ANATOMI SISTEM SARAF DAN INDERA BAMBANG SOEMANTRI
Anatomical Organization of the Nervous system • Central Nervous system : – Brain – Spinal cord
• Peripheral nervous system – Ganglion – Cranial nerves – Spinal nerves
Nervous system includes all neural tissue in body • Central Nervous System – Brain and spinal cord
• Peripheral Nervous System – All neural tissue outside CNS
Cells in Nervous Tissue • Neurons
• Neuroglia
Neuroglia (Neuroglial Cells)
Central Neuroglia Astrocyte protoplasmic astrocyte fibrous astrocyte
Oligodendrocyte perineuronal satellite cell interfascicular cell
Microglia Ependymal Cell
Peripheral Neuroglia Schwann Cell in peripheral nerve and ganglion Capsular (Satellite) Cell in ganglion
Neurons •what is the main defining characteristic of neurons? •have the property of electrical excitability - ability to produce action potentials or impulses in response to stimuli
Representative Neuron
1. cell body or soma -single nucleus with prominent nucleolus -Nissl bodies -rough ER & free ribosomes for protein synthesis -proteins then replace neuronal cellular components for growth and repair of damaged axons in the PNS
-neurofilaments or neurofibrils give cell shape and support bundles of intermediate filaments -microtubules move material inside cell -lipofuscin pigment clumps (harmless aging) - yellowish brown
Neurons 2. Cell processes = dendrites (little trees) - the receiving or input portion of the neuron -short, tapering and highly branched -surfaces specialized for contact with other neurons -cytoplasm contains Nissl bodies & mitochondria
3. Cell processes = axons •
• •
• • •
• • • • •
Conduct impulses away from cell bodypropagates nerve impulses to another neuron Long, thin cylindrical process of cell contains mitochondria, microtubules & neurofibrils - NO ER/NO protein synth. joins the soma at a cone-shaped elevation = axon hillock first part of the axon = initial segment most impulses arise at the junction of the axon hillock and initial segment = trigger zone cytoplasm = axoplasm plasma membrane = axolemma Side branches = collaterals arise from the axon axon and collaterals end in fine processes called axon terminals Swollen tips called synaptic end bulbs contain vesicles filled with neurotransmitters
Functional Classification of Neurons • Sensory (afferent) neurons – transport sensory information from skin, muscles, joints, sense organs & viscera to CNS
• Motor (efferent) neurons – send motor nerve impulses to muscles & glands
• Interneurons (association) neurons – connect sensory to motor neurons – 90% of neurons in the body
Sensory Neurons • Afferent division of PNS • Deliver sensory information from sensory receptors to CNS – free nerve endings: bare dendrites associated with pain, itching, tickling, heat and some touch sensations – Exteroceptors: located near or at body surface, provide information about external environment – Proprioceptors: located in inner ear, joints, tendons and muscles, provide information about body position, muscle length and tension, position of joints – Interoceptors: located in blood vessels, visceral organs and NS -provide information about internal environment -most impulses are not perceived – those that are, are interpreted as pain or pressure
Motor Neurons • Efferent pathways • Stimulate peripheral structures – Somatic motor neurons • Innervate skeletal muscle
– Visceral motor neurons • Innervate all other peripheral effectors • Preganglionic and postganglionic neurons
-both divisions -first neuron h (Pre-ganglioni -second neuro ganglion (Post
-parasy -crani -prega of the -short
Motor Units • Each skeletal fiber has only ONE NMJ • MU = Somatic neuron + all the skeletal muscle fibers it innervates • Number and size indicate precision of muscle control • Muscle twitch – Single momentary contraction – Response to a single stimulus
• All-or-none theory – Either contracts completely or not at all • Motor units in a whole muscle fire asynchronously some fibers are active others are relaxed delays muscle fatigue so contraction can be sustained
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Muscle fibers of different motor units are intermingled so that net distribution of force applied to the tendon remains constant even when individual muscle groups cycle between contraction and relaxation.
Structural Classification of Neurons
• Based on number of processes found on cell body – multipolar = several dendrites & one axon • most common cell type in the brain and SC
– bipolar neurons = one main dendrite & one axon • found in retina, inner ear & olfactory
– unipolar neurons = one process only, sensory only (touch, stretch) • develops from a bipolar neuron in the embryo - axon and dendrite fuse and then branch into 2 branches near the soma - both have the structure of axons (propagate APs) - the axon that projects toward the periphery = dendrites
Structural Classification of Neurons • Named for histologist that first described them or their appearance •Purkinje = cerebellum •Renshaw = spinal cord
• others are named for shapes e.g. pyramidal cells
Classification of neurons by cell size • 1. golgi type I : – Neurons have a long axon and large soma
• 2. Golgy type II : – Neurons have short axon undergoes extensive terminal aeborization and small soma
Synaptic Communication
Synapses • Are the sites of impulse transmission between the presynaptic and post synaptic • Impuls transmission at synapse can occur: – Electrically – chemically
Electrical synapse • Uncommon in mammals • They are present in the brain stem, retina and cerebral cortex • Electrical synapses are usually represented by gap junction that permit free movement of ion from one cell to another • Impulse transmission is much faster across electrical synapse than across chemical synapse
Chemical synapse • Most common mode of communication between two nerve cells • Presynaptic membrane release one or more neurotransmitters into synaptic cleft • Neurotransmitter diffuses across the synaptic cleft to ion-channel receptor on the postsynaptic membrane • Binding of the neurotransmitter to the receptors initiates the opening ion channels, which permits the passage of certain ions, altering the permeability of the postsynaptic membrane and reversing its membrane potentials
Tipes of synapses • Axodendritic: – Between an axon and a dendrite
• Axosomatic: – Between an axon and a soma
• Axoaxonic: – Between two axon
• Dendrodendritic: – between two dendrites
Synaptic morphology • Presynaptic membrane: – Contains metochondria, a few elements of SER, and an abundance of synaptic vesicles.
• Synaptic cleft • Postsynaptic membrane: – Contains neorotransmitter receptors
Nerve ending – nerve terminal • Two structural type : – 1. Motor ending ( terminal of axon ) • Transmit impulses from the CNS to skeletal & smooth muscle & to glands ( secretory ending)
– 2. sensory ending = sensory receptor = terminal of dendrites : • Perceive various stimuli and transmit this input to the CNS
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• These sensory receptor are classified into three type depending on the source of the stimulus, and are components of the general or special somatic and visceral afferent pathway : – Exteroceptors – Proprioceptors – interoceptors
Exteroceptors • Location : near the body surface • Specialized to perceive stimuli from the external environment • These receptors sensitive to : – – – –
Temperature Touch Pressure and Pain
• Are component of the general somatic afferent
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• Special somatic afferent : – Specialized for light ( sense of vision) and sound (sense of hearing)
• Special visceral afferent modality : – Specialized for smell and taste
Proprioceptors • Are specialized receptor located in joint capsules, tendon and intrafusal fibers within muscle. • These general somatic afferent receptors transmit sensory input to the CNS, which translated into information that relates to an awareness of the body in space and movement
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• Vestibular (balance) mechanism, located within the inner ear, are specialized for receiving stimuli related to motion vectors within the head.
