Budi Santoso, dr

Bagian Fisiologi dan Fisika Medik

Fakultas Kedokteran Universitas Sriwijaya
2 SKS
Kuliah konvensional + online
Tata tertib
Evaluasi
KLIK!
TIU
Describe the overall
role of GI system :
Digestion

Absorption

Secretion

Excretion
 TIK
Describe the anatomical structure of GI system from
mouth to anus
Identify the main organs and accessory organs.
Describe digestion in mouth, stomach, and intestine
Describe absorption in stomach and intestine
Describe secretion in GI tract
Describe excretion waste product from GI tract
Explain the regulation GI with other system
 GI tract

Regulation with
Structure Function other system

From To Digest Absorpt Secret Excret

mouth anus ion ion ion ion

motility
 Main organs Acessorius organs
Mouth
Esophagus Salivary gland
Stomach Teeth & tongue
Small intestine Liver & bile
Large intestine Pancreas
Anus
Intestinal gland
Digestion Secretion Absorption Excretion

Mechanical Salivary Feses

/motility gland Stomach formation
Teeth
Stomach
intestinal Gastric Small intestine
juice Duodenum
Jejunum
Chemical ileum
mouth Intestinal
stomach juice
Intestinal Large
intestine
 Digestion motility
Pola gerak saluran cerna
Peristaltik
Gerak propulsif (mendorong)
Seperti memerah susu sapi
Otot sirkuler berkontraksi sec urut
Mixing
Gerak mencampur
Seperti mengocok kantong
Otot sirkuler berkontraksi sec segmental
Digestion
 MASTIKASI
(mengunyah)
Digesti mekanik
pada mulut

DIGLUSI
(menelan)
faring
 Fungsi mastikasi
Mempermudah digesti makanan berserat
Mencegah kerusakan tractus GI
Mempermudah pengosongan makanan dari
lambung
Refleks menelan:
Volunter
Faringeal 6 detik, napas (-)
Esofageal 8-10
gerak peristaltik

Pusat menelan : pons

Digesti mekanik
oesophagus
2-4 cm/detik
Fungsi gaster
Penyimpanan
1,5 l, udara??
Pencampuran
Pengosongan makanan
 Distensi
Gaster
makanan

Refleks
kontraksi

-mulai: korpus
antrum
mixing
- 3x/mnt
Sekresi HCl + makanan

kimus
 Gerak peristaltik sfingter pilorus
Faktor yg memperlambat pengosongan
makanan:
Kimus kental
Kimus asam refleks enterogastrik
Kimus berlemak memacu enterogatron
Efek kolesistokinin
Kimus yang masih banyak di duodenum
 Usus halus
1. Kontraksi segmentasi/mixing utama
2. Kontraksi propulsi/peristaltik

Ususbesar
1. Haustrasi (~segmentasi)
2. Mass movement 1-3x/hari, 20 cm
Greater Omentum- fatty apron.
 Kelenjar saliva
Gaster
Hepar
Pankreas
Intestinum
Seluruh lapisan tractus GI
 Mukus
Disekresi sepanjang tractus GI
Fungsi
Pelumas makanan
Proteksi dinding saluran
Enzim
Disekresi organ tertentu (gaster, pankreas)
Fungsi
Katalisator zat nutrisi
 Organ:
Kelenjar parotis
Kelenjar
submandibula
Kelenjar
sublingual
 Komposisi
Air
Mukus
Ptialin/amilase saliva : digesti tepung
Bikarbonat : netralisir asam
Lisozim : anti bakteri

Pusat pengaturan
Nc. Salivatory di batang otak
Makanan berbau/terlihat/terasa ENAK
Saliva meningkat makanan mudah ditelan
 Komposisi
Mukus
HCl
Pepsinogen
Renin
Intrinsic factor
Gastrin
Somatostatin
pH ~ 2.0 (0.2 at surface of parietal cell)

Coverts pepsinogen to pepsin.

Denatures ingested proteins

Start protein digestion

No carbohydrates
No lipids

Protection from pathogens

Protection from HCl

Alkaline mucus /HCO3-

Tight junctions
Rapid cell division
 Renin : digesti casein
Intrinsic factor : membantu absorbsi B12 pada
usus halus
Gastrin : mengatur sekresi gaster
Somatostatin : inhibitor gastrin
 Mukus (kelenjar Brunner)
Enzim
Sukrase, laktase, amilase digesti CHO
Peptidase digesti protein
Lipase intestinal digesti lemak
Hormon
Kolesitokinin memacu sekresi hepar
Pankreozimin pankreas
Enterokinin usus halus
 Komposisi
Amilase pankreatic CHO
Tripsin protein
Kimotripsin
Lipase Pankreatik lemak
Bikarbonat netralisir asam
Enzyme Zymogen Activator Action
Trypsin Trypsinogen Enterokinase Cleaves internal peptide bonds
Chymotrypsin Chymotrypsinogen Trypsin Cleaves internal peptide bonds
Elastase Proelastase Trypsin Cleaves internal peptide bonds
Carboxypeptidase Procarboxypeptidase Trypsin Cleaves last amino acid from carboxyl-
terminal end of polypeptide
Phospholipase Prophospholipase Trypsin Cleaves fatty acids from phospholipids such
as lecithin
Lipase None None Cleaves fatty acids from glycerol
Amylase None None Digests starch to maltose and short chains
of glucose molecules
Cholesterolesterase None None Releases cholesterol from its bonds with
other molecules
Ribonuclease None None Cleaves RNA to form short chains
Deoxyribonuclease None None Cleaves DNA to form short chains
 Sekresi garam empedu
Campuran kolestrol + bilirubin
Fungsi:
Bersifat detergen: menurunkan tegangan
permukaan air-lemak
Membantu lipase untuk digesti lemak
 Allabsorbed nutrients are sent
to the liver for processing via
the hepatic portal vein.

500 functions to the liver

Storage of iron and fat-soluble
vitamins (A, D, E, K).
Carbohidrate & lipid metabolism
Protein synthesis
Blood detoxification
Regulation of blood cholesterol;
bile production
 Hepatocytes arranged in lobules
Sinusoids in between hepatocytes are
blood-filled spaces
Tortora & Grabowski 9/e 2000 JWS
Kupffer cells phagocytize microbes &
foreign matter
 Tidakada enzim
Hanya mukus
Bakteri >>
produksi vit. K
Feses menjadi bau
Mengurai komponen empedu feses menjadi
coklat
 Anatomical structure Function of GI
of GI Digestion; Mechanical and
Main : mouth, chemical break down of organic
esophagus, stomach, material into small molecules.
intestine, anus Absorption; Uptake of fluids,
Accessories : salivary small molecules, and ions by
gland, liver and bile, epithelial cells lining the lumen.
pancreas
Secretion; The release of water,
acid, buffers, and enzymes by
cells and accessory organs into
the lumen.
Defecation; Elimination of
indigestible substances,
bacteria, cells, and digested
materials through the anus.
1. Molar Absorbsi
2. Gaster Digesti
3. Anus Mastikasi
4. Vesica felea
Transportasi
5. Duodenum
Diglusi
6. Colon descenden
7. Pancreas Sekresi
8. Vena porta Ekskresi
9. Faring Defekasi
10. Apendix
 Bukuajar fisiologi
keedokteran
Guyton edisi 8