消化与吸收专题知识培训.pptx

单击以编辑,母版标题样式,单击以编辑母版文本样式,第二级,第三级,第四级,第五级,#,消化与吸收专题知识培训,消化与吸收专题知识培训,第1页,Digestion(,消化,):,The break-down process whereby the structurally complex foodstuffs of the diet are converted into smaller absorbable units by the enzymes produced within the digestive system,(,食物在消化道内被分解为小分子物质过程,),Mechanical digestion(,机械性消化,),Chemical digestion(,化学性消化,),消化与吸收专题知识培训,第2页,Absorption(,吸收,):,The process that the smaller absorbable units of digestion get across the alimentary tract mucosa and come into blood or lymph.,(,食物经消化后经过消化道粘膜进入血液或淋巴过程,),消化与吸收专题知识培训,第3页,Section1 Structure of Digestive Tract(,消化管结构,),Intracellular digestion (,胞内消化,),Extracellular digestion (,胞外消化,),消化与吸收专题知识培训,第4页,1.Human Digestive Tract(,人消化管,),粘膜层：上皮,上皮下层,粘膜肌层,粘膜下层,:C.T,组织结构,(Submucous layer),环行肌 胃部是三层,Smooth muscle,内斜,中环,外纵,纵行肌,浆膜,:C.T,(Serous membrane),(Tissue structure),(Mucous layer),消化与吸收专题知识培训,第5页,2.The Innervation of Digestive Tract (,消化管神经支配,)Extrinsic NS&Intrinsic NS,CNS,肌间,N,丛,粘膜下,N,丛,R,平滑肌,分泌细胞,内分泌细胞,血管,交,.,副交,N,交,.,副交,N,局部,消化与吸收专题知识培训,第6页,Sympathetic nerve(,交感,N):,The subdivision of the autonomic nervous system that dominates in“fight-or-flight”emergency or stressful situations and perpares the body for strenuous physical activity.,(,源自,T5 T10&L1 L2,在腹神经节和肠系膜上下,N,节换元,),消化与吸收专题知识培训,第7页,交感,N,sympathetic nerve,NE,胃肠平滑肌,血管平滑肌,消化腺,运动及分泌,内在,N,元,消化与吸收专题知识培训,第8页,副：延髓背核,疑核,迷走,N,盆,N,S,2-4,运动及分泌,内在,N,元,胃肠平滑肌,血管平滑肌,消化腺,消化与吸收专题知识培训,第9页,Myenteric plexus(,肌间,N,丛,)Submucous plexus(,粘膜下,N,丛,),Intrinsic plexus(,内在,N,丛,),：,包含感觉、中间、运动神经元组成一个完整,且相对独立整合系统,胃肠运动及分泌,消化与吸收专题知识培训,第10页,Section 2 The Movement and Regulation of Digestive Tract(,消化管运动及调整,),The movement of digestive tract,(,消化道运动,):,Mastication(,咀嚼,),Deglutition(,吞咽,),Gastrointestinal movement(,胃肠运动,),消化与吸收专题知识培训,第11页,Reflex(,反射,):,Any response that occurs,automatically without conscious effort.,(,在,NS,参加下对刺激规律性应答,),Reflex arc(,反射弧,):,The components of a reflex,arc include a receptor,afferent pathway,integrating center,efferent pathway,and,effector.,(,感受器 传入,N N,中枢 传出,N,效应器,),消化与吸收专题知识培训,第12页,1.Gastric movement(,胃运动,),(1),Receptive,relaxation(,胃,容受性舒张,),Definition:,food stimulate the receptors in pharynx and esophagus,through vagus nerve arouse relaxation of fundus and body of stomach muscle.,(,食物刺激咽、食管等处感受器经迷走神经反射性引发胃底、胃体肌舒张,),significance,肽类纤维？