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GI Final > 2 Secretions of the GI Tract and Pancreas > Flashcards

2 Secretions of the GI Tract and Pancreas Flashcards

1
Q

The parotid gland contains what types of cells

A

Serous

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2
Q

What are the main cell types of the submandibular and sublingual glands

A

Mixed mucous and serous

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3
Q

What are the cells which produce the initial saliva

A

Acinar

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4
Q

What cells modify the saliva to make it hypotonic

A

Striated duct (columnar epithelial)

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5
Q

What type of cells contract to eject saliva

A

Contractile (myoepithelial) cells

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6
Q

What is in saliva

A
  • water
  • electrolytes
  • α amylase
  • lingual lipase
  • kallikrein
  • mucus
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7
Q

What is kallikrein

A

Precursor to bradykinin which causes vasodilation

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8
Q

How does saliva compare to plasma

A

Saliva has more K and HCO3

Saliva has less Na and Cl

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9
Q

What is the overall effect of saliva on ions

A

Absorption of Na and Cl

Secretion of K and HCO3

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10
Q

What does parasympathetic do at salivary glands

A

Originates in facial and glossopharyngeal nn and they use mAChR

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11
Q

Where do the sympathetic controls originate

A

T1-3 and superior cervical region and they wrap around arteries

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12
Q

What do parasympathetic do for salivary glands? Sympathetic?

A

Both increase secretions

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13
Q

What factors increase saliva

A
  • conditioning
  • food
  • nausea
  • smell
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14
Q

What decreases saliva

A
  • dehydration
  • fear
  • sleep
  • fatigue
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15
Q

What is downstream of the parasympathetic muscarinic receptor in the salivary glands

A

IP3 and Ca

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16
Q

What is down stream of the sympathetic β receptor on the salivary gland

A

cAMP

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17
Q

What do parietal cells produce

A

HCl and IF

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18
Q

Where are parietal cells mainly found

A

Body of stomach

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19
Q

What do chief cells produce

A

Pepsinogen

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20
Q

Where are chief cells mainly found

A

Body of stomach

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21
Q

What do G cells produce

A

Gastrin

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22
Q

Where are G cells mainly found

A

Antrum of stomach

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23
Q

Where are mucous cells mainly found

A

Antrum

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24
Q

Glands of the stomach are divided into what categories

A

Oxyntic and pyloric

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25
Q

What are the characteristics of oxyntic gland

A
  • located in proximal stomach (body and fundus)
  • parietal cells that secrete acid
  • D cells, mucous cells, ECF cells, chief cells
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26
Q

What are the characteristics of pyloric glands

A
  • located in distal 20% of stomach
  • G cells that secrete and synthesize gastrin
  • D cells, mucous cells, ECF cells
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27
Q

What do D cells produce

A

somatostatin

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28
Q

When the stomach is removed you are at risk for vitamin deficiencies in what vitamins

A

Fat soluble vitamins

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29
Q

What do parietal cells do

A

Secrete HCl

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30
Q

Where is HCl formed in parietal cells

A

Canaliculi

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31
Q

What is the alkaline tide? What cells are responsible

A

Uptake of HCO3 and secretion of HCl; parietal cells

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32
Q

What does the parasympathetic do to G cells

A

Stimulates gastrin release through GRP directly and inhibits release of somatostatin

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33
Q

Increased secretion of gastrin increases secretion of what

A

Somatostatin

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34
Q

What stimulates somatostatin

A

H in gastric lumen

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35
Q

What cells secrete somatostatin

A

D cells

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36
Q

Pepsinogen are secreted by what cells

A

Chief cells

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37
Q

What is the optimal pH for pepsinogen?

A

1.8-3.5

38
Q

What is the most important stimulus for pepsinogen

A

Vagus N

39
Q

How does omeprazole decrease acid

A

Inhibits H/K antiporter

40
Q

How does cimetidine work

A

Acts on the H2 (histamine) receptor as an antagonist which treats GERD, duodenal and gastric ulcers

41
Q

What do ECL cells secrete

A

Histamine

42
Q

What are stimulators of the H/K ATPase on the parietal cells

A 
M3 receptor (vagus)
CCKb receptor (gastrin)
H2 receptor (histamine)
43
Q

What are the main inhibitors for the parietal cells

A

Somatostatin and prostaglandins

44
Q

What does atropine do in parietal cells

A

It is a muscarinic blocker which would function to decrease H secretion in parietal cells

45
Q

What are the phases of gastric HCl secretion

A

Cephalic
Gastric
Intestinal

46
Q

What is the cephalic phase of gastric secretion

A
  • 30% of total HCl secretion
  • stimulated by smell, taste, chewing, swallowing, and conditioned reflexes
  • works via Vagus N
  • Vagus stimulates gastrin which stimulates parietal cells
47
Q

What is the gastric phase of gastric secretion

A
  • 60% of total HCl

- stimulated by stomach distention and AA

48
Q

Distention of fundus and body of stomach activates what

A

Mechanoreceptors in mucosa of oxyntic and pyloric activate direct and indirect vagus stimulation