Interoceptors • Are specialized receptors that perceive sensory information from within organs of the body.
Mechanoreceptors • Mechanoreceptors respond to mechanical stimuli that may deform the receptor or the tissue surrounding the receptor. • Stimuli that trigger the mechanoreceptors are touch, stretch, vibration and pressure
Nonencapsulated mechanoreceptors • Are simple unmyelinated receptors present in the skin, connective tissues and surrounding hair follicle – Peritricial nerve ending, located in the epidermis of the skin, especially in the face and cornea of the eye – Merckel’s disks, specialized for perceiving discriminatory touch, located in non hairy skin and regions of the body more sensitive to touch.
Encapsulated mechanoreceptors • Encapsulated Mechanoreceptors exhibit characteristic structure and are present in specific location – 1. Meissner’ corpuscles : • Specialist for tactile • Location : dermal papillae of the non hair portin of the hand, eyelids, lip, tongue, nipples, skin of the foot and forearm. • Each corpuscle is formed by three or four nerve terminals and their associated Schwann cells, all which are encapsulated by connective tissue.
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– 2. Pacinian corpuscles • Location : in the dermis and hypodermis in the digits of the hand, breast, connective tissue of the joint, periosteum and the mesentery • Spezialied to perceive pressure, touch and fibration • Morphology : – ovoid & large receptor – Single unmyelinated fiber as a core and its Schwann cell – Surrounded by approximately 60 layers of modified fibroblast – Each layer separated by a small fluid-filled space
– 3. Ruffini’s corpuscle • Location : in the dermis of skin, nail beds, periodontal ligament and joint capsules • Composition : – branched nonmyelinated terminals interspersed with collagen fibers – Surrounded by four to five layers of modified fibroblast
– 4. Krause’s end bulb
• Morphology : – Spheris – Unmyelinated nerve ending
• Location : papilla dermis, joints, conjunctiva, peritoneum, genital regions, subendothelial c.t. of the oral and nasal cavities • Function : unknown, they were thought to be receptors sensitive to cold
Muscle spindles and Golgi tendon organs • Muscle spindles provide feedback concerning the changes and the rate alteration of the muscle length • Golgi tendon organs monitor the tension and the rate at which the tension is being produced during movement • Information from these two sensory structures is processed at the unconscious level within the spinal cord; the information also reaches the cerebellum & cerebral cortex, so that individual may sense muscle position.
ANATOMI SISTEM SARAF DAN INDERA B The Special Senses BAMBANG SOEMANTRI
The Five Special Senses: • Smell and taste: chemical senses (chemical transduction) • Sight: light sensation (light transduction) • Hearing: sound perception (mechanical transduction) • Equilibrium: static and dynamic balance (mechanical transduction)
The Chemical Senses: Taste and Smell • The receptors for taste (gustation) and smell (olfaction) are chemoreceptors (respond to chemicals in an aqueous solution) • Chemoreception involves chemically gated ion channels that bind to odorant or food molecules
Taste
3 Types of Lingual Papillae 1. Filiform papillae: – provide friction – do not contain taste buds
2. Fungiform papillae: – contain 5 taste buds each
3. Circumvallate papillae: – contain 100 taste buds each
Location of Taste Buds
• Located mostly on papillae of tongue • Three of the types of papillae: – fungiform – Circumvallate – Filiform
Taste Buds
• Each papilla contains numerous taste buds
• Each taste bud contains many gustatory cells • The microvilli of gustatory cells have chemoreceptors for tastes
The Five Basic Tastes • Sweet: sugars, alcohols, some amino acids, lead salts • Sour: H+ ions in acids • Salty: Na+ and other metal ions • Bitter: many substances including quinine, nicotine, caffeine, morphine, strychnine, aspirin • Umami: the amino acid glutamate (“beef” taste)
Gustatory pathway • Facial nerve (anterior 2/3 of tongue) & Glossopharyngeal nerve (posterior 1/3 of tongue)solitary nucleus of medulla (initiate PsNS reflexes to trigger saliva & gastric secretion)thalamusgustator y cortex of parietal lobes – Fibers also project to the hypothalamus & limbic system (enjoyment)
Influence of Other Sensations on Taste • Taste is 80% smell • Thermoreceptors, mechanoreceptors, nociceptors also influence tastes • Temperature and texture enhance or detract from taste
Smell
Both smell and taste use chemoreceptors.
Of all the senses, only smell and taste have fibers that run to both cortical areas And the limbic system.
Smell • Olfactory epithelium = primary sensory organ – Found on roof of nasal cavity – Olfactory receptors are one of the few neurons to renew thru adult life (replaced ~every 60 days) – Covered w/mucus to dissolve airborne odor molecules
Location of Olfactory (Odor) Receptors
Odor Receptors • Bipolar neurons • Collectively constitute cranial nerve I • Unusual in that they regenerate (on a ~60 day replacement cycle)
Olfactory receptors • Smell is difficult to research • At least 1000 ‘smell genes’ active only in the nose • Extremely sensitive • Nasal cavity also contains pain receptors (ammonia, chili peppers, menthol, etc)
Olfactory receptors are bipolar neurons. •Are replaced throughout lifetime, but lost at the rate of about 1 % per year. •The cilia, or olfactory hairs are the sensitive portions
•Chemical must be dissolved in watery mucus to stimulate the receptor. •Combinations of primary scents allow us to recognize thousands of different odors.
