- •30. Pathophysiology of digestion.
- •30.1. What is deficiency of digestion?
- •30.2. How is deficiency of digestion is classified?
- •30.3. What factors can cause digestion deficiency?
- •30.4. What principles do they use in experimental modulating of digestion deficiency?
- •30.5. With what influences into nervous system do they modulate indigestion?
- •30.6. What disorders of humoral regulation do they use for modeling of indigestion?
- •30.7. What syndromes characterize digestion deficiency?
- •30.8. With what symptoms is dyspeptical syndrome manifestated?
- •30.9. What is anorexia? When does it appear?
- •30.10. What is heartburn? What is its mechanism?
- •30.11. What is belch? What are its mechanisms?
- •30.12. What is nausea and vomiting? What are its mechanisms?
- •30.13. What is constipation? When does it happen?
- •30.14. What is altered bowel sounds? When does it arise?
- •30.15. What is diarrhea? By what can it be caused?
- •30.16. What can be reason of dehydration of organism?
- •30.17. What disorders of pH condition are symptoms of disorders of digestion?
- •30.18. What causes intestinal autointoxication in case of disorder of digestion?
- •30.19. What mechanisms can cause pain syndrome in case of injuries of digestive system?
- •30.20. What disorders of motorical, secretory and absorption function of digestive system can cause disorders of digestion?
- •30.21. What reasons can cause disorders of chewing? What inportance for digestion have these disorders?
- •30.22. What is caries of teeth?
- •30.23. How pathogenesis of caries is nowadays understood?
- •30.24. What is periodontitis? What factors can cause it?
- •30.25. What are the reasons and importance of hypersalivation?
- •30.26. What are the reasons of and importance of hyposalivation?
- •30.27. What is dysphagy? name its reasons and influence.
- •30.28. What is gastric dyskinesia? What are its variants?
- •30.28. Name reasons and importance of hyperkynetic dyskinesia of stomach.
- •30.30. What is pylorospasm?
- •30.31. Name reasons and importance of hypotonic dyskinesia of stomach
- •30.32. There are some types of pathologic gastric secretion:
- •30.33. How is gastric hypersecretion manifestated? What is its importance?
- •30.34. How can gastric hypersecretion be modelated in experiment?
- •30.35. What is ulcer disease? What is its etiology?
- •30.36. What are theories of pathogenesis of ulcer disease?
- •30.37. What pathogenic variants of gastric ulcer do they distinguish nowadays?
- •30.38. What is exogenous gastric ulcer? What can be its reason?
- •30.39. What is peptic ulcer? How is it modelated in experiment?
- •30.40. What is trophic ulcers of stomach? How is it reproduced in experiment?
- •30.41. What is hyporegeneratory ulcers of stomach? What can cause it?
- •30.42. What is the manifestation of gastric hyposecretion? What is its importance?
- •30.43. How can gastric hyposecretion be modelated in experiment?
- •30.44. What are the reasons of pancreatic hypersecretion? How it can manifestate?
- •30.45. What is acute pancreatitis? What is its etiology?
- •30.46. What is main link of pathogenesis of acute pancreatitis? What pathogenic variants of this disease do they distinguish?
- •30.47. What is the characteristic for primary alterative variant of development of acute pancreatitis?
- •30.48. What can cause development of hypertensive variant of acute pancreatitis?
- •30.49. What conditions cause refluxe variant of pancreatitis?
- •30.50. Describe pathogenesis of local changes in case of acute pancreatitis.
- •30.51. What mechanisms can cause pancreatic shock?
- •30.52. With what symptoms is pancreatic shock manifestated?
- •30.53. What reasons can cause development of pancreatic hyposecretion? What is its importance?
- •30.54. What is maldigestion syndrome? What symptoms is its manifestation?
- •30.55. What is intestinal dyskinesia? What are its variants?
- •30.57. How are hypokynetical diskynesies of intestines manfestated? What is its importance?
- •30.58. What is intestinal impassability? How is it classified?
- •30.59. Which changes in organism are the manifestation of intestinal impassability? What is its pathogenesis?
- •30.60. What reasons can cause disorders of defecation? How does such disorders manifestate?
- •30.61. What is malabsorption syndrome? What reasons can cause the disorders of absorption?