49
Q

What does distention of the antrum do

A

Local (pyloropyloric) reflex stimulates gastrin release

50
Q

What do AA in the stomach do

A

Stimulate gastrin release

51
Q

What is the intestinal phase of gastric secretion

A
  • 10% of total HCl

- stimulated by distention of SI (NS mediated) and presence of digested protein (hormonal regulation)

52
Q

Gastric juice is made of what components

A

Non-parietal and parietal

53
Q

Failure to secrete what and from what cell results in pernicious anemia

A

IF from parietal cells

54
Q

Where is Vit B12 absorbed

A

Ileum

55
Q

What cells are present in the gastric mucosa

A

Mucous neck cells and gastric epithelial cells (HCO3)

56
Q

What are the protective factors of the gastric mucosa

A
  • HCO3 and mucous
  • prostaglandins
  • blood flow
  • gastrin
  • GF
57
Q

What are the damaging factors of the gastric mucosa

A
  • acid
  • pepsin
  • nsaids
  • H. pylori
  • EtOH
  • bile
  • stress
58
Q

Gastrinomas are associated with what

A

Zollinger-Ellison syndrome

59
Q

Under normal conditions, secretin administration _______ gastrin but does the opposite in gastrinomas

A

Ihibit

60
Q

Peptic ulcer disease are due to what

A

Excessive H and pepsin OR loss of protective mucosal membrane

61
Q

What is the primary cause of ulcers

A

Defective mucosa caused by H pylori

62
Q

What allows H pylori to colonize

A

Urease

63
Q

What from H pylori causes breakdown of mucosa and underlying cells

A

Cytotoxin

64
Q

How does H pylori have an affect on duodenal ulcers

A
  • inhibits somatostatin secretion from D cells

- gastric H pylori infection spreads and inhibits HCO3

65
Q

H secretion rates are a little higher than normal with what

A

Duodenal ulcers

66
Q

What has the highest rate of H secretion

A

Zollinger ellision syndrome

67
Q

Where are the gastrinomas often

A

Pancreas

68
Q

What are the effects of Zollinger Ellison syndrome

A
  • excessive delivery of H to duodenum

- inactivation of pancreatic lipase due to suboptimal pH

69
Q

How does the pancreas compare to salivary glands

A

Isotonic secretions

70
Q

What comes from pancreatic acinar cells

A

Enzymatic secretions

71
Q

What comes from centroacinar and ductal pancreatic cells

A

Aqueous secretion

72
Q

What is the net result of the pancreas

A

Secretion of HCO3 and absorption of H

73
Q

What are the 3 phases of pancreatic secretion

A

Cephalic

  • initiated via vagus by smell, taste, and conditioning
  • produces mainly enzymatic secretions

Gastric

  • initiated via vagus by distention of stomach
  • produces mainly enzymatic secretions

Intestinal

  • 80% of pancreas secretion
  • enzymatic and aqueous secretions stimulated
74
Q

What is the sympathetic innervation of the pancreas

A

Postganglionic nerves from celiac and superior mesenteric plexuses that are inhibitory

75
Q

What is the parasympathetic innervation of the pancreas

A

Vagus which is stimulatory

Preganglionic synapse in ENS and post ganglionic synapse on exocrine pancreas

76
Q

I cells produce what

A

CCK

77
Q

S cells produce

A

secretin

78
Q

Acinar cells are stimulated by

A

ACh and CCK

79
Q

What stimulates ductal cells of pancreas

A

ACh, CCK, secretin

80
Q

Cystic fibrosis transmembrane conductance regulator causes what to fail early

A

Pancreas, b/c Cl can’t leave cells to come back in and bring HCO3 in

81
Q

What does motilin do?

A

Produces migrating motor complexes

82
Q

Where does GIP get produced? What does it do

A

K cells (duodenum, jejunum)

Decrease H secretion
Increase insulin release

83
Q

Where is iron absorbed

A

duodenum as Fe2

84
Q

What is pleomorphic adenoma

A

Most common type of salivary gland cancer

85
Q

Which bilirubin is water soluble

A

Direct; it is conjugated with glucuronic acid

86
Q

Pancreatic insufficiency results in what deficiency

A

Fat soluble vitamins (ADEK) and B12

87
Q

How is tropical sprue different than celiac

A

Responds to antibiotics

88
Q

What is whipple disease

A

Infection with type of bacteria

Foamy macrophages in lamina propria
Cardiac symptoms
Arthralgias
Neurologic symptoms

89
Q

AST and ALT elevated but ALT>AST

A

Most liver disease

90
Q

Liver enzymes increased and AST>ALT

A

Alcoholic liver disease

91
Q

Alkaline phosphatase is elevated in

A

Cholestasis (biliary obstruction), infiltrative disorders, bone disease

92
Q

Gastrin is secreted by what cells

A

G cells

GI Final (12 decks)

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