Olfactory pathway • Olfactory nerve (axons of receptor cells) synapse in olfactory bulb (on cribriform plate)olfactory tract (w/in bulb) – 1. Thalamusolfactory cortex (frontal lobe) where smells consciously interpreted and identified – 2. (subcortical) hypothalamus/amygdala/limbic system to elicit emotional responses to odors • Danger (fight or flight), appetizing (GI stimulation), reflexes such as sneezing/choking/breathing (ammonia)
Odors • Very complicated • Humans can distinguish thousands
• More than a thousand different odorantbinding receptor molecules have been identified • Different combinations of specific molecule-receptor interactions produce different odor perceptions
Transduction of Smell • Binding of an odorant molecule to a specific receptor activates a G-protein and then a second messenger (cAMP)
• cAMP causes gated Na+ and Ca2+ channels to open, leading to depolarization
•
Anosmia: absence of the sense of smell – Trauma – Colds or allergies producing excessive mucus – Polyps causing blockage – 1/3 are from zinc deficiency
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Vision
Overview of the Eye • Eye acts much like a camera – Lens of eye adjusts to bring object into focus – Pupil of eye constricts to allow less light to enter in bright setting or dilates to allow more light to enter in darker setting – Through bending of light rays, image reaches retina • Sensitive nerve cell layer of eye • Image is transmitted to brain for interpretation
Surface Anatomy of the Eye
• Eyebrows divert sweat from the eyes and contribute to facial expressions • Eyelids (palpebrae) blink to protect the eye from foreign objects and lubricate their surface • Eyelashes detect and deter foreign objects
Conjunctiva • A mucous membrane lining the inside of the eyelids and the anterior surface of the eyes – forms the conjunctival sac between the eye and eyelid
• Forms a closed space when the eyelids are closed
• Conjunctivitis (“pinkeye”): inflammation of the conjunctival sac
The Lacrimal Apparatus • Lacrimal Apparatus: – lacrimal gland – lacrimal sac – nasolacrimal duct
• Rinses and lubricates the conjunctival sac • Drains to the nasal cavity where excess moisture is evaporated
Internal Anatomy of the Eye--Tunics
• Fibrous tunic: sclera & cornea • Vascular tunic: choroid layer
• Sensory tunic: retina
3 Layers of the Eye
Figure 17–4b
Internal Anatomy of the Eye • Anterior Segment contains the Aqueous Humor – – – –
Iris Ciliary Body Suspensory Ligament Lens
• Posterior Segment contains the Vitreous Humor
3 Layers of the Eye
Figure 17–4c
Autonomic Regulation of the Iris
Pupil Constricts
Pupil Dilates
The Two Layers of the Retina • Outer pigmented layer has a single layer of pigmented cells, attached to the choroid tunic, which absorbs light to prevent light scattering inside • Inner neural layer has the photosensory cells and various kinds of interneurons in three layers
Neural Organization in the Retina • Photoreceptors: rods (for dim light) and cones (3 colors: blue, green and red, for bright light)
• Bipolar cells are connecting interneurons • Ganglion cells’ axons become the Optic Nerve
Neural Organization in the Retina • Horizontal Cells enhance contrast (light versus dark boundaries) and help differentiate colors • Amacrine cells detect changes in the level of illumination
The Optic Disc • Axons of ganglion cells exit to form the optic nerve • Blood vessels enter to serve the retina by running on top of the neural layer • The location of the “blind spot” in our vision
Micrograph of the Retina • Light must cross through the capillaries and the two layers of interneurons to reach the photoreceptors, the rods and cones
Light
Opthalmoscope Image of the Retina • The Macula Lutea (“yellow spot”) is the center of the visual image • The Fovea Centralis is a central depression where light falls more directly on cones providing for the sharpest image discrimination • Light bouncing off RBCs’ hemoglobin causes “red eye” in flash photos
Auditory sensations and Equilibrium Hearing and equilibrium rely on mechanoreceptors
The ear is divided into three parts: • Outer ear • Middle ear • Inner ear
Anatomy of Ear
HEARING ONLY
HEARING & BALANCE
Hearing
Sound waves > eardrum > ossicles > oval window > set fluid in motion > vibrations stimulate “hair cells” > cochlear Within Cochlear duct, membranous labyrinth nerve transmits impulse to midbrain > is Spiral Organ of Corti – auditory cortex of temporal lobe
hearing receptors or “hair cells” Figure 8.15
•The ossicles (malleus, incus, and stapes)transmit the vibratory motion from the eardrum to the oval window. The auditory tube allows pressure to be equalized on both sides of the eardrum. These structures are also involved with sound transmission only. INNER EAR : Bony chambers • Cochlea –
hearing
• Vestibule – static equilibrium • Semicircular canals – dynamic equilibrium •The bony labyrinth contains perilymph and membranous sacs filled with endolymph. Within the membranous sacs of the vestibule and semicircular canals are equilibrium receptors. Hearing receptors are found within the membranes of the cochlea.
• Hair cells of the organ of Corti (the receptor for hearing within the cochlea) are stimulated by sound vibrations transmitted through air, membranes, and fluids • Deafness is any degree of hearing loss. Conduction deafness results when the transmission of sound vibrations through the external and middle ears is hindered. Sensorineural deafness occurs when there is damage to the nervous system structures involved in hearing. • Receptors of the semicircular canals (cristae) are dynamic equilibrium receptors, which respond to angular or rotational body movements. Receptors of the vestibule (maculae) are static equilibrium receptors, which respond to the pull of gravity and report on head position. Visual and proprioceptor input are also necessary for normal balance. • Symptoms of equilibrium apparatus problems include involuntary rolling of the eyes, nausea, vertigo, and an inability to stand erect.
Equilibrium – Balance Static equilibrium – maintenance of body posture relative to gravity while the body is still.
Dynamic equilibrium – maintenance of the body posture (mainly the head) in response to sudden movements. Tracking a moving object.
Static Equilibrium •Inside the vestibule are two chambers : utricle and saccule.
•Regions of hair cells and supporting cells called maculae.
