DIGESTIVO NUTRICION

7/23/2019 DIGESTIVO NUTRICION

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APUNTES DE APOYO HISTOLOGA:SISTEMA DIGESTIVO

Introduccin

El tubo digestivo est o!"#do $o! l# %#vid#d o!#l& el es'#go& elest'"#go& el duode(o& el i(testi(o delg#do& el %olo(& el !e%to ) el #(o*+#d# seg"e(to est es$e%i#li,#do $#!# !e#li,#! u(# u(%i'( $#!ti%ul#!e( el $!o%es#"ie(to o l# #bso!%i'( de los (ut!ie(tes (e%es#!ios $#!##te(de! l#s (e%esid#des e(e!g-ti%#s del %ue!$o*

Fig 1: Esquema del tubo digestivoCompartimientos funcionales1-Cavidad oralSu u(%i'( es l# i(gest# ) !#g"e(t#%i'( de#li"e(tos*

2- Vas de paso+o!!es$o(de( # l# #!i(ge& el es'#go ) el%o(du%to #(#l* Su u(%i'( es el tt!#(s$o!te delos #li"e(tos o de sus !estos& si( ee%tu#!"odii%#%io(es sig(ii%#tiv#s*

3- Tracto digestivo+o!!es$o(de( #l est'"#go& i(testi(o delg#do.duode(o& )e)u(o& /leo(0 e i(testi(o g!ueso

.%iego& #$-(di%e& %olo( ) !e%to0* Su u(%i'(u(d#"e(t#l %o!!es$o(de # l# se%!e%i'( dee(,i"#s digestiv#s ) l# #bso!%i'( de l#s"ol-%ul#s !esult#(tes*

4- Sistema de gl!dulas au"iliaresSo( '!g#(os se%!eto!es& 1ue se e(%ue(t!#(ubi%#dos ue!# del tubo digestivo* +o!!es$o(de(# l#s gl(dul#s s#liv#les "#)o!es ) "e(o!es& el2/g#do ) el $(%!e#s* P!odu%e( se%!e%io(es

2#%i# l#!gos %o(du%tos e3%!eto!es*Histologa general del tubo digestivo1- T#!ica mucosa:

E$itelio L"i(# $!o$i#:

Te4ido %o(4u(tivo l#3o Leu%o%itos ) te4ido li(oide


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L"i(# "us%ul#! .$uscularis mucosae0 1ue se e3tie(de desde eles'#go #l #(o*

2- Submucosa Te4ido %o(e%tivo l#3o %o( ib!#s elsti%#s* V#sos& (e!vios& gl(dul#s "u%os#s& te4ido li(oide ) leu%o%itos*

3- T#!ica muscular +i!%ul#! i(te!(#: 5o!"#%i'( de es/(te!es Lo(gitudi(#l e3te!(#

4-T#!ica serosaEst %o(stituid# $o! u( e$itelio $l#(o si"$le ) u(# %#$# de te4ido%o(e%tivo sub)#%e(te* E( l# #!i(ge& es'#go ) !e%to (o e3iste u(#

t6(i%# se!os# %o"o t#l& si(o u(# t6(i%# #dve(ti%i# %o(stituid# s'lo $o!te4ido %o(e%tivo l#3o& e( el 1ue se $uede( e(%o(t!#! #lgu(os v#sos )(e!vios*

Fig% 2: Esquema de la co!stituci&! 'istol&gica del tubo digestivo e!secci&! tra!sversal


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1- Cavidad oral

L# %#vid#d o!#l est li"it#d# $o! #!!ib# $o! el $#l#d#! du!o ) bl#(do& #los l#dos $o! l#s "e4ill#s ) #b#4o $o! l# le(gu# ) el $iso de bo%#*

L# "u%os# o!#l est t#$i,#d# e( tod# su e3te(si'( $o! u( e$itelio$l#(o est!#tii%#do& $e!o su es$eso! ) g!#do de 1ue!#ti(i,#%i'( v#!/#( deu(# !egi'( # ot!#* Puede se! de t!es ti$os: "#sti%#to!i#& de!evesti"ie(to ) es$e%i#li,#d#* L# sub"u%os#& %u#(do est $!ese(te& #lo4# e( su es$eso!gl(dul#ss#liv#les se!os#s )7o "u%os#s ) te4ido li(oide Puede( o (o e3isti! ib!#s "us%ul#!es es1uel-ti%#s

2- Histologa general de las vas de transporte

L#s v/#s de t!#(s$o!te so( tubos "us%ul#!es t#$i,#dos i(te!(#"e(te$o! e$itelio $l#(o est!#tii%#do %o( #lgu(#s gl(dul#s "u%os#s 1ue$!odu%e( "o%o lub!i%#(te* El #li"e(to se t!#(s$o!t# # t!#v-s de los"ovi"ie(tos $e!istlti%os*

1- $ucosa:8evestid# $o! u( e$itelio es%#"oso $lu!iest!#tii%#do (o %o!(ii%#do*Puede( e(%o(t!#!se #lgu(#s %-lul#s de L#(ge!2#(s # (ivel del es'#go*E( l# $o!%i'( su$e!io! del est'"#go l# "us%ul#!is "u%os#e est%o(stituid# s'lo $o! #lgu(#s %-lul#s "us%ul#!es lis#s #isl#d#s* H#%i# l#

u(i'( g#st!oesogi%# se o!"# %o"o u(# %#$# "us%ul#! %o(ti(u#*E( l# l"i(# $!o$i# se e(%ue(t!#( l#s gl(dul#s %#!di#les del es'#go1ue %o!!es$o(de( # gl(dul#s "u%os#s*

2- Submucosa:Posee gl(dul#s esogi%#s sub"u%os#s& de se%!e%i'( "u%os#* Suu(%i'( es lub!i%#! el $#so de los #li"e(tos*

