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Git, Repro, Uro - Presentation Transcript

    • The digestive system
  1. The DIGESTIVE SYSTEM
    • Alimentary tract composed of organs, the primary function of which is the ingestion, digestion and absorption of nutrients
  2. The DIGESTIVE SYSTEM
    • Consists of the tube extending from the mouth to the anus together with the associated organs- salivary glands, liver, pancreas, gallbladder
  3.  
  4. The GIT
    • The tract is long, fibromuscular tube lined internally by specialized epithelium for secretion and absorption
  5. The GIT
    • The wall is divided into
    • Mucosa
    • Submucosa
    • Muscularis layer (inner circular and outer longitudinal)
    • and Serosa/adventitia
  6. Fig. 16.2
  7. GENERAL FUNCTIONS
    • Ingestion of food into the mouth
    • Moves food along the digestive tract
    • Mechanically digests the food into small particles
  8. GENERAL FUNCTIONS
    • Chemically digests the food into simple molecules
    • Absorbs nutrients into the portal and lymphatic circulation
  9. The MOUTH
    • Extends from the lips to the orophaynx
    • Initial digestion of carbohydrates occurs here
    • Contains the teeth, tongue, palate, salivary glands and tonsils
  10. Salivary glands
    • 1. Parotid= secretes purely serous, Stensen’s duct
    • 2.Submandibular/submaxillay= secretes mixed saliva, with Wharton’s duct
    • 3. Sublingual= secretes mixed saliva, with two ducts- duct of Rivinus and duct of Bartholin
  11.  
  12. The Pharynx
    • Oropharynx is a passageway of both food and air
  13. The Esophagus
    • Muscular tube extending from the pharynx to the stomach
    • With upper esophageal sphincter and lower esophageal sphincter
  14. The Esophagus
    • Function: to propel food to the stomach
  15. The Stomach
    • J-shaped dilatable part of the GIT
    • Located on the epigastric area and right upper quadrant
    • With 3 parts:
      • 1. Fundus
      • 2. Body
      • 3. Pylorus
  16. Cells in the stomach
    • 1. Mucus cells
    • 2. Chief cells/principal cells/Zymogenic cells
    • 3. Parietal Cells
    • 4. Argentaffin cells
  17. Cells in the stomach
    • 1. Mucus cells- secrete mucus for protection of the mucosa
  18. Cells in the stomach
    • 2. Chief cells/principal cells/Zymogenic cells
    • secrete Pepsinogen needed for protein digestion
  19. Cells in the stomach
    • 3. Parietal cells/Oxyntic cells- secrete Hydrochloric acid to activate pepsinogen and Intrinsic factor needed to absorb Vitamin B12
  20. Cells in the stomach
    • 4. Argentaffin cells- secrete Serotonin
  21. Small intestine
    • Characteristics:
    • Provided with mesentery
    • Presence of villi
    • Presence of plicae circularis
    • Lined by simple columnar
  22. Fig. 16.14
  23. Parts of Small Intestine
    • 1. DUODENUM- shortest part
    • 2. Jejunum
    • 3. Ileum- longest part
  24. Parts of Small Intestine
  25. Large intestine
    • Characteristics
    • Presence of haustra
    • Presence of taenia coli
    • Presence of appendices epiploicae
  26. Large intestine
    • Characteristics
    • No villi
    • With mesocolon on the appendix, transverse colon and sigmoid colon
  27. Parts of the large intestine
    • Cecum
    • Appendix
    • Ascending colon
    • Transverse colon
    • Descending colon
    • Sigmoid colon
    • rectum
  28.  
