Download Peristalsis – law of intestine

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project

Document related concepts

Fecal incontinence wikipedia , lookup

Colonoscopy wikipedia , lookup

Gastric bypass surgery wikipedia , lookup

Flatulence wikipedia , lookup

Surgical management of fecal incontinence wikipedia , lookup

Transcript
IV MOTILITY OF THE SMALL
INTESTINE
1
Function of Intestinal Motility
(1)To mix chyme with digestive secretion
(2)To bring fresh chyme into contact with the
absorptive surface of the microvili
(3)To propel chyme toward the colon
2
Types of small intestinal movement
1. Tonic contraction: the base of the other contractions
2. Segmentation contractions
(1) def.
When a portion of the small intestine becomes distended
with chyme,
the stretch of the intestinal wall elicits a rhythmical
contraction and relaxation of localized circular muscles
spaced at intervals along the intestine,
(2) function:
mix the chyme with the digestive juice
increase its exposure to the mucosal surface
3
Types of small intestinal movement
3. Peristalsis: propels the small intestinal contents towards the
large intestines
peristaltic rush:initiated by the harmful stimulation
4. MMC:
Occurs during fasting state
moves any undigested material still remaining in the
small intestine into the large intestine
prevents bacteria from remaining in the small intestine
long enough to grow and multiply excessively
4
Segmentation: mix contents to promote
digestion & absorption
5
Peristalsis
• Distinctive pattern of smooth muscle contractions
that propels foodstuffs distally through the
esophagus and intestines
• Mediated by….
• Local, intrinsic nervous system
• Ex: peristalsis is not affect to any significant
degree by vagotomy or sympathectomy
6
Small Intestinal Motility
Peristalsis: movement along the tract
7
Peristalsis
8
Figure 24.4
peristalsis
9
Peristalsis of the small intestine
10
http://medweb.bham.ac.uk/research/toescu/Teaching/OverviewGITY2.html
Peristalsis – law of intestine
11
Berne et al., 2004
Peristalsis – law of intestine
12
Berne et al., 2004
Peristalsis – law of intestine
13
Berne et al., 2004
Peristalsis – law of intestine
14
Berne et al., 2004
Peristalsis – law of intestine
15
Berne et al., 2004
Peristalsis – law of intestine
• Bolus of food →Mechanical distension and mucosal
irritation → stimulates afferent enteric neurons → 2 effects
1. Excitatory motor neurons above the bolus activated →
contraction of smooth muscle above the bolus
• Via Ach, substance P
2. Inhibitory motor neurons → stimulate relaxation of
smooth muscle below the bolus
• Via nitric oxide, vasoactive intestinal peptide and
ATP
16
Control of Intestinal Motility – Neuronal
Mixing – segmentation
Frequency set by slow waves (12/minute duodunum)
additional control: myenteric plexus
Propulsion – peristalsis
Local reflex – stretch causes relaxation distal and
contraction proximal (Bayliss – Starling law of the
intestines)
Moves bolus through intestines
Intestino-intestinal reflex – extrinsic nerves
Local stretch in one area inhibits contraction in rest of
17
bowel
Movement in Small Intestine
Peristalsis (ou propulsivos) e Segmentation (mixing)
18
http://medweb.bham.ac.uk/research/toescu/Teaching/OverviewGITY2.html
Central and peripheral control of contractile patterns
Vagal
centre
Intestinal
wall
Vago-vagal reflexes
Interneurons
Integrating circuits
Sensory neurons
Motorneurons
Program circuits
Contractile
patterns
Enteric nervous system
Intestinal
lumenl
Peptide (CCK) Receptors
Glucose - Osmolality
Long chain fatty acids
Amino acids
Luminal stimuli elicit vago-vagal reflexes which activate integrating and
program circuits of the enteric nervous system.
These activate specific motorneurones responsible for specific contractile
19
patterns.
Control of Intestinal Motility – Hormonal
Gastrin
CCK
Secretin
+ motility --
Glucagon
5-HT
VIP
Motilin
GIP
20
Ileocecal
Valve
• What it is
• Opening to large intestines
• Function: (1) prevent the repulsion (2) control the emptying
• normally closed. Short-range peristalsis in terminal ileum
and distension relaxes IC sphincter --> small amount of
chyme is squirted into the cecum.
• Distension of cecum contracts IC sphincter.
• Gastro-ileal reflex: enhances ileal emptying after eating.
21
• The hormone gastrin relaxes ileocecal sphincter.
V. GASTROINTESTINAL MOTILITY
DURING FASTING STATE
22
Gastric motility on fasting
“Migrating Motor Complex, MMC”
Occurs during fasting
To clear undigested food particles
Peristaltic contractions sweep down stomach and
duodenum – pylorus relaxes
Pattern of contraction approx every 90 min
Slow peristaltic waves sweeping whole of GI tract
23
Thought to be controlled by motilin (胃动素)
24
MMC(migrating motor complex)
• PhaseⅠ: Almost have no contractions 40-60 min
• PhaseⅡ: have contractions, only have few 30-45 min
• PhaseⅢ: have continuous contractions 5-10 min
25
The interdigestive motility consists of three phases
III
Interdigestive Cycles
Phases
II
I
Phase III
Stomach
Phase III
Pylorus
Duodenum
Accumulation
of residues
of chyme
Jejunum
Phase I
Contraction
of reservoir
Forceful
peristaltic
waves
Motor
quiescence
of stomach
and duodenum
III
Phase II
Sporadic
peristaltic waves
Segmenting
contractions
and single
peristaltic waves
Phase II
Motor
quiescence
Ileum
Phase I
Phase III
The phase III of the migrating motor complex (of dog)
Originates simultaneously at the stomach and duodenum
26
Migrates within 90 to 120 minutes along the small intestine
Importance of MMC
1.Sweep the contents of the small intestine
towards the colon
Housekeeper of the small intestine
2.Inhibit the migration of colonic bacteria into
the terminal ileum
27
VI MOTILITY OF THE COLON
28
Large intestine
• Functions
• Absorption of water and electrolytes
• Storage of feces
• In non-ruminant herbivores, fermentative digestion
and absorption of nutrients
• Motility patterns
• mixing (form haustrations)
• propulsive (mass movements)
29
Segmentation in
large intestine
• Haustration: (结肠袋)
modified form of
segmentation in which
intense, local contraction of
circular muscle causes
large intestine to appear to
bulge into sacs
30
Mass movement
• Occurs in colon; also known to occur in
equine cecum
• Period of intense propulsive activity that
moves entire contents of colon distally
toward rectum
• Contractions progress for long distance such that
long length of colon contracts as a unit
• Entry of fecal matter into recturn triggers
defecation reflex
31
Mass Movement
32
Defecation
Defecation Reflex
initiated when rectal walls stretch

parasympathetic reflex

walls of the sigmoid colon and the
rectum to contract & relaxation of
the anal sphincter

External sphincter control is
voluntary control

If defecation is delayed: the reflex
stops until the next mass
movement
33