16. GIT System Flashcards
What are the Gut associated lymphoid tissues? (GALT)
Lymphoid follicles - found in lymph nodes, thymus
Tonsils
These are the collections of lymphoid follicles in the DIGESTIVE TRACT
Tonsils
Tonsils are collectively known as
Waldeyer’s rings
Tonsil found in the pharyn; “Adenoid”
1 Pharyngeal tonsil
Tonsils seen beside Eustachian tube
2 tubal tonsils
Tonsil between palatoglossus(ant pillar) and palatopharyngeus(post pillar)
2 palatine tonsils
Tonsil behind the tongue
1 lingual tonsil
What are the cells found on the surface of tonsils that traps microbes?
M cells*
What immunoglobulins are found in the GIT?
IgA
What are the specialized non encapsulated tonsils found in the Submucosa of the Ileum?
Peyer’s Patches
Responsible for INITIAL phase of digestion and absorption
Oral cavity (lips to pharynx)
Found in saliva that helps the initial digestion of food or STARCH
Amylase
What is the major site of amylase production?
Pancreas
Anterior pillar of fauces
Palatoglossus
Posterior pillar of fauces
Palatopharyngeus
Found between ant and post pillar of fauces; what separates the two
Isthmus of the fauces
Transitional line or junction between mucous membrane of lips and skin
Vermillion border
Keratinized surface of tongue
Dorsal (KD)
Non keratinized surface of tongue
Ventral (Nkv)
What do you call the condition wherein there is ABSENCE OF TONGUE PAPILLAE?
Bald tongue
Bald tongue is associated with (4)
Geographic tongue
Any type of glossitis
Iron deficiency
Vit B9 deficiency
Most common type of anemia
Iron def anemia
Tx for iron def anemia
Ferrous sulfate
Aka food pipe or gullet
Esophagus
Lining of esophagus (protection from friction)
Non keratinized - stratified squamous
Other name for lower esophageal constrictors
Cardiac sphincter
Other term for GERD
Heartburn
Metaplastic change of lining of esophagus seen in patients with GERD
Barret’s esophagus
Lining of esophagus in pxs with GERD
From stratified squamous to simple columnar
- adapts to the acid reflux from stomach
It is the change from specialized (normal) cells to non specialized (normal) cells
Metaplasia
Change from normal to abnormal cells; “premalignant”
Dysplasia
“Hallmark of malignancy”; Absence of differentiation or maturation
Anaplasia
Which of the ffg is not associated with the heart?*
Cardiac sphincter (part of esophagus)
Long movements of chyme; common in Esophagus
Peristalsis
Short movts of chyme; common in Intestines
Segmentation
What do you call the terminal part of esophagus?
Z line of cardiac sphincter
Lining of stomach
Simple columnar epithelium with microvilli
J shaped organ
Stomach
Site for second phase of digestion
Stomach
Regions of the stomach
Cardiac
Body/Fundus
Pylorus
What is the opening of stomach from esophagus?
Cardiac
Cells of stomach that produces mucous for protection to acid
Mucous neck cells
Cells of stomach that secretes:
- Hydrochloric acid or Gastric acid
- Intrinsic factor
Parietal cells or Oxyntic cells
Responsible for the digestion and activation of pepsinogen
Hydrochloric acid or gastric acid
Hormone or factor important for VIT B12 absorption; opens the receptors in the Ileum
Intrinsic factor
What are absorbed in the ILEUM (2)
Vit B12
Bile
Cells of stomach that secretes PEPSINOGEN
Chief cells - “pepCHIEnogen”
Inactive form of pepsin
Pepsinogen
HCl acid activates pepsinogen into Pepsin: which is mainly responsible for:
Protein digestion
Cells of stomach that secretes GASTRIN
G cells
Release of gastrin activates what cells
Gastrin stimulates PARIETAL CELLS to produce more HCl
Phase of gastric secretion: Smelling and thinking of food
Cephalic phase
Phase of gastric secretion: when food enters the stomach
Gastric phase
Phase of gastric secretion: where food enters intestine
Intestinal phase
Phases that increase gastric secretion
Cephalic phase and Gastric phase
Phase that inhibits gastric secretion
Intestinal phase
What happens to stomach during gastric phase
Distention of stomach = ⬆️ gastric secretion
What are the 3 enzymes* secreted during intestinal phase that inhibits gastric secretion and allows contraction of pyloric sphincter
Cck
Secretin
GIP - gastric inhibitory complex
What is the muscle that pumps chyme from stomach to small intestine?