,消化与吸收专题知识培训,第13页,(2)Tonic contraction (,担心性收缩,),(3)Peristalsis(,蠕动,),Gastric BER(,胃基础电节律,):,It stems from longitudinal muscle of greater curvature,35 times per minutes,amplitude is about 515 mv.,(,起源于胃大弯纵行肌层，每分钟,35,次，振幅约,515 mv),消化与吸收专题知识培训,第14页,Function,of peristalsis(,蠕动,),：,Lead to ample mixing of chyme and digestive juice,this is facilitated for chemical digestion.,使食糜与消化液充分混合，利于化学性消化,Mill food(mechanical digestion),磨碎食物,(,即机械性消化,),Push chyme,推进食糜,消化与吸收专题知识培训,第15页,2.Gastric Emptying and Its Regulation (,胃排空及其控制,),Definition:,The process that food enter into duodenum from stomach.,(,食物由胃排入,12,指肠过程,),(1),胃排空,(gastric emptying),消化与吸收专题知识培训,第16页,Emptying velocity(,排空速度,),：,Sugarproteinfat;,Sparse,thin,isosmotic quick,(,稀、细、等渗 快,),(,反之则慢,),消化与吸收专题知识培训,第17页,(2)Regulation of gastric emptying (,胃排空调控,),Entogastric factors accelerate emptying,(,胃内原因促进排空,),：,Entogastric food,（,Nr,）,(,胃内食物,),Gastrin,（,Hr,）,(,胃泌素,),消化与吸收专题知识培训,第18页,Factors of duodenum inhibit emptying,(12,脂肠原因抑制排空,),：,Gastrointestinal reflex,（,Nr,）,(,肠胃反射,),Enterogastrone,（,Hr,）,(,肠抑胃素,),消化与吸收专题知识培训,第19页,Emptying process(,排空过程,),：,Entogastric food(,胃内食物,),emptying stopped(,排空停顿,),motility of the stomach(,胃运动,),胃运动,幽门括约肌舒张 幽门括约肌收缩,胃内压,12,指肠内压,N(,肠胃反射,),H(,肠抑胃素,),Nr.Hr,排空,肠内胃酸被中和,食物被消化吸收,消化与吸收专题知识培训,第20页,3.The movements of small intestine(,小肠运动,),(1)Tonic contraction(,担心性收缩,),Functions,：,Maintain basic pressure(,维持基础压力,),The basis of movements(,是肠运动基础,),Fix and keep shape of small intestine,(,维持小肠位置形状,),消化与吸收专题知识培训,第21页,(2)Segmentation contraction (,分节运动,),消化与吸收专题知识培训,第22页,Functions,：,It can lead to ample mixing of chyme and digestive juice,this is facilitated for chemical digestion.,(,使食糜与消化液充分混合，利于化学性消化,),It can accelerate close contact of chyme and intestinal wall,this is facilitated for absorption.,(,使食糜与肠壁紧密接触，利于吸收,),消化与吸收专题知识培训,第23页,It can press intestinal wall,accelerate blood and lymph circumfluence.,(,挤压肠壁而促进血液、淋巴回流,),(3)Peristalsis(,蠕动,),Peristalsis function:,push chyme,(,推进食糜,),消化与吸收专题知识培训,第24页,(4),Large intestinal movement and defecation (,大肠运动和排便,)The,movement,forms of large intestine (,大肠运动形式,),1),袋状往返运动,2),分节或多袋推进运动,3)Peristalsis(,蠕动,),(mass peristalsis,集团蠕动,),消化与吸收专题知识培训,第25页,Brain stem,cerebral cortex,(,脑干、大脑皮层,),S,2,-S,4,直肠牵张,R,盆,N,阴,部,N,腹肌膈肌,粪,粪,降结肠,乙状结肠,直肠,收,缩,内括约肌松驰,Defecation reflex,(,排便反射,),外括约肌松驰,消化与吸收专题知识培训,第26页,(5)Regulation of digestive tract (,消化管运动调整,),Electrical activity(,电活动,),BER,AP,Nerve factors(,神经原因,),Sympathetic