双语医学课件2-消化系统The-Digestive-System

TheDigestiveSystemTheDigestiveSystemTheDigestiveSystemTheDigest1Gastrointestinaltract胃肠道Accessoryorgans辅助器官(Para.1)Gastrointestinaltract(Para.2双语医学课件2-消化系统The-Digestive-System3TheorganizationofthegastrointestinaltractWhatarethefourlayers?(Concentriclayers)SublayersIntrinsicnerves(内神经)Thegastrointestinaltract胃肠道TheorganizationofThegastroi4双语医学课件2-消化系统The-Digestive-System5Thesubmucosalplexus(Meissnerplexus)

黏膜下层神经丛（即迈斯纳神经丛）

Themyentericplexus(Auerbachplexus)肠肌神经丛（即奥尔巴赫神经丛)

Thesubserosalplexus浆膜下神经网丛

Whatarethethreenerveplexuses?ThesubmucosalplexusWhatare6双语医学课件2-消化系统The-Digestive-System7唾液saliva味蕾tastebuds嗅神经

olfactorynerves胃液的分泌

thesecretionofgastricjuice恒牙permanentteeth咀嚼mastication食管

esophagus蠕动

peristalsis外层纵向肌

outerlongitudinallayersofmuscles内层环形肌

innercircularlayersofmusclesMouthandEsophagus口腔和食道唾液salivaMouthandEsophagu81.Threepairsofsalivaryglands1literofsalivaperdaysalivation唾液分泌1.Threepairsofsalivaryglan91.Threepairsofsalivaryglands1literofsalivaperday2.Autonomicnervoussystem

(自主神经系统)controlssalivation.

(sympatheticandparasympathetic)

(Butnotregulatedbyhormones)salivation唾液分泌1.Threepairsofsalivaryglan10食糜chyme十二指肠duodenumThestomach’smajoranatomicboundaries:食管括约肌贲门

胃大弯和胃小弯

幽门括约肌

十二指肠

Whatarethefunctionalareasofthestomach?fundus,body,antrumStomach胃食糜chymeStomach11双语医学课件2-消化系统The-Digestive-System12胃壁

stomachwall

斜肌层

alayerofobliquemuscle中环层和外纵层在胃底最薄Thecircularandlongitudinallayersofmusclearethinnestinthefundus.胃体和胃窦逐渐变厚Thelayersbecomeprogressivelythickerinthebodyand

antrum.胃粘膜themucosaofthestomachStomach胃胃壁stomachwallStomach13双语医学课件2-消化系统The-Digestive-System141.血液通过腹腔一支动脉输入胃中Bloodissuppliedtothestomachbyabranchoftheceliacartery.2.主动脉沿胃大弯和胃小弯分布Majorarteriesliealongthegreaterandlessercurvatures.3.分叉深入浆膜和肌层

branchandpenetrate

theserosa

andmusclelayers4.形成丰富的侧支循环formarichcollateralcirculationStomach胃Stomach15CardiovascularSystem:

MajorVessels

1.renalartery肾动脉2.vertebralartery脊椎动脉3.subclavianartery锁骨下动脉4.aorta主动脉5.coronaryartery冠状动脉

6.celiacartery腹腔动脉7.superiormesentericartery肠系膜上动脉8.lumbarartery腰动脉9.inferiormesentericartery肠系膜下动脉10.gonadalartery生殖腺动脉CardiovascularSystem:

Major16renalartery肾动脉vertebralartery脊椎动脉3.subclavianartery锁骨下动脉4.aorta主动脉5.coronaryartery冠状动脉6.celiacartery腹腔动脉7.superiormesentericartery肠系膜上动8.lumbarartery腰动脉9.inferiormesentericartery肠系膜下动10.gonadalartery生殖腺动脉renalartery肾动脉17ArichcirculationstomachArichcirculationstomach18liverGastricVeinSplenicVeinliverGastricVeinSplenicVein19静止状态下没有壁张力Inrestingstate,nowalltension.吞咽动作致使底部松弛Swallowingcausesthefundustorelax.食物存储在垂直层或斜纤层Foodisstoredinverticalorobliquelayers液体相对快速地流入胃窦Fluidsflowrelativelyquicklydowntotheantrum.蠕动波使胃动力开始增强Gastricmotilityincreaseswithperistalticwaves(蠕动收缩频率)同时受神经和激素活动影响。Influencedbyneuralandhormonalactivity.GastricMotility胃运动静止状态下没有壁张力GastricMotility201.胃液或胃分泌物gastricjuicesorgastricsecretion2.粘液、酸、酶、激素和内因子Mucus,acid,enzymes,hormones,andintrinsicfactor3.激素被分泌到血液里Thehormonesaresecretedintotheblood.4.其他胃分泌物直接进入胃腔。TheothergastricsecretionsintothestomachlumenGastricSecretion胃分泌1.胃液或胃分泌物GastricSecretion21粘液形成一道防护屏障来抵御酸和蛋白水解酶。Mucusformsaprotectivebarrieragainstacidand