Pyloric sphincter
Is small intestine resistant or susceptible to acid
Susceptible to acid (ayaw sa acid)
*normal wbc count!
4,500-11,000 cells/mL of blood
*normal platelet count!
150,000-450,000
Major site of digestion and absorption
Small intestine
Elevations or folds in the small intestine to increase surface area for absorption
Valves of Kerckring
Valves of Kerckring is aka
Plicae circulares
Projects from Valves of Kerckring ; ⬆️surface area for absorption
Villi
Projects from Villi ; ⬆️surface area for absorption
Microvilli
3 major parts of small intestine
Duodenum
Jejunum
Ileum
C shape; Shortest segment of small intestine
Duodenum
What is absorbed in the Duodenum
Iron = (“I-Do”)
Part of small intestine that is the major site for absorption of almost all nutrients; Numerous folds and projections seen here
Jejunum
Longest segment of small intestine
Ileum
What are absorbed in the Ileum
Vit B12
Bile
Non encapsulated specialized tonsils found in the Ileum of small intestine
Peyer’s patches
Neutralizes acid in the small intestine: Secretes ALKALINE FLUID (2)
Brunner’s gland - duodenum
Secretin: stimulates PANCREAS to secrete alkaline mucous!!
Goblet cells increase or decrease from small intestine to large intestine
Increase goblet cells
Organ where Crypts of Lieberkuhn is located?
Small intestine
Gland that contains enteroendocrine cells; located in the small intestine
Crypts of Lieberkuhn or Intestinal gland
Immune cells found in the small intestine that secretes LYSOZYME for digestion of bacterial cell walls
Paneth cells
What organ is affected in peptic ulcer
Duodenum of small intestine
- (hindi sa stomach kasi nattolerate naman nya ung acidity)
Target cells of Gastrin
Parietal cells - secretes HCl
Cells that secretes CCK
I cells
3 functions of CCK
- stimulates pancreatic enzyme (pancreas:digestion)
- bile secretion (gallbladder)
- relaxation of Sphincter of Oddi
Enzyme for digestion
Pancreatic enzyme
Body excretes bile in response to what
Food with high fat contents
Cells that secretes serotonin and histamine
Enterochromaffin cells
Opposite functions of serotonin and histamine in Blood vessels:
Serotonin: vasocontriction
Histamine: vasodilation
Stimulates gastric acid secretion
Histamine
Secreted in response to BAD food
- increases intestinal motility
- or induced vomiting
Serotonin
Protects stomach from acid
Prostaglandins
Cells that secretes secretin which stimulates pancreas to produce alkaline fluids
S cells:Secretin
Cells that secretes GIP which inhibits gastric motility
K cells : GIP
Beq: parts of large intestine except:
Parts: Cecum Ascending colon Transverse colon Descending colon Sigmoid colon Rectum Anal canal
Part of large intestine where APPENDIX is located
Cecum
Function of appendix
Lymphocyte production
Also called “Vermiworm”
Appendix
Where is the major site of Water absorption?*
Large intestine
3 longitudinal bands of muscle used for peristalsis and segmentation
Taenia coli
Forms the haustra
Taenia coli
Segments of large intestines
Haustra
Goblet cells _ in number towards large intestine
Increase in number of goblet cells - coats feces with mucus
Enterocytes, villi, and microvilli continuous to _ in number in large intestine
Decrease in number or absent
Extramural glands of digestive system
Salivary glands
Liver
Gallbladder
Pancreas
Defensive secretions of Salivary glands
IgA
Lysozyme
Lactoferrin
Functional unit of the liver responsible for:
- Protein synthesis
- alcohol and drug metabolism
- lipid synthesis
- bile production
Hepatocytes
**pancreas:pepsin-protein synthesis din
Organ for bile production
Liver
Macrophage of the liver
Kupffer cells
Pressure that pushes fluid INSIDE cell
Osmotic pressure IN
Pressure that pushes fluid OUTside the cell
Hydrostatic pressure OUT
Most numerous protein in the blood responsible for osmotic pressure
Albumin
> 30 complement proteins for immunity synthesized in the Liver (3)
C3b - opsonin
C5a - chemotoxin
C5b - MAC “membrane attack complex”
Accumulation of C3b (opsonin) in the body
Opsonization
Complement protein attached to the bacteria that attracts macrophages
C3b or opsonin
Complement protein that attacks the membrane of the bacteria; considered as the last resort
C5b MAC
Complement protein for inflammatory response
C5a chemotoxin
What is the hormone responsible for growth?
