Digestive System (Part-I)
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Adult Congenital Megacolon with Acute Fecal Obstruction and Diabetic Nephropathy: a Case Report
2726 EXPERIMENTAL AND THERAPEUTIC MEDICINE 18: 2726-2730, 2019 Adult congenital megacolon with acute fecal obstruction and diabetic nephropathy: A case report MINGYUAN ZHANG1,2 and KEFENG DING1 1Colorectal Surgery Department, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000; 2Department of Gastrointestinal Surgery, Yinzhou Peoples' Hospital, Ningbo, Zhejiang 315000, P.R. China Received November 27, 2018; Accepted June 20, 2019 DOI: 10.3892/etm.2019.7852 Abstract. Megacolon is a congenital disorder. Adult congen- sufficient amount of bowel should be removed, particularly the ital megacolon (ACM), also known as adult Hirschsprung's aganglionic segment (2). The present study reports on a case of disease, is rare and frequently manifests as constipation. ACM a 56-year-old patient with ACM, fecal impaction and diabetic is caused by the absence of ganglion cells in the submucosa nephropathy. or myenteric plexus of the bowel. Most patients undergo treat- ment of megacolon at a young age, but certain patients cannot Case report be treated until they develop bowel obstruction in adulthood. Bowel obstruction in adults always occurs in complex clinical A 56-year-old male patient with a history of chronic constipa- situations and it is frequently combined with comorbidities, tion presented to the emergency department of Yinzhou including bowel tumors, volvulus, hernias, hypertension or Peoples' Hospital (Ningbo, China) in February 2018. The diabetes mellitus. Surgical intervention is always required in patient had experienced vague abdominal distention for such cases. To avoid recurrence, a sufficient amount of bowel several days. Prior to admission, chronic bowel obstruction should be removed, particularly the aganglionic segment. -
THE DIGESTIVE SYSTEM: Introduction and Upper GI
THE DIGESTIVE SYSTEM: Introduction and upper GI Dalay Olson Ph.D Office: Jackson Hall 3-120 Office hours: Monday 2-3pm INTRODUCTION TO GI LEARNING OBJECTIVES 3 Distinguish between the wall layers of the esophagus and those classically represented by the small intestine. ESOPHAGUS STRUCTURE UPPER THIRD ESOPHAGUS STRUCTURE LOWER TWO-THIRDS 4 Describe the voluntary and reflex components of swallowing. PHASES OF SWALLOWING Swallowing is integrated in the medulla oblongata. Voluntary Phase Pharyngeal Phase Esophageal Phase The swallowing reflex requires input from sensory afferent nerves, somatic motor nerves and autonomic nerves. VOLUNTARY PHASE The tongue pushes the bolus of food back and upwards towards the back of the mouth. Once the food touches the soft palate and the back of the mouth it triggers the swallowing reflex. This is the stimulus! PHARYNGEAL PHASE • Once the food touches the soft palate and the back of the mouth it triggers the swallowing reflex. This is the stimulus! • The medulla oblongata (control center) then initiates the swallowing reflex causing the soft palate to elevate, closing of the glottis and opening of the esophageal sphincter (response). • Once the food moves into the esophagus the sphincter closes once again. The glottis then opens again and breathing resumes. ESOPHAGEAL PHASE 1. Food moves along the esophagus by peristalsis (waves of smooth muscle contractions) • If the food gets stuck, short reflexes will continue peristalsis. • Myogenic reflex (you will learn about this later) produces contractions that move food forward. 2. As the bolus of food moves toward the stomach the lower esophageal sphincter relaxes and opens allowing the food to move into the stomach. -
Intestinal Obstruction
