13 - Stomach-Peritoneum Flashcards

1
Q

What is the enteric nervous system

A

brain of the gut
consists of >100 million neurons from the esophagus to the anus
(sensory, motor, interneurons)

capable of generating local reflexse

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2
Q

What are the plexuses of the enteric nervous system

A

influenced by autonomic input

myenteric plexus – controls motility (ex. perstalsis)
- between circular and longitudinal muscle layers

submucosal plexus – controls secretions
- in submucosa

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3
Q

What nerve controls the parasympathetic plexuses of the ENS

A

vagus nerves (CN X)

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4
Q

What controls the sympathetic plexuses of the ENS

A

celiac, sup & inf mesenteric ganglia

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5
Q

What is the peritoneum

A

largest serous membrane of the body

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6
Q

What are the layers of the peritoneum

A

parietal peritoneum
visceral peritoneum

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7
Q

What do the peritoneal folds do

A

support the abdominal organs by acting as a highway for nerve, bv and lympahtics

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8
Q

What are the five folds of the peritoneum

A

falciform ligament – between left and right lobe of liver

lesser omentum – from inferior surface of liver to lesser curvature of stomach

greater omentum – from greater curvature of stomach to transverse colon

mesocolon – from posterior abdominal wall to transverse and sigmoid colon

messentery – suspends most of small intestine for posterior wall

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9
Q

What are the retroperitoneal organs

A

organs only covered by peritoneum on their anterior surface

abdominopelvic cavity
- pancreas
- duodenum
- ascending and descending colon
- kidneys

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10
Q

What are the four layers of the gastric walls

A

same layers in esophagus

mucosa (inside) – contains rugae (innermost, oblique muscle layer)
submucosa
muscularis
serosa - lubricating fluid

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11
Q

What does the stomach do

A

holding reservoir and mixing chamber – no absorption

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12
Q

What does the stomach connect
Where is it located

A

esophagus to duodenum

inferior to the diaphragm

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13
Q

What are the four main regions of the stomach

A

cardia (closest to the heart)
fundus (tip of stomach)
body (major part)
pylorus (at pyloric sphincter)

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14
Q

What does rugae do

A

accomodates the stretching of the mucosa

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15
Q

Where does the most intense churning occur

A

pyloric antrum

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16
Q

Where does the stomach receive blood from

A

branches of the celiac trunk

17
Q

What arteries lie at the lesser curvature of the stomach

A

right and left gastric arteries

18
Q

What arteries lie at the greater curvature of the sotmach

A

left and right gastroomental arteries

19
Q

What are the layers of the muscularis

A

muscularis (longitudinal layer) – outermost
circular layer
oblique layer – innermost

20
Q

What are the parts of the pylorus

A

pyloric antrum (the blender)
- connects to the body of the stomach

pyloric canal
- connects to the duodenum

21
Q

what does the submucosa of the gastric wall do

A

provides innervation and blood supply to the overlying mucosa

22
Q

What do gastric pits do

A

specialized cells that secrete gastric juice (2-3 liters a day) and a protective muscous

23
Q

What is the pH of gastric secretions

A

1.5 and 3.5

24
Q

What are the cell types in gastric pits

A

mucus cells - secrete bicarbonate-rich mucus to protect the gastric lining from stomach acid

parietal cells - secrete hydrochloric acid and intrinsic factor (vit B12 absorption)

chief cells - secrete pepsinogen (digestive enzyme pepsin) and gastric lipase

G cells - secrete the endocrin hormone gastrin
- gastrin increases parietal and cheif cell secretion // increases gastric motility (more churning) and LES tone (nice and tight) // decreases pyloric sphincter tone

25
How is HCl produced
chloride anion and a proton combined seperately in the lumen of the stomach - makes pH really low in the stomach
26
What is HCl secretion regulated by
gastrin (from enteroendocrin G cells) ACh (from parasympathetic fibers) - tells stomach to make more acid Histamine (from mast cells) - glue epithelium down - protection --> makes more acid Cortisol (from adrenal cortex) - slows down stomach in stress
27
What causes gastric ulcers to form
form on the mucosal lining of the stomach if protective mucus production is insufficient or gastric acid secretion is excessive - can lead to perforation of the gastric wall
28
What are the phases to digestion
1. cephalic - receptors for sight, smell, and taste of food activated - thoughts of food (cortex & hyopthalamus --> medulla oblongata --> parasympathetic output) 2. gastric - stretch receptors detect distention of the stomach - chemoreceptors detect increased pH of gastric juice (submucosal plexus 3. intestinal - stretch receptors detect distension of the duodenum - chemoreceptors detect fatty acids and glucose in the duodenum
29
How do neural and endocrine signals help regulate digestion
regulating motility and digestive enzyme secretion
30
What are the factors promoting gastric emptying
neural - parasympathetic (vagus) hormonal - gastrin composition of chyme - carbohydrates & water --> quick emptying
31
What are the factors inhibiting gastric emptying
neural - sympathetic - enterogastric reflex hormonal - CCK - secretin composition of chyme - high protein = moderate emptying - high fat = slow emptying