  29. Anus
    • The anal canal is the last portion of the tract, surrounded by an internal and external anal sphincter
  30. The Peritoneum
    • Serous membrane lining the abdominal cavity
    • Parietal peritoneum- abdominal wall
    • Visceral peritoneum- visceral organs
  31. Fig. 16.3
  32. The Peritoneum
    • Retroperitoneal organs are found posterior to the peritoneum- kidney, pancreas, duodenum, ascending and descending colon, rectum
  33. Mesentery
    • This is a peritoneum folded upon itself extending from the organ to the abdominal wall
  34. Blood supply of the GIT
    • Branches of the celiac trunk
    • Left gastric artery
    • Hepatic artery
    • Superior mesenteric artery
  35. Accessory organs
    • Pancreas
    • A pistol-shaped organ both an endocrine and exocrine gland
    • Parts: head, body and tail
    • Ducts: major is Wirsung, minor is Santorini
  36.  
  37. Accessory organ
    • Liver
    • Largest internal organ
    • Located on the right upper quadrant
    • With right and left lobes
    • Functions to secrete bile
  38. Liver physiology and Pathophysiology = Gynecomastia, testes atrophy 8. Metabolizes estrogen =Deficiencies of Vit and min 7. Stores Vitamims and minerals =Hyper-ammonemia 6. Converts ammonia to urea = Jaundice and pruritus 5. Secreting bile = Bleeding tendencies 4. Synthesizes Clotting factors =Decreased Antibody formation  risk for INFECTION 3. Synthesizes globulins = Hypo-proteinemia 2. Synthesizes proteins = Hypoglycemia 1. Stores glycogen Abnormality in function Normal Function
  39.  
  40. Accessory organ
    • Gallbladder
    • Pear-shaped organ on the right upper quadrant below the liver
    • Parts: fundus, body and neck
    • Functions to store and concentrate bile
  41.  
    • PHYSIOLOGY OF THE GIT
  42. Movement
    • Mouth
    • Chewing or mastication
  43. Secretions
    • Mouth
    • Salivary secretions- salivary amylase or ptyalin begins the digestion of carbohydrates
  44. Movements
    • Mouth and esophagus: Deglutition
    • 1. Voluntary phase- food bolus is pushed by tongue to the pharynx
    • 2. Pharyngeal phase- reflex action
    • 3. Esophageal phase- peristaltic waves moves the food towards the stomach
  45. Stomach movement
    • Mixing waves
    • Peristaltic movements
  46. Fig. 16.12
  47. Secretions
    • Stomach
    • 1. Mucus- by the mucus cells for mucosal protection
    • 2. HCL from parietal cells
    • 3. Pepsinogen from chief cells
    • 4. Intrinsic factor from parietal cells
    • 5. Gastrin =a hormone from the antral G cells
  48. Secretions
    • Stomach
    • Digestion for lipids:
      • Gastric lipase
    • Digestion for proteins:
      • Pepsin
    • No enyme for carbohydrates
  49. Regulation of stomach secretions
    • 1. Cephalic phase- stomach secretions are initiated by the sight, smell, thought and taste of food
  50. Regulation of stomach secretions
    • 2. Gastric phase- secretions are produced upon stomach distention
  51. Regulation of stomach secretions
    • 3. Intestinal phase- acidic chyme from the stomach passes into the duodenum causing inhibition of gastric secretions
  52. Small intestine: movement
    • 1. Segmental contraction mixes food occurring over short distance
    • 2. Peristalsis propels food all throughout the entire intestine
  53. Fig. 16.9
  54. Small intestine: secretions
    • 1. Intestinal lipase for lipids
    • 2. Dissacharidases from the intestinal cells that complete the digestion of carbohydrates
    • 3. Peptidases from the intestinal cells complete the digestion of proteins
  55. Fig. 16.22
  56.  
  57. Large Intestine: secretion and movement
    • Mucus for mucosal protection
    • Mass movement- short peristaltic movement
  58. Large Intestine: secretion and movement
    • Defecation reflex- moves the feces to the internal anal sphincter, mediated by the parasympathetic nerves
    • Distention causes the reflex
  59. Liver secretion
    • Bile- aids in emulsifying the fats
  60. Pancreatic secretions
    • 1. Bicarbonate- to neutralize the acidic chyme from the stomach
    • 2. Pancreatic amylase- for carbohydrate digestion
  61. Pancreatic secretions
    • 3. Pancreatic lipase- for fat digestion
    • 4. Trypsin and chymotrypsin- for protein digestion
    • End of GIT
  62. THE URINARY SYTEM
    • The excretory system consisting of the kidney, ureters, urinary bladder and urethra
  63.  