Intestinal obstruction Prof. Marek Jackowski Definition • Any condition interferes with normal propulsion and passage of intestinal contents. • Can involve the small bowel, colon or both small and colon as in generalized ileus. Definitions 5% of all acute surgical admissions Patients are often extremely ill requiring prompt assessment, resuscitation and intensive monitoring Obstruction a mechanical blockage arising from a structural abnormality that presents a physical barrier to the progression of gut contents. Ileus a paralytic or functional variety of obstruction Obstruction: Partial or complete Simple or strangulated Epidemiology 1 % of all hospitalization 3-5 % of emergency surgical admissions More frequent in female patients - gynecological and pelvic surgical operations are important etiologies for postop. adhesions Adhesion is the most common cause of intestinal obstruction 80% of bowel obstruction due to small bowel obstruction - the most common causes are: - Adhesion - Hernia - Neoplasm 20% due to colon obstruction - the most common cause: - CR-cancer 60-70%, - diverticular disease and volvulus - 30% Mortality rate range between 3% for simple bowel obstruction to 30% when there is strangulation or perforation Recurrent rate vary according to method of treatment ; - conservative 12% - surgical treatment 8-32% Classification • Cause of obstruction: mechanical or functional. • Duration of obstruction: acute or chronic. • Extent of obstruction: partial or complete • Type of obstruction: simple or complex (closed loop and strangulation). CLASSIFICATION DYNAMIC ADYNAMIC (MECHANICAL) (FUNCTIONAL) Peristalsis is Result from atony of working against a the intestine with loss mechanical of normal peristalsis, obstruction in the absence of a mechanical cause. or it may be present in a non-propulsive form (e.g. mesenteric vascular occlusion or pseudo-obstruction) Etiology Mechanical bowel obstruction: A. -
Microbial Biogeography and Ecology of the Mouth and Implications for Periodontal
bioRxiv preprint doi: https://doi.org/10.1101/541052; this version posted February 8, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available for use under a CC0 license. Microbial biogeography and ecology of the mouth and implications for periodontal diseases Authors: Diana M. Proctor1,2,10, Katie M. Shelef3,10, Antonio Gonzalez4, Clara L. Davis Long5, Les Dethlefsen1, Adam Burns1, Peter M. Loomer6, Gary C. Armitage7, Mark I. Ryder7, Meredith E. Millman7, Rob Knight4, Susan P. Holmes8, David A. Relman1,5,9 Affiliations 1Division of Infectious Disease & Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305 USA 2National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892 USA 3Department of Biology, Stanford University School of Medicine, Stanford, CA 94305 USA 4Departments of Pediatrics and Computer Science and Engineering, University of California at San Diego, La Jolla, CA 92093 USA 5Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, CA 94305 USA 6Ashman Department of Periodontology & Implant Dentistry, New York University College of Dentistry, New York, NY 10010 USA 7Division of Periodontology, University of California, San Francisco School of Dentistry, San Francisco, CA 94143 USA 8Department of Statistics, Stanford University, Stanford, CA 94305 USA 9Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304 USA 10These authors contributed equally Corresponding author: David A. Relman: [email protected]; Address: Encina E209, 616 Serra Street, Stanford, California 94305-6165; Phone: 650-736-6822; Fax: 650-852-3291 1 bioRxiv preprint doi: https://doi.org/10.1101/541052; this version posted February 8, 2019. -
2. Bilateral Cleft Anatomy 19
BILATERAL CLEFT ANATOMY IS ATTACHED TO THE SINGLE CLEFT THE PREMAXILLA NORMALLY ROTATED OUTWARD MAXILLA ON ONE SIDE AND THIS ENTIRE COMPONENT IS THE CLEFT SIDE MAXILLA IN AN VARYING DEGREES FROM ASYMMETRICAL DIFFERENT DISTORTION DOUBLE CLEFTS PRESENT AN ENTIRELY CONFIGURA TION IN THE COMPLETE BILATERAL CLEFT THE PREMAXILLA IS UNATTACHED THREE WHICH TO EITHER MAXILLA THUS THERE ARE SEPARATE COMPONENTS IN THEIR DISTORTION THE MAXILLAE ARE MORE OR LESS SYMMETRICAL TWO WHILE THE ARE USUALLY EQUAL TO EACH OTHER IN SIZE AND POSITION FORWARD ITS IN CENTRAL PREMAXILLARY ELEMENT PROCEEDS ON OWN WITHIN ITSELF FOR DIFFERENT DEGREES BUT WITH SYMMETRY EXCEPT IJI POSSIBLE DEVIATION FRONTONASAL THE COMPLETE SEPARATION OF THE CENTRAL COMPONENT OF PROLABIUM AND PREMAXILLA FROM THE LATERAL MAXILLARY SEGMENTS THE VASCULAR ABNORMALLY INFLUENCES NOSE PHILTRUM MUSCULATURE AND OF ALL THREE ELEMENTS ITY NERVE SUPPLY GROWTH DEVELOPMENT WHERE THE CLEFT IS INCOMPLETE ON BOTH SIDES THE DEFORMITY IS LESS AND IS STILL SYMMETRICAL IN SUCH CASE THERE IS USUALLY MORE OR LESS INTACT ALVEOLUS AND LITTLE OR NO PROTRUSION OF THE PRE THE MAXILLA THE COLUMELLA IS LIKELY TO BE LONGER THAN IN COMPLETE CLEFT BUT NOT OF NORMAL LENGTH SOMETIMES SOMETIMES THE DEGREE OF CLEFT VARIES ON EACH SIDE SIDE THE INCOMPLETENESS SHOWS AS ONLY THE SLIGHTEST NOTCH ON ONE SIDE OR THERE CLEFT ON THE OPPOSITE AND HALFWAY OR THREEQUARTER ON THE CLEFT ONE SIDE AND AN INCOMPLETE ONE CAN BE COMPLETE ON OF THE EXASPERATING ASPECT OTHER WHICH CONDITION EXAGGERATES THE ROTATION OF THE IN THE AND NOSE -
