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Process of Digestion

Hormonal Regulation of Fuel


Metabolism
DWI NOVITASARI, S.Kep.,Ns., M.Sc

FROM MACROMOLECULES INTO


MONOMERS

Human Nutritional Needs


Food is used for two purposes: as fuel
(to provide energy for cellular
metabolism) and as a source of
building blocks (monomers for cellular
biosynthesis)
Basic nutrients: carbohydrates, lipids,

proteins, minerals, vitamins

THE GI SYSTEM
MOUTH

FOOD

SUBLINGUAL
AND
SUBMANDIBULAR
SALIVARY GLANDS

HORMON
HORMON

BRAIN
PAROTID
SALIVARY GLAN
TRACHEA
VOLUNTARY

INVOLUNTARY
LIVER
GALLBLADDER

STOMACH
PANCREAS

SMALL INTESTINE
LARGE INTESTINE
RECTUM

ANUS
Adapted by:
Dr. Andreanyta Meliala, PhD.

THE GI DIAGRAM

Heart
Liver

Mouth

Food and
water
Salivary glands

Hepatic
Portal vein

Stomach

Anus

ABSORPTION

Vitamin K
Rectum
Air, Elektrolit
Vitamin
Karbonhidrat Protein
C, D, B2, B12, dll
FLATUS
enzim asam, dll
Mineral Lipid
Pembentukan
Gas CO2, Metana, dll

FECES

SECRETION

Small intestine

Aktifitas
BAKTERI

Large intestine

MOTILITY

Adapted by:
Dr. Andreanyta Meliala, PhD.

NAMES AND LOCATION OF


THE MAJOR SALIVARY GLAND IN THE HUMAN

Parotid duct
Parotid gland

Sublingual
gland

Submandibular gland
Adapted by:
Dr. Andreanyta Meliala, PhD.

MOVEMENTS OF FOOD THROUGH THE PHARYNX


AND UPPER ESOPHAGUS DURING SWALLOWING
Hard Palate

Soft Palate

Pharynx

Epiglottis

Tongue

Upper
esophageal
sphincter
Esophagus

Adapted by:
Dr. Andreanyta Meliala, PhD.

THE THREE REGIONS OF THE STOMACH :


FUNDUS, BODY, AND ATRIUM
Esophagus
Fundus
Body
(secretes mucus
Pepsinogen and HCI)

Duodenum

Pyloric
sphincter

Antrium
(secretes mucus
Pepsinogen and gastrin)
Adapted by:
Dr. Andreanyta Meliala, PhD.

ALTIC WAVES
BUTE TO
TRAL CONTENTS

Esophagus
Lower
Esophageal
sphincter

Duodenum

Pyloric
sphincter

Stomach

Peristaltic
wave

Adapted by:
Dr. Andreanyta Meliala, PhD.

Intestinal Movements

Segmentation
Mixing mucous and enzyme

Slow peristaltic contractions to


encourage absorption
Local contractions (no CNS
involvement)
It takes appr. 5 hrs to digest & move
chymus from duodenum to ileum

Colon Motility
pattern of motility
- Haustration (slow segmentation)
- Mass movement (slow peristaltic; 34
times/day)
Defecation
Distension of rectum stimulates sigmoid
colon and smooth muscle of rectal wall
relaxation of internal sphincter muscle
(outonomic nerve) Defecation conducts
when external sphincter muscle is
relaxed

REGULATION OF GI
FUNCTION
Complex regulation with overlapping
pathways that involve:
Neural
Endocrines
Local control mechanism (little brain;

enteric nervous system)

Regulasi sistem GI

Nerve Regulators
Extrinsic (outside) nerves
release
acetylcholine
and
another
called
adrenaline.
Acetylcholine causes the muscle of the digestive
organs to squeeze with more force and increase
the "push" of food
Acetylcholine also causes the stomach and
pancreas to produce more digestive juice.
Adrenaline relaxes the muscle of the stomach
and intestine and decreases the flow of blood to
these organs.

The intrinsic (inside) nerves


are
triggered to act when the walls of the
organs are stretched by food.
They release many different substances that
speed up or delay the movement of food
and the production of juices by the
digestive organs.

