizing and synthesizing,Accessory Organ of Digestion,消化的辅助器官,Liver-Secretion of Bile,Where is the liver located?,L.216,2.,The metabolic function of the liver,require a large amount of blood,hepatic artery,(,肝动脉,),provides,oxygenated blood,portal venous blood,(,门静脉血,),constitutes70% of the blood supply,to the liver.,Accessory Organ of Digestion,消化的辅助器官,Liver-Secretion of Bile,Secreting 700 to 1200ml bile per day,What does the bile contain?,bile salts,cholestrol,bilirubin,electrolytes,water,胆盐、胆固醇、胆红素、电解液和水,What is the function of bile salts?,(L. 233-235),Accessory Organ of Digestion,消化的辅助器官,Gallbladder (胆囊),Position and Function,How does,the bile,move?,胆汁从肝脏流出，经由左或右肝导管进入肝总管，并在此遇到奥迪括约肌的阻力。奥迪括约肌掌控胆汁流入十二指肠。此后，胆汁经由胆管进入胆囊，并在此贮存、变浓。,Accessory Organ of Digestion,消化的辅助器官,Gallbladder (胆囊),3. How does,Gallbladder,work?,饭后30分钟内，胆囊开始收缩，奥迪括约肌松弛，迫使胆汁通过大的十二指肠乳突进入十二指肠。在口腔和胃消化阶段，迷走神经的类胆碱分支控制胆囊的收缩。胆囊收缩的荷尔蒙调节源于缩胆囊素和胃动素的释放，缩胆囊素和胃动素是在脂肪环境下十二指肠黏膜分泌的。,Accessory Organ of Digestion,消化的辅助器官,Exocrine Pancreas (外分泌胰腺),Location of Pancreas,Why is the pancreas unique?,It has both endocrine and exocrine functions.,3. What does the endocrine pancreas(,内分泌胰腺,) do?,secretes hormones:,insulin,(,胰岛素,),glucagons,(,高血糖素,),Accessory Organ of Digestion,消化的辅助器官,4. What does the exocrine pancreas (外分泌胰腺) do?,secrete,enzymes,(酶) and,alkaline fluids,(碱性流体),Accessory Organ of Digestion,消化的辅助器官,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,流入导管系统，导管系统通向,胰导管,，然后进入,法特壶腹,处的,总胆管,。,Accessory Organ of Digestion,消化的辅助器官,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,.,在某些个体中可见,辅助性导管,分支于,胰导管,，胆汁在被称为,小的十二指肠乳突,的开口处直接进入,十二指肠,。,