Documentos de Académico
Documentos de Profesional
Documentos de Cultura
Na+ Pump
(Na,K-ATPase)
Proton Pump
(H,K-ATPase)
Na+
ATP
K+
HCl
Pancreatic juice
Endopeptidases
# -Amylase
(Enterokinase)
Lipase
(from duodenal
secreted epithelial
by duodenal
(no activation needed) cells)
epithelium
Surface anatomy of abdomen
Duodenum
Liver Functions
• Filter: bacteria, antigens, damaged cells, proteins, hormones and
drugs
• Detoxification: ammonia, alcohol., etc
– alcohol to acetaldehyde(carcinogen)
• Blood reservoir
• Nutrient processor
• Protein synthesis: albumin, binding proteins, transferrin, globulins,
blood clotting factors, fibrinogen, prothrombin, v, vii, ix, x.., apolipoproteins,
angiotensinogen
• Glucose, lipid homeostasis, gluconeogenesis,
• Minerals, Iron & vitamin storage
• Bile synthesis by destruction of old Rbcs
Hepatic Ligaments
• R triangular
• L triangular
• Falciform
• Round,
– remnant of L umbilical vein
• Hepatogastric
• Coronary(to diaphragm)
Liver Referred Pain
Intestines
• Small: 7meters
• Large: 1.5 meters
The Large Intestine
The Large Intestine
Spleen, Position
Referral pain
Liver, ligaments
• Round ligament (ligamentum teres)
• Coronary ligament
• Right triangular ligament
• Left triangular ligament
Liver ligaments
Liver, treatment, side
• Push the liver on both sides With Every Breath
• Push the liver WEB, finish with vibration
• Do the same, finish with rebound
• Stretching on R side, using one elbow on
pelvic, the other below arm + move back &
forth + stretching
• Do the same with leg stretch
• Do the same with hand stretch
Gallbladder, treatment, sitting
• Midclavicular line, below rib8
• Push post+sup
Stomach, attachments
• Liver
• Transvers colon
• Descending colon
Sympathetic nerve
• Greater splanchnic and Lesser splanchnic
nerves join to celiac ganglion
Na+
Cl-
H2O
NaCl Secretion by the Colon
(minor, except when pathological )
Colonic bacteria
There is very little nutrient absorption by the colon,
however:
– In adults
• Weight loss
• Anemia because of poor iron absorption
• Diarrhea, abdominal bloat
• Mouth ulcer
Sugar hurts liver
• The organ uses one type of sugar, called fructose,
to make fat
• Too much refined sugar and high-fructose corn
syrup causes a fatty buildup that can lead to liver
disease
• Some studies show that sugar can be as
damaging to the liver as alcohol, even if you’re
not overweight
• It’s one more reason to limit foods with added
sugars, such as soda, pastries, and candy
Herbal supplements
• Even if the label says “natural,” it may not be
OK for you. For instance, some people take an
herb called kava kava for menopause
symptoms or to help them relax
• Studies show that it can keep the liver from
working right
• That can lead to hepatitis and liver failure
• Some countries have banned or restricted the
herb, but it’s still available in the U.S.
Over weight
• The extra fat can build up in your liver cells
and lead to non-alcoholic fatty liver disease
(NAFLD)
• As a result, your liver may swell
• Over time, it can harden and scar liver tissue
(cirrhosis)
• You are more likely to get NAFLD if you are
overweight or obese, middle-aged, or have
diabetes
Vitamin A
• Your body needs vitamin A, and it’s fine to get
it from plants such as fresh fruits and
vegetables, especially those that are red,
orange, and yellow
• But if you take supplements that have high
doses of vitamin A, that can be a problem for
your liver
Soft drinks
• Research shows that people who drink a lot of
soft drinks are more likely to have non-
alcoholic fatty liver disease (NAFLD)
Acetaminophen
• Be sure to take the right amount! If you
accidentally take too much of anything that
has acetaminophen -- for instance, a pill for
your headache and something else for your
cold, and both have acetaminophen in it -- it
can harm your liver. Check the dose and how
much is OK to take in one day. Stick to those
limits, and you should be fine
Trans fats
• Trans fats are a man-made fat in some
packaged foods and baked goods
• A diet high in trans fats makes you more likely
to gain weight
• That’s not good for your liver. Check the
ingredients list
• Even if it says “0” grams of trans fat, it may still
have a small amount, and that adds up
Alcohol
• You probably already know that drinking too much is
bad for your liver
• But you might not realize that “too much” can happen
without you being an alcoholic or addicted to alcohol.