proteolyticenzymes.GastricSecretion胃分泌粘液形成一道防护屏障来抵御酸和蛋白水解酶。GastricS221.胃液的成分取决于其体积和流动速度Thecompositionofgastricjuicedependson

volume

andflowrate2.氢和氯,钠,钾的浓度变化Thechangeoftheconcentrationsof

hydrogenandchloride,sodium,andpotassium3.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。Therateandvolumeofsecretionarelowestinthemorningandevening.GastricSecretion胃分泌1.胃液的成分取决于其体积和流动速度GastricSec23Whatinhibitsgastricsecretion(胃分泌)?(L.95-96)Unpleasantodorsandtastes;Rage,fear,painWhatcausesincreasedsecretions?分泌物增多与敌对心理或敌意厌恶感有关.GastricSecretion胃分泌Whatinhibitsgastricsecretio241.

功能上可分为三部分：十二指肠，空肠和回肠

Dividedinto3segments:theduodenum,jejunum,andileum2.腹膜是包裹在腹部器官和骨盆腔上的一层浆膜

Theperitoneum

isthe

serousmembrane

surroundingtheorgansofabdomenandpelviccavity.SmallIntestine小肠1.功能上可分为三部分：十二指肠，空肠和回肠Small25SmallintestineIleocecalvalveSmallintestineIleocecalvalve26jejunumAsuspensoryligamentduodenumjejunumAsuspensoryligamentdu27

jejunumAsuspensoryligamentjejunumAsuspensoryl28双语医学课件2-消化系统The-Digestive-System29腹膜Peritoneum腹膜Peritoneum30PeritoneumPeritoneum31双语医学课件2-消化系统The-Digestive-System32MesenteryMesentery331.十二指肠的动脉供应主要由胃十二指肠动脉提供。Thearterialsupplytotheduodenumarisesprimarilyfrom

thegastroduodenalartery.2.小肠平滑肌分布为两层：外部的纵层和内部较厚的环层。Thesmoothmusclesofthesmallintestine

arearrangedintwolayers.

SmallIntestine小肠1.十二指肠的动脉供应主要由胃十二指肠动脉提供。Smal34ArterialsupplytosmallintestineGastroduodenalarteryArterialsupplytosmallintes35双语医学课件2-消化系统The-Digestive-System36双语医学课件2-消化系统The-Digestive-System37双语医学课件2-消化系统The-Digestive-System38双语医学课件2-消化系统The-Digestive-System39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。

IntestinalDigestionandAsborption肠道消化与吸收食物氯化氢和胃蛋白酶Intesti40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

stimulatesintestinalmovementsMixinsecretionfromtheliver,pancreas,andintestinalglandsachurningmotionbringstheluminalcontentintocontactwiththeabsorbingcellsofthevilli.Advancethechymetowardthelargeintestine.IntestinalMotility肠道运动小肠运动IntestinalMotility41肠道运动受两种运动影响：结肠袋分节运动和蠕动。Intestinalmotilityisaffectedbytwomovements:HaustralsegmentationperistalsisIntestinalMotility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。Intesti42Thelargeintestineconsistsof:cecum盲肠apouchappendix阑尾vermiformcolon结肠rectum直肠analcanal肛管LargeIntestine大肠Thelargeintestineconsistso43Thefourpartsofthecolonascendingcolon→升结肠transversecolon→横结肠descendingcolon→降结肠sigmoidcolon→

乙状结肠LargeIntestine大肠ThefourpartsofthecolonLar44肠内物通过盲肠和结肠受两个括约肌控制：theileocecalvalve回盲瓣控制食糜从回肠进入盲肠theO’Beirnesphincter奥贝恩括约肌控制废物从乙状结肠进入直肠。2.analsphincters肛门括约肌internalanalsphincter肛门括约肌externalanalsphincter肛门括约肌

