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anatomi fisiologi lambung

anatomi fisiologi lambung

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Published by: athonisukrisna on Mar 20, 2011
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11/09/2012

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Anatomi Lambung (Gaster)
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f381
Gaster terletak di bagian atas abdomen, terbentang dari permukaan bawah arcus costalis
sinistra sampai regio epigastrica an umbilicalis. Sebagian besar gaster terletak di bawah costae
bagian bawah. Secara kasar gaster berbentuk huruf J dan mempunyai dua lubang, ostium
cardiacum dan ostium pyloricum; dua curvatura, curvatura major dan curvatura minor; dan dua
dinding, paries anterior dan paries posterior.
!eara umum "ambung di bagi men#adi 3 bagian$
1. kardia/kelenjar jantung ditemukan di regia mulut jantung. ni hanya mensekresi mukus
2. fundus/gastric terletak hampir di seluruh corpus, yang mana kelenjar ini memiliki tiga tipe
utama sel, yaitu !
• Sel "igmogenik/chief cell, mesekresi pepsinogen. #epsinogen ini diubah menjadi
pepsin dalam suasana asam. $elenjar ini mensekresi lipase dan renin lambung yang
kurang penting.
• Sel parietal, mensekresi asam hidroklorida dan factor intrinsic. %aktor intrinsic
diperlukan untuk absorbsi vitamin &'( dalam usus halus.
• Sel leher mukosa ditemukan pada bagian leher semua kelenjar lambung. Sel ini
mensekresi barier mukus setebal ' mm dan melindungi lapisan lambung terhadap
kerusakan oleh )*+ atau autodigesti.
3. pilorus terletak pada regia antrum pilorus. $elenajr ini mensekresi gastrin dan mukus, suatu
hormon peptida yang berpengaruh besar dalam proses sekresi lambung.
La%isan La%isan Lambung
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Lambung terdiri atas em%at "a%isan $
1. +apisan peritoneal luar atau lapisan serosa yang merupakan bagian dari peritoneum viseralis.
4ua lapisan peritoneum visceral menyatu pada kurvatura minor lambung dan duodenum,
memanjang kearah hati membentuk omentum minus. +ipatan peritoneum yang kelaur dari organ
satu menuju organ lain disebut ligamentum. #ada kurvatura mayor peritoneum terus kebawah
membentuk omentum mayus.
2. +apisan berotot yang terdiri atas tiga lapis!
• serabut longitudinal, yang tidak dalam dan bersambung dengan otot esofagus,
• serabut sirkuler yang paling tebal dan terletak di pilorus serta membentuk otot
sfingter; dan berada di bawah lapisan pertama, dan
• serabut oblik yang terutama dijumpai pada fundus lambung dan berjalan dari
orifisium kardiak, kemudian membelok ke bawah melalui kurvatura minor 5lengkung
kecil6.
3. +apisan submukosa yang terdiri atas jaringan areolar berisi pembuluh darah dan saluran limfe.
+apisan mukosa yang terletak di sebelah dalam, tebal, dan terdiri atas banyak kerutan atau rugue,
yang hilang bila organ itu mengembang karena berisi makanan.
4. 7embran mukosa dilapisi epitelium silindris dan berisi banyak saluran limfe. Semua sel8sel
itu mengeluarkan sekret mukus. #ermukaan mukosa ini dilintasi saluran8saluran kecil dari
kelenjar8kelenjar lambung. Semua ini berjalan dari kelenjar lambung tubuler yang bercabang8
cabang dan lubang8lubang salurannya dilapisi oleh epithelium silinder. 9pithelium ini
bersambung dengan permukaan mukosa dari lambung. 9pithelium dari bagian kelejar yang
mengeluarkan sekret berubah8ubah dan berbeda8beda di beberapa daerah lambung.
&ersarafan dan A"iran 'ara( &ada Lambung
#ersarafan pada lambung umumnya bersifat otonom. Suplay saraf parasimpatis untuk
lambung di hantarkan ke dan dari abdomen melalui saraf vagus. :runkus vagus mencabangkan
ramus gastric, pilorik, hepatic dan seliaka.
#ersarafan simpatis melalui saraf splangnikus mayor dan ganglia seliakum. Serabut8
serabut afferent simpatis menghambat pergerakan dan sekresi lambung. #leksus auerbach dan
submukosa 5 meissner 6 membentuk persarafan intrinsic dinding lambung dan mengkoordinasi
aktivitas motorik dan sekresi mukosa lambung.
Suplai darah dilambung berasal dari arteri seliaka. 4ua cabang arteri yang penting dalam
klinis adalah arteri duodenalis dan pankreas tikoduodenalis 5retroduodenalis6 yang berjalan
sepanjang bulbus posterior duodenum. :ukak dinding posterior duodenum dapat mengerosi
arteri itu menyebabkan perdarahan. 4arah vena dari lambung dan duodenum serta berasal dari
pankreas, limpa dan bagian lain saluran cerna berjalan ke hati melalui vena porta.
). *isio"ogi Lambung
Secara umum gaster memiliki fungsi motorik dan fungsi pencernaan ; sekresi, berikut fungsi
+ambung!
1. Fungsi motorik
• %ungsi reservoir
7enyimpan makanan sampai makanan tersebut sedikit demi sedikit dicernakan dan bergerak ke
