A.

Anatomi Lambung (Gaster)
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ostium cardiacum dan ostium pyloricum. Secara umum lambung di bagi menjadi 3 bagian: 1. dua curvatura. kardia/kelenjar jantung ditemukan di regia mulut jantung. terbentang dari permukaan bawah arcus costalis sinistra sampai regio epigastrica an umbilicalis. dan dua dinding. Sebagian besar gaster terletak di bawah costae bagian bawah.e250d328373f220122a028a9a55cfb004163e74f049000046038eaa33ea9921075a853861917d96 97304a0153c00041b000215d32c20027a124794b1881303787f49110488c16debf947113120373 73d0302195709091c207de12766bd131f1f312053d2001200099fc2031dea14c0c1717ab557e014 9402600129274e0221a5186917dca94d11a71689c679cdd983b3173a9da30026d06088559cb817 4adcd941453220b7626a98682020c46b3726020820432a6025226027e4c0001bd0038801126282 2948021b1f3534c7c308e1973bd2930c64f82a2c33ff3bb190957a829524754918945d6e5a891d1 6012a7001d3150fe2b13a306543eae340fe240c3604537dd9870511a130b55e40108883c8001880 019e2314e6b444fec55695b3437d3384d35209f6a7597a229e707363c8266c24b00247335ee7b81 d7811119e6148f594805bb10336186924103988055616d013df1aa5729171623371167039f1b4a d5f61830a781360f1221e77008fc34e0b40010b545716300452ea1edd242aa6437b2574a34d332c c4f29f079b7d09321c6242000e00040ec00010a0300ca008452a09f80a2f0c5ba4df5001f4b91b8f 911abc926de7c02b0f10012944452964866e521bb14078fab417666636b6d3459cb58e65c4171b4 4ff01ebf029f167aa7041a13644000f402383c9aa48da0f78381e0d0604026015f7b701076a4440a 499963314753557b2f8ab8fd3144050232ce429f627635bb53f1724629db2030f8001a7313cfbf29 19af82713000ac1300408d0334ea100f0d4a49d673939718b38b1a6eef142025040636117fa3014 f282b5b1e871288a39b28713fb357268a157072001f99016a5d44de9911076013b01b274dc613cf fd48e7b3279eb2025382a7d0e20013dc0012650b100f0b0114b00ec530029202620b00327602611 c011b8501c41f0a7e983b293711a0e10001b5001d8e03090b71b6839a9626829963a4c3e1a2037f 636b66600c2d603140002eb352ffd1053484aff9b11aaaae53b9870a1b4c0a5b40220003bf0b4b4 6400bdf155bd4816597bb5829671dfaa576541608fa3001320470b40683cf00141906d194586326 a6bc7660caf324700100120c05a96f4a618a50b006002e6353506705617000099c97af16468f614 9494b3af8a4617a90817f2e293de04446e35148e2bb92ec2a4906639fb059136810049383801617 f381 Gaster terletak di bagian atas abdomen. Ini hanya mensekresi mukus . paries anterior dan paries posterior. curvatura major dan curvatura minor. Secara kasar gaster berbentuk huruf J dan mempunyai dua lubang.

