Digestive-System消化系统英文值得收藏

L/O/G/ODigestiveSystemContents•Part1Introduction•Part2Pepticulcer•Part3AcutePancreatitisAnatomy•Anatomically,thedigestivesystemconsistsofa30-feetlongmucousmembrane-linetubebeginningwiththemouthandendingwiththeanus•Thedigestivesystemiscomposedofninemainorgans:mouth、pharynx、esophagus、stomach、smallintestine、largeintestine、liver、gallbladderandpancreasMucous粘液的Anus肛门Pharynx咽部Esophagus食管Pancreas胰腺Overview1•Howmanyorgansarethereinthedigestivesystem?Whatarethey?TheorgansofthedigestivesystemTheprimaryfunctionsofthedigestivesystemIngestion摄入DigestionAbsorption吸收Elimination排泄4123PhysiologyofthemajororgansOrganMovementDigestiveJuicesusedFoodParticlesBrokenDownMouthChewingSalivaStarchEsophagusSwallowingNoneNoneStomachUppermuscleinstomachrelaxestoletfoodenterandlowermusclemixesfoodwithdigestivejuiceGastricjuice(likeStomachacid)ProteinIntestinePeristalsisSmallintestinedigestivejuiceStarch,protein,andcarbohydratesPancreasNonePancreaticjuiceStarch,fats,andproteinLiverandgallbladderNoneBileFatsCommonSymptomsLossofappetiteNauseaandVomittingAbdominaldistension&painDiarrhea4123CommonSymptomsHematochezia便血Hematemesis呕血Constipation便秘Jaundice黄疸8567hemat-hem-bloodhematologyhematologisthemorrhageHematocheziaHematemesis-itisinflammatiomgastritishepatitisenteradenitisnephritischolecystitisEpidemiologicalinvestigationMorbiditygastrointestinaldiseasespatientsthemorbidityofchronicgastritisis30%pepticulcerchronicgastritis120millionpeopleaccountedformorethan70%theincidenceofpepticulceris10%theelderly2012ChinesecancerregistrationreportHepaticcarcinomaGastriccarcinomaEsophagealcancerColoncancerCancerdeathrateslist04.autoimmunity03.Dietandenvironmentalfactors01.InfectionwithabacteriumcalledH.Pylori(Hp)02.Useofdrugslikenonsteroidalanti-inflammatorydrugs(NSAIDs非甾体抗炎药)Vision03Vision04EtiologyEtiologyMethodsofexaminationBiopsy活检GastrointestinaldynamicsLaparotomy剖腹探查术456Endoscopy内窥镜ImageologicalexaminationLaboratoryinspection:bloodandstoolroutines,C-ureabreathtest123vocabularygastr-stomachgastriticgastralgiagastrorrhagiagastrorrhaphygastrographygastradenitisgastroscopy-scopy镜检法endoscopyenteroscopycystoscopycholecystoscopygastroscopyproctoscopy-ectomy切除术gastrectomyappendectomycholecystectomycystectomyvocabulary•-stomy:造口术、吻合术•appendicostomy•gastrostomy•gastroduodenostomy•-tomy:切开术•pancreatomy•gastrotomy•anatomyPepticulcerPepticulcer(PU)：Mainlyreferstothechroniculceroccursinthestomachandduodenummucosa(n.[解剖]粘膜),namely,gastriculcer(GU)andduodenalulcer(DU).Thebasicformationofulceristhegastricacidandpepsin(n.[医]胃蛋白酶)digestion.ClinicallyDUismorecommonthanGUwiththeratiobeingabout3:1.DUoccursinyoungadults.TheageofonsetofGUisgenerally10yearsolderthanDU.Autumn,winterandspringaretheseasonsofPU.Overview2Howmanytypescanthepepticulcerbeclassified?Whatarethey?Etiology1、H.pyloriinfection:themaincauseofpepticulcer.2、Gastricacidandpepsin：PUisduetogastricacidandpepsinconsistinggastricjuicecausedbytheirowndigestion.3、Drugfactors：someNSAIDs,anticancerdrugshavedamagingeffectsongastricandduodenalmucosa,whichwasmostobviousinNSAIDs.NSAIDsinadditiontodirecteffectsonthegastricandduodenalmucosacausedthedamage,mainlythroughtheinhibitionofprostaglandinsynthesis.H.Pylori幽门螺杆菌Pepsin胃蛋白酶Duodenal十二指肠的Mucosa粘膜Prostaglandin前列腺素Synthesis合成4、Otherriskfactors·Cigarette·Psychologicalfactors·GeneticfactorsPathologyLocation:95%ofDUisintheduodenalbulb(十二指肠球部).Afewoccurredinthebackofbulb；85%ofGUlocateinthelessercurvatureofstomach（胃窦小弯）andtheangleofstomach（胃角）.Number:mostofthemaresingle,afewcasesarecrinosity（多发).Shape:roundoroval（椭圆）Depth:Theshallowulcerinvolvesmucosalmuscularlayer（粘膜肌层）,someulcersreachtomuscularlayer（肌层）andevenserouscoat（浆膜层）.Afewulcersleadstoperforation（穿孔）.Thebottomofulcerisclean,withsmoothedgeandashenorsallowcoating（灰白或灰黄苔）.Recovertime:4-8WClinicalFeaturessymptom——AbdominalPain1、Longterm：severalyearsorevendecades.2、Periodical(周期性的)attack:theattackandrelievedstageappearalternately.发作期与缓解期交替出现3、Rhythmicepigastricpain.节律性上腹疼GU·irregulargastricpainaftermeal·Ingestionoffoodandantacids（制酸剂）cannotrelievepainDU·Burningpainworsewhenhungryoratnight·IngestionoffoodandantacidsoftenrelievepainOthersymptoms：BelchingAbdominaldistensionNauseaSatietySigns：Epigastrictenderness(notspecificity)Belching打嗝Nausea恶心Satiety早饱Epigastric上腹部的Tenderness压痛laboratoryexaminationBariummeal（钡餐）Bariumstudiesoftheproximalgastro-intestinaltractarestillcommonlyusedasafirsttestfordocumentinganulcer.ForaDU,itappearsasawell-demarcatedcrater,oftenseeninthebulb.ForaGU,itmayrepresentbenignormalignantdisease.Typically,abenignGUalsoappearsasadiscretecraterwithradiatingmucosalfoldsoriginatingfromtheulcermargin.（GU可能是良性和恶性。典型的良性表现为游离龛影，粘膜皱襞从溃疡边缘向内放射集中）Barium钡proximal近端的demarcated界定的crater龛影discrete游离的benign良性的malignant恶性的Endoscopy----mostsensitiveandspecificTestfordetectionofH.PyloriInvasive:Rapidurinescreeningtest（快速尿素酶实验）,Histologyculture（组织学培养）.Non-invasive:Serology，C-Ureabreathtest（碳呼气试验）.Urine尿Histology组织学Serology血清学Urea尿素-ology学问、学科PathologyEtiologyHistologyhematologySerology-pathy病nephropa