4a.) Intro to Stomach Flashcards

1
Q

What do enteroendocrine cells secrete?

What do enterochromafin cells secrete?

A
  • Enteroendocrine: hormones
  • Enterochromaffin (like cells): secrete histamine
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2
Q

Describe the general pathway that hormones, produced by organs of the gut, take

A
  • Hormones released from endocrine cells
  • Pass into portal circulation
  • Through liver
  • Enter systemic circulation
  • Travel via systemic circulation to pretty much the place they were produced
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3
Q

Describe paracrine signalling

A

Hormone only has an effect in the vicinity of the gland secreting it (act in local environment so only diffuse short distances)

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4
Q

Describe neurocrine secretion

A

Action potential reaches neurone and causes it to release hormone

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5
Q

Provide an example of a neurocrine hormone in gut

A
  • Gastrin releasing peptide

It is released from post ganglionic fibres of the vagus nerve. GRP then acts to increase release of gastrin from G cells

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6
Q

State the two broad categories/families of gastrointestinal hormones

State two hormones in each category

A
  • Gastrin family: gastrin, cholecystokinin
  • Secretin family: secretin, gastric inhibitory peptide
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7
Q

For gastrin hormone, state:

  • What stimulates release
  • Where it is released from
  • What it results in
A
  • Stimulated by peptides/aa, GRP and Ach
  • Released from G cells (in antrum of stomach)
  • Increases gastric acid secretion
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8
Q

For cholecystokinin (CCK) hormone, state:

  • Where it is released from
  • What stimulates it’s release
  • What the hormone causes
A
  • Released from I cells in duodenum & jejunum
  1. CCK release stimulated by fats & proteins
  2. Causes gallbladder contraction
  3. Pancreas stimulated to increase pancreatic/gallbladder secretions
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9
Q

For hormone secretin, state:

  • Where it is released from
  • What stimulates it’s release
  • What the hormone causes
A
  1. Secretin stimulated by H+ and fatty acids
  2. Secretin released from S cells in duodenum
  3. Secretin increases HCO3 secretion from pancreas/gallbladder and decreases gastric acid secretion
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10
Q

For gastric inhibitory peptide, state:

  • What stimulates release
  • Where it is released from
  • Actions of the hormone
A
  1. Sugars, amino acids & fatty acids stimulate release
  2. GIP released from cells in duodenum
  3. Increases insulin secretion and decreases gastric acid secretion
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11
Q

State 4 functions of stomach

A
  • Short term storage
  • Disrupt food through contractions of smooth muscle
  • Digestion
  • Disinfect
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12
Q

What is rugae and why is it beneficial in the stomach?

A

Rugae= temporary folds in the mucosa of stomach which allow it to distend

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13
Q

Label this image of stomach

A
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14
Q

State the epithelial transition from lower oesophagus to stomach

A
  • Lower oesophagus: stratified squamous
  • Stomach: simple columnar
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15
Q

State the 4 specialist epithelial cells present in the stomach

A
  • Mucous cells
  • Parietal cells
  • Chief cells
  • G cells
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16
Q

How many muscle layers does the stomach have? State the name of each

A

Remember: 4 layers of GI tract= mucosa, submucosa, muscular layer, serosa. We have already said in basic anatomy FC that muscular layer has two layers: outer longitudinal layer and inner circular layer.

The stomach has an extra oblique layer of muscle to enable it to mix and grind contents as well as move them along

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17
Q

What is the role of stomach acid? (3)

A
  • Helps to unravel proteins creating a larger surface are for enzymes to act on
  • Activates proteases in stomach lumen (pepsinogen - pepsin)
  • Disinfect stomach contents
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18
Q

Describe the contractions in:

  • Upper stomach
  • Lower stomach
A
  • Upper stomach: sustained contractions that create basal tone
  • Lower stomach: strong peristalsis to mix contents every 20 seconds or so
19
Q

Describe how the shape of the stomach aids movement of food

A

Stomach larger at proximal end than distal end meaning:

  • Contents are accelerated
  • Lumps are left behind
20
Q

How often is liquid chyme ejected into duodenum?