yang mana kelenjar ini memiliki tiga tipe utama sel. Pepsinogen ini diubah menjadi pepsin dalam suasana asam. Faktor intrinsic diperlukan untuk absorbsi vitamin B12 dalam usus halus. • Sel leher mukosa ditemukan pada bagian leher semua kelenjar lambung. yaitu : • Sel zigmogenik/chief cell. mensekresi asam hidroklorida dan factor intrinsic. mesekresi pepsinogen. Sel ini mensekresi barier mukus setebal 1 mm dan melindungi lapisan lambung terhadap kerusakan oleh HCL atau autodigesti. fundus/gastric terletak hampir di seluruh corpus. 3. Kelenjar ini mensekresi lipase dan renin lambung yang kurang penting.2. pilorus terletak pada regia antrum pilorus. Lapisan Lapisan Lambung 0100090000036a6b09000000ede3040000001610000026060f002220574d464301000000000001 00793900000000490000000020000004e2080004020900010000006c0000000000000000000000 440200008c0200000000000000000000eb4600007f4f000020454d4600000100040209000f00000 001000000000000000000000000000000000400005802000040010000bb000000000000000000 00000000000000e2040078da0200460000002c00000020000000454d462b014001001c00000010 0000000210c0db010000006000000060000000460000005000000044000000454d462b22400400 0c000000000000001e4009000c00000000000000244001000c0000000000000030400200100000 00040000000000803f214007000c00000000000000460000000cfe000000fe0000454d462b08400 085fcfd0000f0fd0000047a02000210c0db01000000000000000000000000000000000000000100 0000ffd8ffe000104a46494600010201004800480000ffed14f650686f746f73686f7020332e30003 842494d03ed0a5265736f6c7574696f6e0000000010004800000001000100480000000100013842 494d040d18465820476c6f62616c204c69676874696e6720416e676c65000000000400000078384 2494d041912465820476c6f62616c20416c74697475646500000000040000001e3842494d03f30b 5072696e7420466c61677300000009000000000000000001003842494d040a0e436f7079726967 687420466c6167000000000100003842494d2710144a6170616e657365205072696e7420466c61 . • Sel parietal. Kelenajr ini mensekresi gastrin dan mukus. suatu hormon peptida yang berpengaruh besar dalam proses sekresi lambung.

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Lapisan berotot yang terdiri atas tiga lapis: • serabut longitudinal. Dua lapisan peritoneum visceral menyatu pada kurvatura minor lambung dan duodenum. yang tidak dalam dan bersambung dengan otot esofagus. • serabut sirkuler yang paling tebal dan terletak di pilorus serta membentuk otot sfingter. Lapisan peritoneal luar atau lapisan serosa yang merupakan bagian dari peritoneum viseralis. Pada kurvatura mayor peritoneum terus kebawah membentuk omentum mayus. .02186a69293211f8c3124ac913d4028d6b311cfba1722951feaf975eb9db7960e6cf98996a384b136 3d46a5c1f91a67aabfdf5b13b1b01dd5d83bdcf5864f62f5e6fd96877ad17f12cfed4c8d0e277c55c8 b8adf78b82831b5924cb1e7de8e9f3635c68f256cd5762755c906e9653ddd4ac7407f9d07fab3c7a9 df9379a7653b3ed7b05eeee2e6f2306356446148c7747a89e2413a41fe100791e848a1ecdc36d9c2f f0014aaca2cd555091418ac54492d44b99ca2c41c63f1b8f8629aae495e58f54c515d23ff0038f6404 9054c9f47ac904007fc1e43a170d86eb7bbb09059b7d228acb2b550283c4927141fcce067a5ced1ec fa0a4a1c6d14b8edd398dc294f143353c7b4b3082bb2a584d5525357d6d252530104f295592478d 348b92001efd04cacc3234d7d0d2bc71803edff000f44dbb72adcb3dd4d1496f1588e2c655c2f0150 09241f41539e8d4edec90aac6c1f7500c7c8c8b357d34f3c551250bd64721344b25385a79eaa9aa98 c65ac4002e2e1afecfedeb4258e3edff57fabedea1add2dda3b928b4602a2a060d3cf3e440a8f5e9bf7 56df8327f77957a7a5f2181dbcad463eea4929e944349784870626642c508b285be9200f6b2e6d41 24b6091e94f2fe7d28daf727b25fa2d674371153a7d73ea47d95fe7d119ec8d9eed21f0539711930b 7928e744154c69d84acf385826aaa9966b248100517fd20b1f68e5536e9ab181fcffd8f3ea67e5cdde dfb45c3f6d062bfeac7fabe5d15a93666fdadafa3a1a6aa9682824fbcaccb645d1e6968a915d850d3e 269273342996ab99fc724d223414f123b005d900640b7481ae99ab9f3f5e877757c921b3b6b24589 Lambung terdiri atas empat lapisan : 1. 2. memanjang kearah hati membentuk omentum minus. kemudian membelok ke bawah melalui kurvatura minor (lengkung kecil). dan berada di bawah lapisan pertama. Lipatan peritoneum yang kelaur dari organ satu menuju organ lain disebut ligamentum. dan • serabut oblik yang terutama dijumpai pada fundus lambung dan berjalan dari orifisium kardiak.

