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Applied Surgical Physiology Vivas - part 9

Làm thế nào để so sánh với phần còn lại của ruột? Khối lượng hàng ngày các chất tiết đường ruột (ml mỗi ngày) có thể được tóm tắt: Nước bọt: 1.500 dạ dày: 2.000 mật: 500 tuyến tụy: 1500 ruột nhỏ: 1.500 8. Bao nhiêu nước không ruột non hấp thụ mỗi ngày? Giả sử rằng lượng đường uống là 2.000 ml mỗi ngày, ruột non hấp thụ khoảng 8.500 ml nước mỗi ngày. | APPLIED SURGICAL PHYSIOLOGY VIVAS S SMALL INTESTINE 7. How does this compare to the rest of the gut The daily volume of gut secretions in mL per day may be summarised Saliva 1 500 Gastric 2 000 Bile 500 Pancreatic 1 500 Small intestine 1 500 8. How much water does the small bowel absorb per day Assuming that oral intake is 2 000 mL daily the small bowel absorbs about 8 500 mL of water daily. The colon about 400 mL daily. This leaves around 100 mL excreted in the faeces per day. 9. What are the effects of terminal ilectomy Loss of bile salt re-uptake this alters the colonic flora and changes the consistency of stools. There is also increased bile salt manufacture by the liver in response to reduced uptake increasing the incidence of gallstones Decreased Vitamin B12 uptake producing macrocytic anaemia Reduced water absorption this is one of the important functions of the terminal ileum. This can lead to loose and frequent stools Reduced uptake of g-globulin the terminal ileum is full of lymphatic tissue and there is some re-uptake of immunoglobulin. Loss of this tissue may affect local gut immune surveillance 138 APPLIED SURGICAL PHYSIOLOGY VIVAS SODIUM BALANCE 1. What is the major distribution of sodium in the body Sodium is the major extracellular cation of the body 50 is found in the ECF 45 found in the bone 5 in the intracellular compartment Note that 70 of this ion is found in a readily-exchangeable form 2. What is the major physiological role for this ion This is the ion that generates the greatest osmotic force. For this reason it is vital for the internal water balance between the intracellular and extracellular spaces. The osmolality that it generates also influences the control of the ECF volume that is under renal control. This osmotic role occurs because this ion is so abundant in the body. 3. What is the daily sodium requirement 1 mmol kg 1 per day. 4. Give some causes for hyponatraemia. Water excess Increased intake polydipsia iatrogenic e.g. TURP .