A

3 times per minute

21
Q

Describe the blood supply of the stomach

A

Celiac trunk has 3 branches:

  • Left gastric artery
  • Splenic artery- short gastric, left gastroepiploic
  • Common hepatic- gastroduodenal atery, right gastric & proper hepatic artery. Gastroduodenal gives rise to superior pancreasticoduoenal artery & right gastroepiploic artery

Right and left gastric anastomose= lesser curve

Right and left gastroeplipoic anastomose = greater curve

22
Q

State the venous drainage of the stomach

A
  • Left & right gastric veins directly into portal vein
  • Short gastric veins (fundus), left gastro-epiploic/ometnal veins
  • Right gastoepilpic vein, left and right pancreaticoduodenal veins drain into superior mesenteric vein
23
Q

Describe receptive relaxation of stomach

A
  • Consume food
  • Get vagally mediated relaxation of stomach
    • Allows food to enter stomach without increasing intra-gastric pressure too much
    • Prevents reflux of stomach contents during swallowing
24
Q

State what each of the following cells in stomach secretes

  • Parietal cell
  • G Cell
  • Enterochromaffin like cell (ECL)
  • Chief cell
  • D cell
  • Muscous cells
A
25
Q

Which cells are responsible for acid production in stomach?

What are they stimulated by?

A
  • Parietal cells
  • Stimulated by: gastrin, histamine & Ach
26
Q

State 2 circumstances under which acid production in stomach is increased

A
  • Amino acids/peptides detected
  • Stomach is distended
27
Q

State 2 circumstances under which stomach acid production decreases

A
  • Stomach distension reduces
  • Low pH detected
28
Q

State which each of the following regions of the stomach predominantly secretes

  • Cardia
  • Fundus/body
  • Pylorus
A
29
Q

Where are things secreted from in stomach?

A
30
Q

What stimulates HCL release from parietal cells in stomach?

A
  • Gastrin
  • Ach
  • Histamine
31
Q

State the three phases of digestion

A
  1. Cephalic
  2. Gastric
  3. Intestinal
32
Q

Describe HCL production is inhibited when food leaves stomach

A
  • Food acts as a buffer, when it leaves stomach pH drops
  • Low pH activates D cells
  • D cells release somatostatin
  • Somatostatin inhibits:
    • G cells: which then inhibits gastrin
    • ECL cells: which inhibits histamine

(we know that gastrin, histamine and Ach stimulate parietal cells to secrete acid)

33
Q

Describe the cephalic stage of digestion

A

Vagus (parasympathetic) nerve stimulates:

  • Parietal cells to secrete gastric secretions before food is swallowed
  • GRP release from G cells

Gastric motility also increases

34
Q

Describe the gastric stage of digestion

A
  • Distension of stomach stimulates vagus activity
  • Vagus nerve stimulates parietal and G cells
  • AA and smal peptides further stimulate G cells
  • Presence fo food prevents lowering of pH and removes inhibition on gastrin
  • Gastrin, along with enteric nervous system, then causes strong smooth muscle contractions
35
Q

Describe the intestinal phase of digestion

A

First part is about increasing acids production:

  • Chyme, released into duodenum, initially stimulates gastrin secretion which stimulates acid production

Second party about reducing acid secretion:

  • Very quickly get inhibition of G cells
  • Lipids activate enterogastric reflex which reduces parasympathetic activity to stomach to reduce acid secretion and stomach motility
  • Chyme stimulates CCK and secretin to further reduce acid secretion
36
Q

What does the stomach secrete, and what cells secrete this, to protect itself?

A

Foveolar cells secrete mucus to form a mucus layer that adheres to epithelium and prevents it from physical damage. HCO3- is secreted into the mucus to help it act as a barrier against stomach acid

37
Q

What does the stomch have to buffer acid that has breached the mucus layer?

A

Gastric mucosa has rich blood supply that can remove and buffer acid that has breached mucus layer. Prostaglandsin promote this process.

38
Q

State some things that can breach stomach defences

A
  • Alcohol: dissolves mucus layer
  • Helicobacter pylori: chronic active gastritis
  • NSAIDs: inhibit prostaglandins
39
Q

Describe how acid in antrum stimulates D cells

A
  • Acid (H+) stimulates D cells to release somatostatin which inhibits gastrin release from G cells to inhibit too much acid being produced from parietal cells
40
Q

Describe where abouts on abdominal aorta the superior mesenteric artery branches

A
41
Q

What does stomach acid do to zymogens?

A

Activates the unactived enzymes (zymogens)

42
Q

This image is summary!

A
43
Q

Briefly summarise all 3 phases of digestion (including HCl production at each stage)

A