  64. Major functions
    • Eliminates wastes
    • Controls blood and fluid volume
    • Regulates acid-base balance
    • Regulates RBC production by erythropoietin
  65. The Kidney
    • Retroperitoneal organ surrounded by capsule and fats
    • Right is lower than the left
    • The substance is composed of renal cortex ( where nephrons are located) and renal medulla ( where collecting ducts are found)
  66.  
  67. The Nephron
    • Functional unit of the kidney that produces urine by filtration
    • Composed of
      • Efferent arteriole
      • Glomerulus
      • Afferent arteriole
      • Bowman’s capsule
      • Convoluted tubules- proximal, loop of Henle and distal
  68.  
  69. Special cells in the nephron
    • Juxtaglomerular cells- secrete renin and erythropoietin
    • Podocytes
  70. Blood supply of the kidney
    • Renal artery- branch of the abdominal aorta
    • Renal vein- drains into the inferior venal cava
  71. Renal pelvis
    • Funnel-shaped expanded portion of the ureter
    • Formed by the calyces
    • Collects urine from the kidney
  72. The Ureter
    • Left and right
    • A long slender tube that propels urine from the kidney to the urinary bladder
    • With smooth muscles and transitional epithelium
    • With innervations from the sympathetic and parasympathetic
  73.  
  74. The urinary bladder
    • Hollow pyramid shaped organ located in the pelvis
    • Lined with transitional epithelium
    • With thick detrusor muscles
    • Micturition reflex resulting from the distension of the organ
    • Impulses are transmitted to the sacral parasympathetic segments to initiate urination
  75. Fig. 18.17
  76. Urethra
    • Tube extending from the urinary bladder to the external urethral orifice
      • 1 ½ inches in females
    • 3 parts in Males
      • 1. Prostatic urethra- most dilatable
      • 2. Membranous urethra- least dilatable and shortest
      • 3. Penile urethra- longest
  77.  
  78. Renal Physiology
    • Urine formation
    • 1. Urinary blood flow
    • 2. Glomerular filtration
    • 3. Tubular reabsorption
    • 4. tubular secretion
  79.  
  80.  
  81.  
  82. Fig. 18.12
  83. Fig. 18.13
  84. Fig. 18.14
    • End of renal
  85. The MALE Reproductive system
    • Made up of organs, ducts and glands whose function is to produce spermatozoa and androgens
  86. Internal Male reproductive organs
    • 1. Testes
    • 2. Ducts- epididymis, vas deferens and ejacularoty duct
    • 3. Glands- prostate and Cowper’s
    • 4. Seminal vesicle
  87. The testes
    • Male gonad housed in the scrotum
    • Divided into lobules containing tubules and cells
    • Sperm cells are produced in the seminiferous tubules
    • Leydig cells secrete testosterone
  88. Spermatogenesis
    • Begins during puberty
    • Occurs in the seminiferous tubules
    • Spermatogonia divides by MITOSIS into primary spermatocytes
    • Primary spermatocytes divide by MEOSIS to produce secondary spermatocytes
  89.  
  90. Spermiogenesis
    • Maturation of sperm cells
    • Secondary spermatocytes become spermatids and go to the epididymis for maturation into spermatozoa
  91. Ducts
    • 1. Epididymis- coiled tube
    • 2. Vas deferens- long tube from the epididymis to the seminal vesicle
    • 3. Ejaculatory duct- formed by the union of the vas deferens and the duct of the seminal vesicle
  92. Glands
    • 1. Prostate gland- glandular and muscular tissue produces likely, slightly acidic fluid and contributes 20% of the semen
    • 2. Seminal Vesicle- convoluted pouch, secretes alkaline fluid and fructose contributing to the bulk of the semen
    • 3. Cowper’s glands- secrete mucus for lubrication
  93. Fig. 19.5a
  94. External genitalia
    • 1. Scrotum- two chambered sac contains the testes
    • 2. Penis- erectile tissue consists of two corpora cavernosa and one corpora spongiosa
      • With 3 parts- bulb, shaft and glans
  95. The semen
    • Mixture of glandular secretions from the prostate and seminal vesicle and spermatozoa from the testes
    • Volume: 2.5-5 ml
    • Sperm count- 50-150 million per ml
    • SEMEN:
      • Is a thick whitish fluid ejaculated by the male during orgasm, contains spermatozoa and fructose-rich nutrients.
