Clinical pathophysiology of the digestive system

Disorder of stomach secretory function

According to mechanism:•Organic disturbances of stomach glands•Change I functional activity of secretory cells According to kind of disturbance•Hypersecretion•Hyposecretion

Key-points for hypersecretion

The four inputs to parietal cells that regulate acid secretionby controlling the transfer of the H,K-ATPase pumps incytoplasmic vesicle membranes to the plasma membrane.

Gastritis

Gastritis

Disorder of stomach motor function

• Hypercinesis – increased motility• Hypertonus – increased degree of contraction• Hypocinesis - decreased motility• Hypotonus - decreased degree of contraction Pathological reflexes• Nausea• Vomiting• Belching

Gastric Juice Secretion, Mucosal Protection and Risk of Ulcer

Gastric Juice Secretion, Mucosal Protection and Risk of Ulcer

Gastric Juice Secretion, Mucosal Protection and Risk of Ulcer

Disorders After Stomach Surgery

Disorders After Stomach Surgery

Disorder of digestion in intestine• Disorders of the pick out of bile and pancreatic juice

are accompanied by disorders of all types of digestion, development of putrefaction and fermentation in the intestine (at closing, or squeezing the excretory ducts of glands in cystic fibrosis mucoviscidosis, because of pancreatic cancer, acute and chronic pancreatitis and duodenitis, violating the neurohumoral mechanisms of regulation of secretion, particular functions of the vagus nerve, the allocation of secretin, cholecystokinin, pancreatic polypeptide).

• Disorders of digestion of nutrients combined in maldigestion syndrome.

• Malabsorption of substances in the gut combined into a syndrome, which is characterized by diarrhea, weight loss, protein deficiency, signs of hypovitaminosis.

Causes of Acute Pancreatitis

Consequences of Acute Pancreatitis

Causes of Chronic Pancreatitis

Consequences of Chronic Pancreatitis

Causes of Constipation

Consequences of Constipation and (Pseudo-)Obstruction

Etiology and pathogenesis of liver insufficiency

• Infectious agents (hepatitis B virus, tuberculosis bacillus, helmints)• Hepatotropic poison (drugs - tetracycline, sulfonamides, industrial poisons - carbon tetrachloride, arsenic, chloroform, vegetable poisons - aflatoxin, muscarine)• Physical impacts (ionizing radiation)• Biological drugs (vaccines, serums)• Violation of blood circulation (thrombosis, embolism, venous congestion)• Endocrine pathology (diabetes mellitus, hyperthyroidism)• Tumors• Hereditary ensymopathy

Causes of Liver Failure

Consequences of Liver Failure

Fibrosis and Cirrhosis of the Liver

Fibrosis and Cirrhosis of the Liver

Clinical syndromes in liver injury

Lack of liver disorders manifested its functions lesion:• metabolic (involved in carbohydrate, fat, protein metabolism, metabolism of vitamins, hormones, biologically active substances)• protection (phagocytic and antitoxic)• digestive and excretory (the formation and release of bile)• hemodynamic (involved in maintaining systemic circulation).

Cholelithiasis: Abnormal Cholesterol to Bile Salt Ratio

Clinical syndromes of jaundice• Acholia associated with non-receipt of bile in the

intestine due to violations of the formation and outflow of bile. Acholia manifested disorders of digestion and absorption of fats, hypovitaminosis A, E, K, decreased intake of unsaturated fatty acids of phospholipids to build cell membranes, intestinal motility violation, increasing decay and fermentation.

• Dyscholia - violation of the physical-chemical properties of bile, causing it acquires the ability to form stones (due to genetic predisposition, poor nutrition, metabolic disorders, infectious-inflammatory processes, cholestasis).

Cholelithiasis: Abnormal Cholesterol to Bile Salt Ratio

Etiology and pathogenesis of jaundice

• Jaundice - a syndrome caused by an increase in blood bilirubin (hemolytic, parenchymal, mechanical).

• In hemolytic jaundice due to destruction of a large number of red blood cells accumulate indirect, protein bound bilirubin.

• When parenchymal jaundice disturbed capture, and excretion of bilirubin in hepatocytes due to their injuries.

• In mechanical jaundice occurs outflow obstruction of bile, compression of biliary tract tumor or scar, closing within a stone, worms, thick bile.

Mechanisms and Consequences of Cholestasis

Methods of experimental study of liver pathology

• hepatic-cell failure simulating full or partial removal of the liver, the introduction of poisons (carbon tetrachloride, chloroform, trinitrotoluene);• cholestatic model obtained by squising bile ducts by ligature;• hepatic vascular insufficiency simulating by overlapping portocaval anastomosis, ligation portal vein, hepatic vein, hepatic artery.