9 $uscular:Est %o(stituid# "#)o!it#!i#"e(te $o! "6s%ulo liso& %o( e3%e$%i'( de

l# #!i(ge& l# $o!%i'($!o3i"#l del es'#go .te!%io su$e!io!0 ) dist#l del%o(du%to #(#l& do(de e3iste "6s%ulo es1uel-ti%o est!i#do* E( el te!%io"edio del es'#go se e(%ue(t!#( ib!#s "us%ul#!es lis#s ) es1uel-ti%#se(t!e"e,%l#d#s*

;(dve!ticia


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3- Histologa del tracto digestivo

L# ei%#%i# de los $!o%esos #bso!titos ) se%!eto!es del t!#%to digestivo se"e4o!# #l #u"e(t#! l# su$e!i%ie de %o(t#%to e(t!e l#s %-lul#s e$iteli#les) l# lu,< esto se log!# "edi#(te:

=* Vellosidades: Pliegues de e$itelio de !evesti"ie(to 2#%i# l# lu,>* Invaginaciones del epitelioo!"#(do est!u%tu!#s tubul#!es9* Formaciones glandulares %o"$le4#s i(te!(#s o e3te!(#s # l#$#!ed del t!#%to:

i0 Mu%os#ii0 5ov-ol#s gst!i%#s

iii0 Gl(dul#s gst!i%#s

Estmago

L# est!e%2# ,o(# situ#d# #l!ededo! de l# u(i'( del es'#go %o( elest'"#go se %o(o%e %o"o %#!di#s* L# !egi'( #boved#d# 1ue sob!es#le$o! e(%i"# del %#!di#s es el u(dus ) el g!#( seg"e(to %e(t!#l es el%ue!$o* El %ue!$o se %o(ti(6# %o( u(# !egi'( %'(i%#& de(o"i(#d# #(t!o$il'!i%o& ,o(# 1ue %o(tie(e el es/(te! $il'!i%o& %u)# !el#4#%i'( $e!"ite el$#so del %o(te(ido gst!i%o #l duode(o*

Histol'gi%#"e(te s'lo se disti(gue( t!es ,o(#s dete!"i(#d#s $o! l#

est!u%tu!# "i%!os%'$i%# de l# "u%os#* El %#!di#s& l# !egi'( 6(di%#.u(dus ) %ue!$o #(#t'"i%os0 ) l# !egi'( $il'!i%# 1ue i(%lu)e el #(t!o$il'!i%o& el %o(du%to $il'!i%o ) el $/lo!o*

Fig% 3: )egio!es a!at&micas del est&mago * corte para demostrarpliegues


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L# su$e!i%ie i(te!(# del est'"#go $!ese(t# u(os $liegues .!ug#e o$li%#e "u%os#e0 1ue des#$#!e%e( #l diste(de!se el est'"#go* Du!#(tel#s %o"id#s& el %ie!!e del es/(te! $il'!i%o ) l# ge(e!#%i'( de o(d#s de%o(t!#%%i'( "us%ul#! !edu%e( el #li"e(to # u(# "#s# vis%os#

se"il/1uid# %o(o%id# %o"o 1ui"o* ?ste se e(%ue(t!# e(t!e"e,%l#do %o(%ido %lo!2/d!i%o ) l# $e$si(#& u(# $!ote#s# 1ue %o"ie(,# l# digesti'(de l#s $!ote/(#s*

L# "u%os# gst!i%# est !e%ubie!t# $o! u( epitelio prismtico altosin borde de cepillo %o( %-lul#s caliciformes 1ue se%!et#( "o%o )bi%#!bo(#to* L# %#$# de "u%us "s el e$itelio %o(stitu)e( l# b#!!e!# de"u%os# gst!i%#*

Est# "u%os# $!ese(t# i(v#gi(#%io(es 1ue %o!!es$o(de( # l#sfov!olas"desde %u)o o(do se e3tie(de( l#s gl(dul#s gst!i%#s $o!todo el es$eso! de l# "u%os#* Los es$#%ios 1ue 1ued#( e(t!e l#sgl(dul#s est( o%u$#dos $o! el te4ido %o(e%tivo l#3o de l# l"i(#$!o$i#*

L#s t!es ,o(#s 2istol'gi%#s del est'"#go diie!e( e( l# $!ou(did#d del#s ov-ol#s& l# o!"# de sus gl(dul#s ) l#s $!o$o!%io(es !el#tiv#s de%-lul#s se%!eto!#s*

A (ivel del %#!di#s e( l# u(i'( g#st!oesogi%# se $!odu%e l# t!#(si%i'(del e$itelio es%#"oso esogi%o # e$itelio %il/(d!i%o& !#,'( $o! l# %u#l se

le de(o"i(# t#"bi-( u(i'( escamocolumnar* L#s ov-ol#s so( $o%o$!ou(d#s ) l#s gl(dul#s %#!di#les #so%i#d#s # -st#s est( %o"$uest#s$!i(%i$#l"e(te $o! %-lul#s "u%ose%!eto!#s*L# e3$osi%i'( del e$itelio es%#"oso #l %ido ) e(,i"#s gst!i%#s d# lug#!