•Otoliths – “ear rocks”
Dynamic Equilibrium •Semicircular canals
•In ampulla is the crista ampullaris – contains hair cells and supporting cells covered by a gelatinous mass called the cupula. •Neurological connections between eyes and semicircular canals – for tracking •Nystagmus
Dynamic Equilibrium • • • • •
Receptors found in semicircular canals Respond to angular or rotatory movements Oriented in 3 planes Ampulla, Crista Ampullaris, Cupula Movement constant rate, adapts
Figure 8.14

1. Roz`ainSyakirah IzzahRabi`atul 2. What is Digestion? Digestion is a catabolic process in which largecomplex molecules (carbohydrates, lipids,proteins, nucleic acids) are broken down intosimpler monomers (monosaccharides, glyceroland fatty acids, amino acids, and nucleotides)which can be absorbed by the body. 3. FunctionBreakdown of ingested foodAbsorption of nutrients into the bloodProduction of cellular energy (ATP)Constructive and degradative cellular activities 4. Types of Digestionmechanical chemicalno chemical there is a change in the chemical change food. in the food. food is broken downhydrolysis reactionsinto smaller pieces, carried out by mixed with digestive enzymes containedjuices secreted in thewithin the digestive body. juices. 5. Proses Pencernaan Mechanical ChemicalIngestion PropulsionAbsorption Defecation DigestionDigestion 6. Six Processes of Digestion1.Ingestion getting food into the mouth2.Propulsion moving foods from one region ofthe digestive system to another3.Mechanical digestion Mixing of food in the mouth by the tongue Churning of food in the stomach Segmentation in the small intestine 7. 4.Chemical Digestion Enzymes break down food molecules into theirbuilding blocks Each major food group uses different enzymes Carbohydrates are broken to simple sugars Proteins are broken to amino acids Fats are broken to fatty acids and alcohols5.Absorption End products of digestion are absorbed in theblood or lymph Food must enter mucosal cells and then intoblood or lymph capillaries6.Defecation Elimination of indigestible substances as feces 8. Proses Pencernaan 9. Division of digestivesystem organsAlimentary canal Accessory organ continuous coiledsecrete digestive hollow tube that runs juices by ductsfrom the mouth to (exocrine glands) into the anus the alimentary canal. 10. Alimentary Canal OrgansMouth PharynxEsophagus StomachSmall intestineLarge intestineAnus 11. Accessory Digestive Organs Salivary glands Teeth PancreasLiverGall Bladder 12. Mouth Oral Cavity (Ac) Mastication (chewing)of food Mixing masticated foodwith saliva Initiation of swallowingby the tongue Allowing for the senseof taste 13. Salivary Glands (Ac)Salivary Glands: Saliva-producing glands Parotid glands located anterior to ears Submandibular glands Sublingual glandsSaliva: Mixture of mucus and serous fluids Helps to form a food bolus Contains salivary amylase to begin starch digestion Dissolves chemicals so they can be tasted 14. Teeth (Ac) The role is to masticate (chew)food Humans have two sets of teeth Deciduous (baby or milk) teeth 20 teeth are fully formed by agetwo Permanent teeth Replace deciduous teethbeginning between the ages of 6to 12 A full set is 32 teeth, but somepeople do not have wisdomteeth Types of teeth: Incisors - cutting Canines - tearing Premolars shearing, shredding Molars - grinding 15. Tooth Structure Crown exposed part Outer enamel Dentin Pulp cavity Neck Region in contact with the gum Connects crown to root Root Periodontal membrane attached to the bone Root canal carrying blood vessels and nerves 16. Pharynx (Al) Serves as a passageway forair and food Food is propelled to theesophagus by two musclelayers Longitudinal inner layer Circular outer layer Food movement is byalternating contractions ofthe muscle layers(peristalsis) 17. Esophagus (Al) Runs from pharynx to stomach through thediaphragm Conducts food by peristalsis(slow rhythmic squeezing) Passageway for food only (respiratory systembranches off after the pharynx) 18. Liver and Gall Bladder (Accessory Organs) Largest gland in the body Composition Bile salts Bile pigment (mostly bilirubin from the breakdown of hemoglobin) Cholesterol Phospholipids Electrolytes Stores bile from the liver byway of the cystic duct Bile is introduced into theduodenum in the presence offatty food Gallstones can cause blockages 19. Stomach 20. Stomach (Al) Located on the left side of the abdominal cavity Food enters at the cardioesophageal sphincter Regions of the stomach Cardiac region near the heart Fundus Body Pylorus funnel-shaped terminal end Food empties into the small intestine at the pyloricsphincter Rugae internal folds of the mucosa External regions Lesser curvature Greater curvature 21. Function of Stomach Acts as a storage tankfor food Site of food breakdown Chemical breakdown ofprotein begins Delivers chyme(processed food) to thesmall intestine 22. Pancreas (Ac) Produces a wide spectrum of digestiveenzymes that break down all categories offood Enzymes are secreted into the duodenum Alkaline fluid introduced with enzymesneutralizes acidic chyme Endocrine products of pancreas Insulin Glucagon 23. Large Intestine (Al) Larger in diameter, but shorterthan the small intestine Frames the internal abdomen Cecum saclike first part ofthe large intestine Appendix Accumulation of lymphatic tissue that sometimes becomes inflamed (appendicitis) Hangs from the cecum Colon Ascending Transverse Descending S-shaped sigmoidal Rectum Anus external body opening 24. Functions of Large Intestine Absorption of water Eliminates indigestible food from the body as feces Does not participate in digestion or absorption ofdigested food Goblet cells produce mucus to act as a lubricant Site of production of Vitamin K by symbiotic bacteriawhich live off the remains of food that have not beendigested or absorbed in the small intestine. Thesebacteria produce over 50% of fecal matter. 