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GI Final > 1 Motility of the GI Tract > Flashcards

1 Motility of the GI Tract Flashcards

1
Q

What do parietal cells secrete

A

HCl and IF

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2
Q

What do chief cells secrete

A

Pepsinogen

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3
Q

What are the pacemaker cells of the GI

A

Interstitial cells of Cajal

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4
Q

What type of muscle cell transmission do the ICC follow

A

SM (Na —> Ca —> K)

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5
Q

What is the spike rate in the stomach

A

3/min

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6
Q

What is the spike rate in the duodenum

A

12/min

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7
Q

What stimulates spikes in electrical activity in the gut

A
  • stretch
  • ACh
  • parasympathetics
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8
Q

What stimulates hyperpolarization of the gut

A
  • NE

- sympathetics

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9
Q

What is the resting membrane potential in the gut

A

-56

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10
Q

The contractions of SM are due to what ion

A

Ca (but it doesn’t propagate the rxn)

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11
Q

What effects does Ca entry have

A
  • responsible for rising phase of AP

- triggers contraction

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12
Q

What is responsible for the falling phase of SM

A

K

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13
Q

Why is the proximal stomach in tonic contraction

A

To keep contents away from the LES

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14
Q

Why does the distal stomach have phasic contractions

A

Mechanical digestion to aid in chemical digestion

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15
Q

Half of our _______ and 90 percent of our _______ come from bacteria in our gut

A

Dopamine; serotonin

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16
Q

What is the myenteric plexus responsible for

A

Inhibitory and excitatory nerves control the function of the circular and longitudinal mm

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17
Q

What does the submucosal plexus do

A

Secretomotor neurons promote vasodilation, regulate the secretion of fluid and electrolytes, and contractions of the muscularis mucosa

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18
Q

What occurs in the mouth

A
  • mastication
  • buffers neutralize acids
  • antibacterial agents kill some bacteria in food
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19
Q

What is deglutition

A

Swallowing

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20
Q

What is in saliva

A

Water, electrolytes, mucin, IgA ab, lysozyme, salivary amylase

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21
Q

Chewing muscles are innervated by what n

A

Fifth cranial

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22
Q

What is the function of chewing

A
  • reduce size
  • mix food and saliva
  • increases SA
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23
Q

The oral portion of swallowing is under __________ control while pharyngeal is under __________ control

A

Voluntary; involuntary

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24
Q

Sensory signals pass through what nerves to the swallowing center in the medulla (during pharyngeal phase)

A

Glossopharyngeal
Vagus
Trigeminal

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25
Q

What are the three phases of swallowing

A

Oral
Pharyngeal
Esophageal

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26
Q

What is the end of the oral phase

A

Tongue moving food back to oropharnyx

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27
Q

What is the end of the pharyngeal phase

A

Forcing food through the UES

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28
Q

Where does the esophageal phase end

A

With food passing through the LES

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29
Q

What is primary peristalsis

A

First contraction wave pushing food through LES

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30
Q

What initiates secondary peristalsis

A

Distention of the esophagus

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31
Q

What is primary peristalsis regulated by

A

Medulla

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32
Q

What regulates secondary peristalsis

A

Medulla and myenteric NS

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33
Q

If the vagus is cut, what peristalsis continues

A

Secondary

34
Q

What helps move food down

A

Contractions proximal to the food and negative pressure for transient relaxation

35
Q

What is the process called in which a vagovagal reflex causes the stomach to relax to receive food

A

Receptive relaxation

36
Q

What does receptive relaxation allow

A

Stomach to expand w/o increasing intragastric pressure

37
Q

What do the myenteric neurons release to get the sphincters to relax

A

NO and VIP

38
Q

What is the makeup of the UES

A

Striated circular m

39
Q

What is the makeup of the LES

A

SM

40
Q

What causes an increase in LES tone

A
  • ACh
  • increased intraabdominal and intragastric pressure
  • gastrin
  • motilin
  • protein-rich foods
41
Q

What causes a decrease in LES tone

A
  • NO
  • VIP
  • CCK
  • GIP
  • β receptor agonists
  • secretin
  • progesterone
  • prostaglandin E
  • fat-rich food
42
Q