#l #se(t#"ie(to !e%ue(te de $#tolog/#s*

E( l# "u%os# del %o!$us ) u(dus l#sov-ol#s so( $o%o $!ou(d#s ) l#sgl(dul#s 1ue se o!igi(#( de ell#s so(l#!g#s ) !e%t#s* Est#s gl(dul#s gst!i%#sse de(o"i(#( #o$nticas@ ) est(%o(stituid#s $o! %i(%o ti$os die!e(tes de%-lul#s:i+ C,lulas madre: $e1ue#s ) b#soil#s7C de l# lo(gitud i(testi(#l est sus$e(dido del


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"ese(te!io # l# $#!ed do!s#l #bdo"i(#l< ) el /leo(& 1ue %o(stitu)e los97C dist#les*

%a absorcin de los nutrientes se ve favorecida porformaciones &ue aumentan la superficie total de la mucosa'

1- /liegues circulares vlvulas de 0irri!g+P!ese(t#( o!ie(t#%i'( t!#(sve!s#l& de = "" de #ltu!# $o! 9 de es$eso!&so( est!u%tu!#s $e!"#(e(tes 1ue o se oblite!#( %u#(do se dil#t# el'!g#(o* Au"e(t#( e( 9 ve%es l# su$e!i%ie i(testi(#l*

2- Vellosidades i!testi!ales:&=&C "" de lo(gitud& dis%u!!e( $#!#lel#s #l e4e "#)o! del i(testi(o*+o!!es$o(de( # $liegues !ode#dos de e$itelio 1ue e( el %e(t!o est(o!"#d#s $o! te4ido %o(e%tivo l#3o 1ue %o(tie(e u(# !ed de %#$il#!ese(est!#dos ) u( %o(du%to 1uil/e!o %e(t!#l* El %o(du%to 1uil/e!o d!e(# #u( $le3o li(ti%o situ#do e( l# l"i(# $!o$i# sub)#%e(te ) $!o$o!%io(#u(# v/# de t!#(s$o!te # los l/$idos #bso!bidos desde l# "u%os# i(testi(#l2#%i# l# s#(g!e*Au"e(t#( e( ve%es el !e# de l# "u%os#*9 l!dulas tubulares simples: Criptas de ieber'!El e$itelio 1ue !e%ub!e l#s vellosid#des es u( epitelio prismtico conborde de cep(llo& lo 1ue #u"e(t# l# su$e!i%ie de l# "u%os# 9 ve%es"s* Este e$itelio $osee ; ti$os %elul#!es:i0 C,lulas madre:Se sit6#( el %uello de l#s %!i$t#s* O!igi(#( los ; ti$os%elul#!es 1ue se des%!ibi!( # %o(ti(u#%i'(*ii0 C,lulas absorbe!tes:+-lul#s %il/(d!i%#s %o( "i%!ovellosid#des* U(osil#"e(tos se $!o)e%t#( desde los e3t!e"os de l#s "i%!ovellosid#des )

se e(t!el#,#( $#!# o!"#! u(# %#$# su$e!i%i#l %o(ti(u# %o(o%id# %o"oel gli%o%li,* Estos il#"e(tos so( e3te(sio(es de $!ote/(#s i(teg!#les del$l#s"#le"# ) %o(st#( de u( $oli$-$tido %e(t!#l %o( %#de(#s l#te!#les deoligos#%!idos* E( est# t!#"# so( #bso!bid#s l#s e(,i"#s 1ue 2id!oli,#(dis#%!idos ) di$-$tidos ) u(# ve, deg!#d#dos diu(de( # los %#$il#!essube$iteli#les*iii0 as c,lulas calici5ormes est( dise"i(#d#s e(t!e l#s %-lul#s#bso!be(tes ) se%!et#( "o%o*iv0 E(t!e l#s %-lul#s e$iteli#les de l#s vellosid#des ) l#s %-lul#sgl#(dul#!es se dist!ibu)e( c,lulas ,!teroe!docri!as& ti$o G& S& I.se%!et#( %ole%isto1ui(i(#0& %-lul#s D& MO 1ue se%!et#( "otili(# )%-lul#s L 1ue se%!et#( e(te!oglu%#g'(*v0 L#s c,lulas de /a!et'o!"#( g!u$os e( l# b#se de l#s %!i$t#s* Tie(e(u( %ito$l#s"# "ode!#d#"e(te b#s'ilo ) #bu(d#(tes g!(uloseosi('ilos de se%!e%i'(* Se $ie(s# 1ue dese"$e#( u(# i"$o!t#(teu(%i'( e( el %o(t!ol de l# lo!# b#%te!i#(# del i(testi(o* Se%!et#(liso,i"# ) %!i$tidi(#s& #"b#s %o( ee%to #(ti"i%!obi#(o*


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E( l# l"i(# $!o$i# del /leo( #de"s de l# 2#bitu#l $!ese(%i# deleu%o%itos e3iste( ol/%ulos li(oides #g!u$#dos %o(stitu)e(do l#s /lacasde /e*er1ue se e3tie(de( 2#st# l# sub"u%os# ) o!"#( $#!te del (T*I("edi#t#"e(te $o! e(%i"# de ell#s se ubi%#( l#s c,lulas $ 1ue se$ie(s# 1ue #%t6#( %o"o %-lul#s $!ese(t#do!#s de #(t/ge(o* Ade"s l#s

%-lul#s $l#s"ti%#s se%!et#( Ig A es$e%/i%#s 1ue o!"#( $#!te delsiste"# se%!eto! i("u(it#!io* Estos #(ti%ue!$os se u(e( # !e%e$to!esubi%#dos e( l# b#se de l#s %-lul#s e$iteli#les ) so( t!#(s$o!t#dos #t!#v-s de -st#s $#!# se! libe!#dos 2#%i# l# lu, do(de so( !ete(idos #(ivel del gli%o%li, do(de (eut!#li,#( vi!us ) to3i(#s e i(2ibe( l##d2e!e(%i# de b#%te!i#s #l e$itelio*

L# sub"u%os# e( el duode(o est o%u$#d# e( g!#( $#!te $o! l#sgl(dul#s de B!F((e! 1ue se%!et#( u(# "u%i(# #l%#li(# %l#!# %o( u(elev#do %o(te(ido de bi%#!bo(#to 1ue $!otege el i(testi(o de l# #%ide,del 1ui"o ) elev# el $H 2#st# el g!#do '$ti"o !e1ue!ido $o! l#s e(,i"#s$#(%!eti%#s* Ade"s e( l# sub"u%os# se e(%ue(t!# el $le3o (e!viosode Meiss(e! 1ue i(e!v# l# "us%ul#!is "u%os#e ) el "6s%ulo liso de l#svellosid#des i(testi(#les*