25. Small Intestine (Al) The bodys major digestive organ all digestion of foodis completed in this organ Site of nutrient absorption into the blood Duodenum (25cm = 10 inches) 12 finger widthslong Attached to the stomach Curves around the head of the pancreas Where bile and pancreatic juices enter the alimentary canal Jejunum (2.5m = 8 feet) empty Attaches anteriorly to the duodenum Ileum (3.6m = 12 feet) twisted Extends from jejunum to large intestine 26. Small Intestine (Internal Structure) Villi are small fingerlikestructures formed by themucosa Give the small intestine moresurface area for absorption Fold in the intestine are calledcircular folds or plicaecirculares Deep folds of the mucosa andsubmucosa Do not disappear when filledwith food The submucosa has Peyerspatches (collections oflymphatic tissue) 27. Villi Internal Structure and Function Absorptive cells are found on thesurface epithelium which aresimple columnar microvilliatedepithelium Blood capillaries are below thesurface epithelium and this iswhere monosaccharides, aminoacids, and nucleic acids enter intothe blood stream and are takento the liver for processing Lacteals (specialized lymphaticcapillaries) where lipids areabsorbed and eventually re-enterthe blood stream to be taken tothe liver for processing. 28. DIGESTION OF NUTRIENT 29. WHAT IS NUTRIENT? Substance in food that is used by the body topromote normal growth ,maintenance andrepair. Divide into 6 categories major nutrient:carbohydrate,lipids,water andprotein minor nutrient:vitamin and mineral 30. WHAT IS DIGESTION? Process of breaking down ingested food intosmall molecule For example:-In mouth,salivary amylase convert starch tomaltose,maltotriose and a-dextrin-In stomach,pepsin convert protein to peptide-Lingual and gastric lipases converttriglycerides into fatty acid,diglycerides andmonoglycerides 31. DIGESTION OF CARBOHYDRATE Salivary amylase keep continue in stomachbut then it was stop by acidic pH. So, just afew starches are broken down Starches that not already broken down intomaltose,maltotriose and a-dextrins arecleaved by pancreatic amylase Although pancreatic amylase acts both onglycogen and starches but it doesnt effectcellulose 32. After amylase split starch into smallfragment,a brush-border enzyme called a-dextrinase acts on the resulting a-dextrins,clipping off one glucose unit at a time Ingested molecules of sucrose,lactose andmaltose (disaccharides)-are not acted on untilthey reach small intestine 33. Sucrase breaks sucrose into molecule ofglucose and fructose Lactase digest lactose into molecule of glucoseand galactose Maltase split maltose and maltotriose intotwo or tree molecules of glucose,respectively Digestion of carbohydrate ends withproduction of monosaccharides,which thedigestive system is able to absorb 34. DIGESTION OF PROTEIN Protein are fragmented into peptide by action ofpepsin Enzyme in pancreatic juice-trypsin,chymotrypsin,carboxypeptidase andelastase-continue to break down protein intopeptide Although all these enzyme convert whole proteininto peptide,their action differ somewhere bcozeach split peptide bonds between differentamino acid 35. Trypsin,chymotrypsin and elastase all cleavethe peptide bond between a specific aminoacid and its neighbor Carboxypeptidase splits off the amino acid atthe end of peptide Protein digestion is completed by twopeptidase in aminopeptidase and dipeptidase 36. Aminopeptidase cleaves off amino acid at theamino end of peptide Dipeptidase splits dipeptides into singleamino acid 37. DIGESTION OF LIPIDS The most abundant lipids in diet aretriglycerides,consist of molecule of glycerolbonded to three fatty acid molecule Enzyme that split triglycerides andphospholipids are called lipase Three type of lipases that can participate inlipid digestion are lingual lipase,gastric lipaseand pancreatic lipase 38. Triglycerides are broken down by pancreaticlipase into fatty acid and monoglycerides Large lipid globule containing triglyceride canbe digested in the small intestine,and itundergo emulsification Emulsification-process in which large lipidglobule is broken down into several small lipidglobule.it involve bile 39. The small lipid globule formed fromemulsification provide a large surface areathat allow pancreatic juice to function moreeffectively 40. DIGESTION OF NUCLEIC ACID Pancreatic juice contain twonucleases:ribonuclease which digest RNA anddeoxyribonuclease which digest DNA Result of the action of this two nuclease arefurther digested by nucleosidases andphosphatase into pentose,phosphates andnitrogenous base These product are absorbed via activetansport 41. ABSORPTION 42. WHAT IS ABSORPTION?Passage of digested nutrients fromgastrointestinal tract into the bloodor lymph 43. ABSORPTION OF MONOSACCHARIDES The capacity of small intestine to absorbmonosaccharide is huge-an estimated 120grams per hour As a result, all dietary carbohydrate that aredigested normally are absorbed, leaving onlyindigestible cellulose and fiber in feces. Monosaccharides pass from the lumenthrough the apical membrane via facilitateddiffusion or active transport. 44. -Fructose(found in fruit)-is transported viafacilitated diffusion-Glucose and galactose are transported intoabsorptive cells of the villi via secondary activetransport that is coupled to the active transportof Na+ Monosaccharide then move out of absorptivecells through their basolateral surface viafacilitated diffusion and enter the capillaries ofthe villi 45. ABSORPTION OF AMINO ACIDS,DIPEPTIDES AND TRIPEPTIDES Protein is absorbed as amino acid via activetransport, mainly occur in deodenum andjejunum Half of the absorbed amino acid are present infood and the other half come from the bodyitself as protein in digestive juice and deadcells that slough off the mucosal surface. 46. 95-98% of the protein present in smallintestine is digested and absorbed. Different transporter carry different type ofamino acid-some amino acid enter absorptive cell of thevilli via Na+ dependent secondary activetransport which is silmilar to the glucosetransporter and the other amino acid areactively transported by themselves 47. Amino acid move out of the absorptive cellsvia diffusion and enter capillaries of the villus :both monosaccharides and amino acid aretransported in the blood to the liver by way ofhepatic portal system. 48. ABSORPTION OF LIPID All dietary lipid are absorbed via simple diffusion Because of emulsification and digestion;triglycerides are mainly broken down intomonoglycerides and fatty acid, which can beshort-chain fatty acid or long-chain fatty acid Short-chain fatty acid are hydrophopic and smallin size. Thus, they can dissolve in the wateryinstestinal chyme,pass through the absorptivecells via simple diffusion 49. Long-chain fatty acid are large andhydrophobic and have difficulty beingsuspended in the watery environment of theintestinal chyme. So, bile salt help them to bemore soluble Bile salt surround the long-chain fatty acid andforming tiny sphere called micelles. 