内科学 消化系统总论 ppt课件

EVALUATION OF PATIENT WITH GI DISEASE
Imaging studies Laboratory tests
Historyห้องสมุดไป่ตู้+Symptoms +Sign
History & symptoms
The diagnosis drives predominantly from the patient’s history
Structure /function and diseases
The biggest organ
Homeostasis Excretion
Synthesis
Filter Defense
Death
symptoms signs
Common Lesions of Digestive System
inflammation(炎症) Ulcer (溃疡) bleeding(出血) perforation (穿孔) neoplasm (肿瘤) functional disturbances(功能失调 )
• Genetic Influences
Classification of Liver Diseases
• Viral Hepatits • Nonalcoholic fatty liver • Alcoholic liver disease • Immune & autoimmune liver diseases • Drug-induced liver disease • Genetic liver diseases • Mass lesions • Vascular injury • Liver involvement in systemic diseases
• 你所经历的课堂，是讲座式还是讨论式？ • 教师的教鞭
• “不怕太阳晒，也不怕那风雨狂，只怕先生骂我 笨，没有学问无颜见爹娘 ……”
• “太阳当空照，花儿对我笑，小鸟说早早早……”
Structure and functions
The two activities under voluntary control are swallowing and defecation.
• Nausea & Vomiting • Altered bowel habits ( constipation,
diarrhea, steatorrhea)
• GI bleeding (melena/hematemesis/hematochezia)
small intestinal bacterial overgrowth)
• Altered Gut Transit (obstruction by gastric cancer or colon cancer, Achalasia, constipation, diarrhea)
• Immune Dysregulation (ulcerative colitis, Crohn’s disease)
Cardinal Symptoms of GI diseases
• Abdominal pain ( GI and extra GI) (peptic ulcer,appendicitis, IBD)
• Heartburn (gastroesophageal reflux disease, GERD)
Characteristics of Digestive System
Many normal GI reflexes involve extrinsic vagus or splanchnic nerve pathways.
An active brain-gut axis further alters function in regions
Characteristics of Digestive System
➢ Immune organ
Gastrointestinal-associated lymphoid tissue, (GALT)
Characteristics of Digestive System
• Not only a digestive organ but also endocrine organ pancreas gastrin (胃泌素) glucagon(胰高糖素) somatostatin( 生长抑素) VIP(血管活性肠肽) insulin(胰岛素)
The physician must identify the timing, type,location and severity of the symptoms, when and where they occur, aggravating and alleviating factors, and any associated symptoms.
• Impaired Gut Blood Flow (intestinal and colonic ischemia)
• Neoplastic Degeneration (Esophageal, gastric, colon, pancreatic, biliary cancer)
• Disorders without Obvious Organic Abnormalities (IBS)
Classification of GI Diseases
• Impaired Digestion and Absorption (Biliary obstruction, Chronic pancreatitis)
• Altered Secretion (Zollinger-Ellison syndrome, atrophic gastritis,
Digestive System
Introduction
Structure and functions
Assimilation of nutrients Elimination of waste
精品资料
• 你怎么称呼老师？
• 如果老师最后没有总结一节课的重点的难点，你 是否会认为老师的教学方法需要改进？