© 2003 Science Press Internet Services FISIOLOGIA DIGESTIVA (BCM II) Clase 10: Fisiología del colon Dr. Michel Baró A.

© 2003 Science Press Internet Services The anatomy of the colon is shown

© 2003 Science Press Internet Services Circular and longitudinal muscle layers in colon

© 2003 Science Press Internet Services The layers of the colonic wall are shown

© 2003 Science Press Internet Services Normal colonic mucosa in biopsy specimen

© 2003 Science Press Internet Services Maturation process of colonic epithelial cells (3 a 5 días)

© 2003 Science Press Internet Services A human rectal columnar epithelial cell

© 2003 Science Press Internet Services Arterial blood supply to the colon is shown

© 2003 Science Press Internet Services The venous system that drains the colon is shown

© 2003 Science Press Internet Services The extrinsic innervation of the colon

© 2003 Science Press Internet Services Intrinsic innervation of the colonic wall

© 2003 Science Press Internet Services Ganglia in submucosal and myenteric plexuses

© 2003 Science Press Internet Services Lymph nodal drainage of the colon and anus (a)

© 2003 Science Press Internet Services Lymph nodal drainage of the colon and anus (b)

© 2003 Science Press Internet Services Scintigraphic pattern of colonic transit

© 2003 Science Press Internet Services Time a substance spends in each region of colon

© 2003 Science Press Internet Services Distinct motor patterns as measured by manometry Contracciones de corta duración: estacionarias, de mezcla Contracciones de larga duración: estacionarias o migratorias breves Contracciones de gran amplitud: movimientos de masa

© 2003 Science Press Internet Services Patterns of migration of contractions

© 2003 Science Press Internet Services Presence and intensity of short-duration contractions

© 2003 Science Press Internet Services Colonic electrical control or slow-wave activity Borde submucoso Borde mientérico

© 2003 Science Press Internet Services Electrical activity from the human colon SSB: Short spike burst. LSB: Long spike burst. MLSB: Migrating long spike burst

© 2003 Science Press Internet Services Patterns of motor and myoelectric activity (perros)

© 2003 Science Press Internet Services Development of high-amplitude propagating contractions

© 2003 Science Press Internet Services Colonic contents and motor activity in colon

© 2003 Science Press Internet Services Motility of colon over 24-hour period Colonic motility index

© 2003 Science Press Internet Services Gastrocolonic motor response to meal ingestion

© 2003 Science Press Internet Services Fecal bolus in the colon has been postulated

© 2003 Science Press Internet Services Mediation of both limbs of colonic peristaltic reflex

© 2003 Science Press Internet Services Motor activity of colon modulated by vagal activity (ferret) Actividad fásica espontánea del colon proximal

© 2003 Science Press Internet Services Colonic motor function can be significantly altered Am J Med 1951

© 2003 Science Press Internet Services Summary of small intestinal and colonic fluid balance

© 2003 Science Press Internet Services Major electrolyte transport mechanisms

© 2003 Science Press Internet Services Proposed pathways of active sodium transport in colon (a)

© 2003 Science Press Internet Services Proposed pathways of active sodium transport in colon (b)

© 2003 Science Press Internet Services The colon exhibits a net secretion of potassium

© 2003 Science Press Internet Services Sodium absorption and potassium secretion

© 2003 Science Press Internet Services The colonic lumen possesses a luxuriant flora

© 2003 Science Press Internet Services Fecal flora organisms

© 2003 Science Press Internet Services The anatomy of the rectum and anus

© 2003 Science Press Internet Services The muscular arrangement of the levator ani muscles

© 2003 Science Press Internet Services The histology of the rectal and anal mucosae

© 2003 Science Press Internet Services The arterial blood supply specific for the anus

© 2003 Science Press Internet Services Factors necessary for maintenance of fecal continence

© 2003 Science Press Internet Services The pressure profile of the anal canal

© 2003 Science Press Internet Services Triple loop mechanism of external anal sphincter

© 2003 Science Press Internet Services Epithelial nerve endings provide a specialized system

© 2003 Science Press Internet Services Fecal continence aided by highly compliant rectum (a)

© 2003 Science Press Internet Services Fecal continence aided by highly compliant rectum (b)

© 2003 Science Press Internet Services The reflex responsiveness of the anal region Reflejo inhibitorio rectoanal