L# %#$# "us%ul#! $osee l#s dos l"i(#s "us%ul#!es %#!#%te!/sti%#s )es !es$o(s#ble del $e!ist#ltis"o* E( l# $#!te dist#l del /leo( l# %i!%ul#!i(te!(# se e(g!os# $#!# o!"#! el es/(te! ileo%e%#l* E(t!e #"b#s %#$#sse e(%ue(t!# el $le3o "ie(t-!i%o de Aue!b#%2& %u)#s ib!#s ee!e(tesso( e( g!#( $#!te l#s !es$o(s#bles de l# "otilid#d i(testi(#l*

L# se!os# %o(siste e( u( epitelio plano tambi!n denominadomesotelio& se$#!#do de l# "us%ul#! sub)#%e(te $o! u(# i(# %#$# dete4ido %o(4u(tivo l#3o* El i(testi(o delg#do est sus$e(dido # l# $#!ed#bdo"i(#l "edi#(te el "ese(te!io 1ue est o!"#do $o! dos %#$#s de"esotelio # %#d# l#do de u(# l"i(# i(# de te4ido %o(4u(tivo l#3o 1ue#$o!t# l# %i!%ul#%i'( s#(gu/(e# #l i(testi(o* L#s dos %#$#s de "esoteliose se$#!#( 2#%i# l# $#!ed $oste!io! #bdo"i(#l* U(# !e%ub!i! l# %#vid#d$e!ito(e#l %o(stitu)e(do el $e!ito(eo $#!iet#l ) l# ot!# se #d2ie!e )!e%ub!e l#s v/s%e!#s %o(stitu)e(do el $e!ito(eo vis%e!#l*

Intestino grueso

Tie(e %e!%# de =*C " de lo(gitud ) se divide e( %iego& %olo(#s%e(de(te& %olo( t!#(sve!so& %olo( des%e(de(te& sig"oideo .o sig"#0&!e%to ) #(o< si( e"b#!go l# est!u%tu!# 2istol'gi%# es si"il#! e( todosestos seg"e(tos*


9/20

L# mucosa no posee pliegues circulares ni vellosidadesintestinales ) su superficie es mu) lisa* +o(tie(e gl(dul#stubul#!es .%!i$t#s de Liebe!F2(0 "e(os (u"e!os#s )Mu) $!'3i"#s %o(stituid#s $o! %-lul#s #bso!be(tes %il/(d!i%#sbu(d#(tes %-lul#s %#li%io!"es& %-lul#s -(te!oe(do%!i(#s& %-lul#s "#d!e

) %-lul#s #bso!be(tes e( el =79 su$e!io! ) e( l# su$e!i%ie de l# "u%os#*

E( el i(testi(o g!ueso se #bso!be( los l/$idos 1ue (o ue!o(#bso!bidos $o! el i(testi(o delg#do ) so( %o(ve!tidos # 1uilo"i%!o(es$o! l#s %-lul#s #bso!be(tes< si( e"b#!go l# u(%i'( $!i(%i$#l de est#s%-lul#s es l# #bso!%i'( de #gu# ) s#les ) %o(%e(t!#! l#s 2e%es* Abso!be(el sodio ) el %lo!o ) libe!#( el $ot#sio ) el bi%#!bo(#to # l# lu,*

E( l# l"i(# $!o$i# se e(%ue(t!#( ('dulos li(oides 1ue se e3tie(de(2#st# l# sub"u%os#*

E( l# $o!%i'( dist#l del !e%to se $!odu%e u(# t!#(si%i'( #b!u$t# dee$itelio %il/(d!i%o # e$itelio es%#"oso $lu!iest!#tii%#do* E( el #(o estee$itelio es si"il#! #l de l# $iel& i(%luid#s l#s gl(dul#s seb%e#s )#$o%!i(#s #so%i#d#s*

A l# #ltu!# del #(o el "6s%ulo liso %i!%ul#! est e(g!os#do ) o!"# eles/(te! i(te!(o del #(o* Ms #b#4o 2#) u( #(illo %i!%ul#! de "6s%uloest!i#do 1ue %o(stitu)e el es/(te! e3te!(o del #(o*

El #$-(di%e ve!"io!"e est %o(stituido $o! l#s %#$#s %#!#%te!/sti%#s

del tubo digestivo ) tie(e #bu(d#(te te4ido li(ti%o*

Hgado

Es l# gl(dul# "#)o! del %ue!$o< $!ese(t# u( $eso #$!o3i"#do de=&C g* Se sit6# e( el %u#d!#(te su$e!io! de!e%2o de l# %#vid#d#bdo"i(#l*

Su u(%i'( %o"o gl(dul# #%%eso!i# es l# de $!odu%i! l# bilis& l# %u#l se#l"#%e(# e( l# ves/%ul# bili#! 1ue se ubi%# e( l# %#!# i(e!io! del 2/g#do*

El 2/g#do& l# ves/%ul# bili#! ) l#s v/#s bili#!es %o(stitu)e( el siste"#2e$#tobili#!*

5u(%io(es del 2/g#do=* Se%!e%i'( de Bilis>* Met#bolis"o de L/$idos9* Met#bolis"o de Hid!#tos de +#!bo(o;* Met#bolis"o P!otei%o


10/20

C* Deg!#d#%i'( de 2o!"o(#s* Deto3ii%#%i'( de d!og#s ) to3i(#s* 5u(%i'( I("u(e

El 2/g#do est !ode#do $o! u(# %$sul# de te4ido %o(e%tivo

.%$sul# de Glisso(0& !e%ubie!t# # su ve, $o! $e!ito(eo* P!ese(t# u(2ilio # t!#v-s del %u#l $e(et!#( l# #!te!i# 2e$ti%#& l# ve(# $o!t# )s#le el %o(du%to 2e$ti%o %o"6(*

