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ENGLISH FOR MEDICAL SPECIALISTS Знаменська І.В. 1частина.doc
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Stomach functions

The major stomach functions are to store and mix the ingested food.

Secretions of the stomach. Stomach secretions include mucus, hydrochloric acid, gastrin, intrinsic factor, and pepsinogen, the inactive form of the protein-digesting enzyme pepsin. Mucus protects the stomach lining. Pepsinogen is converted to pepsin, which digest proteins. Hydrochloric acid promotes pepsin activity and kills microorganisms. Intrisnic factor is necessary for vitamin B12 absorption.

Regulation of stomach secretion. Approximately 2 to 3 L of gastric secretions (gastric juice) are produced each day. Diet dramatically affects the secretion amount; up to 700 ml are secreted as a result of a typical meal. Both nervous and hormonal mechanisms regulate gastric secretions. Regulation of stomach secretion is divided into 3 phases: cephalic, gastric, and intestinal. The cephalic phase is initiated by the sight, smell, taste, or thought of food. Nerve impulses from the medulla stimulate hydrochloric acid, pepsinogen, and gastrin secretion. The gastric phase is initiated by distention of the stomach, which stimulates gastrin secretion and activates central nervous system and local reflexes that promote secretion. The intestinal phase is initiated by acidic chime, which enters the duodenum and stimulates neuronal reflexes and the secretion of hormones that induce and then inhibit gastric secretions.

Mixing of stomach contents. Ingested food is mixed with the secretions of the stomach glands to form a semi-fluid material called juice (chime). This mixing is accomplished by gentle mixing waves, which are peristaltic-like contractions that occur every 20 seconds to mix the ingested material with the secretions of the stomach. Peristaltic waves occur less frequently. They are more powerful than mixing waves, and force the chime near the periphery of the stomach toward the pyloric sphincter. Roughly 80% of the contractions are mixing waves, and 20% are peristaltic waves.

Regulation of stomach emptying.The amount of time food remains in the stomach depends on the number of factors, including the type and volume of food. Liquids exist in the stomach within 1 and ½ hours to 2 and ½ hours after ingestion. After a typical meal the stomach is usually empty within 3 to 4 hours. Gastrin and stretching of the stomach stimulate stomach emptying.

Regulation of stomach movements. If the stomach empties too fast, the efficiency of digestion and absorption is reduced. If the rate of emptying is too slow, the highly acidic contents of the stomach may damage the stomach wall and reduce the rate at which nutrients are digested and absorbed. Stomach emptying is regulated to prevent these two extremes. Stomach stretches and relaxes to increase volume. Conversely, many of the hormonal and neural mechanisms decrease the rate of the stomach emptying.

OVERVIEW

The stomach stores and mixes the ingested food. The major function of the stomach is to prepare the food for further digestion and absorption into the blood. The stomach is a dilated portion of the alimentary tract. It consists of the fundus, the body, and the antrum. The upper opening of the stomach is called the cardiac sphincter and the lower one is called the pyloric sphincter. The cardiac sphincter relaxes and contracts to move food from the esophagus into the stomach. The pyloric sphincter allows food to leave the stomach when it has been sufficiently digested. Different gastric glands are in the stomach. The glands of the stomach secrete gastric juice. This juice contains pepsins and hydrochloric acid. Pepsin converts proteins into smaller substances. Hydrochloric acid is necessary for the correct action of pepsin.

LESSON 27

LIVER

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