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    Git, Repro, Uro Git, Repro, Uro Presentation Transcript

      • The digestive system
    • The DIGESTIVE SYSTEM
      • Alimentary tract composed of organs, the primary function of which is the ingestion, digestion and absorption of nutrients
    • The DIGESTIVE SYSTEM
      • Consists of the tube extending from the mouth to the anus together with the associated organs- salivary glands, liver, pancreas, gallbladder
    •  
    • The GIT
      • The tract is long, fibromuscular tube lined internally by specialized epithelium for secretion and absorption
    • The GIT
      • The wall is divided into
      • Mucosa
      • Submucosa
      • Muscularis layer (inner circular and outer longitudinal)
      • and Serosa/adventitia
    • Fig. 16.2
    • GENERAL FUNCTIONS
      • Ingestion of food into the mouth
      • Moves food along the digestive tract
      • Mechanically digests the food into small particles
    • GENERAL FUNCTIONS
      • Chemically digests the food into simple molecules
      • Absorbs nutrients into the portal and lymphatic circulation
    • The MOUTH
      • Extends from the lips to the orophaynx
      • Initial digestion of carbohydrates occurs here
      • Contains the teeth, tongue, palate, salivary glands and tonsils
    • 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
    •  
    • The Pharynx
      • Oropharynx is a passageway of both food and air
    • The Esophagus
      • Muscular tube extending from the pharynx to the stomach
      • With upper esophageal sphincter and lower esophageal sphincter
    • The Esophagus
      • Function: to propel food to the stomach
    • 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
    • Cells in the stomach
      • 1. Mucus cells
      • 2. Chief cells/principal cells/Zymogenic cells
      • 3. Parietal Cells
      • 4. Argentaffin cells
    • Cells in the stomach
      • 1. Mucus cells- secrete mucus for protection of the mucosa
    • Cells in the stomach
      • 2. Chief cells/principal cells/Zymogenic cells
      • secrete Pepsinogen needed for protein digestion
    • Cells in the stomach
      • 3. Parietal cells/Oxyntic cells- secrete Hydrochloric acid to activate pepsinogen and Intrinsic factor needed to absorb Vitamin B12
    • Cells in the stomach
      • 4. Argentaffin cells- secrete Serotonin
    • Small intestine
      • Characteristics:
      • Provided with mesentery
      • Presence of villi
      • Presence of plicae circularis
      • Lined by simple columnar
    • Fig. 16.14
    • Parts of Small Intestine
      • 1. DUODENUM- shortest part
      • 2. Jejunum
      • 3. Ileum- longest part
    • Parts of Small Intestine
    • Large intestine
      • Characteristics
      • Presence of haustra
      • Presence of taenia coli
      • Presence of appendices epiploicae
    • Large intestine
      • Characteristics
      • No villi
      • With mesocolon on the appendix, transverse colon and sigmoid colon
    • Parts of the large intestine
      • Cecum
      • Appendix
      • Ascending colon
      • Transverse colon
      • Descending colon
      • Sigmoid colon
      • rectum
    •  
    • Anus
      • The anal canal is the last portion of the tract, surrounded by an internal and external anal sphincter
    • The Peritoneum
      • Serous membrane lining the abdominal cavity
      • Parietal peritoneum- abdominal wall
      • Visceral peritoneum- visceral organs
    • Fig. 16.3
    • The Peritoneum
      • Retroperitoneal organs are found posterior to the peritoneum- kidney, pancreas, duodenum, ascending and descending colon, rectum
    • Mesentery
      • This is a peritoneum folded upon itself extending from the organ to the abdominal wall
    • Blood supply of the GIT
      • Branches of the celiac trunk
      • Left gastric artery
      • Hepatic artery
      • Superior mesenteric artery
    • 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
    •  
    • Accessory organ
      • Liver
      • Largest internal organ
      • Located on the right upper quadrant
      • With right and left lobes
      • Functions to secrete bile
    • 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
    •  
    • 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
    •  
      • PHYSIOLOGY OF THE GIT
    • Movement
      • Mouth
      • Chewing or mastication
    • Secretions
      • Mouth
      • Salivary secretions- salivary amylase or ptyalin begins the digestion of carbohydrates
    • 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
    • Stomach movement
      • Mixing waves
      • Peristaltic movements
    • Fig. 16.12
    • 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
    • Secretions
      • Stomach
      • Digestion for lipids:
        • Gastric lipase
      • Digestion for proteins:
        • Pepsin
      • No enyme for carbohydrates
    • Regulation of stomach secretions
      • 1. Cephalic phase- stomach secretions are initiated by the sight, smell, thought and taste of food
    • Regulation of stomach secretions
      • 2. Gastric phase- secretions are produced upon stomach distention
    • Regulation of stomach secretions
      • 3. Intestinal phase- acidic chyme from the stomach passes into the duodenum causing inhibition of gastric secretions
    • Small intestine: movement
      • 1. Segmental contraction mixes food occurring over short distance
      • 2. Peristalsis propels food all throughout the entire intestine
    • Fig. 16.9
    • 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
    • Fig. 16.22
