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GI > 2. Physiology > Flashcards

2. Physiology Flashcards

1
Q

What are the 3 divisions of splanchnic nerves of the sympathetic nervous system that innervate the main portion of the GI tract? What vertebral level is each?

A

Greater (T5-9).
Lesser (T10-11).
Least (T12).

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2
Q

What are the two main parasympathetic nerves to the gut? What vertebral level is each from?

A 
Vagus nerve (cranial).
Pelvic splanchnic nerves (S2-4).
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3
Q

What nervous system stimulates the gut increasing motility?

A

Parasympathetic

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4
Q

What nervous system can operate completely independently?

A

Enteric

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5
Q

Where in the GI tract does the enteric nervous system exist?

A

From mouth to anus

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6
Q

One of the two main plexuses of the enteric nervous system is the mucosal (meissner’s) plexus. In which layer of the GI tract is it found and what does it control?

A

In the submucosa.

Secretions and blood flow.

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7
Q

One of the two main plexuses of the enteric nervous system is the myenteric (Auerbach’s) plexus. In which layer of the GI tract is it found and what does it control?

A

In the muscularis propria between circular and longitudinal muscle.
Motility.

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8
Q

What other nervous systems does the enteric nervous system communicate with?

A

Parasympathetic and sympathetic

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9
Q

What is the name of the 2 types of cells in the mucosa of the GI tract that secrete hormones?

A 
Enteroendocrine cells (G,S,D).
ECL cells (secrete histamine).
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10
Q

What are the two broad categories of gastrointestinal hormones?

A

Gastric family.

Secretin family.

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11
Q

Why do patients with abdominal pain first present with pain that is vague and not necessarily felt in the anatomical location of the cause of the pain?

A

If viscera becomes distended, then visceral peritoneum is involved. The visceral afferents accompany the sympathetic motor fibres, which go back to their spinal sensory ganglia and pain is felt in the corresponding dermatome.

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12
Q

What does the sympathetic nervous system mainly innervate?

A

Blood vessels

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13
Q

What type of pain is felt from foregut structures?

A

Epigastric pain.

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14
Q

What type of pain is felt from midgut structures?

A

Periumbilical pain.

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15
Q

What type of pain is felt from hindgut structures?

A

Suprapubic/hypogastric pain.

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16
Q

Where is pain from gallstones felt?

A

Right upper quadrant/right shoulder tip pain.

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17
Q

Where is pain from pancreatitis felt?

A

Back pain.

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18
Q

Where is pain caused by the oesophagus felt?

A

Retrosternal pain.

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19
Q

All muscle is smooth in the GI tract except in which 3 places?

A

Pharynx.
Upper third of oesophagus.
External anal sphincter.

20
Q

What are the 5 types of phasic contractions of the GI tract?

A 
Periodic.
Tonic.
Peristalsis.
Segmentation.
Mass movement.
21
Q

What are periodic contractions of the GI tract for?

A

Propulsion and mixing.

22
Q

What are tonic contractions of the GI tract? In what 3 places do they occur?

A

Constant level of contraction.

Upper stomach, ileocaecal valve, internal anal sphincter.

23
Q

What is peristalsis of the GI tract? Where does contraction occur in relation of contents?

A

Propel contents in one direction.

Contraction proximal to contents (relaxation distal).

24
Q

What is segmentation of the GI tract?

A

To and fro movements where contraction splits contents and then relaxes to mix contents.

25
Q

What is mass movement in the GI tract? Where does it occur?

A

Rapid movement of contents into rectum.

Occurs in distal colon.

26
Q

What is the gastronomic reflex?

A

An increase in motility/mass movement in the GI tract in response to stretch of the stomach.

27
Q

What is a paralytic ileus?

A

Loss of GI contractility

28
Q

What is achalasia?

A

Failure of the lower oesophageal sphincter to relax leading to dysphagia.

29
Q

What is Hirschsprung’s disease?

A

Lack of myenteric and submucosal plexuses resulting in functional obstruction.

30
Q

Name 3 things tat the GI tract secretes

A 
Water.
Acid.
Alkali.
Enzymes.
Mucus.
Waste products.
Emulsifiers.
Intrinsic factor.
31
Q

Name 2 functions of stomach acid

A

Innate barrier to infection.
Prepares proteins for digestion.
Activates enzymes.

32
Q

What is he function of HCO3?

A

To neutralise acid from both food and the stomach.

33
Q

How does the GI tract secrete cholesterol and bilirubin?

A

In bile from the liver.

34
Q

What is the function of bile salts in the GI tract?

A

Are emulsifiers. Increase the surface area of lipids to aid digestion by lipases and allows lipid break down products to be transported in the gut.

35
Q

Give 2 functions of mucus in the GI tract

A

Protects against acidic environment in the stomach.
Protects against bacteria in the small intestine as contains antibacterial compounds.
Harbours bacteria in the large intestine as provides a partial food source, whilst separating them from epithelium.
Lubricates.

36
Q

What do enzymes breakdown in the GI tract?

A

Protein, fat, carbohydrates.

37
Q

Where in the GI tract are Brunner’s glands found?

A

Duodenum

38
Q

What are crypts of Lieberkuln?

A

Intestinal glands

39
Q

How are molecules absorbed by the GI tract?

A

Moved across the enterocyte or paracellularly.

40
Q

What type of cells are the active absorptive cells present in the GI tract?

A

Simple columnar-enterocytes.

41
Q

Give 2 consequences of reduced absorption in the GI tract

A

Diarrhoea.
Malnutrition.
Anaemia in Crohn’s and coeliac disease.

42
Q

How is water absorbed passively after meals?

A

Driven my nutrients coupled with Na+ (sodium co-transporters).

43
Q

How is water absorbed in between meals?

A

Na+ and Cl- are absorbed via sodium/hydrogen and chloride/bicarbonate exchangers.

44
Q

How is the remaining water absorbed in the colon so that stool can be desiccated?

A

Via epithelial Na+ channels

45
Q

Roughly how much fluid is lost in faeces each day?

A

0.1L

GI (15 decks)

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