Dua cabang arteri yang penting dalam klinis adalah arteri duodenalis dan pankreas tikoduodenalis (retroduodenalis) yang berjalan sepanjang bulbus posterior duodenum. Epithelium dari bagian kelejar yang mengeluarkan sekret berubah-ubah dan berbeda-beda di beberapa daerah lambung. Membran mukosa dilapisi epitelium silindris dan berisi banyak saluran limfe. hepatic dan seliaka.3. Semua ini berjalan dari kelenjar lambung tubuler yang bercabangcabang dan lubang-lubang salurannya dilapisi oleh epithelium silinder. Persarafan dan Aliran Darah Pada Lambung Persarafan pada lambung umumnya bersifat otonom. berikut fungsi Lambung: 1. dan terdiri atas banyak kerutan atau rugue. Suplay saraf parasimpatis untuk lambung di hantarkan ke dan dari abdomen melalui saraf vagus. Darah vena dari lambung dan duodenum serta berasal dari pankreas. pilorik. Suplai darah dilambung berasal dari arteri seliaka. Fungsi motorik • Fungsi reservoir . Lapisan submukosa yang terdiri atas jaringan areolar berisi pembuluh darah dan saluran limfe. Fisiologi Lambung Secara umum gaster memiliki fungsi motorik dan fungsi pencernaan & sekresi. tebal. 4. yang hilang bila organ itu mengembang karena berisi makanan. Epithelium ini bersambung dengan permukaan mukosa dari lambung. Persarafan simpatis melalui saraf splangnikus mayor dan ganglia seliakum. Semua sel-sel itu mengeluarkan sekret mukus. Lapisan mukosa yang terletak di sebelah dalam. Permukaan mukosa ini dilintasi saluran-saluran kecil dari kelenjar-kelenjar lambung. Tukak dinding posterior duodenum dapat mengerosi arteri itu menyebabkan perdarahan. B. Pleksus auerbach dan submukosa ( meissner ) membentuk persarafan intrinsic dinding lambung dan mengkoordinasi aktivitas motorik dan sekresi mukosa lambung. Serabutserabut afferent simpatis menghambat pergerakan dan sekresi lambung. Trunkus vagus mencabangkan ramus gastric. limpa dan bagian lain saluran cerna berjalan ke hati melalui vena porta.

Pengosongan lambung di atur oleh saraf dan hormonal 2. rangsangan vagus • Sekresi factor intrinsik. Memungkinkan absorpsi vitamin B12 dari usus halus bagian distal. Beberapa mixing wave . obat-obatan dan kerja. Gelombang ini merendam makanan dan mencampurnya dengan hasil sekresi kelenjar lambung dan menguranginya menjadi cairan yang encer yang disebut chyme. Fungsi pencernaan dan sekresi • Pencernaan protein oleh pepsin dan HCL • Sintesis dan pelepasan gastrin. emosi. gerakan peristaltik yang lembut dan berriak yang disebut gelombang pencampuran (mixing wave) terjadi di perut setiap 15-25 detik. • Sekresi mucus. MEKANIK Beberapa menit setelah makanan memasuki perut. Menyesuaikan peningkatan volume tanpa menambah tekanan dengan relaksasi reseptif otot polos yang diperantarai oleh saraf vagus dan dirangsang oelh gastrin. peregangan antrum. keasaman. aktivitas osmotis. • Fungsi mencampur Memecahkan makanan menjadi partikel-partikel kecil dan mencampurnya dengan getah lambung melalui kontraksi otot yang mengelilingi lambung. volume. Proses Pencernaan Makanan Di Lambung 1. • Fungsi pengosongan lambung Diatur oleh pembukaan sfingter pylorus yang dipengaruhi oleh viskositas.Menyimpan makanan sampai makanan tersebut sedikit demi sedikit dicernakan dan bergerak ke saluran pencernaan. Dipengaruhi oleh protein yang di makan. keadaan fisisk. Membentuk selubung yang melindungi lambung serta berfungsi sebagai pelumas sehingga makanan lebih mudah untuk diangkut.