nerve(-)gastrointestinal movement,交感,N (-),胃肠运动,Vagus nerve(+)gastrointestinal movement,迷走,N (+),胃肠运动,消化与吸收专题知识培训,第27页,Intraparietal nerve plexus(,壁内,N,丛,):,Regulating gastrointestinal movement,(,调整胃肠运动,),Cerebral cortex(,大脑皮层,):,Interest for food effects digestion.,Psychogenic enterorrhea,(,对食物好恶对消化影响,精神性腹泻,),消化与吸收专题知识培训,第28页,3.,Humoral factors(,体液原因,),:,Gastrointestinal hormone(,主胃肠激素,):,Motilin(,胃动素,),Gastrin(,胃泌素,),抑胃肽,NE,Secretin(,促胰液素,),movement,movement,消化与吸收专题知识培训,第29页,Section 3 The Secretion and Regulation of Digestive Juice (,消化液分泌及调整,),1.The secretion of saliva(,唾液分泌,),消化与吸收专题知识培训,第30页,(1)The characters,、,components and functions,of saliva (,唾液性质与成份与作用,),Moisten,dissolve food(,湿润、溶解食物,),clean,protect mouth cavity(,清洁、保护口腔,),lubricate,hydrolyze amylum,kill bacteria,(,润滑 水解淀粉 杀菌,),消化与吸收专题知识培训,第31页,(2),T,h,e regulation of salivary,secretion,(,唾液分泌调整,),Double excitation effect of sympathesis nerve,and parasympathesis nerve,(,交感与副交感双重兴奋作用,),Conditioned reflex(,条件反射,),Unconditioned reflex(,非条件反射,),消化与吸收专题知识培训,第32页,2.Gastric secretion(,胃液分泌,),(1),Characters,components and functions of,gastric juice,(,胃液,性质、成份和作用,),无色透明，,pH 0.9,1.5,消化与吸收专题知识培训,第33页,Pepsinogen(,胃蛋白酶原,)chief,cell secretion (,主细胞分泌,),pepsin,胃蛋白酶,HCl,protein,蛋白质,月,示,和胨,+,pH2,消化与吸收专题知识培训,第34页,Mucus and,HCO3,-,(,粘液与碳酸氢盐,),胃粘液,-,碳酸氢盐屏障,表面上皮细胞,粘液颈细胞,贲门腺,pyloric gland(,幽门腺,),glycoprotein,糖蛋白,消化与吸收专题知识培训,第35页,Functions,：,Lubricate,protect gastric mucosa,gastric mucosal barrier;recovering gastric mucosal epithelia.,(,润滑、保护胃粘膜,胃粘液屏障，胃粘膜屏障,;,胃粘膜上皮更新,),消化与吸收专题知识培训,第36页,The,secretion,of hydrochloric acid-,parietal cell(,盐酸壁细胞分泌,),The functions of hydrochloric acid (,盐 酸 作 用,):,消化与吸收专题知识培训,第37页,1,),Activate pepsinogen and supply suitable PH to,pepsin,(,激活胃蛋白酶原并给胃蛋白酶提供,活动所需酸性,pH),2),Kill bacteria,(,杀菌,),3),Accelerate denaturation of protein,and,facilitated to digestion,(,使蛋白质变性易于消化,),消化与吸收专题知识培训,第38页,4)Accelerate the secretion of pancreatic juice,、,bile,、,small intestinal juice.,(,促进胰液、胆汁、小肠液分泌,),5)Accelerate the absorption of small intestinal,to iron and calcium.,(,促进小肠对铁、钙吸收,),消化与吸收专题知识培训,第39页,F,u,nction,：,1)P,rotect B,12,doesnt hydrolyzed by digestive enzyme (,保护,B,12,不被消化酶水解,),2)Accelerate the absorption of ileum mucosa to B,12,.,(,促进,B,12,经回肠粘膜吸收,),Intrinsic factor(,内因子,),消化与吸收专题知识培训,第40页,(2)The regulation of gastric juice secretion (,胃液分泌调整,),Sham feeding(,假饲,),Fig 5-18,消化与吸收专题知识培训,第41页,Gastric