    •  
    • Large Intestine: secretion and movement
      • Mucus for mucosal protection
      • Mass movement- short peristaltic movement
    • Large Intestine: secretion and movement
      • Defecation reflex- moves the feces to the internal anal sphincter, mediated by the parasympathetic nerves
      • Distention causes the reflex
    • Liver secretion
      • Bile- aids in emulsifying the fats
    • Pancreatic secretions
      • 1. Bicarbonate- to neutralize the acidic chyme from the stomach
      • 2. Pancreatic amylase- for carbohydrate digestion
    • Pancreatic secretions
      • 3. Pancreatic lipase- for fat digestion
      • 4. Trypsin and chymotrypsin- for protein digestion
      • End of GIT
    • THE URINARY SYTEM
      • The excretory system consisting of the kidney, ureters, urinary bladder and urethra
    •  
    • Major functions
      • Eliminates wastes
      • Controls blood and fluid volume
      • Regulates acid-base balance
      • Regulates RBC production by erythropoietin
    • 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)
    •  
    • 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
    •  
    • Special cells in the nephron
      • Juxtaglomerular cells- secrete renin and erythropoietin
      • Podocytes
    • Blood supply of the kidney
      • Renal artery- branch of the abdominal aorta
      • Renal vein- drains into the inferior venal cava
    • Renal pelvis
      • Funnel-shaped expanded portion of the ureter
      • Formed by the calyces
      • Collects urine from the kidney
    • 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
    •  
    • 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
    • Fig. 18.17
    • 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
    •  
    • Renal Physiology
      • Urine formation
      • 1. Urinary blood flow
      • 2. Glomerular filtration
      • 3. Tubular reabsorption
      • 4. tubular secretion
    •  
    •  
    •  
    • Fig. 18.12
    • Fig. 18.13
    • Fig. 18.14
      • End of renal
    • The MALE Reproductive system
      • Made up of organs, ducts and glands whose function is to produce spermatozoa and androgens
    • Internal Male reproductive organs
      • 1. Testes
      • 2. Ducts- epididymis, vas deferens and ejacularoty duct
      • 3. Glands- prostate and Cowper’s
      • 4. Seminal vesicle
    • 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
    • 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
    •  
    • Spermiogenesis
      • Maturation of sperm cells
      • Secondary spermatocytes become spermatids and go to the epididymis for maturation into spermatozoa
    • 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
    • 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
    • Fig. 19.5a
    • 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
    • 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
    • THE FEMALE reproductive system
      • Group of organs with the function of production of ovum and sex hormones
    • 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
    • The Internal organs
      • OVARY
        • Firm almond shaped organ covered by the peritoneum
        • Two parts: cortex and medulla
        • CORTEX- follicles are found
        • Medulla- connective tissue
    • 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
    • Fig. 20.2
    •  
    • 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
    •  
    • 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
    • The endometrium
      • 3 layers of the endometrium
      • 1. Stratum Functionale
          • Stratum compactum
          • Stratum spongiosum
      • 2. Stratum basale or germinativum
    • Uterine ligaments
      • Broad ligament
      • Round ligament
      • Cardinal ligament
      • Utero-sacral ligament
    • Fig. 19.8
    • 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
    •  
    • External genitalia
      • 1. Vestibule- space between the labia minora
      • 2. Pudendal cleft- space between the labia majora
      • 3. Clitoris- erectile tissue, homologue of penis
    • 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
    • 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”
    •  
    • PHYSIOLOGY of female reproduction
      • 1. Puberty
      • 2. Menstruation
      • 3. Menopause
    • 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
    • Fig. 19.11
    • 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
    •  
    • Fig. 19.14
    • The uterine cycle
      • Consists of 3 phases
      • Menstrual phase
      • Proliferative phase
      • Secretory phase
    • OVARIAN cycle Consists of three phases 1. Pre-ovulatory : follicular phase 2. Ovulatory phase 3. Post-ovulatory : Luteal phase
    •  
    • 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!
    • Uterine cycle: proliferative Phase
      • Day 5- day 14
      • Epithelial cells of functionale multiply and form glands
      • Due to the influence of estrogen
    • 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
    • OVARIAN cycle
      • Consists of three phases
      • 1. Pre-ovulatory : follicular phase
      • 2. Ovulatory phase
      • 3. Post-ovulatory : Luteal phase
    • 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
    • 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
    • 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
    • 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
    • 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
    •  
    • 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