2. Pepsin memecah ikatan peptide antara asam amino yang membentuk protein. Lambung juga mensekresikan renin yang penting dalam mencerna susu. lebih banyak mixing wave yang hebat dimulai dari tubuh dan makin intensif saat mencapai pilorus. Pepsin disekresikan menjadi bentuk inaktif yang disebut pepsinogen. Pepsinogen tidak akan diubah menjadi pepsin aktif sampai ia melakukan kontak dengan asam hidroklorik yang disekresikan oleh sel parietal. Enzim ini beroperasi dengan baik pada pH 5-6 dan memiliki peranan terbatas pada lambung orang dewasa. Kedua. Rantai protein yang terdiri dari asam amino dipecah menjadi fragmen yang lebih kecil yang disebut peptide. Makanan berada di fundus selama satu jam atau lebih tanpa tercampur dengan getah lambung. yang merupakan tempat penyimpanan utama. Pergerakan ke depan atau belakang (maju/mundur) dari kandungan lambung bertanggung jawab pada hampir semua pencampuran yang terjadi di perut. Gelombang berikutnya mendorong terus dan menekan sedikit lagi menuju duodenum. Rennin tidak terdapat pada sekresi lambung pada orang dewasa . Penggumpalan mencegah terlalu seringnya lewatnya susu dari lambung menuju ke duodenum (bagian pertama dari usus halus). sel-sel lambung dilindungi oleh mukus basa. Selama pencernaan berlangsung di perut. Saat makanan mencapai pilorus. Pyloric spinchter hampir selalu ada tetapi tidak seluruhnya tertutup. pencernaan dengan air liur tetap berlanjut. Mukus menutupi mukosa untuk membentuk hambatan antara mukus dengan getah lambung. khususnya setelah pepsin diaktivasi. Pepsin paling efektif di lingkungan yang sangat asam di perut (pH=2) dan menjadi inaktif di lingkungan yang basa. sehingga tidak dapat mencerna protein di sel-sel zymogenic yang memproduksinya. Hampir semua makanan ditekan kembali ke perut. Renin dan Ca bereaksi pada susu untuk memproduksi curd. Lipase lambung memecah trigliserida rantai pendek menjadi molekul lemak yang ditemukan dalam susu. pencernaan terutama dilakukan melalui enzim pepsin. Bagi orang dewasa. Enzim lain dari lambung adalah lipase lambung. setiap mixing wave menekan sejumlah kecil kandungan lambung ke duodenum melalui pyloric spinchter. KIMIAWI Prinsip dari aktivitas di perut adalah memulai pencernaan protein. Selama ini berlangsung.terjadi di fundus. Orang dewasa sangat bergantung pada enzim yang disekresikan oleh pankreas (lipase pankreas) ke dalam usus halus untuk mencerna lemak.

Enzim dan Hormon yang Berperan dalam Pencernaan di Lambung 1. Hormon Gastrin Kerja merangsang meningkatkan pengeluaran pergerakan tonus istirahat lambung insulin SEBdan usus mencegahmempermudah Makna refluks mempermudah Fisiologis lambung pencampuran metabolisme waktu pencampuran glukosa dan pangadukan merangsang sekresi mempermudah relaksasi lambung asamreseptif dan dapat pepsin lambung dengan mudahmempermudah meningkatkan pencernaan volume. Enzim pepsin: mengubah protein menjadi pepton 3. Enzim lipase: memecah lemak menjadi asam lemak 5. HCl: mmbunuh kuman dan mengasamkan makanan . tanpa meningkatkan tekanan merangsang sekresi factor intrinsic mempermudah absorpsi dalam usus merangsang sekresi enzim pancreas mempermudah pencernaan merangsang peningkatan aliran empedu hati mempermudah pencernaan 2. Enzim rennin: mengendapkan kasein dalam susu 4.

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