Histol'gi%#"e(te el$#!-(1ui"# 2e$ti%o seo!g#(i,# e( lobulillos 2e$ti%os%lsi%os 1ue %o!!es$o(de( #subu(id#des i!!egul#!"e(te2e3#go(#les o!"#d#s $o!l"i(#s e(est!#d#s de2e$#to%itos 1ue se dis$o(e( e(o!"# !#di#d# e( to!(o # u(#ve(# %e(t!#l& ubi%#d# e( el%e(t!o del lobulillo*

E( los (gulos de est#su(id#des 2e3#go(#lese3iste( !e#s t!i#(gul#!es&%o(stituid#s $o! u( est!o"#

%o(4u(tivo l#3o& 1ue %o(tie(e( e( su i(te!io! u(# !#"# de l# #!te!i#

2e$ti%#& u(# !#"# de l# ve(# $o!t#& u( %#$il#! li(ti%o ) u(%o(du%tillo bili#!* A est#s est!u%tu!#s se les %o(o%e e( %o(4u(to %o"ot!/#d#s o es$#%ios $o!t#* L# bilis $!odu%id# $o! los 2e$#to%itos sevie!te e( u(# !ed de %#(#l/%ulos de(t!o de l#s l"i(#s de 2e$#to%itos) lu)e e( o!"# %e(t!/$et# #l lobulillo 2#%i# los %o(du%tillos bili#!esde los es$#%ios $o!t#* E( l# $e!ie!i# de los lobulillos l#s !#"#s de l# #!te!i# 2e$ti%# )ve(# $o!t# %o(lu)e( e( los si(usoides 2e$ti%os 1ue se dis$o(e(e(t!e l#s l"i(#s de 2e$#to%itos* L# s#(g!e lu)e desde l#s t!/#d#s #l# ve(# %e(t!#l& %i!%ul#(do e( o!"# %e(t!/$et#*

L# $#!ed de los si(usoides est o!"#d# $o! u(# %#$# dis%o(ti(u#de %-lul#s e(doteli#les e(est!#d#s 1ue %#!e%e( de "e"b!#(# b#s#l*E(t!e l# $#!ed de los si(usoides ) l#s l"i(#s de 2e$#to%itos e3isteu( est!e%2o es$#%io $e!isi(usoid#l %o(o%ido %o"o el es$#%io de Disse&o%u$#do $o! u(# !ed de ib!#s !eti%ul#!es ) $l#s"# s#(gu/(eo 1ueb## lib!e"e(te l# su$e!i%ie de los 2e$#to%itos* A este (ivel se


11/20

$!odu%e el i(te!%#"bio "et#b'li%o e(t!e los 2e$#to%itos ) el $l#s"# )se o!"# l# #bu(d#(te li(# 2e$ti%#*

Ade"s& e( el es$#%io de Disse se e(%ue(t!#( %-lul#s#l"#%e(#dot#s de g!#s# o %-lul#s de Ito& de o!"# est!ell#d# )

u(%i'( $o%o %o(o%id#*Ad2e!id#s #l e(dotelio ) e"itie(do sus $!olo(g#%io(es 2#%i# eles$#%io de Disse est( l#s %-lul#s de JF$e! 1ue so( "#%!'#gosi4os $e!te(e%ie(tes #l siste"# #go%/ti%o "o(o(u%le#!& %u)# u(%i'(es #go%it#! e!it!o%itos e(ve4e%idos ) ot!os #(t/ge(os* Ade"s #%t6#(%o"o %-lul#s $!ese(t#do!#s de #(t/ge(o*

Los 2e$#to%itos %o(stitu)e( #l!ededo!del K de l# $obl#%i'( %elul#! delte4ido 2e$ti%o* So( %-lul#s $oli-d!i%#s%o( = ' > (6%leos es-!i%os $oli$loides )(u%l-olo $!o"i(e(te* P!ese(t#( el%ito$l#s"# #%id'ilo %o( %ue!$osb#s'ilos ) so( "u) !i%os e( o!g#(elos*Ade"s e( su %ito$l#s"# %o(tie(e(i(%lusio(es de glu%'ge(o ) g!#s#*

L# "e"b!#(# $l#s"ti%# de los2e$#to%itos $!ese(t# u( do"i(iosi(usoid#l %o( "i%!ovellosid#des 1ue "i!# 2#%i# el es$#%io de Disse )u( do"i(io l#te!#l 1ue "i!# 2#%i# el 2e$#to%ito ve%i(o* L#s

"e"b!#(#s $l#s"ti%#s de dos 2e$#to%itos %o(tiguos deli"it#( u(%#(#l/%ulo #l %u#l se! se%!et#d# l# bilis*

L# $!ese(%i# de "6lti$les o!g#(elos e( el 2e$#to%ito se !el#%io(#%o( sus "6lti$les u(%io(es& %o"o so( l# s/(tesis de $!ote/(#s.#lb6"i(#& ib!i('ge(o ) li$o$!ote/(#s del $l#s"#0& el "et#bolis"ode 2id!#tos de %#!bo(o& l# o!"#%i'( de bilis& el %#t#bolis"o de!"#%os ) t'3i%os ) el "et#bolis"o de l/$idos& $u!i(#s )glu%o(eog-(esis*L# %i!%ul#%i'( 2e$ti%# de %#!%te! %e(t!/$eto ) est d#d# $o! elsiste"# Po!t# ) l# #!te!i# 2e$ti%#*

