11

Digestive System I

dr. Nelly
Zuroidah
PENDAHULU 2
AN
Abdomen adalah bagian
truncus yang terletak di
antara thorax dan pelvis.
Dengan cavum thorax
dibatasi oleh diaphragma;
dengan cavum pelvis
dibatasi oleh bidang datar
yang melalui apertura
pelvis superior atau
aditus pelvis dan pelvis
sendiri
4 QUADRANT ABDOMEN 3
9 REGIO ABDOMEN 4
5
6
7
 Dinding
Ventral 8

Abdomen
Kutan
Subkutan Fascia
abdominis superficialis
Otot & fascianya :
a. M. obliquus abdominis
externus
b. M. obliquus abdominis
internus
c. M. Transversus abdominis
b. M. Rectus abdominis
Fascia Transversalis
Peritoneum Parietalis
 DINDING 9
DORSAL
ABDOMEN

Otot
m. psoas major
m. illiacus
m. quadratus
lumborum
 10
a. Epigastrica superior

a. Epigastrica inferior

a. Circumflexa iliaca superficial a. Epigastrica superficialis

a. Circumflexa iliaca profunda

 Struktur
Khusus 11
Dinding
Abdomen
Linea alba garis o.k.
pertemuan aponeurosis
otot-2 dinding abdomen
Sarung Rectus
( Vagina m.recti
abdominis )
Kumpulan aponeurosis
yang membungkus M.
rectus abdominis
 PERITONEUM 12
DAN CAVITAS
PERITONEAL
Peritoneum :
suatu selaput serosa
yang melapisi dinding cavum
abdomen dari sebelah dalam
terdiri dari dua lembar yaitu
peritoneum parietal dan
viscerale.
Peritoneum yang langsung
melekat pada dinding
abdomen disebut
peritoneum parietale
peritoneum yang menutupi
organ-organ disebut
peritoneum viscerale
 13
Organ intra dan
extra peritoneal Intra peritoneal Extra peritoneal

Organ retro/ Gaster Ren

extraperitoneal Lien Ureter
Organ-organ dalam Vesica Fellea Vesica urinaria
cavum abdomen yang Duodenum pars superior Vena cava inf
sebagian kecil (<1/3 Hepar Erior
bagiannya) ditutupi Jejunum Aorta abdominalis
oleh peritoneum Ileum Pangkreas
visceral Colon transversum Colon ascenden
Organ intra peritoneal. Colon sigmoid Colon descenden
Sebaliknya organ yang Caecum rektum
keseluruhannya atau Appendix
hampir seluruhnya
(lebih dari setengah
bagian) dibungkus oleh
peritoneum.
14
 15
15

Gastro Intestinal Tract

 16

DIGESTI Types
Mechanical (physical)
ON Chew
Tear
Processing of food Grind
Mash
Mix
Chemical
Catabolicreactions
Enzymatic hydrolysis
Carbohydrate
Protein
Lipid
 17
Ingestion
Taking of food into the body
Peristalsis
Function of Physical movement along the tract

Digestive Digestion
Mechanical and chemical breakdown of food
System Absorption
Passage of food from digestive tract into body
Defecation
Elimination of indigestible substances from
body
 18

PROSES
PENCERNA
AN
Accessories 19
Structures
Anatomy of the Mouth and Throat
20
Human Deciduous and Permanent Teeth 21
Dorsal Surface of the Tongue 22
The Major Salivary
23
Glands
 24
Sequence
Voluntary stage
Deglutitio Push food to back of mouth
n Pharyngeal stage
(swallowin Raise
Soft palate
g) Larynx + hyoid
Tongue to soft palate

Esophageal stage
Contract pharyngeal muscles
Open esophagus
Start peristalsis
 25
Control
Nerves
Glossopharyngeal
Deglutition Vagus

(swallowing) Accessory
Brain stem
Deglutition center
Medulla oblongata
Pons

Disorders
Dysphagia
Aphagia
 26

Usually collapsed (closed)

Esophagu 3 constrictions
Aortic arch
s

Left primary bronchus
Diaphragm
Surrounded by
SNS plexus
Blood vessels
Functions
Secrete mucous
Transport food
27
 28
Peristalsis and Segmentation
 29

Sphincters
Esophagu Upper
s Lower
Abnormalities
Achalasia
Atresia
Hernia
Barrets
esophagus
Esophageal varices
 30
Stomach/
Gaster/ Usually J shaped
Lambung Left side, anterior to the
spleen
Mucous membrane
G cells make gastrin
Goblet cells make mucous
Gastric pit Oxyntic gland
Parietal cells Make HCl
Chief cells Zymogenic cells
Pepsin
Gastric lipase
Anatomy of the 31
Stomach
3 muscle layers
Oblique
Circular
Longitudinal
Regions
Cardiac sphincter
Fundus
Antrum (pylorus)
Pyloric sphincter
Contains enzymes that
work best at pH 1-2
 32
Functions
Mix food
Reservoir
Start digestion of Absorbs
Protein
Alcohol
Nucleic acids
Fats Water
Activatessome enzymes Lipophilic acid
Destroy some bacteria
B 12
Makes intrinsic factor B
12 absorption
Destroys some bacteria
Small 33
Intestine
Extends from
pyloric sphincter
ileocecal valve
Regions
Duodenum
Jejenum
Ileum
Movements
Segmentation
Peristalsis
 34
Small Intestine

Histology
Intestinal glands Intestinal enzymes
Duodenal glands Alkaline mucous
Paneth cells Lysozyme
Microvilli
Lacteals
Plica circularis
Smooth muscle
Lymphatic tissue GALT
Vascular
Small Intestine
35
Absorbs
80% ingested water Lipids
Electrolytes
Monoglycerides
Vitamins
Fatty acids
Minerals Micelles
Carbonates Chylomicrons
Active/facilitated transport
Monosaccharides
Proteins
Di-/tripeptides
Amino acids
Structures of the Alimentary
Canal 36
Structure of the Villi in the Small
Intestine 37
 38

Kelenjar kelenjar usus menghasilkan enzim

Secretes enzim pencernaan, yaitu :

digestiv a. Peptidase, berfungsi mengubah peptide

menjadi asam amino
e b. Sukrase, berfungsi mengubah sukrosa
menjadi glukosa dan fruktosa.
enzymes c. Maltase, berfungsi mengubah maltose
menjadi glukosa
d. Laktase, berfungsi mengubah laktosa
menjadi glukosa dan galaktosa
 39
Small
Intestine

Requires pancreatic
enzymes & bile to
complete digestion
 Anatomy of the Large
40
Intestine
Large
Intestine
Extends from
ileocecal valve to
anus
Regions
Cecum Appendix
Colon
Ascending
Transverse
Descending
Rectum
Anal canal
 41
Large Intestine.

Histology
No villi
No permanent circular folds
Smooth muscle
Taeniae coli
Haustra
Epiploicappendages
Otherwise like rest of Gl tract
 Large
42
Intestine
Functions
Mechanical digestion
Haustral Absorbs
churning
More water
Peristalsis
Vitamins
Reflexes B
Gastroileal K
Gastrocolic Concentrate/eliminate wastes
Chemical digestion
Bacterial digestion
Ferment carbohydrates
Protein/amino acid breakdown
 Feces Formation and Defecation 43

Chyme dehydrated to form feces Control

Feces composition Parasympathetic
Water Voluntary
Inorganic salts
Epithelial cells
Bacteria
Byproducts of digestion
Defecation
Peristalsis pushes feces into rectum
Rectal walls stretch
 44

ANY QUESTION ???