It’s easy to drink more than you think. Many glasses
can hold a lot more than one standard serving, which is
5 ounces of wine (that’s a little more than half a cup),
12 ounces of regular beer, or 1.5 ounces of liquor
• If you drink, be sure to keep it moderate -- that’s one
drink a day for women and up to 2 per day for men
Lymph nodes
• Lymphatic vessels lead into lymph nodes
• The body has around 600 to 700 of lymph
nodes in the groin, neck, armpits, around the
heart, lungs, and intestines
• The largest concentration of lymph tissue
called gut-associated lymphatic tissue (GALT)
surrounds the intestines
• Lymphatic fluid flows primarily upwards
towards the neck
• The lymphatic system has no pump of its own
and must rely on the movement of the body’s
musculoskeletal system to circulate
Ways to activate lymphatic system
• Movement/ Exercise
• Deep diaphragmatic breathing
• Rebounding
– Rebounding is the equivalent to jumping up and
down on a mini-trampoline
• Dry Skin Brushing or Effleurage
• Circular muscular fibers
• Gastrophrenic ligament
• Coronary falx of the stomach
Coronary falx of the stomach
• Peritoneal fold formed by gastric artery
• Concave below, stretched out between celiac
trunk and posterior flank of lesser curvature
Lungs, evaluation, supine
• Push on shoulder + Breathing
• Push scapula and anterior of ribs + breathing
• Push sides of sternum with knife hand +
breathing
• Push both hands on sternum + breathing
• Push diaphragm + breathing
• Hold trapezius muscle + push rib1
Description Vertebral Contents
level
Caval opening T8 The caval opening passes through the central tendon of the
diaphragm. It contains the inferior vena cava and some
branches of the right phrenic nerve
Esophageal hiatus T10 The esophageal hiatus is situated in the posterior part of the
diaphragm, located slightly left of the central tendon
through the muscular sling of the right crus of the
diaphragm.
It contains the esophagus, and anterior and posterior vagal
trunks
Aortic hiatus T12 The aortic hiatus is in the posterior part of the diaphragm,
between the left and right crus.
It contains the aorta, the azygos vein, and the thoracic duct
two lesser apertures greater and lesser right splanchnic nerves
of right crus
two lesser apertures greater and lesser left splanchnic nerves and the hemiazygos
of left crus vein
Description Vertebral Contents
level
behind the diaphragm, sympathetic trunk
under the medial
lumbocostal arch
areolar tissue between the superior epigastric branch of the internal thoracic
the sternal and costal artery and some lymphatics from the abdominal wall
parts (see also foramina and convex surface of the liver
of Morgagni)
areolar tissue between This interval is less constant; when this interval exists,
the fibers springing from the upper and back part of the kidney is separated
the medial and lateral from the pleura by areolar tissue only
lumbocostal arches
Goal of treatment
• Liberate all tension restraining the original
diaphragmatic dynamic imposed on the intra-
abdominal organs and to restore the plasticity
and elasticity of those organs in order to
maintain their homeostasis
Subjects
• Lungs and Diaphragm
• Liver
• Gallbladder
• Pancreas
• Stomach
• Intestine
• Kidney
• Bladder
• Uterus
Visceral Osteopathy
• Evaluation techniques
• Treatment techniques
Contraindications
• Bone fracture
• Tumor
• Infection
• Pregnancy
• Scar/bleeding
Treatment techniques
• Push
• Mobilization
• Vibration
• Recoil/Rebound (Lymphatic Technique)
• Scooping
Lungs, active evaluation, sitting
• Compare 2 sides
• Put both hands over shoulder girdle+ breathing
• Put hands around ribs below arm on each side
• Put hands on both sides + breathing
• Hands below diaphragm(from back)
• Hands over chest (upper ribs) from back
• Push rib 1 on both sides
• Push hands over sternum and thoracic vertebra
Lungs, passive evaluation, sitting
• Similar to active, but try to move chest from
different areas
• Push cartilaginous parts of chest