- choices from boards*
Insulin*
- because of Insulin like growth factor
For chondrogenesis and protein anabolism (from GH)
Insulin like growth factor
For thrompopoiesis or platelet formation
Thrombopoietin
Test done to check for fragility of capillaries:
Sign for rupture of capillaries:
Torniquet = Petechiae
Carrier protein for iron
Tranferrin
hormone for RAAS
Angiotensinogen
Vein towards capillaries
Portal vein
2 portal veins in the body seen in:
Liver
Hypophysis
Hepatic portal vein is from what veins?
Superior mesenteric vein
Splenic vein
Portal triad
*boards: except:
Portal vein
Hepatic artery
Bile duct
Other term for jaundice
Icterus
Cause of jaundice or icterus
Any liver damage
- yellowish color: destroys hepatocytes=interrupts pathway of bile metabolism
Capillary with PORES? (All capillaries are continuous except for)
Hepatic sinusoids
Space between hepatic sinusoids and hepatocytes
Space of disse
Bile is produced in what organ?
Liver
- hepatocytes (cells)
What are the clotting factors produced in the liver that are Vitamin K dependent
2/7/9/10
Bile in large intestine?
Stercobilin - color of feces (E coli)
Grave yard of rbc
Spleen
Not all dead rbc goes to spleen, some are reabsorbed in the body because of what cells
Macrophages
Macrophages take the _ of dead rbcs
Hemoglobin - red
Bile metabolism
HAPPENS IN MACROPHAGES: Hemoglobin (from dead rbc) - red Heme - red Porphyrin - red Biliverdin - green Bilurubin - yellow *either stays in the macrophage = HEMOSIDERIN (golden brown)
*or makatakas sa macrophage: goes to the Liver/HEPATOCYTES to form BILE and stored in the GALLBLADDER because sphincter of oddi is always closed
– bile is absorbed in the ILEUM > goes back to circulatory > goes to the KIDNEYS = Urobilin (yellow urine) > Goes to Large intestine = Stercobilin (brown feces)
Why are bruises change in color
Refraction of light kaya purple
- also Because of metabolism of hb of rbc by the macrophages
For storage and excretion of bile
Gallbladder
Inflammation of gallbladder
Cholecystitis
Gall stones
Cholelithiasis
Gallbladder releases bile in response to (3)
CCK (main!)
Secretin
Gastrin
Glands of Luschka are found in what organ???
Gallbladder
Exocrine portion of pancreas
Head part
Major pancreatic duct
Wirsung’s duct
Accessory pancreatic duct
Duct of santorini
Opens and closes HEPATOPANCREATIC duct and allow excretion of bile and pancreatic enzymes
Sphincter of Oddi
Hepatopancreatic duct = what ducts
Pancreatic duct and BILE duct
Hepatopancreatic duct opens in
Ampulla of vater of duodenum
Secretes alkaline mucous in response to secretin
Pancreas
Cells that secretes pancreatic enzymes
Acinar cells of pancreas
Pancreatic enzyme that breaks down FATS
Pancreatic lipase
Enzyme that breaks down STARCH
Amylase
- produced by:
Pancreas (major site)
Salivary glands
Enzyme that breaks down PROTEIN
Trypsinogen (most important!!)
Cells that releases histamine
Mast cells
Eosinophils
Basophils
Platelets
Histamine receptors for smooth muscle cells
H1 receptor
Histamine receptor for STOMACH
H2 receptor - “sTWOmach”
What happens if you have allergy to something
- Yung mast cells may nakaattach na IgE
- maddetect nla yung antigen (kung san ka allergic) ~ attachment
- mast cells magrrelease ng histamine:
*pag nagbind sa H1 receptor
Smooth muscle cells (target site)
~ BV: vasodilation (redness)
~Bronchi: bronchoconstriction (diff breathing)
*pag nagbind sa H2 receptor
Stomach (target site)
~ ⬆️ HCl acid (abdominal pains)
Target site of H1 receptors
H1
Smooth muscle cells
BV and bronchi
Drug of choice for H1 receptor (allergy)
- vasodilation of BV (redness)
- bronchoconstriction (diff breathing)
H1 blockers
H1 blockers (3)
Diphenhydramine HCl (Benadryl)
- antihistamine + sedative (drowsiness)
Loratidine (Claritin/Allerta)
Cetirizine
Doc for H2 receptor allergy (abdominal pains)
H2 blockers
H2 blockers
Ranitidine
Cimetidine
**also for hyperacidity
What is the drug for HYPERACIDITY????*
Antihistamines (H2 receptors)
GI tract extend from
Oral cavity (lips) to Anus