50. The micelles move from the interior of thesmall intestinal lumen to the absorptive cell. At that point, long-chain fatty acid diffuse outof the micelle into absorptive cells, leavingmicelles behind the chyme 51. ABSORPTION OF ELECTROLYTE Electrolyte that are absorbed by the smallintestine come from gastrointestinalsecretions and some are part of ingestedfoods and liquids Recall that electrolyte are compound thatseparate into ions in water and conductelectricity 52. Sodium ion are actively transported out ofabsorptive cells by basolateral sodium-potassium pump after they have moved intoabsorptive cells via diffusion and secondaryactive transport. Negatively charge bicarbonate,chloride,iodideand nitrate ion can passively follow Na+ oractively transported 53. Calcium ion also are absorbed actively in aprocess stimulated by calcitriol Other electrolyte such asiron,potassium,magnesium and phosphateions are absorbed via active transportmechanism 54. ABSORPTION OF VITAMINS Fat soluble vitamin A,D,E and K are includedwith digested dietary lipid and absorbed viasimple diffusion Water-soluble vitamin such as B and C alsoabsorbed via simple diffusion. However B12combine with intrinsic factor produced by thestomach and combination is absorbed in theileum via an active transport mechanism 55. ABSORPTION OF WATER the total volume of fluid that enter small intestineeach day about 9.3 liters-comes from ingestion ofliquid and from various gastrointestinal secretion The small intestine absorbs about 8.3 liters offluid; the remainder passes into the largeintestine, where most of the rest of it-about 0.9liter Only 0.1 liter of water is excreted in the feceseach day. Most is excreted via urinary sytem 56. All water absorption in GI tract occur via osmosisfrom the lumen of the intestine throughabsorptive cells and into blood capillaries Because water can move across the intestinalmucosa in both direction, the absorption of waterfrom small intestine depend on the absorption ofelectrolyte and nutrient to maintain osmoticbalance with blood The absorbed electrolyte,monosaccharides andamino acid establish a concentration gradient forwater that promote water absorption via osmosis 57. METABOLISMA 58. Metabolisma Tindak balas kimia yang berlaku dalam sel hidupyang membolehkan sel membesar dan membiakdan mengekalkan struktur mereka. Dibahagikan kepada dua jenis :1) Katabolisme : menghasilkan tenaga, seperti pemecahan makanan dalam repirasi sel.1) Anabolisme : memenggunakan tenaga untuk membentuk komponen sel seperti protein dan asid nukleik. 59. Laluan Metabolik 60. Metabolisma karbohidrat Tdpt 3 jenis kmpln utama karbohidrat iaitu :a) Monosakarida gula ringkas : glukosab) Disakarida gula kompleks : maltosac) Polisakarida gula kompleks y bsr : kanji,glikogen Laluan ini melibatkan pemecahan molekul-molekul karbohidrat didalam organ hati, kerana hati menyimpan glukos. Glukosa merupakan monosakarida yang paling penting dalammetabolisme tubuh. Glukosa yang terkandung dalam nutrisi masuk ke dalam sistemsirkulasi atau ke dalam darah untuk dipindah ke sel-sel tubuh yangmemerlukannya atau diubah pada hati menjadi molekul yang lain. Glukosa adalah sumber tenaga utama bagi sel-sel haiwan, danmerupakan satu-satunya sumber tenaga bagi manusia. 61. METABOLISMA LIPID Lipid ialah sebatian organik yang mengandungi karbon, hidrogen, dan oksigen. Jenis utama lipid adlh lemak, minyak, fosfolipid, dan steroid sprti kolesterol,testosteron,estrogen dan progesteron. Lemak & minyak adlh cnth lipid y dtempatkan dlm kategoriLipidtrigliserida, y tdiri drp 1 gliserol dan 3 asid lemak. 62. METABOLISMA PROTEIN Protein adalah molekul-molekul y bsr &kompleks. Monomer bgi protein adlh asid amino. Sel badan akn mengeluarkan asid amino daripadadarah dan menggunakannya untuk membinaprotein, untuk kegunaan sendiri(enzymes,membranes, muscle protein) dan untukmengeksport(mucus,hormones). ATP akan tbentuk jika glukosa dan lemak tidakmencukupi atau jika kekurangan Asid amino. 63. METABOLISMA NUKLEIK ASID Asid nukleik merupakansejenis makromolekulyang terdiri daripadarantaian nukleotida.Dalam biokimia molekulini mampu membawamaklumat ataumembentuk strukturdalam sel. 64. Asid nukleik yang biasa termasuk asid deoksiribonukleik (DNA) dan asid ribonukleik (RNA). Asid nukleik terdapat dalam semua benda hidup, kerana mereka terkandung dalam segala sel. Asid nukleik juga terdapat di dalam virus. Metabolisme asid nukleik adalah proses yang mana nukleotida disintesis . Sintesis asid nukleik juga merupakan satumekanisme, anabolik umumnya melibatkan tindak balas kimia fosfat, gula pentose, dan asas bernitrogen. Pemusnahan asid nukleik adalah prosedur katabolik umumnya melibatkan tindakbalas enzim. 65. Diet dan PemakananDiet Seimbang Pengambilan makanan yang mengandungisemua nutrien seperti protein,karbohidrat,lemak, vitamin, garam mineral, dan air sertapelawas dalam kuantiti yang diperlukan.Pemakanan kajian berkaitan dengan pengambilan makananuntuk proses pertumbuhan ,pemulihan danpengawalan kesihatan. 66. Kumpulan MakananAsas 67. FungsiKesan berlebihanKesan kekuranganKarbohidrat Membekalkan tenaga utama lebihan berat badanMarasmus(ptumbuhauntuk keperluan badan n tbantut)Protein membentuk dan membaikilemak mningkat, paras penghasilan antiboditisu, membentuk enzim,kalsium drh tjejas menurun & risikoantibodi, hormon, agenjangkitan meningkat.pengangkutPenyakit KwasyiokorLemak membekalkan tenaga &lebihan berat badan Kekurangan beratpengekalan suhu,badanmembekalkan asid lemakperlu, penyerapan vitaminlarut lemak 68. Garam Galian Dibahagikan kpd 2 kumpulan :- Makronutrien (dplukan dlm Kuantiti bsr)- Mikronutrien (dplukan dlm kuantiti kecil) 69. Makronutrien sumber fungsi Kesan kekuranganKalsiumsusu, keju, ikan mbina tlg & gigi yang kuat, mnolong pmbekuan drh, riket,osteoporosi bilis, bijirin dplukan untk pengecutan otot & pmindahan impuls s, pdarahansaraf. bpnjangan. Magnesium Bijirin,syrn Menjana enzim yang diperlukan untuk mengeluarkan Otot lemah hijau,susu,tenaga dalam tubuh. Diperlukan oleh tubuh dalam daging pembentukan bahan genetik dan pertumbuhantulang. kaliumSusu, daging,Pemindahan impuls saraf, pengecutan otot Ganguan dlm pisang, sstm saraf sayuran hijauFosforus Susu, daging,Mbntk tulang & gigi yang kuat, menggiatkan enzim- Tulang rapuh, bijirin, telur enzim yang diperlukan tubuh untuk menukarkan kerosakan gigi.makanan kepada tenaga.NatriumGaram, daging, Mngekalkan