juice secretion of,cephalic phase,(,头期胃液分泌,),The food stimulates cephalic receptor cause gastric juice secretion,.,(,食物刺激头部感受器引发胃液分泌,),消化与吸收专题知识培训,第42页,Cephalic,R,nerve,center gastric gland,secrete gastric juice,G cell,-,gastrin,（,胃泌素）,characters:,quantity and acidity is high,digestive enzyme is higher.,(,量、酸度很高，消化力,(,酶,),尤高,),(,头部,R),(,中 枢,),(,胃腺分泌胃液,),消化与吸收专题知识培训,第43页,G,astric juice secretion of,gastric phase,(,胃期胃液分泌,),Food stimulates stomach cause the gastric,juice secretion.(,食物刺激胃引发胃液分泌）,消化与吸收专题知识培训,第44页,胃底胃体机械刺激 中枢胃腺,分泌胃液,食物 胃幽门部机械刺激 壁内神经丛,胃幽门部化学刺激幽门部,G,细胞 胃泌素,Characters:,Acidity is quite high,digestive enzyme is weaker than cephalic phase,.,(,酸度高，消化力,(,酶,),比头期弱,),消化与吸收专题知识培训,第45页,Gastric juice secretion of,intestinal phase,(,肠期胃液分泌,),The food stimulates intestine cause the gastric secretion,（,食物刺激肠引发胃液分泌,）,消化与吸收专题知识培训,第46页,Small intestine,(,小肠,),food,Gastrin,，,entero-oxyntin,（胃泌素、肠泌酸素,),G,astric gland secrete gastric juice,(,胃腺分泌胃液,),characters:,few quantity.,(,量少,),消化与吸收专题知识培训,第47页,Inhibitory regulation of gastric secretion (,胃液分泌抑制性调整,),1),HCl,胃窦粘膜,G,细胞,mucosal D cell,somatostain,intestinal mucosa S cell,secretin,duodenal ampulla bulbomycin,胃,泌,素,胃,液,(,粘膜,D,细胞,),(,生长抑素,),(,肠粘膜,S,细胞,),(,促胰液素,),(12,指肠球部,),(,球抑胃素,),消化与吸收专题知识培训,第48页,2),Fat,small intestine enterogasterone,mucosa,(,肠抑胃素,),(,小肠粘膜,),gastric juice,(,胃液,),gastric movement,(,胃运动,),消化与吸收专题知识培训,第49页,3)Hypertonic solution small intestine mucosa,(,高张溶液,)(,小肠粘膜,),osmotic pressure,R,inhibitive,H,(,小肠渗透压,R)(,抑制性,H),胃液,消化与吸收专题知识培训,第50页,4)PGE,Vagus nerve,gastrin,(,迷走,N,、胃泌素,),gastric,wall release PGE,(,胃壁释放,PGE),胃液,消化与吸收专题知识培训,第51页,5)The effects of different food on gastric juice secretion (,不一样食物对胃液分泌作用,),Protein sugarfat,(,蛋白质,糖类,脂肪,),Corn,sweet potato,alcohol,coffee,(,玉米面,白薯,红薯,酒精,咖啡,),消化与吸收专题知识培训,第52页,3.The secretion of pancreatic juice (,胰液分泌,),HCO,3,-,H,2,O,Enzymes,Small vessel,cell,(,小导管细胞,),Acinar cell,(,腺泡细胞,),Pancreas,(,胰腺,),消化与吸收专题知识培训,第53页,(1),The characters,、,components and functions of pancreatic juice (,胰液性质成份和作用,),Characters,Achromia and tasteless,(,无色无臭,),pH7.8-8.4,消化与吸收专题知识培训,第54页,Components and functions,Water,dilute food,(,稀释食物,),消化与吸收专题知识培训,第55页,Sodium bicarbonate(,碳酸氢盐,),counteract acid and supply suitable pH for activity of digestive enzyme in small intestine,(,中和胃酸并提供小肠内消化酶活动所需最适,pH),pH7-8,H,HCO,3,-,+,消化与吸收专题知识培训,第56页,Organic components:digestive