Tongue -Tie (Ankyloglossia) and Lip -Tie (Lip Adhesion)
Tongue -Tie (Ankyloglossia) and Lip -Tie (Lip Adhesion) What is Tongue-Tie? Most of us think of tongue -tie as a situation we find ourselves in when we are too excited to speak. Actually, tongue- tie is the non medical term for a relatively common physical condition that limits the use of the tongue, ankyloglossia. Lip -tie is a condition where the upper lip cannot be curled or moved normally. Before we are born, a strong cord of tissue that guides development of mouth structures is positioned in the center of the mouth. It is called a frenulum. As we develop, this frenulum recedes and thins. The lingual (tongue) or labial (lip) frenulum is visible and easily felt if you look in the mirror under your tongue and lip. In some children, the frenulum is especially tight or fails to recede and may cause tongue/lip mobility problems. The tongue and lip are a very complex group of muscles and are important for all oral function. For this reason having tongue tie can lead to nursing, eating, dental, or speech problems, which may be serious in some individuals. When Is Tongue and Lip- Tie a Problem That Needs Treatment? Infants A new baby with a too tight tongue and/or lip frenulum can have trouble sucking and may have poor weight gain. If they cannot make a good seal on the nipple, they may swallow air causing gas and stomach problems. Such feeding problems should be discussed with Dr. Sierra. Nursing mothers who experience significant pain while nursing or whose baby has trouble latching on should have their child evaluated for tongue and lip tie. -
Celiac Disease: It's Autoimmune Not an Allergy
CELIAC DISEASE: IT’S AUTOIMMUNE NOT AN ALLERGY! Analissa Drummond PA-C Department of Pediatrics Division of Pediatric Gastroenterology HISTORY OF CELIAC DISEASE Also called gluten-sensitive enteropathy and nontropical spue First described by Dr. Samuel Gee in a 1888 report entitled “On the Coeliac Affection” Term “coeliac” derived from Greek word koiliakaos-abdominal Similar description of a chronic, malabsorptive disorder by Aretaeus from Cappadochia ( now Turkey) reaches as far back as the second century AD HISTORY CONTINUED The cause of celiac disease was unexplained until 1950 when the Dutch pediatrician Willem K Dicke recognized an association between the consumption of bread, cereals and relapsing diarrhea. This observation was corroborated when, during periods of food shortage in the Second World War, the symptoms of patients improved once bread was replaced by unconventional, non cereal containing foods. This finding confirmed the usefulness of earlier empirical diets that used pure fruit, potatoes, banana, milk, or meat. HISTORY CONTINUED After the war bread was reintroduced. Dicke and Van de Kamer began controlled experiments by exposing children with celiac disease to defined diets. They then determined fecal weight and fecal fat as a measure of malabsorption. They found that wheat, rye, barley and to a lesser degree oats, triggered malabsorption, which could be reversed after exclusion of the “toxic” cereals from the diet. Shortly after, the toxic agents were found to be present in gluten, the alcohol-soluble fraction of wheat protein. PATHOPHYSIOLOGY Celiac disease is a multifactorial, autoimmune disorder that occurs in genetically susceptible individuals. Trigger is an environmental agent-gliadin component of gluten. -
IDP Biological Systems Gastrointestinal System