      • During ejaculation, semen receives contributions of fluid from
        • Prostate gland
        • Seminal vesicle
        • Epididymis
        • Bulbourethral gland
      • Average pH = 7.5
      • The average amount of semen released during ejaculation is 2.5 -5 ml. It can live with in the female genital tract for about 24 to 72 hours.
      • (60-200 million/ml of ejaculation ave. of 400 million/ ejaculation )
      • 90 seconds- cervix
      • 5 minutes.- end of fallopian tube
  96. THE FEMALE reproductive system
    • Group of organs with the function of production of ovum and sex hormones
  97. Parts of the reproductive system
    • EXTERNAL (vulva)
    • 1. Mons pubis
    • 2. Labia majora
    • 3. Labia majora
    • 4. Clitoris
    • 5. Hymen
    • 6. Vestibule
    • 7. Pudendal cleft
    • INTERNAL
    • 1. Ovary
    • 2. Fallopian tubes
    • 3. Uterus
    • 4. Vaginal canal
  98. The Internal organs
    • OVARY
      • Firm almond shaped organ covered by the peritoneum
      • Two parts: cortex and medulla
      • CORTEX- follicles are found
      • Medulla- connective tissue
  99. The internal organs
    • Fallopian tubes
    • Bilateral ducts extends laterally from the uterus
    • 4 parts
    • 1. Infundibulum- funnel shape, with fimbriae
    • 2. Ampulla- widest part; usual site of FERTILIZATION
    • 3. Isthmus- narrowest part
    • 4. Interstitial or Intramural- embedded in the uterine wall
    • FUNCTION: Transport of ovum
  100. Fig. 20.2
  101.  
  102. The Uterus
    • Pear-shaped organ with a cavity
    • 3 main parts
    • 1. Fundus- upper dome-shape part
    • 2. Corpus or Body- broad part
    • 3. Cervix- narrow lower part
      • Isthmus- junction between the body and the cervix
    • POSITION: Anteverted and Anteflexed
  103.  
  104. The Uterus
    • The uterine wall is made up of three layers
    • 1. Epimetrium- superficial part surrounded by the perimetrium
    • 2. Myometrium- thickest muscular part
    • 3. Endometrium- inner layer
    • FUNCTION: Fetal development in pregnancy
  105. The endometrium
    • 3 layers of the endometrium
    • 1. Stratum Functionale
        • Stratum compactum
        • Stratum spongiosum
    • 2. Stratum basale or germinativum
  106. Uterine ligaments
    • Broad ligament
    • Round ligament
    • Cardinal ligament
    • Utero-sacral ligament
  107. Fig. 19.8
  108. Vaginal canal
    • Connects the cervix to the vestibule
    • Fibromuscular canal lined with mucus and covered with hymen
    • The remnant of hymen is called CARUNCULAE MYRTIFORMIS
    • Function: organ of copulation and passageway of baby
  109.  
  110. External genitalia
    • 1. Vestibule- space between the labia minora
    • 2. Pudendal cleft- space between the labia majora
    • 3. Clitoris- erectile tissue, homologue of penis
  111. External genitalia
    • 4. Labia majora- thick fold of skin, homologue of scrotum
    • 5. Labia Minora- thin fold of skin devoid of hairs
    • 6. Mons pubis/veneris- elevated area above the labia
  112. Mammary gland
    • Modified sweat gland
    • Consists of glandular and adipose tissue
    • Estrogen  for breast development
    • Progesterone  for lobular development
    • Prolactin  for milk production
    • Oxytocin  for milk “let down”
  113.  