- •30.62. What reasons can cause the disorders of absorption in intestines?
- •30.63. What is intestinal enzymopathy? How can it be manifestate?
- •30.64. What enterocytic disorders can cause malabsorption syndrome?
- •30.65. What postenterocytic disorders can cause disorders of absorption of substances in intestines?
30. Pathophysiology of digestion.
30.1. What is deficiency of digestion?
Deficiency of digestion is pathological condition, when digestive system doesn’t provide absorption of nutrients into the organism. It causes development of starvation (see part 18)
30.2. How is deficiency of digestion is classified?
Due to clinical development digestion deficiency is divided into acute and chronic digestion deficiency.
Due to anatomic principle digestion deficiency can be caused by disorders: a)in oral cavity; b)in stomach; c)in intestines.
Digestion deficiency can be total (general) and partial (selective). In case of general digestion deficiency it is disorder of absorption of all nutrients, in case of selective- only some types of it (for example lipids, lactose, vitamin B12 etc.)
Due to ethiology digestive deficiency can be inherited and acquired. The last can be: a) infectious; b) caused by influence of physical factors (for example in case of acute radiation sickness); c) caused by influence of chemical substances; d) disregulative; e) alimentary;
Pathophysiological principle divides digestion deficiency into 3 variants. It is deficiency caused by disorders of: a) motorical function of digestive system; b)its secretion function; c)absorption processes.
30.3. What factors can cause digestion deficiency?
Alimentary (food) factors: a)eat of poor quality or rough food; b) non-regular eating; c) disbalanced nourishment (for example decreasing of vitamins in food); g) abuse of alcohol
Ionizing radiation has main importance among factors of this group. It influences at epithelial cell of digestive tube, which have high mitotic activities. In case of influence of dose of radiation more than 10 Gr., intestine form of radiation sickness develops, which quickly ends with death (see part 5).
Chemical substances. It cause digestive disorders in cases of poisoning of non-organic substances at work and at conditions of life.
Biological factors: a) bacteria (for example Vibrio Cholerae, typhoid fever, paratyphoid salmonellae and others); c) viruses (for example adenoviruses); d) helminthes.
Organic disorders: a) malformed digestive organs; b)after operative conditions; c) tumors of digestive system.
Disorders of neural and humoral regulation. Digestive disorders can develop in case of: a) psychoemotional disorders (neurotical and neurosoid conditions); b) psychiatric diseases (schizophrenia, maniac-depressive syndrome); c)organic diseases of nervous system (encephalitis, diencephalitis); d) disorders of peripheral structures of vegetative nervous system; e) reflective disorders (different viscero-visceral reflexes).
Disorders of secretion and synthesis of gastrointestinal hormones (gastrine, secretine, cholecystokinine-pancreosemine and others) can cause disorders of humoral regulation of digestion.
30.4. What principles do they use in experimental modulating of digestion deficiency?
Principle of removal. Surgically removal of some organs of digestive system (stomach, small intestine, large intestine). E. London made main researches. It was shown that removal of some parts of digestive system cause digestion deficiency. But digestive system has big compensation abilities. It is proved, that animals lived after removal of stomach, the whole ileum, main part of jejunum, and almost whole colum and rectum.
Principle of isolation. It got wide using at pathophysiological and physiological researches thanks to Pavlov’s works. He offered method of isolated stomach. Besides this method of isolated intestines loop is often used, it is put anastomosis between different parts of digestive system. Unlike methods of removal with these methods we can get additional information about character and mechanisms of changes in isolated parts of digestive system, about changes of neural and humoral regulation in these conditions.
Principle of abduction. It is raking aside of food and chimus, digestive secretion out of digestive system or to another its parts. Such methods can illustrate principle: a) imagined feeding (making esophagostome according to Pavlov; b) making fistules of intestines; c) removing salivary ducts, pancreatic duct and common biliary duct.
Principle of exogenous injures. In case of modeling of pathological processes in digestive system they use different injuring influences: physical (high and low temperature, ionizing radiation), chemical (acids, alkalis, salts of heavy metals, organic substances), biological (bacteria and its toxins).
Principle of violation of neural regulation (see question 30.5)
Principle of violation of humoral regulation (see question 30.6)