El siste"# $o!t# %o(stitu)e el CK del lu4o s#(gu/(eo .=C"l7"i(0 ) %o(tie(e s#(g!e $o%o o3ige(#d# ) !i%# e( (ut!ie(tes$!ove(ie(te del t!#%to g#st!oi(testi(#l ) b#,o* L# %i!%ul#%i'( ge(e!#l est d#d# $o! l# #!te!i# 2e$ti%# 1ue%o(tie(e l# s#(g!e o3ige(#d# .i!!ig#%i'( (ut!i%i#0*


12/20

A (ivel de los si(usoides %o(lu)e( l# %i!%ul#%i'( 2e$ti%# ) $o!t#*Estos d!e(#( su %o(te(ido # l# ve(# 2e$ti%# %e(t!#l& de -st# # l#sve(#s 2e$ti%#s de!e%2# e i,1uie!d# ) i(#l"e(te # l# ve(# %#v#i(e!io!*

El te4ido 2e$ti%o %o!!es$o(de # u( te4ido est#ble* P!ese(t# u(# g!#(%#$#%id#d de !ege(e!#%i'( e( !es$uest# # est/"ulos e3te!(os& t#les%o"o lesio(es o $!o%esos tu"o!#les* Si( e"b#!go l#s lesio(es%!'(i%#s %o"o el #l%o2olis"o e i(e%%io(es 2e$ti%#s i"$li%#( u(#$-!did# %o(st#(te ) $!olo(g#d# del $#!-(1ui"# si( e3isti!$!olie!#%i'( %o"$e(s#to!i#* +o"o !esult#do el $#!-(1ui"# 2e$ti%oes !ee"$l#,#do $o! te4ido ib!oso& #%6"ulos de g!#s# ) %i!!osis*

*ncreas

El $(%!e#s %o!!es$o(de # u(# gl(dul# "i3t#& ubi%#d# e( l# $#!ed$oste!io! del #bdo"e(*

Histol'gi%#"e(te el est!o"# est %o(stituido $o! l# %$sul# ) lost#bi1ues %o(e%tivos l#3os 1ue deli"it#( los lobulillos $#(%!eti%os*

El $#!-(1ui"# est %o(stituido $o! %-lul#s e3o%!i(#s ) e(do%!i(#s*El $#!-(1ui"# e3o%!i(o est %o(stituido $o! #%i(os se!osos%o"$uestos $o! %-lul#s e$iteli#les de o!"# $i!#"id#l dis$uest#s#l!ededo! de u(# lu, de $e1ueo %#lib!e* L#s %-lul#s #%i(os#s $osee((6%leo !edo(do& %o( (u%l-olo $!o"i(e(te ) %ito$l#s"# i(te(s#"e(te

b#s'ilo* Posee( e( l# !egi'( su$!#(u%le#! g!(ulos de ,i"'ge(o 1ue%o(tie(e( $!e%u!so!es de e(,i"#s digestiv#s* Los #%i(os est(!ode#dos $o! ib!#s !eti%ul#!es& %#$il#!es s#(gu/(eos ) %-lul#s$e!iv#s%ul#!es*

El siste"# du%t#l $!ese(t# u(# $#!ti%ul#!id#d e( el se(tido 1ue los%o(du%tos i(te!%#l#!es $e(et!#( e( lu, #%i(#!& o!"#(do l#s ll#"#d#s%-lul#s %e(t!o#%i(#!es& 1ue $!ese(t#( o!"# %6bi%# o #$l#(#d#& setie( $o%o ) $osee( es%#sos o!g#(elos %ito$l#s"ti%os*

L# $o!%i'( e3t!#%i(#! de los du%tos est o!"#d# $o! %-lul#s %6bi%#s# %il/(d!i%#s b#4#s ) se %o(ti(6# e( los %o(du%tos i(te!lobulill#!es 1uei(#l"e(te dese"bo%#!( #l %o(du%to $#(%!eti%o $!i(%i$#l 1uedese"bo%# e( #"$oll# 2e$#to$#(%!eti%#*

El $(%!e#s e(do%!i(o est o!"#do $o! # los islotes de L#(ge!2#(s1ue est( dise"i(#dos e(t!e los #%i(os del $(%!e#s e3o%!i(o* No!e$!ese(t#( "s del =>K del volu"e( $#(%!eti%o*


13/20

+o!!es$o(de( # #g!eg#dos de %-lul#s e$iteli#les #t!#ves#d#s $o!u(# !i%# !ed de %#$il#!es e(est!#dos* Los islotes est( deli"it#dos$o! u(# !ed de ib!#s !eti%ul#!es* Los ti$os %elul#!es ) u(%io(es del$(%!e#s e(do%!i(o ests es$e%ii%#dos e( l# t#bl# =*

L# !egul#%i'( de l# u(%i'( $#(%!eti%# es de ti$o -(te!oe(do%!i(# )(e!vios#*

Tabla 1% Tipos celulares de los islotes de a!ger'a!s%

C!lula +bicacin Hormona Funcin

A Pe!i-!i%#s Glu%#g'( Au"e(t#gli%e"i#

B +e(t!#les I(suli(# Dis"i(u)egli%e"i#

D Dis$e!s#s So"#tost#ti(# .0 +-lul#s A) BDis"i(u)e"otilid#d delt!#%todigestivo )

ves/%ul#PP .50 Dis$e!s#s Poli$-$tido

P#(%!eti%o.0 Se%!e%i'(e3o%!i(# delP(%!e#s

G Dis$e!s#s G#st!i(# P!odu%%i'(H+l


14/20

Secrecio!es org!icas del p!creas:

S/(tesis de $!ote/(#s*L# u(id#d u(%io(#l del $(%!e#s e3o%!i(o es el #%i(o& el %u#l est#%o"$uesto $o! %-lul#s de o!"# $i!#"id#l* L#s %-lul#s #%i(#!estie(e( die!e(%i#s est!u%tu!#les ) u(%io(#les e( el !e# del $e3%o( !el#%i'( #l !e# b#s#l*

