人體的奧秘 - 醫生咁撚好賺唔係無原因 (4)

目錄

(1)基本既心臟介紹
lihkg.com/thread/649350

(2)基本既肺部介紹
lihkg.com/thread/652225

(3)基本既腎臟介紹
lihkg.com/thread/665504

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  In the following several articles, I will talk about the organs in digestive system. The first one is the stomach, probably the most famous one. 

    係黎緊既幾篇野，我都會講消化系統 (digestive system)。講到消化系統，我唸大家第一個唸起既器官一定係胃 (stomach)，所以我今次都係講胃先。

    The stomach is like a pocket. It acts as a storage room of food and carries out digestion. 

    胃呢就好似一個袋咁。佢主要既用途係裝食物同埋消化食物。

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    Before talking about the anatomical structure of stomach, I would like to talk about the oral cavity first. 

    咁講個胃之前，我想講下個口腔 (oral cavity) 既解剖結構先。

    The oral cavity can be divided in to two part, mandible and maxilla. 

    咁口腔可以分做兩個部份，上顎 (maxilla) 同埋下顎 (mandible)。

    Normally, we have total 32 teeth, with tongue at the mandibular part. Some of us may have total 28 teeth only, as the 4 last molar teeth (wisdom teeth) are removed. 

    正常黎講呢，我地會有總共32隻牙齒，有D人得28隻，因為剝左4隻智慧齒 (wisdom teeth)，而條脷就係下顎個到。


# Some details of teeth

2 maxillary central incisors, 2 mandibular central incisors, 2 maxillary lateral incisors, 2 mandibular lateral incisors, 2 maxillary canines, 2 mandibular canines, 4 maxillary premolars, 4 mandibular premolars, 6 maxillary molars, 6 mandibular molars, toal 32 teeth. #

#識多小小牙齒

32隻牙齒細分落去可以分做上顎同下顎既牙齒，兩邊一樣，分別有

2隻中門齒、2隻側門齒、2隻犬齒、4隻前臼齒、6隻臼齒，總共16隻牙齒。#

    Saliva is being secreted into the oral cavity, by salivary glands. There are 3 major salivary glands, they are, sublingual glands, submandibular glands and parotid glands. 

    唾液 (saliva), 姐係口水，由唾液腺 (salivary glands) 分泌到口腔。我地有三隻主要唾液腺，佢地分別係舌下腺 (sublingual glands)、頜下腺 (submandibular glands) 同腮腺 (parotid glands)。

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    The cell types in salivary glands are mainly mucous cells and serous cells. 

    係唾液腺裡面有兩隻細胞，分別係黏液細胞同漿液細胞。

    (1)mucous cells - secrete mucosa that mainly provides protection and water. 

    (2)serous cells - secrete serous fluid that mainly provides enzymes and water. 

    (1)黏液細胞 - 分泌黏液整黏膜 (mucosa)，主要係保護同濕潤口腔。

    (2)漿液細胞 - 分泌漿液 (serous fluid)，而漿液既主要成份係酶 (enzymes) 同水份。

    No need to look too deep into the cell structures in the figure (plus it may not be totally correct at all), just for you to have an idea that different glands consist of different cell types with different functions and shapes. 

    BTW，唔洗太介意張圖個粒細胞既細節，只係想比知道番唔同既腺 (glands) 由唔同既細胞組成，有唔同既功能同外形，而且張圖都唔一定係100%正確。

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    When we talk about 'glands', usually we are talking about an unit structure like this. 

    其實當我地講腺 (glands)，我地通常係想表達依一種結構。

    This is called an acinus, a berry-like structure, where the green cells are responsible for secretion and the red cells are constructing the duct to the epithilium. Do you remember something? Yes, an alveolus, glands and alveoli share the same anatomical structure, but with different physiological function. The glands with this type of unit structure is called the exocrine glands, secreting substances to the epithilium. Thereofre, salivary gland is one of the exocrine glands. 