LargeIntestine大肠肠内物通过盲肠和结肠受两个括约肌控制：LargeIntes45

Whatcausestokillpathogens(病原体)andbacteriathroughoutthegastrointestinaltract?AcidinthestomachBileacidsecretionIntestinalmotilityAntibodyproduction

Whereareanaerobesmainlyfound?(L.196-197)IntestinalBacteria肠道细菌Whatcausestokillpatho46AccessoryOrganofDigestion消化的辅助器官Whataretheaccessoryorgansofdigestion?Liver→producesbilegallbladder→storesbileexocrinepancreas→producesenzymes

neededforthecompletedigestionofcarbohydrates,proteins,andfats.Besides,producesanalkalinefluid.Liver

→Italsoreceivesnutrientsabsorbedbythesmallintestine,metabolizingandsynthesizingAccessoryOrganofDigestionWh47AccessoryOrganofDigestion消化的辅助器官Liver---SecretionofBileWhereistheliverlocated?L.2162.

Themetabolicfunctionoftheliver

requirealargeamountofblood

hepaticartery(肝动脉)providesoxygenatedblood

portalvenousblood(门静脉血)

constitutes70%ofthebloodsupplytotheliver.AccessoryOrganofDigestionLi48AccessoryOrganofDigestion消化的辅助器官Liver---SecretionofBileSecreting700to1200mlbileperdayWhatdoesthebilecontain?bilesaltscholestrolbilirubin,electrolyteswater胆盐、胆固醇、胆红素、电解液和水

Whatisthefunctionofbilesalts?

(L.233-235)AccessoryOrganofDigestionLi49AccessoryOrganofDigestion消化的辅助器官Gallbladder(胆囊)PositionandFunctionHowdoesthebilemove?

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。AccessoryOrganofDigestionGa50AccessoryOrganofDigestion消化的辅助器官Gallbladder(胆囊)3.HowdoesGallbladder

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。AccessoryOrganofDigestionGa51AccessoryOrganofDigestion消化的辅助器官ExocrinePancreas(外分泌胰腺)LocationofPancreasWhyisthepancreasunique?

Ithasbothendocrineandexocrinefunctions.3.Whatdoestheendocrinepancreas(内分泌胰腺)do?

secreteshormones:

insulin(胰岛素)

glucagons(高血糖素)AccessoryOrganofDigestion52AccessoryOrganofDigestion消化的辅助器官4.Whatdoestheexocrinepancreas(外分泌胰腺)do?

secreteenzymes(酶)andalkalinefluids(碱性流体)

AccessoryOrganofDigestion53AccessoryOrganofDigestion消化的辅助器官

Secretionsdrainintoasystemofductsthatleadstothepancreaticduct,whichemptiesintothecommonbileductattheampullaofVate.

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。

AccessoryOrganofDigestion54AccessoryOrganofDigestion消化的辅助器官

Insomeindividualsanaccessoryductbranchesoffthepancreaticductanddrainsdirectlyintotheduodenumatanopeningcalledtheminorduodenalpapilla.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。AccessoryOrganofDigestion55TheDigestiveSystemTheDigestiveSystemTheDigestiveSystemTheDigest56Gastrointestinaltract胃肠道Accessoryorgans辅助器官(Para.1)Gastrointestinaltract(Para.57双语医学课件2-消化系统The-Digestive-System58TheorganizationofthegastrointestinaltractWhatarethefourlayers?(Concentriclayers)SublayersIntrinsicnerves(内神经)Thegastrointestinaltract胃肠道TheorganizationofThegastroi59双语医学课件2-消化系统The-Digestive-System60Thesubmucosalplexus(Meissnerplexus)

黏膜下层神经丛（即迈斯纳神经丛）

Themyentericplexus(Auerbachplexus)肠肌神经丛（即奥尔巴赫神经丛)

Thesubserosalplexus浆膜下神经网丛

Whatarethethreenerveplexuses?ThesubmucosalplexusWhatare61双语医学课件2-消化系统The-Digestive-System62唾液saliva味蕾tastebuds嗅神经

olfactorynerves胃液的分泌

thesecretionofgastricjuice恒牙permanentteeth咀嚼mastication食管

esophagus蠕动

peristalsis外层纵向肌

outerlongitudinallayersofmuscles内层环形肌

innercircularlayersofmusclesMouthandEsophagus口腔和食道唾液salivaMouthandEsophagu631.Threepairsofsalivaryglands1literofsalivaperdaysalivation唾液分泌1.Threepairsofsalivaryglan641.Threepairsofsalivaryglands1literofsalivaperday2.Autonomicnervoussystem

(自主神经系统)controlssalivation.