Est#s %-lul#s tie(e( u( "u) bie( des#!!oll#do #$#!#to de Golgi ) el8et/%ulo E(do$ls"i%o& 1ue so( ese(%i#les $#!# l# s/(tesis )#l"#%e(#"ie(to de l#s $!ote/(#s* * Los g!(ulos de %i"'ge(o see(%ue(t!#( e( l# !egi'( #$i%#l ) so( ,o(#s de #l"#%e(#"ie(to* El(6%leo de l# %-lul# est# lo%#li,#do e( l# b#se*

L# u(%i'( $!i"#!i# de l#s %-lul#s #%i(#!es $#(%!eti%#s e( $!odu%i!g!#(des %#(tid#des de $!ote/(#s e(,i"ti%#s 1ue so( t!#sl#d#d#s #lduode(o # t!#v-s de los %o(du%tos $#(%!eti%os*

L#s e(,i"#s $#(%!eti%#s luego de se! si(teti,#d#s& se #l"#%e(#(%o"o G8ANULOS DE +IMOGENO& los %u#les luego vie!te( su%o(te(ido #l es$#%io lu"i(#l del #%i(o # t!#v-s de u( "e%#(is"o dee3o%itosis*


15/20

L# %-lul# #%i(#! es esti"ul#d# $o! l# #%etil %oli(# &l#%ole%isto1ui(i(#& l# bo"besi(# ) l# subst#(%i# P # $o! i(te!"edio de!e%e$to!es de "e"b!#(# "edi#dos $o! el IP9 &) l# se%!eti(# ) elVIP # t!#v-s de l# #de(il %i%l#s#*

El $(%!e#s e3o%!i(o se%!et# u(# v#!ied#d de $!ote/(#s& 1ue so(ese(%i#les $#!# l# digesti'( ) #bso!%i'( de los (ut!ie(tes*


16/20

El K de l#s e(,i"#s $#(%!eti%#s so( e(,i"#s $!oteol/ti%#s*

L#s e(,i"#s so( si(teti,#d#s $o! el #%i(o e( o!"# i(#%tiv#&e"$#%#d#s e( g!(ulos ) #%o"$##d#s e( el $o! u( i(2ibido! delt!i$si(oge(o* L#s e(,i"#s vi#4#( $o! los %o(du%tos $#(%!eti%os #lduode(o e( est# o!"# i(#%tiv# ) #l lleg#! #l duode(o u(#e(te!o1ui(#s# del bo!de de %e$illo del duode(o& %o(vie!te el

t!i$si(oge(o 1ue es l# o!"# i(#%tiv# # t!i$si(# 1ue es l# o!"##%tiv#& l# %u#l # su ve, #%tiv# el !esto de e(,i"#s $#(%!eti%#s*

L/1uidos ) ele%t!olitos del $(%!e#s*

L# se%!e%i'( b#s#l del $(%!e#s es de *>*9 %%7"i(uto& $e!o%u#(do 2#) esti"ul#%i'( sob!e el $(%!e#s este volu"e( #s%ie(de# ; %% 7"i(utos* L# se%!e%i'( $#(%!eti%# di#!i# es de >*C lit!os#$!o3i"#d#"e(te* El l/1uido se%!et#do $o! el $(%!e#s es l#%o"bi(#%i'( de l# se%!e%i'( del #%i(o %o"o de los %o(du%tos

$#(%!eti%os* L# u(%i'( de los l/1uidos $!odu%idos $o! los #%i(os$#(%!eti%os es l# de se!vi! %o"o "edio de t!#(s$o!te # l#s e(,i"#s$!odu%id#s*

H#) u(# die!e(%i# e( l# se%!e%i'( i'(i%# de los #%i(os %o(!es$e%to # los %o(du%tos $#(%!eti%os& se se%!et# "#s bi%#!bo(#to e(


17/20

el %o(du%to $#(%!eti%o ) "e(os %lo!o 1ue el #%i(o& ) e( esteulti"o 2#) "#s se%!e%i'( de %lo!o ) "e(os de bi%#!bo(#to*

El bi%#!bo(#to se%!et#do $o! el $(%!e#s $!ovie(e del +> ) H>1ue diu(de( de l# sub"u%os# # l# %-lul# del %o(du%to$#(%!eti%o& e( est# %-lul# # t!#v-s de l# #(2id!#s# %#!b'(i%# seo!"# %ido %#!b'(i%o 1ue luego d# o!ige( #l bi%#!bo(#to*

P#!# l# se%!e%i'( de bi%#!bo(#to se !e1uie!e de %lo!o& el %u#l se!e%i%l# $o! #%%i'( de u( !egul#do! de "e"b!#(# +5T8* El "#)o!#ge(te esti"ul#do! del bi%#!bo(#to ) #gu# $o! el $(%!e#s es l#SE+8ETINA*

Age(tes %o"o l# SOMATOSTATINA $!odu%e( i(2ibi%i'( de l#se%!e%i'( $#(%!eti%#& lo "is"o 1ue l#s $!ost#gl#(di(#s de l#se!ie E*

Al #u"e(t#! l# !#t# de se%!e%i'( de 4ugo $#(%!eti%o& se#u"e(t# l# $!odu%%i'( de bi%#!bo(#to ) dis"i(u)e l# se%!e%i'(de %lo!o& "#(te(i-(dose est#ble l# de N#*


18/20

8EGULA+ION DE LA SE+8E+ION PAN+8EATI+A

El $H del 1ui"o gst!i%o debe se! (eut!#li,#do $o! l# se%!e%i'($#(%!eti%# $o! v#!i#s !#,o(es& l# $!i"e!# $o! 1ue el %ido ) l#$e$si(# gst!i%# $!odu%e( lesio(es sob!e l# "u%os# duode(#l& u($H (eut!o es i"$o!t#(te $#!# l# #%tiv#%i'( de l#s e(,i"#s$#(%!eti%#s ) l# solubilid#d de los %idos bili#!es*

