4LE Physio HM Flashcards

1
Q

What are the components of the GI system?

Mouth
Pharynx
Esophagus
Salivary glands
Pancreas
Stomach
Liver
Gallbladder
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus
A
Mouth and Pharynx
Esophagus
Stomach
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus
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2
Q

What are the accessory organs in the GI system?

Mouth and Pharynx
Esophagus
Salivary glands
Pancreas
Stomach
Liver
Gallbladder
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus
A

Salivary glands
Pancreas
Liver
Gallbladder

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3
Q

What are the physiological processes of GIT

A

Motility
Secretion
Absorption
Digestion

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4
Q

What are the secretory part of the GI system?

Mouth and Pharynx
Esophagus
Salivary glands
Pancreas
Stomach
Liver
Gallbladder
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus
A
Mucosa of SI
Large Intestines
Esophagus
Pharynx
Salivary glands
Liver
Pancreas
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5
Q

What neuroligic system of the body facilitates digestion and absorption that is most concerend with the process if digestion?

  • Autonomic Nervous system - parasympathetic
  • Enteric Nervous system - sympathetic
  • Somatic Nervous System
A

Autonomic Nervous system - parasympathetic

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6
Q

It is a type of ANS that Inhibits control of the GIT

Sympathetic
Parasympathetic

A

Sympathetic

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7
Q

It is the dominant neural control of the GIT

  • Autonomic Nervous system
  • Enteric Nervous system
  • Somatic Nervous System
A

ANS

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8
Q

90% of GIT is mostly composed of?

SKELETAL MUSCLE
SMOOTH MUSCLE
GLANDS
CARDIAC MUSCLE

A

SMOOTH MUSCLE

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9
Q

The ANS is usually most functional in?

SKELETAL MUSCLE
SMOOTH MUSCLE
GLANDS
CARDIAC MUSCLE

A

glands, cardiac muscle and smooth muscle

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10
Q

Urge to vomit, nausea, abdominal pain and other SOS signals makes the ____ to communicate to the brain .

  • Autonomic Nervous system
  • Enteric Nervous system
  • Somatic Nervous System
A

ENS

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11
Q

Neurological system that is for voluntary control of skeletal ms at the external anal sphincter, mouth and pharynx and the upper 1/3 of the esophagus

  • Autonomic Nervous system
  • Enteric Nervous system
  • Somatic Nervous System
A

Somatic Nervous System

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12
Q

THE_____ facilitases localized contraction and secretions that can respond to the changes that are felt by the sensory neurons

  • Autonomic Nervous system
  • Enteric Nervous system
  • Somatic Nervous System
A

ENS

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13
Q

interneuron projecting caudally and functions for muscle relaxation

Ach-
GCRP
somastatin
substance P

A

somastatin

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14
Q

they are release by bipolar neurons and functions in pain pathways and modulate inflammation

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin
A

substance P
GCRP
Ach-

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15
Q

two types of electrical waves that excites the GIT smooth ms

  • true action potential
  • not action potential

Slow wave
Spike potential

A

Slow wave - not action potential

Spike potential - true action potential

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16
Q

It occur when the RMP of GI smooth ms becomes more positive that -40mV

Slow wave - not action potential
Spike potential - true action potential

A

Spike potential

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17
Q

Inhibit motor and secretory function of GIT

Sympathetic NS
Parasympathetic NS

A

Sympathetic NS

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18
Q

stimulates motor and secretory function of GIT

Sympathetic NS
Parasympathetic NS

A

Parasympathetic NS

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19
Q

Parasympathetic and sympathetic nerve system both carry _____ nerve fibers

afferent
efferent

A

afferent

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20
Q

Type of neurotransmitter that is in the myenteric plexus and contracts the smooth ms

