内科学消化系统总论.ppt

内科学消化系统总论

AssimilationofnutrientsEliminationofwasteStructureandfunctions

StructureandfunctionsThetwoactivitiesundervoluntarycontrolareswallowinganddefecation.

CharacteristicsofDigestiveSystemManynormalGIreflexesinvolveextrinsicvagusorsplanchnicnervepathways.Anactivebrain-gutaxisfurtheraltersfunctioninregions

Immuneorgan Gastrointestinal-associatedlymphoidtissue,(GALT) CharacteristicsofDigestiveSystem

Notonlyadigestiveorganbutalsoendocrineorgan pancreas gastrin(胃泌素) glucagon(胰高糖素) somatostatin(生长抑素) VIP(血管活性肠肽) insulin(胰岛素)CharacteristicsofDigestiveSystem

Structure/functionanddiseasesThebiggestorganHomeostasisSynthesisExcretionFilterDefensesymptomssignsDeath

?inflammation(炎症)?Ulcer(溃疡) ?bleeding(出血) ?perforation(穿孔) ?neoplasm(肿瘤) ?functionaldisturbances(功能失调)CommonLesionsofDigestiveSystem

ClassificationofGIDiseasesImpairedDigestionandAbsorption(Biliaryobstruction,Chronicpancreatitis)AlteredSecretion(Zollinger-Ellisonsyndrome,atrophicgastritis,smallintestinalbacterialovergrowth)AlteredGutTransit(obstructionbygastriccancerorcoloncancer,Achalasia,constipation,diarrhea)

ImmuneDysregulation(ulcerativecolitis,Crohn’sdisease)ImpairedGutBloodFlow(intestinalandcolonicischemia)NeoplasticDegeneration(Esophageal,gastric,colon,pancreatic,biliarycancer)DisorderswithoutObviousOrganicAbnormalities(IBS)GeneticInfluences

ClassificationofLiverDiseasesViralHepatitsNonalcoholicfattyliverAlcoholicliverdiseaseImmuneautoimmuneliverdiseasesDrug-inducedliverdiseaseGeneticliverdiseasesMasslesionsVascularinjuryLiverinvolvementinsystemicdiseases

LaboratorytestsHistory+Symptoms+SignImagingstudiesEVALUATIONOFPATIENTWITHGIDISEASE

?Thediagnosisdrivespredominantlyfromthepatient’shistory?Thephysicianmustidentifythetiming,type,locatio