L# !egul#%i'( de l# se%!e%i'( $#(%!eti%# l# $ode"os dividi! e(:%eli%#& gst!i%# e i(testi(#l*

5ASE +E5ALI+A: L# esti"ul#%i'( de est# #se $!ovie(e de l#i(teg!#%i'( de est/"ulos %o"o el "#sti%#!& ole! o s#bo!e#!* Es!es$o(s#ble de %#si el CK de l# se%!e%i'( $#(%!eti%#* Losest/"ulos vi#4#( $o! v/# v#g#l # los #%i(os ) %o(du%tos$#(%!eti%os*

5ASE GAST8I+A: Est# #se es i(i%i#d# $o! l# diste(si'( del esto"#go%u#(do lleg# el bolo #li"e(ti%io ) $o! l# $!ese(%i# de #"i(o%idos )$-$tidos e( l# lu, del esto"#go* Este esti"ulo #%tiv# !ele4osv#gov#g#les ) #u"e(t# l# se%!e%i'( de l# GAST8INA& e( est# #se l#"#)o! se%!e%i'( es de e(,i"#s $#(%!eti%#s ) (o de #gu# )

bi%#!bo(#to* Su #$o!te e( l# se%!e%i'( $#(%!eti%# es del "e(osdel =K de l# se%!e%i'( tot#l*

L# v#goto"/# su$!i"e est# #se*

5ASE INTESTINAL* Es l# #se "s i"$o!t#(te de l# se%!e%i'($#(%!eti%#* Se i(i%i# $o! l# e(t!#d# de 1ui"o gst!i%o e( l# lu, delduode(o ) e( el %u#l i(te!vie(e( el NE8VIO VAGO& LA SE+8ETINAY LA +OLE+ISTOUININA .++J0*

L# SE+8ETINA ) l# ++J so( se%!et#d#s $o! %-lul#s e(do%!i(#s 1uese e(%ue(t!#( el duode(o*

L# ++J es esti"ul#d# $o! l# $!ese(%i# de A+IDOS G8ASOS .%o("#)o! i(te(sid#d los %idos g!#sos s#tu!#dos ) de "#s de %#!bo(os0* Los t!igli%-!ido (eut!os (o esti"ul#( l# se%!e%i'($#(%!eti%# # "e(os 1ue se $!odu,%# li$olisis de ellos* T#"bi-( se


19/20

$ie(s# 1ue 2#) !e%e$to!es es$e%i#les $#!# #"i(o%idos )oligo$e$tidos 1ue $!odu%e( esti"ul#%i'( de est# #se*

L# #%%i'( de l# ++J es u(d#"e(t#l"e(te PA8A+8INA ) (oe(do%!i(# %o"o se $e(s#b# #(te!io!"e(te& 2#%ie(do su ee%to # (ivel

de l#s ib!#s vg#les #d)#%e(tes* L# #%%i'( 2o!"o(#l de l# ++J (oes t#( i"$o!t#(te*

L# $!ese(%i# de u( $H b#4o e( el 1ui"o de o!ige( gst!i%o esti"ul#l# $!odu%%i'( de SE+8ETINA& ) $#!e%e 1ue t#"bi-( se 2#%e $o! v/#PA8A+8INA& #de"s de l# #%%i'( ENDO+8INA* L# se%!e%i'( debi%#!bo(#to es $!o$o!%io(#l # l# %#!g# de %ido e( el duode(o*

Bibliografa

e!eser6 Fi!!: 78istologa96 3 Ed6 Edit% /a!america!a6 (rge!ti!a62;;;%

Faucett6


20/20

P8EGUNTAS DE APLI+A+IN PA8A NUT8I+ION

= Se#le l# %o(stitu%i'( ge(e!#l del siste"# digestivo ) l#s u(%io(es$!i(%i$#les de %#d# u(o de los %o"$o(e(tes*> Des%!ib# l# %o(stitu%i'( 2istol'gi%# ge(e!#l del t!#%to digestivo&

se#l#(do los ele"e(tos 2istol'gi%os $osibles de e(%o(t!#! e( l#sdisti(t#s %#$#s*

9 Des%!ib# e( o!"# %o"$#!#tiv# l#s v#!i#%io(es !egio(#les2istol'gi%#s de l#s v/#s de t!#(s$o!te del t!#%to digestivo* .5#!i(ge&es'#go ) %o(du%to #(#l0*

; Des%!ib# l#s v#!i#%io(es 2istol'gi%#s e3iste(tes e( l# "u%os# )sub"u%os# de l# u(i'( es'#gogst!i%# ) "u%os# gst!i%#&se#l#(do su i"$o!t#(%i# u(%io(#l*

C Des%!ib# %o"$#!#tiv#"e(te l#s v#!i#%io(es 2istol'gi%#s e3iste(tese( l#s "u%os#s ) sub"u%os#s e(t!e el i(testi(o delg#do ) eli(testi(o g!ueso*

Des%!ib# l# o!g#(i,#%i'( "o!ou(%io(#l del 2/g#do& es$e%ii%#(dolos %o"$o(e(tes 1ue %o(stitu)e( u( lobulillo 2e$ti%o %lsi%o ) l#t!/#d# $o!t#*

Des%!ib# el !e%o!!ido de l# %i!%ul#%i'( $o!t#2e$ti%#& es$e%ii%#(dolos #s$e%tos "o!ou(%io(#les de los si(usoides 2e$ti%os ) del eles$#%io de Disse*

+o"$#!e los %o"$o(e(tes e3o%!i(o ) e(do%!i(o del $(%!e#s&

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DIGESTIVO NUTRICION

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