the place of gut physiology

biochemistry of digestion

within the anatomy of the gastrointestinal tract physiology absorption of nutrients ...follows digestion of food other

www.nlm.nih.gov/research/visible/visible_gallery.html

the clinical approach

craft knowledge

diagnosis

nosology of disease entities--pathology

   

physiological anatomy

lumen

sphincter (examples)

the gut wall

layers

immune system anatomy

break


 
 


control systems

endocrine control extrinsic intrinsic	Pavlov's group (in the 1890s) believed that all gut reflexes were mediated by nerves, but noticed that even after cutting nerve connections between the pancreas and duodenum, application of acid in the duodenum caused release of serous fluid from the pancreas. Bayliss and Starling discovered in 1902 a substance from the small intestine that led to this pancreatic secretion when injected. They called this a 'hormone', from the greek meaning 'to excite'. Thus the first hormone discovered was secretin. (J. C. Lockart) historical note
	three gut hormones (released by and affecting cells of the gastrointestinal mucosa) with the circumstances of their release and their main effects

  immune control

 

neural control extent of 'voluntary' control extrinsic intrinsic

template for neurophysiological pathways for peristalsis

 

clinical significance of efferent pathways localisation radiation referral embryological basis

comparison of 'somatic' and 'visceral' nociceptive pathways; location of the corresponding stimuli and nature of the resulting pain sensations

References and Advanced Reading. Relationship between Endocrine and Neural Physiology. Berne & Levy 4th ed. p. 779. Saul Genuth's insightful little essay on the deep connection between nervous and endocrine function. Jumps about in scale a bit from the cellular to the systemic. Just over two sides long--about 3 minutes work: a perfect start for that quiet evening at home alone... In Talking with Patients many of James Christensen's points about history taking--the most important step in diagnosis--apply to medicine in general, not gastroenterology alone. Not a list of facts to learn, but an essay to consider (25 minutes' reading time) and bookmark. On-line resources located through http://www.medicalstudent.com. Links mentioned in this article were valid when last checked on 29th March 2005: please report broken links.

Sample multiple-choice question for discussion. The gastrointestinal tract (choose the best answer)... (a) is a selector of molecules from the environment (b) carries out two main processes--digestion, then absorption (c) is controlled by the central nervous system at its two ends (d) has a lumen which is outside the body (e) all of the above

Intestinal Function 1. Gut Reactions: immune function, motility and (exocrine) secretion Intestinal Function 2. Crossing the Border: fluid and nutrients at the epithelium Intestinal Function 3. When things don't work out right: pathophysiology of diarrhea