Ministry of Public Health of Ukraine M. Gorky Donetsk National Medical University
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Ministry of Public Health of Ukraine M. Gorky Donetsk National Medical University The digestion in the stomach. Composition and properties of the gastric juice. The adaptive changes of stomach secretion. Methodical instructions for students Donetsk 2009 The digestion in the stomach. Composition and properties of the gastric juice. The adaptive changes of stomach secretion. Actuality of subject: Importance of topic studying “The digestion in the stomach. Composition and properties of the gastric juice. The adaptive changes of stomach secretion” is determined by role of stomach in organism that does not limit only digestive functions. Diseases, which connect with dysfunction of stomach, occupied one of the main places in the common structure of incidence of illness. Knowledge of digestion mechanism in stomach is necessary for therapeutist, surgeon and stomatologist. ^ To be able to interpret mechanisms of digestion in stomach for understanding its role in integrate activity of the organism and further use of the knowledge in therapeutical, gastroenterological and surgical clinic. Specific purposes Purposes of initial level of knowledge To be able to:
You must decide some tasks in order to reveal your initial level of knowledge-skill: ^ Task # 1. The action of gastrin and histamine on secretion of the stomach has studied at experimental animal, which has deinnervated stomach. How did injection of these substances influence on stomach secretion?
Task # 2. Patient has atony of the stomach. In consequence of this retention of chyme evacuation was observed. Lack of which hormone, that stimulate motor function of the stomach, leads to atony?
Task # 3. The activity of proteases, which produced in the fundal part of the stomach, was studied at the experimental animal. Which pH was optimum for better activity of these enzymes?
If you decide previous tasks then you must decide following tasks independently. Task # 4. Maintenance of gastricsins was decreased in gastric juice of 58 year old man after operation on the stomach. Where did this substance is produced?
Task # 5. Great part of the stomach was extracted at the 60 year man. What occur with digestion of proteins after this operation?
Task # 6. The analysis of the biopsy material of stomach mucous of patient, which has gastritis, determined significance decrease in number of parietal cells. How did this influence on intesivity of gastric secretion?
Basic theoretical questions.
LITERATURE
^ Task # 1. During the experiment on the dogs the stomach isolation was carried out by Geidengain’s method. It was determined, that latent period of gastric juice secretion in small isolative stomach after operation was differed from secretion of basic stomach. What led to this?
Task # 2. At laboratory experiment the composition and properties of the adult man gastric juice were studied. It was determined, that one of component parts of juice was hydrochloric acid. What was pH of pure gastric juice?
Task # 3. The 150 ml of meat broth was brought into gastric cavity to experimental animal through tube. Which hormone will release in the blood in response to food intake in stomach?
Task # 4. Inhabitants of hot climatic zones traditionally use piquant seasoning. What function of the stomach increases in consequence of these substances using?
If you decide previous tasks then you must decide following tasks independently. Task # 5. A 54 year old man was investigated in gastroenterological department. Doctor prescribed histaminic test to him. With what purpose was histamine injection?
Task # 6. A 45 year old man had peptic ulcer. During examination of the gastric juice it was determined, that number of basal secretion was 100 ml/h and acidity was 60 mmol/l. What substance lead to this changes?
Task # 7. A 75 year old man, who lost teeth, feeds by the cutting small and humidified food. During this he complains on heavy feeling in region of stomach, delay of food digestion. What phase of gastric secretion has changed?
Task # 8. At 75 year old man the initial part of the small intestine was extracted. What changes occurred with stomach?
Approximate basic of work. Laboratory work # 1.The function of gastric juice digestion and role hydrochloride acid. For work necessary. Fibrin, Gastric juice, 0.5% solution of HCl, Sodium bicarbonate in powder, Lighter, test-tubes in racks, pipettes, thermostat, litmus paper. Purpose of the work: to reveal role of the hydrochloric acid in digestion of proteins, and also role of pepsin in digestion of non-soluble fibrin in solution of albulose and peptone. Speed of work. Take 4 number test-tubes, and in three of them fill 2ml gastric juice, and in fourth – 2ml of HCl. Determine presence of free hydrochloric acid in the gastric juice by litmus paper. Fill sodium to total neutralization in second test-tube with gastric juice. Maintenance of third slowly bring to boiling, in consequence of this pepsin destroys. Put down the same small pieces of fibrin in each of four test-tubes and place in thermostat by temperature near 38C. In 15 minutes take out and value result. Fibrin reformed only in the first test-tube, in second and third test-tubes changes didn’t arise, in fourth test-tube (with HCl) piece of fibrin increase in size, took place swelling. Laboratory work # 2. Determination of gastric juice proteolytic activity on Mett’s method. Raw white of the egg coagulates in glass tubes with diameter of 1-2mm. These tubes have 2-3cm long// Put down tubes with raw white in middle in test-tubes with the gastric juice, and test-tubes place in thermostat on one hour. Under influence of pepsin the white digests. Size of proteins that digested is 3mm at an empty stomach, size of proteins that digested is 7mm with maximal stomach secretion. ^ Task. A 53 year old man with disease of stomach was admitted in gastroenterological department. What type of stimulation of gastric secretion were used for examination? А. Exploratory breakfast. В. Introduction of secretion stimulation in intestine. С. Introduction of secretion stimulation in the colon. D. Conditioned-reflector food stimulation. Е. Weak electrical stimulation of the tongue. ^ After organization part, in the beginning of study, after actualization of topic pay attention to necessity to be able to interpret peculiarities of gastric secretion. After this the teacher checking initial level of knowledge-skill which you received before. After decision of teaching tasks students independent interpret physiologic properties of stomach, you must pay attention to damage of stomach activity which lead to different diseases and influence on common organism state. You must pay attention to practical importance of physiologic properties of stomach. During this students use table-train and grafological structure of topic (addition 1) . After this students decide teaching tasks which they receive during this. Students with teacher modulate situation tasks on these topics. Teacher corrects mistake students’ actions. Students carry out laboratory works independent. For consolidate the topic students see education film After this students decide control tasks. Sum up of study and announcement marks. ^
Addition 1. Graf logical structure of topic “ Digestion in the stomach.” ^ Esophagotomy Isolated stomach Intubation Telemetric X-rayDigestiveDigestive depotSecretory MotorAbsorptive Excretory Take part in water-salt exchange Hemopoietic Glands of stomach mucous membrane Chief cells Ferments pepsin Parietal cells Mucosal cells Mucoid secretion Cerebral Stimulation of mouth chemo and mechanoreceptors, visual and olfactory receptors Gastric Stimulation of stomach chemo and mechanoreceptors IntestinalStimulation of duodenum chemo and mechanoreceptors                      Acute Chronic    Interpret of organism physiological state for further use this knowledge in clinic          Secretion phases NondigestiveProtectiveHCl | |||||||||||||||||||||||||||||||||||||||||||||||||||