keseimbangan air dlm bdn, mngekalkanKekejangan otot telur, susutknn osmosis cecair dlm bdn. 70. Mikronutrien sumber Fungsi Kesan kekuranganIodinUdang, kerang, Mbntk hormonGoiter, kretinisme pd makanan laut tiroksinaknk-knkBesi Hati, bayam, kacang, Mbntk hemoglobinAnemia telur kuningFlorin Air minuman, teh,Mengukuhkan enamel Karies gigi sayuranpd gigi 71. Vitamin Kumpulan sebatian organik yang diperlukan dalam kuantiti yang keciluntuk memelihara dan mengekalkan kesihatan. Dikelaskan kepada 2 kumpulan :a) Larut lemak: - tidak dapat dikumuh melalui air kencing tetapi disimpan dalam badan - vitamin A, D, E dan K.a) Larut air: - tidak dapat disimpan dalam badan dan sebarang kuantiti berlebihan akan larut dalam air dan dikumuhkan keluar melalui air kencing. - Vitamin B kompleks dan vitamin C. 72. jenis sumber fungsi Kesan kekuranganVitamin C buah-buahan. memelihara tisu phubung, kshtnskurvi ( gusi kulit & pemulihan luka yang cepat, bdarah, kulit mngkatkan ketahanan thdplebam, sendi jgkitanbgkak)Vitamin D Keju, mentega dan telur. mbantu pnyerapan kalsium &penyakit riket, fosforus, mbina tulang dan gigi karies gigi yang kuatVitamin E sayuran hijau,minyak memelihara kshtn sstm otot, sarafkemorosotan ototkelapa sawit.& sstm pedaran darah, bhn & saraf poksidaan bgi asid lmk tepuVitamin K hati,bayam dan kubis.mbantu dalam pembekuan darahbdarah secaraberlebihanVitamin A susu, tomato, lobakMembina pigmen pada retina rabun malam,merahmata untuk penglihatan jelas padakulit tidak yang waktu malam & memastikan sihat ptumbuhan sel epitelium kulit yang sihat. 73. Air Merupakan 70% drp berat bdn manusia. Peranan :a) Sbg pelarutb) Medium tndk bls kimia dlm bdn.c) Medium pengangkutan bhn mknn tcerna, oksigen, bhn pkumuhan.d) Pengawalaturan suhu bdn : Bila kekurangan air, suhu tubuh akan menjadi panas dan naik. Khdiran air akan mbntu mstabilkan suhu bdn.e) Sbg pelincir : mngurangkan geseran tulang pd sendi.f) Pkumuhan : urea,asid urik & grm mineral blebihan dsingkirkn melalui air kencing dan peluh. 74. TENAGA 75. Tenaga Penting dalam Tubuh1. Tenaga Kinetik: Tenaga yang dibekalkan oleh sebatian ikatan bertenaga tinggi seperti ATP, ADP, dll.2. Tenaga berpotensi: Tenaga yang tidak aktif disimpan di dalam badan dalam bentuk glikogen dan yang terdapat dalam makanan. 83 76. Pengukuran Tenaga1. Kalori: Jumlah tenaga haba yang diperlukan untuk menaikkan suhu satu gram air sebanyak satu darjah celsius.2. Kilokalori (Kcal) Jumlah haba yang diperlukan untuk meningkatkan suhu 1 kg. air sebanyak sebanyak 1 darjah celsius.3. Unit metrik yang digunakan ialah kilojoule(KJ) 1 Kilokalori (Kcal) = 4.184 KJ) 84 77. Pengukuran Nilai Tenaga dalam Makanan Dengan menggunakan alat kalorimeter Jumlah tenaga yang dihasilkan oleh setiapsampel protein, lemak dan karbohidrat1 g. Karbohidrat =4 kcal1 g. Lemak =9 kcal1 g. Protein =4 kcal1 g. Alkohol =7 kcal85 78. Contoh Pengiraan 1 Berapakah nilai tenaga yang dalam satu gelas susuberatnya 244g ? Jika dalam susu 100g susumengandungi:4.9g CHO; 3.5g protein; 3.7g lemak; 0.6 mineraldan 1.2g vitaminCHO = 244/100 x 4.9g x 4kcal = 47.8 kcalProtein = 244/100 x 3.5g x 4kcal = 34.2 kcalLemak = 244/100 x 3.7g x 9kcal = 81.3 kcalJumlah nilai tenaga = 163.3 kcal86 79. Contoh pengiraan 2Diet mengandungi 2200 kcal dan mengandungi210g CHO, dan 120g lemak, kira: Berapakah jumlah g protein dalam sajian? Kira peratus setiap nutrien [CHO, protein danlemak] dalam sajian?87 80. a. Jumlah g protein CHO membekal = 210 x 4 kcal= 840 kcal Lemak membekal = 120 x 9 kcal= 1080 kcal Protein = 2200 (1080 + 840) = 280 kcalJumlah g protein = 280/4= 70 gb. Peratus CHO, Protein dan Lemak Peratus CHO = 840/2200 x 100 =38.2% Peratus Lemak = 1080/2200 x 100 = 49.1% Peratus Protein = 280/2200 x 100 =12.7%88 81. Soalan:1. Potato crisps mengandungi 6.3 g protein, 35.9g lemakdan 49.3 karbohidrat pada tiap-tiap 100 g.Kira nilai tenaga yang terdapat dalam 200 g potatocrips?2. Berapakah jumlah nilai tenaga dalam satu keping daging beratnya 90g jika dalam 100g daging mengandungi 15.3g protein, 18.8g lemak, 0.1g karbohidrat , 0.2g mineral 0.2 vitamins dan 65.5g air ? 89 82. 3. Diet Pak Ali membekal 2600 kcal sehari. Diet tersebut mengandungi 250g karbohidrat, 70g protein. Kira? a. Berapakah jumlah g lemak dalam diet Pak Alipada hari tersebut?b.Kira peratus setiap nutrien (karbohidrat,protein dan lemak) yang terdapat dalam dietPak Ali ?90 83. Input TenagaTenaga/kilokalori yang terdapat dalam makanan Output TenagaTenaga yang diperlukan @ digunakanoleh tubuh untuk beberapa perkara: Kadar Metabolisme Asas [Basal EnergyRate] Aktiviti Fizikal Pertumbuhan Tindakan Spesifik Dinamik Makanan91 84. Bilakah Kadar Metabolisme Asas diukur?1. Selepas 12 18 jam mengambil makanan terakhir.2. Seseorang dalam keadaan rehat.3. Dalam bilik yang sesuai, suhu selesa.4. Kebiasaan diukur selepas bangun tidur waktu pagi. 92 85. Pengukuran Penggunaan tenaga Jumlah tenaga yang dijana @ digunakanoleh tubuh dapat diukur secara langsung @tidak langsung.Kilorimetri Langsung Individu diletakkan di dalam kilokalorimeter/bilik khas Kaedah sangat mahal. Cuma beberapa unitterdapat di seluruh dunia Di Malaysia hanya satu, terdapat diUniversiti Hospital. 93 86. Kilorimetri Tak Langsung Kaedah yang lebih mudah Diukur dengan menentukan penggunaan oksigen danpengeluaran karbon dioksida pada masa tertentudengan menggunakan alat respirasi Dapat digunakan semasa individu berbaring rehat @menjalankan berbagai aktiviti Pada setiap liter oksigen yang digunakan akanmemerlukan 4.825 kilokalori tenaga.94 87. Kadar Metabolisme Asas [KMA] Basal Metabolisme Rate[BMR] Kadar Metabolisme Asas- Jumlah tenaga yang diperlukan oleh tubuh untuk menjalankan proses-proses penting dalam tubuh.- Kadar tubuh menggunakan tenaga untuk kekalkan fungsi penting untuk hidup. Kadar Metabolisme Rehat (KMR)- Penggunaan tenaga pada keadaan yang sama kecuali selepas makan atau berlatih95 88. Kaedah mengira keperluan tenaga untukKMA (Basal Metabolisme Rate)1. Menggunakan anggaran 1 kilokalori/minit = 60 m/jam X 24jam/hari = 1440 kilokalori/hari96 89. 2. Alat Respiratori Bebedict-Roth (Penggunaan O2)Ali mengambil 1.08 liter O2 dalam masa 6 minit. Kiraberapa jumlah keperluan tenaga KMA dalam sehari ?[Piawai 1 liter O2 = 4.825 kcal]6 minit Ali mengambil 1.08 liter oksigen1 jam (60 minit) = 1.08 x 60/6 = 10.8 liter OksigenSehari (24 jam) =10.8 liter x 24 jam = 259.2 liter OksigenKMA= 259.2 x 4.825 = 1251 kcal. 97 90. 