(sympatheticandparasympathetic)

(Butnotregulatedbyhormones)salivation唾液分泌1.Threepairsofsalivaryglan65食糜chyme十二指肠duodenumThestomach’smajoranatomicboundaries:食管括约肌贲门

胃大弯和胃小弯

幽门括约肌

十二指肠

Whatarethefunctionalareasofthestomach?fundus,body,antrumStomach胃食糜chymeStomach66双语医学课件2-消化系统The-Digestive-System67胃壁

stomachwall

斜肌层

alayerofobliquemuscle中环层和外纵层在胃底最薄Thecircularandlongitudinallayersofmusclearethinnestinthefundus.胃体和胃窦逐渐变厚Thelayersbecomeprogressivelythickerinthebodyand

antrum.胃粘膜themucosaofthestomachStomach胃胃壁stomachwallStomach68双语医学课件2-消化系统The-Digestive-System691.血液通过腹腔一支动脉输入胃中Bloodissuppliedtothestomachbyabranchoftheceliacartery.2.主动脉沿胃大弯和胃小弯分布Majorarteriesliealongthegreaterandlessercurvatures.3.分叉深入浆膜和肌层

branchandpenetrate

theserosa

andmusclelayers4.形成丰富的侧支循环formarichcollateralcirculationStomach胃Stomach70CardiovascularSystem:

MajorVessels

1.renalartery肾动脉2.vertebralartery脊椎动脉3.subclavianartery锁骨下动脉4.aorta主动脉5.coronaryartery冠状动脉

6.celiacartery腹腔动脉7.superiormesentericartery肠系膜上动脉8.lumbarartery腰动脉9.inferiormesentericartery肠系膜下动脉10.gonadalartery生殖腺动脉CardiovascularSystem:

Major71renalartery肾动脉vertebralartery脊椎动脉3.subclavianartery锁骨下动脉4.aorta主动脉5.coronaryartery冠状动脉6.celiacartery腹腔动脉7.superiormesentericartery肠系膜上动8.lumbarartery腰动脉9.inferiormesentericartery肠系膜下动10.gonadalartery生殖腺动脉renalartery肾动脉72ArichcirculationstomachArichcirculationstomach73liverGastricVeinSplenicVeinliverGastricVeinSplenicVein74静止状态下没有壁张力Inrestingstate,nowalltension.吞咽动作致使底部松弛Swallowingcausesthefundustorelax.食物存储在垂直层或斜纤层Foodisstoredinverticalorobliquelayers液体相对快速地流入胃窦Fluidsflowrelativelyquicklydowntotheantrum.蠕动波使胃动力开始增强Gastricmotilityincreaseswithperistalticwaves(蠕动收缩频率)同时受神经和激素活动影响。Influencedbyneuralandhormonalactivity.GastricMotility胃运动静止状态下没有壁张力GastricMotility751.胃液或胃分泌物gastricjuicesorgastricsecretion2.粘液、酸、酶、激素和内因子Mucus,acid,enzymes,hormones,andintrinsicfactor3.激素被分泌到血液里Thehormonesaresecretedintotheblood.4.其他胃分泌物直接进入胃腔。TheothergastricsecretionsintothestomachlumenGastricSecretion胃分泌1.胃液或胃分泌物GastricSecretion76粘液形成一道防护屏障来抵御酸和蛋白水解酶。Mucusformsaprotectivebarrieragainstacidand

proteolyticenzymes.GastricSecretion胃分泌粘液形成一道防护屏障来抵御酸和蛋白水解酶。GastricS771.胃液的成分取决于其体积和流动速度Thecompositionofgastricjuicedependson

volume

andflowrate2.氢和氯,钠,钾的浓度变化Thechangeoftheconcentrationsof

hydrogenandchloride,sodium,andpotassium3.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。Therateandvolumeofsecretionarelowestinthemorningandevening.GastricSecretion胃分泌1.胃液的成分取决于其体积和流动速度GastricSec78Whatinhibitsgastricsecretion(胃分泌)?(L.95-96)Unpleasantodorsandtastes;Rage,fear,painWhatcausesincreasedsecretions?分泌物增多与敌对心理或敌意厌恶感有关.GastricSecretion胃分泌Whatinhibitsgastricsecretio791.

