胃消化系统课件.pptVIP

* III GASTRIC MOTILITY * Major Function of Gastric Motility To serve as a reservoir To break food into small particles and mix food with gastric secretions To empty gastric contents into the duodenum at a controlled rate * 1. Functional Anatomy of the Stomach * * * three anatomic regions (A) and two functional regions (B) Gastric reservoir Tonic contractions Gastric pump Phasic contractions B Fundus Corpus Antrum Pylorus A * 2. Responses to Gastric Filling – Receptive Relaxation * Receptive relaxation Nerve reflex Stimulation: Food (chewing and swallowing) Receptors: in mouth, pharynx and esopahgus Effect: relaxation of the fundus and body of the stomach Importance: food and fluid accommodation in stomach * * Reflex relaxation of the gastric reservoir: receptive, adaptive and feedback Inhibitory vagal fibre (NANC-inhibition) Nutrients CCK Relaxation of gastric reservoir ACH Vagus centre 1. Receptive relaxation Mechanical stimuli in the pharynx 3. Feedback relaxation 2. Adap tive relax ation Nutrients Tension receptors Distension NO + VIP et al. * 3. Peristalsis of the Gut and Gastric Emptying * Gastric Motility Peristaltic waves: Body ? Antrum Body Thin muscle ? weak contraction ? No mixing Antrum Thick muscle ? powerful contraction Mixing Contraction of pyloric sphincter ? Only small quantity of gastric content (chyme) entering duodenum Further mixing as antral contents forced back towards body * propulsion retropulsion emptying Bulge Rapid flow of liquids with suspended small particles and delayed flow of large particles towards pylorus Emptying of liquids with small particles whereas large particles are retained in the buldge of the terminal antrum Antrum Three Phases of the Gastric Pump Contraction Retropulsion of large particles and clearing of the terminal antrum * * Control of Gastric Motility Vagovagal reflex – fundal relaxation Myenteric plexus – slow waves – contraction Parasympathetic and Gastrin – increase contraction force a