IDP Biological Systems Gastrointestinal System Section Coordinator: Jerome W. Breslin, PhD, Assistant Professor of Physiology, MEB 7208, 504-568-2669, [email protected] Overall Learning Objectives 1. Characterize the important anatomical features of the GI system in relation to GI function. 2. Describe the molecular and cellular mechanisms underlying GI motility. Highlight the neural and endocrine regulatory mechanisms. Characterize the different types of GI motility in different segments of the GI tract. 3. Define the major characteristics and temporally relate the cephalic, gastric, and intestinal phases of GI tract regulation. 4. For carbohydrates, proteins, fats, vitamins, minerals, and oral drugs, differentiate the processes of ingestion, digestion, absorption, secretion, and excretion, including the location in the GI tract where each process occurs. 5. Contrast the sympathetic and parasympathetic modulation of the enteric nervous system and the effector organs of the GI tract. 6. Describe the similarities and differences in regulating gastrointestinal function by nerves, hormones, and paracrine regulators. Include receptors, proximity, and local vs. global specificity. 7. Understand the basic mechanisms underlying several common GI disorders and related treatment strategies. Learning Objectives for Specific Hours: Hour 1 – Essential Concepts: Cellular transport mechanisms and Mechanisms of Force Generation 1. Describe the composition of cell membranes and how distribution of phospholipids and proteins influence membrane permeability of ions, hydrophilic, and hydrophobic compounds. 2. Using a cell membrane as an example, define a reflection coefficient, and explain how the relative permeability of a cell to water and solutes will generate osmotic pressure. Contrast the osmotic pressure generated across a cell membrane by a solution of particles that freely cross the membrane with that of a solution with the same osmolality, but particles that cannot cross the cell membrane. -
Pathophysiology, 6Th Edition
McCance: Pathophysiology, 6th Edition Chapter 38: Structure and Function of the Digestive System Key Points – Print SUMMARY REVIEW The Gastrointestinal Tract 1. The major functions of the gastrointestinal tract are the mechanical and chemical breakdown of food and the absorption of digested nutrients. 2. The gastrointestinal tract is a hollow tube that extends from the mouth to the anus. 3. The walls of the gastrointestinal tract have several layers: mucosa, muscularis mucosae, submucosa, tunica muscularis (circular muscle and longitudinal muscle), and serosa. 4. Except for swallowing and defecation, which are controlled voluntarily, the functions of the gastrointestinal tract are controlled by extrinsic and intrinsic autonomic nerves (enteric plexus) and intestinal hormones. 5. Digestion begins in the mouth, with chewing and salivation. The digestive component of saliva is α-amylase, which initiates carbohydrate digestion. 6. The esophagus is a muscular tube that transports food from the mouth to the stomach. The tunica muscularis in the upper part of the esophagus is striated muscle, and that in the lower part is smooth muscle. 7. Swallowing is controlled by the swallowing center in the reticular formation of the brain. The two phases of swallowing are the oropharyngeal phase (voluntary swallowing) and the esophageal phase (involuntary swallowing). 8. Food is propelled through the gastrointestinal tract by peristalsis: waves of sequential relaxations and contractions of the tunica muscularis. 9. The lower esophageal sphincter opens to admit swallowed food into the stomach and then closes to prevent regurgitation of food back into the esophagus. 10. The stomach is a baglike structure that secretes digestive juices, mixes and stores food, and propels partially digested food (chyme) into the duodenum. -
Dynamic Evaluation of Forces During Mastication
Project Number: ME-SYS-0787 Dynamic Evaluation of Forces During Mastication A Major Qualifying Project Submitted to the Faculty of WORCESTER POLYTECHNIC INSTITUTE In partial fulfillment of requirements for the Degree of Bachelor of Science By Justin McGarry Anthony Spangenberger Date: Approval: Professor Satya Shivkumar, Advisor Abstract A reproduction of the human masticatory system is presented here to evaluate mechanical properties of foods, relevant design elements of the simulator, and the overall practicality of the system. The model incorporates a cam-driven linkage system providing realistic motion of the mandible, with reaction forces measured by strain gages on two axes to record