DZUHRI AL OKTA

405140187
PEMICU 1
GI
Lo 1. anatomi dan histologi sistem pernafasan
mulut - esofagus
THROAT
Mouth
Human Deciduous and Permanent Teeth
Histology of Upper Digestive
1. Cavum oris
2. Pharynx
Upper digestive
3. Esophagus
4. Stomach
5. Small Intestine
Lower digestive
6. large Intenstine
Labium Oris
1. Cutanea area : thin skin with addenda skin
2. Intermediate area (red lip area)
• Layered flat without horns epithelium
• Transparant because contain eleidin.
• Contains capillaries
3. Oral mukosa area
• The histology structure = cheek
• Layered flat without horns epithelium
• There is labial gland in Tn. Submucosa that products seromucus
• Under submucosa  striated muscle ( M. orbicularis oris )
Dorsal Surface of the Tongue
Tongue
Oesophagus
1. Tn. Mucosa
• Layered flat without horns epithelium
• Under of epithelium  lamina propia (thin single layer connective tissue)
• One longitudinal smooth mucsle
2. Tn. Submucosa
• There is submucosa / oesophageal gland
• Often contain fat cells
3. Tn. Muscularis
• 1/3 proximal  striated muscle
• 1/3 centre  mixing striated muscle & smooth muscle
• 1/3 distal  smooth muscle
4. Tn. Adventitia (Serosa)
• loose connective tissue that fuse with adv. trakea
 Lo 2.FISIOLOGI MENELAN
• The process of swallowing begins with a voluntary (oral) phase that
includes a preparatory phase during which a food bolus suitable for
swallowing is prepared and a transfer phase during which the bolus is
pushed into the pharynx by contraction of the tongue.
• The bolus then activates oropharyngeal sensory receptors that initiate the
deglutition reflex. The deglutition reflex is centrally mediated and involves
a complex series of events. It serves both to propel food through the
pharynx and the esophagus and to prevent its entry into the airway.
• When the bolus is propelled backward by the tongue, the larynx moves
forward and the upper esophageal sphincter (UES) opens. As the bolus
moves into the pharynx, contraction of the superior pharyngeal constrictor
against the contracted soft palate initiates a peristaltic contraction that
proceeds rapidly downward to move the bolus through the pharynx and
the esophagus.
• The lower esophageal sphincter (LES) opens as the food enters the
esophagus and remains open until the peristaltic contraction has
swept the bolus into the stomach.
• Peristaltic contraction in response to a swallow is called primary
peristalsis. It involves inhibition followed by sequential contraction of
muscles along the entire swallowing passage. The inhibition that
precedes the peristaltic contraction is called deglutitive inhibition.
Local distention of the esophagus from residual food activates
secondary peristalsis.
Lo 3 biokimia
Lo 4.disfagia dan odynofagia
Disfagia
• Dysphagia is defined as a sensation of "sticking" or obstruction of the
passage of food through the mouth, pharynx, or esophagus.
(Harrison's Internal Medicine)
• Aphagia: complete esophageal obstruction
• Odynophagia: painful swallowing
• Globus pharyngeus: the sensation of a lump lodged in the throat (no
difficulty is encountered when swallowing is performed)
• Phagophobia: fear of swallowing
Dysphagia may be divided into:
1. Oral Pharyngeal Dysphagia
Associated with poor bolus formation and control.
Oropharyngeal dysphagia is defined as difficulty in moving the bolus from the mouth to the
esophagus.
Pharyngeal stasis leads to nasal regurgitation and laryngeal aspiration during the process of
swallowing.

2. Esophageal Dysphagia
Esophageal dysphagia refers to the sensation of food sticking or getting hung up in the base of your
throat or in your chest. Some of the causes of esophageal dysphagia include: Achalasia. This occurs
when your lower esophageal muscle (sphincter) doesn't relax properly to let food enter your
stomach.
In an adult, the esophageal lumen can distend up to 4 cm in diameter. When the esophagus cannot
dilate beyond 2.5 cm in diameter, dysphagia to normal solid food can occur. Dysphagia is always
present when the esophagus cannot distend beyond 1.3 cm.
Results abnormalites in peristaltis and deglutitive inhibition due to diseases of the esophageal
striated or smooth muscles.