    張圖既結構叫腺泡 (acinus), 係一個果實既形狀。張圖入面綠色既係負責分泌物質既細胞；紅色既係負責建構分泌物管道到上皮組織 (epithilium) 既細胞。睇到個結構，唔知你有冇唸起D野呢？冇錯啦，就係肺泡，腺同肺泡既解剖結構極似，但係個生理作用就完全唔同。所有有依種叫腺泡結構既腺都叫做外分泌腺 (exocrine glands)，負責將物質分泌到上皮組織。所以唾液腺都係外分泌腺既一員。

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    But there is another type of 'glands', called the endocrine gland. This type of glands have different unit structure compared with exocrine glands. I personally think 'endocrine gland' is a bad name, as the definition is 'glands that secrete substances into the bloodstream', meaning that organs like liver and kidney can be considered as endocrine glands. That's confusing. 

    但係有另一種腺 (glands)，叫做內分泌腺 (endocrine glands)，依種腺個解剖結構係同外分泌腺完全唔同，我個人覺得個名係改得幾差下，因為所有會將物質分泌到血液既腺就叫內分泌腺，令到腎呀、肝呀依D器官都可以叫做內分泌腺。真係奇撚怪。

    However, be careful, both exocrine and endocrine glands can be called 'xxx gland'. For example, adrenal glands - endocrine glands, sweat glands - exocrine glands. Don't mess up. 

    重有要小心既係，唔係所有既「咩咩腺」都係叫外分泌腺，例如：腎上腺 (adrenal glands)就唔係外分泌腺，而係內分泌腺，而汗腺 ( sweat glands) 就係外分泌腺，亂七八糟，所以要小心。

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    So now, let's jump to the structure of the stomach. 

    終於到胃既解剖結構。

    The stomach can be divided into four parts, cardia, fundus, main body and pylorus. 

    胃可以分做四個部分，分別係賁門 (cardia)、胃底 (fundus)、胃主體 (body) 同幽門 (pylorus)。

    (1) The cardia is the entry of the stomach. It is called the cardia as it is the part in stomach closest to the heart. 

    (2) The fundus is the green region of the figure. 'Fundus' means bottom or base, so...hmmm... special naming. It contains most of the gastric exocrine glands in the stomach. 

    (3) The main body provides room for storage. 

    (4) The pylorus can be futher divided into pyloric antrum and pyloric canal. It is the exit area of the stomach. Also, between the small intestine (or more specific, duodenum) and pyloric canal, there is a pyloric sphincter (a kind of muscle) controlling the flow of food from stomach to small intestine. 

    (一) 賁門係胃既入口，上皮組織既變化點就係食道同賁門分界。

    (二) 胃底係張圖綠色既部分。雖然佢叫「胃底」，但實際就係胃頂，嗯. 幾有趣。胃底有好多胃外分泌腺。

    (三) 胃主體係用黎裝住D未消化食物。

    (四) 幽門可以分做胃竇 (pyloric antrum) 同幽門管 (pyloric canal)。依到就係胃既出口。重有就係，係小腸 (small intestine) 同幽門管中間，有一舊幽門括約肌 (pyloric sphincter)，控制住食物走入去小腸既時間同份量。

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    There are gastric exocrine glands secrete gastric acid to assist digestion in stomach. The cell types of the gastric exocrine glands are mainly oxyntic cells, zymogenic cells and surface mucous cells. They are just different cells type with different functions like mucous cells and serous cells. 

    胃外分泌腺係胃用黎分泌胃酸 (gastric acid) 既。咁胃外分泌腺主要既細胞有三種，泌酸細胞 (oxyntic cells)、酶原細胞 (zymogenic cells) 同埋表面黏液細胞 (surface mucous cells)，佢地就係係胃外分泌腺裡面有唔同作用既細胞。

# Some details in the cells of gistric exocrine glands

    [physiological name (anatomical name) - function]

    oxyntic cells (parietal cells) - gastric intrinsic factor (GIF) and HCl synthesis

    zymogenic cells (chief cells) - pepsinogen and gastric lipase synthesis

    surface mucous cells (foveolar cells) - protective gastric mucosa synthesis #

#  識多小小胃外分泌腺細胞

    [生理學名稱 (解剖學名稱) - 生理作用]

    泌酸細胞 (胃壁細胞) - 合成胃內在因子 (GIF) 同氫氯酸 (HCl)

    酶原細胞 (主細胞) - 合成胃蛋白酶原同胃脂肪酶

    表面黏液細胞 (小凹細胞) - 合成胃黏膜 #

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    Here are the basic physiological functions

    跟住落黎就係基礎生理作用啦。

    Using the perspective of food. 