© 2003 Science Press Internet Services Defecation involves a coordinated interaction

© 2003 Science Press Internet Services Summary of muscular actions required for defecation

© 2003 Science Press Internet Services Manometric and electromyographic responses to defecation

© 2003 Science Press Internet Services Alteraciones motoras del colon

© 2003 Science Press Internet Services Sagittal view of anorectal anatomy

© 2003 Science Press Internet Services Incontinencia fecal

© 2003 Science Press Internet Services Anorectal continence mechanisms

© 2003 Science Press Internet Services Diagnostic studies for fecal incontinence

© 2003 Science Press Internet Services Diagnostic studies for fecal incontinence

© 2003 Science Press Internet Services Anorectal function in neurogenic disorders

© 2003 Science Press Internet Services Fecal incontinence associated with spinal cord injury

© 2003 Science Press Internet Services Anorectal findings in spinal cord injuries

© 2003 Science Press Internet Services Fecal incontinence associated with pudendal neuropathy (A)

© 2003 Science Press Internet Services Fecal incontinence associated with pudendal neuropathy (B)

© 2003 Science Press Internet Services Fecal incontinence associated with pudendal neuropathy (C)

© 2003 Science Press Internet Services Fecal incontinence associated with pudendal neuropathy (D)

© 2003 Science Press Internet Services External sphincter electromyographic patterns (A)

© 2003 Science Press Internet Services External sphincter electromyographic patterns (B)

© 2003 Science Press Internet Services External sphincter electromyographic patterns (C)

© 2003 Science Press Internet Services Pudendal nerve latencies

© 2003 Science Press Internet Services Anal endosonography

© 2003 Science Press Internet Services Normal anatomy as viewed by anal endosonography (A)

© 2003 Science Press Internet Services Normal anatomy as viewed by anal endosonography (B) Esfinterotomía (interno)

© 2003 Science Press Internet Services Normal anatomy as viewed by anal endosonography (C) Desgarro obstétrico

© 2003 Science Press Internet Services Anorectal manometry in fecal incontinence (A)

© 2003 Science Press Internet Services Anorectal manometry in fecal incontinence (B) normal

© 2003 Science Press Internet Services Biofeedback (A)

© 2003 Science Press Internet Services Biofeedback (B)

© 2003 Science Press Internet Services Constipación

© 2003 Science Press Internet Services Colonic scintigraphy (A)

© 2003 Science Press Internet Services Colonic scintigraphy (B)

© 2003 Science Press Internet Services Colonic transit of markers

© 2003 Science Press Internet Services Colonic transit patters in chronic constipation (A)

© 2003 Science Press Internet Services Colonic transit patters in chronic constipation (B)

© 2003 Science Press Internet Services Colonic motor activity can be studied (A)

© 2003 Science Press Internet Services Colonic motor activity can be studied (B)

© 2003 Science Press Internet Services Propagating contractions in healthy control subjects vs constipated

© 2003 Science Press Internet Services Colonic motility within 30 mins after breakfast

© 2003 Science Press Internet Services Distal bowel in Hirschsprung's disease (A)

© 2003 Science Press Internet Services Distal bowel in Hirschsprung's disease (B)

© 2003 Science Press Internet Services Balloon manometry

© 2003 Science Press Internet Services Idiopathic megacolon

© 2003 Science Press Internet Services Rectal compliance in idiopathic megarectum

© 2003 Science Press Internet Services Using the Schuster-type balloon manometer y puborectal

© 2003 Science Press Internet Services Pressure changes and electromyographic recordings

© 2003 Science Press Internet Services Rectocele (A)

© 2003 Science Press Internet Services Rectocele (B)

© 2003 Science Press Internet Services Subtotal colectomy with ileorectal anastomosis

© 2003 Science Press Internet Services Diagnostic or Rome criteria

© 2003 Science Press Internet Services Barium enema in irritable bowel syndrome patient

© 2003 Science Press Internet Services Emotions and colon motility

© 2003 Science Press Internet Services Emotions and colonic motility (A) Delay stressor motor EMG Pneumograma

© 2003 Science Press Internet Services Emotions and colonic motility (B)

© 2003 Science Press Internet Services Emotions and colonic motility (C)

© 2003 Science Press Internet Services Visceral sensations

© 2003 Science Press Internet Services A 73-year-old woman with constipation

© 2003 Science Press Internet Services Fin