功能上可分为三部分：十二指肠，空肠和回肠

Dividedinto3segments:theduodenum,jejunum,andileum2.腹膜是包裹在腹部器官和骨盆腔上的一层浆膜

Theperitoneum

isthe

serousmembrane

surroundingtheorgansofabdomenandpelviccavity.SmallIntestine小肠1.功能上可分为三部分：十二指肠，空肠和回肠Small80SmallintestineIleocecalvalveSmallintestineIleocecalvalve81jejunumAsuspensoryligamentduodenumjejunumAsuspensoryligamentdu82

jejunumAsuspensoryligamentjejunumAsuspensoryl83双语医学课件2-消化系统The-Digestive-System84腹膜Peritoneum腹膜Peritoneum85PeritoneumPeritoneum86双语医学课件2-消化系统The-Digestive-System87MesenteryMesentery881.十二指肠的动脉供应主要由胃十二指肠动脉提供。Thearterialsupplytotheduodenumarisesprimarilyfrom

thegastroduodenalartery.2.小肠平滑肌分布为两层：外部的纵层和内部较厚的环层。Thesmoothmusclesofthesmallintestine

arearrangedintwolayers.

SmallIntestine小肠1.十二指肠的动脉供应主要由胃十二指肠动脉提供。Smal89ArterialsupplytosmallintestineGastroduodenalarteryArterialsupplytosmallintes90双语医学课件2-消化系统The-Digestive-System91双语医学课件2-消化系统The-Digestive-System92双语医学课件2-消化系统The-Digestive-System93双语医学课件2-消化系统The-Digestive-System94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。

IntestinalDigestionandAsborption肠道消化与吸收食物氯化氢和胃蛋白酶Intesti95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

stimulatesintestinalmovementsMixinsecretionfromtheliver,pancreas,andintestinalglandsachurningmotionbringstheluminalcontentintocontactwiththeabsorbingcellsofthevilli.Advancethechymetowardthelargeintestine.IntestinalMotility肠道运动小肠运动IntestinalMotility96肠道运动受两种运动影响：结肠袋分节运动和蠕动。Intestinalmotilityisaffectedbytwomovements:HaustralsegmentationperistalsisIntestinalMotility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。Intesti97Thelargeintestineconsistsof:cecum盲肠apouchappendix阑尾vermiformcolon结肠rectum直肠analcanal肛管LargeIntestine大肠Thelargeintestineconsistso98Thefourpartsofthecolonascendingcolon→升结肠transversecolon→横结肠descendingcolon→降结肠sigmoidcolon→

乙状结肠LargeIntestine大肠ThefourpartsofthecolonLar99肠内物通过盲肠和结肠受两个括约肌控制：theileocecalvalve回盲瓣控制食糜从回肠进入盲肠theO’Beirnesphincter奥贝恩括约肌控制废物从乙状结肠进入直肠。2.analsphincters肛门括约肌internalanalsphincter肛门括约肌externalanalsphincter肛门括约肌

LargeIntestine大肠肠内物通过盲肠和结肠受两个括约肌控制：LargeIntes100

Whatcausestokillpathogens(病原体)andbacteriathroughoutthegastrointestinaltract?AcidinthestomachBileacidsecretionIntestinalmotilityAntibodyproduction

Whereareanaerobesmainlyfound?(L.196-197)IntestinalBacteria肠道细菌Whatcausestokillpatho101AccessoryOrganofDigestion消化的辅助器官Whataretheaccessoryorgansofdigestion?Liver→producesbilegallbladder→storesbileexocrinepancreas→producesenzymes

neededforthecompletedigestionofcarbohydrates,proteins,andfats.Besides,producesanalkalinefluid.Liver

→Italsoreceivesnutrientsabsorbedbythesmallintestine,metabolizingandsynthesizingAccessoryOrganofDigestionWh102AccessoryOrganofDigestion消化的辅助器官Liver---SecretionofBileWhereistheliverlocated?L.2162.

Themetabolicfunctionoftheliver

requirealargeamountofblood

hepaticartery(肝动脉