real time changes in food structure. The experiment demonstrates that the construction of a mastication simulator is feasible and allows texture profiling and discrimination between similar foods. i Acknowledgements Our MQP was completed with the help of several individuals who offered professional advice and technical guidance. We would like to thank Prof. Satya Shivkumar, our project advisor, for guiding us with his extensive knowledge of materials and testing procedures, Prof. John Hall for his help with the sensors used in this project and his willingness to lend some of the necessary equipment, Prof. Robert Norton for his advice on the fixture design, Fred Hutson for lending equipment from the physics department for use in calibration of the fixture, Randy Robinson for the computer used for recording data, Neil Whitehouse, Toby Bergstrom, and Adam -
Adult Intussusception
1 Adult Intussusception Saulius Paskauskas and Dainius Pavalkis Lithuanian University of Health Sciences Kaunas Lithuania 1. Introduction Intussusception is defined as the invagination of one segment of the gastrointestinal tract and its mesentery (intussusceptum) into the lumen of an adjacent distal segment of the gastrointestinal tract (intussuscipiens). Sliding within the bowel is propelled by intestinal peristalsis and may lead to intestinal obstruction and ischemia. Adult intussusception is a rare condition wich can occur in any site of gastrointestinal tract from stomach to rectum. It represents only about 5% of all intussusceptions (Agha, 1986) and causes 1-5% of all cases of intestinal obstructions (Begos et al., 1997; Eisen et al., 1999). Intussusception accounts for 0.003–0.02% of all hospital admissions (Weilbaecher et al., 1971). The mean age for intussusception in adults is 50 years, and and the male-to-female ratio is 1:1.3 (Rathore et. al., 2006). The child to adult ratio is more than 20:1. The condition is found in less than 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. Intussusception in adults occurs less frequently in the colon than in the small bowel (Zubaidi et al., 2006; Wang et al., 2007). Mortality for adult intussusceptions increases from 8.7% for the benign lesions to 52.4% for the malignant variety (Azar & Berger, 1997) 2. Etiology of adult intussusception Unlike children where most cases are idiopathic, intussusception in adults has an identifiable etiology in 80- 90% of cases. The etiology of intussusception of the stomach, small bowel and the colon is quite different (Table 1). -
Anthropometrical Orofacial Measurement in Children from Three to Five Years Old
899 MEDIDAS ANTROPOMÉTRICAS OROFACIAIS EM CRIANÇAS DE TRÊS A CINCO ANOS DE IDADE Anthropometrical orofacial measurement in children from three to five years old Raquel Bossle(1), Mônica Carminatti(1), Bárbara de Lavra-Pinto(1), Renata Franzon (2), Fernando de Borba Araújo (3), Erissandra Gomes(3) RESUMO Objetivo: obter as medidas antropométricas orofaciais em crianças pré-escolares de três a cinco anos e realizar a correlação com idade cronológica, gênero, raça e hábitos orais. Métodos: estudo transversal com 93 crianças selecionadas por meio de amostra de conveniência consecutiva. Os responsáveis responderam a um questionário sobre os hábitos orais e as crianças foram submetidas a uma avaliação odontológica e antropométrica da face. O nível de significância utilizado foi p<0,05. Resultados: as médias das medidas antropométricas orofaciais foram descritas. Houve diferença estatística nas medidas de altura da face (p<0,001), terço médio da face (p<0,001), canto externo do olho até a comissura labial esquerda/direita (p<0,001) e lábio inferior (p=0,015) nas faixas etárias. O gênero masculino apresentou medidas superiores na altura de face (p=0,003), terço inferior da face (p<0,001), lábio superior (p=0,001) e lábio inferior (p<0,001). Não houve diferença estatisticamente significante na altura do lábio superior em sujeitos não brancos (p=0,03). A presença de hábitos orais não influenciou os resultados. O aleitamento materno exclusivo por seis meses influenciou o aumento da medida de terço médio (p=0,022) e da altura da face (p=0,037). Conclusão: as médias descritas neste estudo foram superiores aos padrões encontrados em outros estudos.