FOOD PROCESSING
Includes:
Ingestion
Digestion
Absorption
Elimination

Mechanical Breakdown

Biting
Chewing
Grinding
Emulsification
Increases surface area for enzymatic
attack

Sekresi lambung: - HCL


- pepsinogen
- Gastrin

Sekresi di usus halus

Kurang lebih 1.8 L


Fungsi
pelumas
Buffer
melarutkan enzym dari pankreas

Sekresi Pankreas

Absorbsi

Absorbsi monosakarida

Absorbsi monogliserida dan asam


lemak

Absorbsi asam amino

Vitamin
Larut lemak (A, D, E, K): lewat bersama lipid
Larut air (B, C): masuk bersama air
B12 : faktor intrinsik di lambung mengikat B12
dan diabsorbsi di ileum
Air dan mineral
Mirip reabsobsi di tubulus ginjal dengan aktif
transport Na, reabsorbsi air secara pasif
mengikuti gradien osmotik
Normalnya 95% air masuk usus kecil sebelum
masuk kolon
Cl mengikuti Na dari lumen GI ke dalam darah
Kalsium, potassium, magnesium, iodine,
bicarbonate, iron

Absorbsi di kolon
Reabsorbsi air
1500 mL/hr di kolon; 1300 mL

reabsorbsi
Feses terdiri: - 75% air
- 5% bakteri
- 20% undigested
material,
inorganic material,
epitel

Reabsobsi garam empedu, vitamin,


bilirubin, toxins

Bile salts
Reabsorbsi, dibawa ke hepar

Vitamin
Bakteri di kolon membentuk 3 vitamin

Vitamin K: fat soluble; diperlukan


untuk sintesis faktor pembekuan di
hati
Biotin: water soluble; diperlukan
untuk metabolisme glukosa
Vitamin B5: water soluble; diperlukan
untuk biosintesis hormon steroid dan
beberapa neurotransmiter

The blood glucose level involve the


combined actions of insulin, glucagon,
epinephrine, and cortisol on metabolic
processes in many body tissues, but
especially in liver, muscle, and adipose
tissue.
The pancreas secretes insulin or
glucagon in response to changes in blood
glucose

GASTRIN
Origin: Stomach
Stimulus: Food in stomach
Function: Stimulates HCl & pepsinogen
secretion, increases stomach motility

GASTRIN actions
in general: stimulates gastric secretion
& motility
1. Stimulates gastric acid secretion
2. Stimulates pepsin&intrinsic factor
secretion by the stomach
3. Stimulates growth of gastric &
intestinal mucosa (thropic action)
4. Increase the tone of musculature of
the LOS,stomach & small intestine
5. Stimulates insulin and glucagon
secretion (after a protein meal)
6. Stimulates calcitonin secretion

SECRETIN
Origin: Duodenum
Stimulus: Acid
Function: Stimulates pancreatic secretions.
Slows stomach motility and acid
production

SECRETIN actions
1.

2.
3.
4.
5.
6.

Stimulates bicarbonate rich-watery alkaline


pancreatic juice by increasing bicarbonate
secretion of biliary tract
Increases bicarbonate secretion of biliary
tract
Augments the action of CCK-PZ in producing
pancreatic secretion of digestive enzymes
Decreases gastric acid secretion
May cause contraction of the pyloric
sphincter
Increases insulin secretion; but inhibits
glucagon secretion

Cholecystokinin
u/ pemecahan lemak

Stressors (anxiety, fear, pain,


hemorrhage, infections, low blood
glucose, starvation) stimulate hormone
cortisol, acts on muscle, liver, and
adipose tissue to supply the organism
with fuel
In adipose tissue, cortisol leads to an
increase in the release of fatty acids from
stored TAGs gluconeogenesis in the liver.
Cortisol stimulates the breakdown of
muscle proteins and the export of amino
acids to the liver for gluconeogenesis.
In the liver, cortisol promotes
gluconeogenesis by stimulating synthesis

Adipose tissue produces leptin that


regulates feeding behavior and energy
expenditure so as to maintain adequate
reserves of fat.
Leptin acts on receptors in the arcuate
nucleus of the hypothalamus, causing the
release of anorexigenic peptides, including
-MSH, that act in the brain to inhibit eating
Leptin also stimulates sympathetic nervous
system action on adipocytes, leading to
uncoupling of mitochondrial oxidative
phosphorylation, with consequent
thermogenesis.

The orexigenic (appetite-stimulating)


neurons stimulate eating by producing
and releasing:
1. neuropeptide Y (NPY)
2. -melanocyte-stimulating hormone (
MSH)

Ghrelin hormone
Produced in the stomach
Acts on orexigenic neurons in the arcuate
nucleus to produce hunger before a
meal

The hormone adiponectin


stimulates:
1. fatty acid uptake and oxidation
2. inhibits fatty acid synthesis