saluran pencernaan. 7enyesuaikan peningkatan volume tanpa menambah tekanan dengan
relaksasi reseptif otot polos yang diperantarai oleh saraf vagus dan dirangsang oelh gastrin.
• %ungsi mencampur
7emecahkan makanan menjadi partikel8partikel kecil dan mencampurnya dengan getah
lambung melalui kontraksi otot yang mengelilingi lambung.
• %ungsi pengosongan lambung
4iatur oleh pembukaan sfingter pylorus yang dipengaruhi oleh viskositas, volume, keasaman,
aktivitas osmotis, keadaan fisisk, emosi, obat8obatan dan kerja. #engosongan lambung di atur
oleh saraf dan hormonal
2. Fungsi pencernaan dan sekresi
• #encernaan protein oleh pepsin dan )*+
• Sintesis dan pelepasan gastrin. 4ipengaruhi oleh protein yang di makan, peregangan
antrum, rangsangan vagus
• Sekresi factor intrinsik. 7emungkinkan absorpsi vitamin &'( dari usus halus bagian
distal.
• Sekresi mucus. 7embentuk selubung yang melindungi lambung serta berfungsi
sebagai pelumas sehingga makanan lebih mudah untuk diangkut.
&roses &enernaan +a,anan 'i Lambung
1. MEKANIK
&eberapa menit setelah makanan memasuki perut, gerakan peristaltik yang lembut dan
berriak yang disebut gelombang pencampuran 5mi<ing wave6 terjadi di perut setiap '18(1 detik.
Gelombang ini merendam makanan dan mencampurnya dengan hasil sekresi kelenjar lambung
dan menguranginya menjadi cairan yang encer yang disebut chyme. &eberapa mi<ing wave
terjadi di fundus, yang merupakan tempat penyimpanan utama. 7akanan berada di fundus
selama satu jam atau lebih tanpa tercampur dengan getah lambung. Selama ini berlangsung,
pencernaan dengan air liur tetap berlanjut.
Selama pencernaan berlangsung di perut, lebih banyak mi<ing wave yang hebat dimulai
dari tubuh dan makin intensif saat mencapai pilorus. #yloric spinchter hampir selalu ada tetapi
tidak seluruhnya tertutup. Saat makanan mencapai pilorus, setiap mi<ing wave menekan
sejumlah kecil kandungan lambung ke duodenum melalui pyloric spinchter. )ampir semua
makanan ditekan kembali ke perut. Gelombang berikutnya mendorong terus dan menekan sedikit
lagi menuju duodenum. #ergerakan ke depan atau belakang 5maju/mundur6 dari kandungan
lambung bertanggung jawab pada hampir semua pencampuran yang terjadi di perut.
2. KIMIAWI
#rinsip dari aktivitas di perut adalah memulai pencernaan protein. &agi orang dewasa,
pencernaan terutama dilakukan melalui en"im pepsin. #epsin memecah ikatan peptide antara
asam amino yang membentuk protein. =antai protein yang terdiri dari asam amino dipecah
menjadi fragmen yang lebih kecil yang disebut peptide. #epsin paling efektif di lingkungan yang
sangat asam di perut 5p)>(6 dan menjadi inaktif di lingkungan yang basa. #epsin disekresikan
menjadi bentuk inaktif yang disebut pepsinogen, sehingga tidak dapat mencerna protein di sel8sel
"ymogenic yang memproduksinya. #epsinogen tidak akan diubah menjadi pepsin aktif sampai ia
melakukan kontak dengan asam hidroklorik yang disekresikan oleh sel parietal. $edua, sel8sel
lambung dilindungi oleh mukus basa, khususnya setelah pepsin diaktivasi. 7ukus menutupi
mukosa untuk membentuk hambatan antara mukus dengan getah lambung.
9n"im lain dari lambung adalah lipase lambung. +ipase lambung memecah trigliserida
rantai pendek menjadi molekul lemak yang ditemukan dalam susu. 9n"im ini beroperasi dengan
baik pada p) 18/ dan memiliki peranan terbatas pada lambung orang dewasa. ?rang dewasa
sangat bergantung pada en"im yang disekresikan oleh pankreas 5lipase pankreas6 ke dalam usus
halus untuk mencerna lemak. +ambung juga mensekresikan renin yang penting dalam mencerna
susu. =enin dan *a bereaksi pada susu untuk memproduksi curd. #enggumpalan mencegah
terlalu seringnya lewatnya susu dari lambung menuju ke duodenum 5bagian pertama dari usus
halus6. =ennin tidak terdapat pada sekresi lambung pada orang dewasa
-n.im dan /ormon 0ang )er%eran da"am &enernaan di Lambung
1. Hormon Gastrin
2. Enim pepsin! mengubah protein menjadi pepton
3. Enim rennin! mengendapkan kasein dalam susu
4. Enim "ipase! memecah lemak menjadi asam lemak
#. H$"! mmbunuh kuman dan mengasamkan makanan
Ker%a Makna Fisio"ogis
merangsang sekresi asam dan pepsin mempermudah pencernaan
merangsang sekresi factor intrinsic mempermudah absorpsi dalam usus
merangsang sekresi en"im pancreas mempermudah pencernaan
merangsang peningkatan aliran empedu hati mempermudah pencernaan
merangsang pengeluaran insulin mempermudah metabolisme glukosa merangsang pergerakan lambung dan usus mempermudah pencampuran
mempermudah relaksasi reseptif lambung lambung dapat dengan mudah meningkatkan volume, tanpa meningkatkan tekanan
meningkatkan tonus istirahat S9& mencegah refluks lambung waktu pencampuran dan pangadukan

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