3. Berasaskan Berat badan, Umur & Jantina Lelaki< 50 tahun = 1.0 kcal/kg X BB/1 Jam> 50 tahun = 0.9 kcal/kg X BB/1 Jam Wanita< 50 tahun = 0.9 kcal/kg X BB/1 Jam> 50 tahun = 0.8 kcal/kg X BB/1 Jam98 91. Contoh: Kira berapakah jumlah tenaga untuk KMA dalam sehari bagi mereka yang berikut?a. En. Adam berumur 45 tahun mempunyai berat badan 65 kg Keperluan tenaga KMA = 1 x 65 x 24 jam= 1560 kcalb. Cik Fatimah berumur 26 tahun mempunyai berat badan 46 kg. Keperluan tenaga KMA = 0.9 x 46 x 24 jam= 993.6 kcal99 92. Kira berapakah jumlah tenaga untuk KMA dalam sehari bagimereka berikut?1. En. Ramlee berumur 45 tahun mempunyai berat badan 65 kg ?2. Cik Fatimah berumur 25 tahun mempunyai berat badan 46 kg.3. Pak Adam berumur 66 tahun mempunyai berat badan 63 kg4. Mak Timah berumur 70 tahun mempunyai berat badan 81 kg. 100 93. 4. Kaedah Pengiraan WHO.Gunakan Berat badan (dalam kg) WanitaBerat dalam Kg x 0.95 kcal x 24 jam LelakiBerat dalam Kg x 1.0 kcal x 24 jamContoh: Aminah berumur 13 tahun dan berat badan 50 kg. 50kg x 0.95 kcal x 24 jam =1140 Kcal Ramlee, berat badan 58 kg dan berumur 25 tahun58kg x 1.0 kcal x 24 jam = 1392 Kcal 101 94. Kira berapakah jumlah tenaga untuk KMA dalam sehari bagimereka mengikut kiraan WHO?1. En. Yunus berumur 48 tahun mempunyai berat badan 73 kg ?2. Cik Rohani berumur 28 tahun mempunyai berat badan 53 kg.3. Hamidah berumur 35 tahun mempunyai berat badan 62 kg4. Halim berumur 70 tahun mempunyai berat badan 74 kg. 102 95. Formula FAO/WHO untuk ukur REE[Resting Energy Expenditure]Lelaki3- 9 22.7w) + 49510 - 1717.5w + 65118 - 2915.3w + 67930 - 6011.6w + 879 > 6013.5w + 487 103 96. Formula FAO/WHO untuk ukur REE bagi Wanita3-9 22.5w + 499 10-1712.2w + 746 18-2914.7w + 496 30-60 8.7w + 829> 6010.5w + 596104 97. Latihan:1. Aminah mempunyai berat badan 50 kg. , berumur 18 tahun . Kirakan keperluan tenaga Aminah dalam sehari dengan menggunakan Formula REE ? = 14.7 w + 496 = ( 14.7 x 50 ) + 496 = 735 + 496 = 1231 kcal/hari2. Hamid mempunyai berat badan 78kg dan berumur 33 tahun. Kirakan keperluan tenaga dengan Formula REE? 105 98. Faktor-Faktor yang mempengaruhiKadar Metabolisme Asas seseorang1. Komposisi tubuh -Kandungan tisu seseorang. -Tisu tanpa lemak (otot) : tinggi KMA -Tisu berlemak sedikit tenaga -Lelaki perlu KMA tinggi kerana mempunyai lebih tisu tanpa lemak. 106 99. 2. Keadaan Tubuh: Jalankan aktiviti Fizikal - 2 lelaki sama umur, tinggi & berat badan - Jalankan tugas fizikal yang berbeza. Seorang buruh danseorang akauntan - Buruh perlu banyak KMA berbanding akauntan kerana buruhmempunyai otot-otot terbentuk berbanding akauntan3. Jantina: - Lelaki lebih tenaga KMA berbanding wanita - Lelaki muda dewasa mempunyai 14% lemak daripada berat badan - Wanita muda dewasa mempunyai 23%- 32% lemak daripada beratbadan4. Tidur: Kurang tenaga KMA5. Malnutrisi:Tenaga KMA rendah 107 100. 6. Tekanan mental: lebih tenaga bagi orang. yang mengalami masalah mental7. Suhu Tubuh - Kalau suhu tubuh tinggi KMA tinggi - Setiap 1 darjah tambahan suhu boleh tingkatkan 13 kcal KMA badan8. Suhu persekitaran - suhu panas kita perlu KMA yang rendah - suhu sejuk kadar KMA tinggi bagi panaskan badan9. Kehamilan - Tenaga KMA tinggi untuk menghamil bayi 300- 330 kcal lebih daripada wanita biasa - Ibu menyusu KMA tinggi bagi proses mengeluarkan susu 500- 550 kcal lebih daripada wanita biasa10. Umur: Umur meningkat keperluan KMA menurun11. Merokok: lebih 10 peratus daripada orang tidak merokok108 101. Soalan: Norzalina 25 tahun, tinggi 1.63 m dan berat badan 65 kg. Berikut adalah jumlah kalori yang dimakan iaitukarbohidrat 190g; protein 120g dan lemak 93g mengikut 24- jam dietary recallnya.a. Dengan menggunakan data di atas kirakan: (i) jumlah kalori dan tunjukkan peratus karbohidrat, protein dan lemak ? (ii)Peratus pengambilan makananb. Beri penjelasan tentang diet yang diamalkan oleh Norzalina mengikut perkiraan WHO menggunakan (i) berat badan dan (ii) norma REE109 102. (i) Jumlah pengambilan kalori:a.karbohidrat = 190 X 4 kcal= 760 kcalb.protein = 120 X 4 kcal= 480kcalc.lemak = 93 X 9 kcal = 837 kcalJumlah= 2077kcal(ii) Peratus pengambilan makanana.karbohidrat = 760/2077 X 100= 36.6 %b.protein = 480/2077 X 100= 23.1 %c.lemak = 837 /2077 X 100 = 40.3% 110 103. i. Berat badan dengan perkiraan WHO =0.95 kcal X kg (berat badan) X 24 jam =0.95 kcal X 65 kg X 24 jam =1482 kcalii. Berat badan berdasarkan Norm= (14.7W) + 496= (14.7 X 65 ) + 496= 955.5 + 496= 1451.5 kcal111 104. Berdasarkan penjadualan PemakananNorzalina telah mengambil lebihanmakanan:Mengikut kiraan berat badan mengikut Formula WHO = 595 kcal [2077 1482] Mengikut keperluan norm=525.9 kcal [2077 1551.1 ]112 105. Menu 3000-4000kcal 113 106. Menu 4000-5000kcal 114 107. Menu 5000-6000kcal 115 108. Body Energy BalanceEnergy intake = total energy output(heat + work + energy storage)Energy intake is liberated during foodoxidationEnergy outputHeat is usually about 60%Storage energy is in the form of fat orglycogenCopyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 109. Digestive Homeostasis Disorders ULCERS erosion of the surface of thealimentary canal generally associated withsome kind of irritant 110. Digestive Homeostasis Disorders CONSTIPATION acondition in which thelarge intestine is emptiedwith difficulty. Too much water isreabsorbed and the solid wastehardens 111. Digestive Homeostasis Disorders DIARRHEA a gastrointestinaldisturbance characterized bydecreased water absorption andincreased peristaltic activity of thelarge intestine. This results in increased, multiple,watery feces. This condition may result in severedehydration, especially in infants 112. Digestive Homeostasis Disorders APPENDICITIS an inflammation of theappendix due to infection Common treatment is removal of theappendix via surgery 113. Digestive Homeostasis Disorders GALLSTONES an accumulation ofhardened cholesterol and/or calciumdeposits in the gallbladder Can either be passed (OUCH!!) orsurgically removed 114. Digestive Homeostasis Disorders ANOREXIA NERVOSA - a psychologicalcondition where an individual thinks theyappear overweight and refuses to eat. Weighs 85% or less than what isdevelopmentally expected for age and height Young girls do not begin to menstruate at theappropriate age. 115. Digestive Homeostasis Disorders HEART BURN ACID from the stomachbacks up into the esophagus. 116. Sekian,Terima Kasih 117. http://highered.mcgraw-hill.com/sites/0072495855/student_view0/chapter26/animation__organs_of_digestion.html