enzymes (,有机成份主要是各种消化酶,),：,Pancreatic amylase,(,胰淀粉酶,),malt sugar,glucose,(,麦芽糖、葡萄糖,),淀粉,消化与吸收专题知识培训,第57页,Lipase,(,胰脂肪酶,),Fatty acid,glyceride,glycerin,(,脂肪酸、甘油一酯、甘油,),辅脂酶,脂肪,消化与吸收专题知识培训,第58页,胰蛋白酶,(trypsin),糜蛋白酶,(chymotrypsin),(,多肽、,AA),肠,致,活,酶,蛋白质,和胨,酸,Trypsinogen,(,胰蛋白酶原,),Chymotrypsinogen,(,糜蛋白酶原,),+,月示,消化与吸收专题知识培训,第59页,Others,Carboxypeptidase,羧基肽酶,Deoxyribonuclease,(,脱氧,),核糖核酸酶,消化与吸收专题知识培训,第60页,(2)The,r,e,gulation,of pancreatic juice (,胰液分泌,调整,),Nr,Enzyme is quite abundant,H,2,O and HCO,3,are few.,(,酶很丰富，但,H2O,、,HCO3,-,极少,),Hr,Secretin(,促胰液素,),Enzyme is quite few,H2O and HCO3,are abundant.,(H2O,、,HCO3,-,很丰富，但酶极少,),消化与吸收专题知识培训,第61页,Cholecystokinin(,胆囊收缩素,),Enzyme is abundant,quantity is slightly increased.,(,酶多，量增加少许,),Gastrin(,胃泌素,),Enzyme is abundant,quantity is slightly increased.,(,酶多，量增加少许,),消化与吸收专题知识培训,第62页,Secretin(,促胰液素,),Food,(,刺激强度：盐酸,蛋白分解产物,脂酸钠,),small intestine secretin,(,促胰液素,),mucosa S cell,(,小肠粘膜,S,细胞,),水盐,胰腺,小导管细胞,消化与吸收专题知识培训,第63页,Cholecystokinin,CCK(,胆囊收缩素,),Food,(,蛋白分解产物,脂酸钠,盐酸,脂肪,),small intestine,CCK,mucosa I cell,(,小肠粘膜,I,细胞,),cholecyst contraction pancreatic acinar cell,排胆汁,酶,(,胆囊收缩,),(,胰腺腺泡细胞,),消化与吸收专题知识培训,第64页,4.The Secretion and Regulation of Other Digestive Juice(,其它消化液分泌及调整,),Bile(,胆汁,):,Vagus N,(,迷走,N),G.,S.,CCK (+),Small intestinal juice(,小肠液,),:,Vagus N G.,S.,CCK,VIP,消化与吸收专题知识培训,第65页,intestinal mucosa,(,肠粘膜,),Chyme,(,食糜,),local reflex,(,局部反射,),intestinal,gland(,肠 腺,),Small intestinal,juice(,小肠液,),Gastrin(,胃泌素,),Secretin(,促胰液素,),CCK(,胆囊收缩素,),VIP,消化与吸收专题知识培训,第66页,Section 4 Absorption(,吸收,),Definition:,The process that various of digestive product,water,and salt enter into blood and lymph,through epithelial cell.,(,各种消化产物和水分,盐类等经过上皮细胞进,入血液和淋巴过程,),消化与吸收专题知识培训,第67页,1.The Structural Basis and The Place of Absorption,(,吸收部位与结构基础,),消化与吸收专题知识培训,第68页,Small intestine is the important place of absorption,(,小肠是吸收主要场所,),：,Surface area,(,面积,)200m,2,Retention time is,3-8h,(,停留,3-8h),绒毛运动具唧筒作用,Digestion is complete,(,消化完全,),Segment contraction,(,分节运动,),消化与吸收专题知识培训,第69页,2.The absorption of various nutrient substance (,各种主要营养物质吸收,),物 质 形式 路径 机 制,糖 单糖 血 继主,蛋白质,AA,血 继主,脂肪 脂肪酸,.,甘一 淋巴,(,血,),单纯,.,出胞,(,水,),维生素 维生素 血 主动、扩散,(,脂,),维生素 维生素 淋巴 单纯,.,出胞,消化与吸收专题知识培训,第70页,substance shape,pathway,mechanism,water H,2,O blood,渗透,Na Na,+,blood,主动,Fe Fe,2+,blood,主动,Ca Ca,2+,blood,主动,negative iron,Cl,-,、,HCO3,-,blood,随,Na(,被动,),消化与吸收专题知识培训,第71页,