1,VISCERAL SYSTEM Osteopathic approch 内脏系统整骨方法,TakeCare Osteopathic Academy Milano - Italy,2,Human digestive system Anatomy notes 消化系统解剖,TakeCare Osteopathic Academy Milano - Italy,3,Phases Include包括以下几个过程 Ingestion摄入 Movement运送 Mechanical and Chemical Digestion 机械及化学消化 4. Absorption吸收 5. Elimination排泄,DIGESTION消化,4,Mechanical (physical)机械（物理） Chew咀嚼 Tear撕碎 Grind磨碎 Mash捣碎 Mix混合 Chemical化学 Enzymatic reactions to improve digestion of酶促反应来帮助以下的消化 Carbohydrates碳水化合物 Proteins蛋白质 Lipids脂类,5,Gastrointestinal (Gl) tract 胃小肠收缩Structures结构 Mouth口 Pharynx咽 Esophagus食管 Stomach胃 Duodenum十二指肠 Small intestine小肠 Large Intestine大肠 Rectum直肠,6,Approximately 10” long大概10英寸长（约25厘米） Functions include:功能包括： Secrete mucus 分泌粘液 Moves food from the throat to the stomach using muscle movement: peristalsis应用蠕动这种肌肉活动方式将食物从喉部运至胃部 If acid from the stomach gets in here thats heartburn.如果胃酸从这里分泌则会导致胃灼热,ESOPHAGUS食管,7,J-shaped muscular bag that stores the food you eat, breaks it down into tiny pieces. 胃为呈J型的肌肉囊，储存吃下的食物，并分解成小碎块 Mixes food with digestive juices that contain enzymes to break down proteins and lipids. 通过胃液混合食物，包括了分解蛋白质和脂类的酶 Acid in the stomach kills bacteria.胃酸起到杀菌作用 Food found in the stomach is called chyme.胃中的食物称为食糜,STOMACH胃,8,SMALL INTESTINE小肠,Small intestine is about 7 meters long 小肠约7米 Lining of intestine walls has finger-like projections called villi, to increase surface area.小肠壁的内面有指状突起，叫做小肠绒毛，增加小肠内表面积 The villi are covered in microvilli which further increases surface area for absorption.小肠绒毛的表面又覆有微绒毛，进一步增加吸收作用的内表面积,9,10,Nutrients from the food pass into the bloodstream through the small intestine walls.食物的养分通过小肠壁进入血液Absorbs:吸收 80% ingested water 80%摄入的水分 Vitamins 维生素 Minerals 矿物质 Carbohydrates 碳水化合物 Proteins 蛋白质 Lipids 脂类Secretes digestive enzymes分泌消化酶类,11,About 5 feet long约5英寸长（30厘米） Accepts what small intestines dont absorb 收入小肠未能吸收的物质 Rectum (short term storage which holds feces before it is expelled). 直肠（在粪便排出前短期存储）,LARGE INTESTINE大肠,12,Functions功能 Bacterial digestion细菌消化（作用） Ferment carbohydrates 碳水化合物酶类 Protein breakdown 蛋白质降解,LARGE INTESTINE大肠,13,Largest gland in the body (1.5 Kg) 最大的腺体，重约1.5千克 Under the diaphragm, within the rib cage in the upper right quadrant of the abdomen 膈肌下方，腹部的上右四分之一区域,LIVER肝,14,LIVER肝,4 Lobes4个叶 Major: left and right 最大：左和右 Minor: caudate and quadrate 最小:尾状和方形叶 Ducts导管 Common hepatic肝总管 Cystic胆囊管 From gallbladder由胆囊发出 Common bile Choledochus胆总管 Joins pancreatic duct at hepatopancreatic ampulla在肝胰壶处加入胰管,15,LIVER肝,16,LIVER肝,肝的功能,解毒,血液循环和过滤,血糖调节,胆汁运输,合成及储存氨基酸、蛋白质、维生素及脂肪,17,ORGANS MOVEMENT器官的运动 Organs can make different types of movement. 器官可以进行多种类型的运动 They are under the pushing of diaphragm (respiratory rythm); 在膈肌的推动下（呼吸节奏） they are under cranial-sacral breathe; 在颅-骶的最初呼吸推动下 they have got their personal inner cellular motion. 有着它们自己内在的细胞运动 We will approch, assest and fix only the first level, using very soft osteopathic techniques. 我们只在第一种运动水平探索，帮助和调整，应用轻柔的整骨技术,18,STOMACH:胃It moves around the fixed points, the cardia and pylorus and celiac trunk in particular. During inspiration, your stomach drops and then swing to the right, both in the frontal and horizontal plane. It crumples in on itself, making a functional movement to reshuffle and gastric emptying.在固定点附近运动，贲门、幽门，特别是胃体。在吸气时，胃下垂并且在额状面和水平面都移向右侧。自身皱缩，来完成自身胃排空的功能活动,We can find different dysfunctions: 有多种类的功能失常 Ligamentous dysfunction 韧带的功能失常 Sphincter dysfunction (pylorus or cardia) 括约肌的功能失常（幽门或贲门） Global positional dysfunction (rotation) 整体位置功能失常（旋转）,19,GLOBAL DENSITY TEST整体密度测试One hand assests the tissue density (5 rib space) 一只手测试组织密度（5度的肋间隔） We can use this test to understand how tissues are organized (hard sensation, bad dysfunction) 利用这个测试可以了解生理组织是如何工作的（感觉越硬，功能失常越严重）TEST OF CLOCKWISE AND ANTICLOCKWISE ROTATION 顺时针及逆时针测试 We can let the stomach rotate or follow the breathing times. 可以让胃旋转或者跟随呼吸的时程 During inspiration, stomach makes a clockwise rotation. 在吸气时，胃做顺时针旋转How to fix?如何调整？ Using the right respiratory time.应用合适的呼吸时机 Gain movement in one time, lock movement in the other (the dysfunctional one) 某一时期获得运动，而在另一时期固定（功能失常时期）,20,ESOPHAGUS:食管Its a long muscolar tube, it starts from the hyoid, on the midline. Then moves slightly to the left, until cross the left dome of the diaphragm. Its divided in 3 different parts: cervical, thoracic and abdominal. As for all pipe-shape organs, we assest it by elongation.是一条很长的肌肉管道，起自于舌骨，位于身体中线。轻微向左，直到越过膈肌的左圆顶。分为3段，颈段、胸段和腹段。和所有的管状的结构一样，我们采取拉长的方式进行测试。,21,Cervical part: from hyoid to C6 颈段：从舌骨到C6 One hand contact hyoid, other hand the cricoid cartilage: Traction the esophagus along the longitudinal axis with the caudal hand while the hand cranial blocks the hyoid. 一只手触摸舌骨，另一只手置于环状软骨：沿着身体纵轴用近端手固定舌骨，远端手牵拉食管 Fix: Tensioning tissue and recoil with the caudal hand 调整：牵张组织，然后利用远端手放开产生回弹Thoracic part: from C6-7 to T9 胸段：从C6-7到T9 Cranial hand on the sternum. caudal hand on the rib cartilage of K6. depress and pull with caudal hand. 近端手置于胸骨，远端手在第6肋软骨 Fix: Tensioning tissue and recoil with both hands along the longitudinal axis. 调整：牵张组织，然后利用两只手沿着身体纵轴回弹,