What are some causes of GERD

A
  • loss of LES tone
  • increase ν of transient relaxations
  • loss of 2o peristalsis
  • increase stomach V or P
  • increased production of H+
43
Q

What is achalasia

A

LES doesn’t open fully and food becomes stuck in esophagus

44
Q

What causes achalasia

A

-degeneration of the neurons in myenteric plexuses (inhibitory)

45
Q

What enzyme is at fault in achalasia

A

NO synthase and decrease in VIP

46
Q

What are the symptoms of achalasia

A
  • regurg of food
  • chest pain
  • difficulty swallowing
  • cough
  • weight loss
47
Q

Gastric motility is divided into what 2 zones

A

Orad (Fundus, cardia, and upper portion of body)

Caudad (lower body and antrum)

48
Q

What are the muscle layers of the stomach

A

Circular, longitudinal, oblique

49
Q

What is the primary purpose of the orad region

A

Accommodating new food

50
Q

What is the musculature of the orad region llike

A

Thin

51
Q

What signal functions to decrease contractions and gastric distensibility

A

CCK

52
Q

What is a major function of the caudad region

A

Retropulsion back into the stomach

53
Q

What functions to increase contractions

A

Vagus nerve
Gastrin
Motilin

54
Q

What decreases contractions of GI

A

Sympathetics
Secretin
GIP

55
Q

What increases gastric emptying

A
  • decrease in distensibility of the orad stomach
  • increased force in caudad stomach
  • increase in the diameter and inhibition of segmenting contractions of the duodenum
56
Q

Inhibition of stomach emptying depends on

A
  • relaxation of the orad region
  • decrease in force and number of contractions in the caudad region
  • contraction of the pylorus
  • increase in segmenting contractions of duodenum
57
Q

What are some duodenal factors that slow emptying

A
  • secretin release (increases pyloric tone)
  • lipid digestion stimulating CCK and GIP which reduces motility
  • products of protein digestion
  • hypertonicity of fluid in duodenum
58
Q

What is the housekeeper of the stomach

A

MMC (migrating motor complex)

59
Q

When is the MMC active

A

During fasting it contracts every 90 to 120 mins

60
Q

What does the MMC do

A

Removes:

  • mucus
  • sloughed cells
  • bacteria
61
Q

What is gastroparesis

A

Gastric emptying being delayed despite obstruction

62
Q

What are the symptoms of gastroparesis

A

Early satiety, nausea, vomiting, bloating, and upper abdominal discomfort

63
Q

Gastroparesis can result from systemic diseases involving neuromuscular function such as

A

Diabetes and scleroderma

64
Q

Gastroparesis can also occur with damage to

A

Vagus

65
Q

What is the main function of the SI

A

Breakdown into simple molecules

66
Q

What are the types of movement in the SI

A

Peristalsis and segementation contractions

67
Q

What is the myenteric reflex

A

Distention causing peristalsis

68
Q

What is released during distention of the GI? What is activated in response

A

Serotonin; IPANs

69
Q

What enhances intestinal motility

A
  • gastrin
  • CCK
  • 5HT
  • thyroxine
  • insulin
70
Q

What decreases intestinal motility

A

Secretin and glucagon

71
Q

What causes vomitting

A

High positive thoracic pressure

72
Q

What types of muscle is the IAS? EAS?

A

SM; striated

73
Q

What is the innervation of the LI

A

Vagus to splenic flexure then pelvis splanchnic

74
Q

What is the sympathetic innervation of the LI

A

T5-L2 or the thoracolumbar outflow

75
Q

What can LI movements be initiated by

A
  • gastrocolic or duodenocolic reflexes
  • intense stimulation of parasympathetics
  • overdistention of colon
76
Q

The parasympathetic system causes what in the rectum? IAS? EAS?

A

Contract; relax; relax

77
Q

What does sympathetic cause in rectum? IAS? EAS?

A

Relax; contract; contract

78
Q

When does the urge to defecate begin

A

18 mm Hg

79
Q

When does involuntary defecation begin

A

55 mm Hg

80
Q

What reflexes are self contained in the GI

A

Ileogastric
Enterogastric
Gastrocolic
Colonoileal reflex

81
Q

What the long reflexes of the GI

A

Vomiting
Pain
Vagovagal
Defectation

GI Final (12 decks)

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