  114. PHYSIOLOGY of female reproduction
    • 1. Puberty
    • 2. Menstruation
    • 3. Menopause
  115. Puberty
    • Begins with the onset of the first menstruation= MENARCHE
    • GnRH (from hypothalamus) Gonadotrophins (LH and FSH from the ant pit) levels are increased
    • Tanner- states that the initial sign of puberty in girls is breast development
  116. Fig. 19.11
  117. Menstrual cycle
    • Cyclical changes in the uterus controlled by hormones
    • Duration: 24-35 days
    • Changes in the 3 systems/organs:
    • 1. Uterus  uterine cycle
    • 2. Ovary  ovarian cycle
    • 3. Hormone  hormonal cycle
    • MENSTRUATION:
    • Menstrual cycle/ female reproductive cycle- monthly discharge of blood from the uterus occurring form puberty to menopause wherein about 30-80 cc (60 cc ave.) of blood, epithelial cells and mucus are being discharged
    • Maturation of Oocytes:
      • first formed in utero - 5 to7 million;
      • first 5 months in utero - 2 million immature oocytes per ovary
      • at birth - 2 million in BOTH ovaries
      • 7 yrs of age only - 500,000/ovary
      • 22y/o only - 300,000/ovary
      • Reproductive age only - 300–400 oocytes
      • Menopause - none
  118.  
  119. Fig. 19.14
  120. The uterine cycle
    • Consists of 3 phases
    • Menstrual phase
    • Proliferative phase
    • Secretory phase
  121. OVARIAN cycle Consists of three phases 1. Pre-ovulatory : follicular phase 2. Ovulatory phase 3. Post-ovulatory : Luteal phase
  122.  
  123. Uterine Cycle: Menstrual phase
    • Day 1- day 5
    • First day of bleeding is the first day of cycle
    • Stratum functionale (compactum and spongiosum) is shed
    • Around 60 ml average!
  124. Uterine cycle: proliferative Phase
    • Day 5- day 14
    • Epithelial cells of functionale multiply and form glands
    • Due to the influence of estrogen
  125. Uterine cycle: Secretory phase
    • Day 15- day 28
    • Endometrium becomes thicker and glands secrete nutrients
    • Uterus is prepared for implantation
    • Due to progesterone
    • If no fertilization  constriction vessels  menstruation
  126. OVARIAN cycle
    • Consists of three phases
    • 1. Pre-ovulatory : follicular phase
    • 2. Ovulatory phase
    • 3. Post-ovulatory : Luteal phase
  127. Ovarian Cycle; preovulatory/follicular
    • Variable in length: day 6- day 13
    • Dominant follicle matures and becomes graafian follicle with primary oocyte
    • FSH increases initially then decreases because of estrogen increase
  128. Ovarian cycle: Ovulatory phase
    • Day 14
    • Rupture of the graafian follicle releasing the secondary oocyte
    • Due to the LH surge
    • MITTELSCHMERZ- pain during rupture of follicle
  129. OVARIAN cycle: Post-ovulatory: luteal phase
    • Day 15- day 28
    • MOST CONSTANT 14 days after ovulation
    • Corpus luteum secretes Progesterone
    • If no fertilization, corpus luteum will become corpus albicans then degenerate
    • Decreased estrogen and progesterone
  130. Hormonal cycle
    • 1. Menstrual phase
      • Decreased Estrogen, decreased progesterone, decreased FSH and decreased LH
    • 2. Proliferative/ Pre-ovulatory phase
      • Increased FSH and Estrogen in small amounts
  131. Hormonal cycle
    • 3. Ovulatory phase
      • Increased FSH, Increased LH (surge) Increased Estrogen
    • 4. Post ovulatory/luteal Phase
      • Increased Estrogen, increased progesterone, decreased FSH and LH
  132.  
  133. MENOPAUSE
    • Cessation of menstruation for at least one year occurring at the age of 45-52
    • Decreased estrogen and progesterone
    • Increased FSH
    • End of reproductive

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