Samenvatting Thema 4 - Tractus Digestivus Geneeskunde jaar 2 deel II
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Course
GNK 2.1 Thema 4 Tractus Digestivus
Institution
Rijksuniversiteit Groningen (RuG)
Dit is het tweede deel van de samenvatting van thema 4 Tractus Digestivus Geneeskunde jaar 2 semester 1! Deze samenvatting bevat alle leerstof van week 12 en 13 en grotendeels de leerstof van week 14. Het is een overzichtelijke en volledige samenvatting, duidelijk weergegeven, inclusief illustratie...
Thema 4 – Tractus Digestivus deel II
Geneeskunde Jaar 2 semester 2.1
Week 13 – Zuurbranden ................................................................................................................................. 2
Anatomie ............................................................................................................................................................ 2
Van boven naar beneden .......................................................................................................................... 2
Embryologie .............................................................................................................................................. 3
De abdominale vascularisatie ................................................................................................................... 4
De verdeling in het abdomen .................................................................................................................... 6
De oesophagus .......................................................................................................................................... 7
De maag .................................................................................................................................................... 7
De dunne darm ......................................................................................................................................... 7
De dikke darm ........................................................................................................................................... 7
De lever ..................................................................................................................................................... 8
De galblaas ................................................................................................................................................ 9
De pancreas ............................................................................................................................................ 10
De milt ..................................................................................................................................................... 11
Fysiologie .......................................................................................................................................................... 12
De GI-tract ............................................................................................................................................... 12
De mond.................................................................................................................................................. 12
De oesophagus ........................................................................................................................................ 13
De maag .................................................................................................................................................. 13
Het duodenum ........................................................................................................................................ 15
De lever en de galblaas ........................................................................................................................... 15
De pancreas ............................................................................................................................................ 15
De dunne darm ....................................................................................................................................... 17
Colon en rectum...................................................................................................................................... 18
Pathologie......................................................................................................................................................... 20
Epidemiologie ......................................................................................................................................... 20
Klinische benadering van een patiënt met gastro-intestinale problemen .............................................. 20
Aandoeningen van de oesophagus ......................................................................................................... 22
Aandoeningen van de maag.................................................................................................................... 24
Aandoeningen van de dunne darm ......................................................................................................... 30
Functionele gastrointestinale aandoeningen (FGID)............................................................................... 37
Aandoeningen van de pancreas .............................................................................................................. 39
Farmacologie .................................................................................................................................................... 43
Eerste-episode maagklachten ................................................................................................................. 43
Antacida .................................................................................................................................................. 43
H2-antagonisten...................................................................................................................................... 44
Protonpompremmers ............................................................................................................................. 44
Muco-beschermende middelen .............................................................................................................. 46
H. Pylori uitroeiingstherapie ................................................................................................................... 48
Week 14 – Geelzien ...................................................................................................................................... 49
Histologie van de lever...................................................................................................................................... 49
Pathologische histologie van de lever............................................................................................................... 53
Fysiologie van de lever ...................................................................................................................................... 56
Anatomie................................................................................................................................................. 56
Functies ................................................................................................................................................... 57
Meten van bilirubine in het gal als diagnostiek ...................................................................................... 60
,Week 13 – Zuurbranden
Anatomie
Van boven naar beneden
- Oesophagus
o Bovenste sfincter
o Onderste sfincter
- Maag
o Cardiac regio
o Fundus
o Body
o Prylorus regio (antrum en canal)
- Duodenum
o Lever
o Galblaas
o Pancreas
o Milt
- Jejenum
- Ileum
- Ileocecal junctie
o Ileocecale klep
- Cecum
- Appendix
- Ascending colon
- Transverse colon
- Descending colon
- Sigmoïd colon
- Rectum
- Anale kanaal
,Embryologie
Gastro-intestinale stelsel begint als buis, met drie delen:
- Foregut
o Vascularisatie: truncus coeliacus
o Organen: oesophagus, maag, lever,
galblaas, galwegen, pancreas en
proximale deel van het duodenum.
- Midgut
o Vascularisatie: a. mesenterica superius
o Organen: distale deel van het duodenum,
jejenum, ileum, cecum, appendix,
ascending colon en proximale 2/3e deel
van het colon transversus.
- Hindgut
o Vascularisatie: a. mesenterica inferior
o Organen: distale 1/3e deel van het colon
transversus, descending colon, sigmoïd
colon en bovenste anale canaal.
Truncus couliaceus
- 3 aftakkingen:
o A. gastrica sinistra (groen)
§ Gaat over in de gastrica dextra
o A. splenica (blauw)
o A. hepatica communis (rood)
§ Gaat over in de a. hepatica propria
• Gaat over in a. gastrica dextra
(oranje)
• Gaat over in a. gastroduo-
denalis (geel)
è Anastomose: a. gastrica sinistra en
a. hepatica communis
a. splenica en
a. hepatica communis
, De abdominale vascularisatie
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