    你係一舊食物。

    (1) The food is being delivered into the oral cavity, the first stage of digestion begins. 

    (2.1) Enzymatic hydrolysis (break down using water) of food is carried out by the saliva. (chemical digestion)

    (2.2) Mastication (chewing). (physical digestion)

    (3) After the first stage of digestion, the food becomes the bolus, food that is ready to be swallowed, rounded shape. 

    (一) 食物比人放左入個口腔，第一階段消化開始。

    (二點一) 口水對食物進行酶促水解 (Enzymatic hydrolysis)。(化學性消化)

    (二點二) 用牙齒咬食物 (Mastication)。 (物理性消化)

    (三) 第一階段消化結束，舊食物變左做食團 (bolus)。


# Some details in first stage of digestion 

    Several enzymes are produced by salivary glands to carry out hydrolysis of food. 

    (i) Amylase - synthesized by 3 main salivary glands, speed up the hydrolysis of carbohydrates

    (ii) Lingual lipase - synthesized by Von Ebner glands (minor salivary glands), speed up the hydrolysis of lipids. #

# 識多小小第一階段消化

    唾液裡面有幾種酶可以促進食物水解

    (壹) 澱粉酶 - 由o個3條主要既唾液腺合成，促進醣類食物水解。

    (貳) 舌脂肪脢 - 由艾伯納腺合成，促進脂類食物水解。#


    (4) The bolus is being swallowed, the action of swallowing includes the movement of epiglottis to cover the air tract, so the bolus goes into the esophagus. 

    (5) The esophagus delivers the bolus to the stomach by wave-like propulsion. 

    (6) The bolus goes into the stomach, and begins the second stage of digestion. 

    (7.1) Hydrolysis is carried out by gastric acid. (chemical digestion)

    (7.2) Stomach-churning is carried out by the muscular wall. (physical digestion)

    (8) The bolus becomes the chyme, the pulpy acidic fluid after the second stage of digestion

    (9) The chymes are stored in the stomach and gradually squirted into the small intestine (or the duodenum). 

    (四) 食團比人吞左，吞嚥依個動作令到會厭郁，冚住個氣管，再將食物送入去食道。

    (五) 食道用一種叫波浪推進既方式將舊食團送入個胃到。

    (六) 食團入左個胃，開始第二階段消化。

    (七點一) 胃酸對食團進行進一步既水解作用。(化學性消化) 

    (七點二) 胃壁攪動進一步整散食物。(物理性消化)

    (八) 第二階段消化結束，食團變做食糜 (chyme)。

    (九) 食糜儲存係胃入面，慢慢咁逐D逐D咁噴入去小腸。

# Some details in second stage of digestion 

    Amylase would be denatured in gastric acid, so the digestion of carbohydrates in stomach is slow. Also, Several enzymes and chemicals are produced by gastric glands to carry out hydrolysis. 

    (i) Pepsinogen - produced by chief cells, the inactive form of pepsin, enzyme of protein hydrolysis. 

    (ii) Hydrochloric acid (HCl) - produced by parietal cells, activate pepsinogen to pepsin, lower the pH value to speed up the hydrolysis and kill the bacteria. 

    (iii) Gastric lipase - produced by chief cells, speed up the hydrolysis of lipids. 

    (iv) Gastric intrinsic factor (GIF) - produced by parietal cells, assist the absorption of vitamin B12. #

# 識多小小第二階段消化

    澱粉酶會比胃酸破壞，或者專業D叫變性 (denatured) ，所以胃對醣類食物既消化能力好低。

    而胃酸裡面有幾種酶同物質可以促進食物水解。

    (壹) 胃蛋白酶原- 由主細胞合成，未啟動既胃蛋白酶，胃蛋白酶可以促進蛋白質水解。

    (貳) 氫氯酸 (HCl) - 由胃壁細胞合成，用作啟動胃蛋白酶原同促進食物水解。

    (參) 胃脂肪脢 - 由主細胞合成，促進脂類食物水解。

    (肆) 胃內在因子 - 由胃壁細胞合成，幫助吸收維生素B12。#

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The food digestion is still processing. To be continued in small intestine.  

食物消化重進行緊，密切留意發展。

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