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin
A

gamma - aminobutyric acid

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21
Q

it is an interneuron meurotransmitter

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin
A

serotonin

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22
Q

An inhibitory neurotransmitter from synapsing adregenic neuron

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin
A

neuropeptide Y

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23
Q

Pacemaker cells found in the CT interstitium near the smooth ms cells and is the pacemaker sites of slow waves

myenteric plexus
Interstitial cells of Cajal (ICC)
Cholecystikinin 
GIP
Sensing Cells
A

Interstitial cells of Cajal (ICC)

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24
Q

True action potential found in the GIT that excites muscle contraction

Slow wave
Spike potential

A

Spike potential

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25
Q

When does the frequency of spike potential increases?

the higher the slow wave potential rises
the higher the slow wave potential decreases
the lower the slow wave potential rises
the loweer the slow wave potential decreases

A

the higher the slow wave potential rises

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26
Q

Pathway of basic electrical rhythm

a) ICC- interstitial cells of cajal -> Slow waves -> smooth muscle contraction -> spike potential
b) Slow waves -> spike potential -> ICC- interstitial cells of cajal -> smooth muscle contraction
c) ICC- interstitial cells of cajal -> Slow waves -> spike potential -> smooth muscle contraction
d) ICC- interstitial cells of cajal -> spike potential -> Slow waves -> smooth muscle contraction
e) ICC- interstitial cells of cajal -> smooth muscle contraction-> Slow waves -> spike potential

A

ICC- interstitial cells of cajal -> Slow waves -> spike potential -> smooth muscle contraction

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27
Q

Main endocrine hormones

myenteric plexus
Interstitial cells of Cajal (ICC)
Cholecystikinin 
GIP
Sensing Cells
A
Cholecystikinin 
- gall bladder contraction
- gastrointestinal motility
- pancreatic exocrine secretion
Secretin
- pancreatic exocrine secretion
GIP
-incretin activity
Motilin
- gastrointestinal motility
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28
Q

Examples of paracrine

histanime
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin
A

histanime

somatostatin

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29
Q

Function of Paracrine - processes where a chem messenger/regulatory peptide is released from ____ in the intestinal wall

myenteric plexus
Interstitial cells of Cajal (ICC)
Cholecystikinin 
GIP
Sensing Cells
A

sensing cell

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30
Q

A mechanical digestion of food to facilitates enzymatic digestion

A

mastication or chewing

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31
Q

Saliva is secreted by:

parotid gland (largest salivary gland)
sublingual gland
submandibular gland

A

parotid gland (largest salivary gland)
sublingual gland
submandibular gland

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32
Q

List major charactersitic of saliva

  • large vol relative to mass (1-1.5L per day)
  • low K conc
  • high osmolarity (quite diluted)
  • contains specialized inorganic materials
A
  • large vol relative to mass (1-1.5L per day)
  • high K conc
  • low osmolarity (quite diluted)
  • contains specialized organic materials
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33
Q

salivary component involved in lubrication

mucins
proline-rich glycoproteins
Cholecystikinin 
GIP
water 
amylase
defensins
lipase
ribunuclease
A
mucins
proline-rich glycoproteins
water
amylase
defensins
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34
Q

salivary component involved in growth

epidermal growth fator EGF
Trasforming growth factor (TGF) - a, b
fibroblast GF - FGF
insulin-like gf

A

epidermal growth fator EGF
Trasforming growth factor (TGF) - a, b
fibroblast GF - FGF
insulin-like gf

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35
Q

salivary component involved in buffering

water
gustin
mucin
bicarbonate
phosphate ions
proteins
A

bicarbonate
phosphate ions
proteins

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36
Q

salivary component involved in digestion

mucins
proline-rich glycoproteins
Cholecystikinin 
GIP
water 
amylase
defensins
lipase
ribunuclease
A
amylase
lipase
ribonuclease
protease
water
mucin
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37
Q

salivary component involved in taste

water
gustin
mucin
bicarbonate
phosphate ions
proteins
A

water

gustin

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38
Q

salivary component involved in speech

water
gustin
mucin
bicarbonate
phosphate ions
proteins
A

water

mucin

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39
Q

a ) Phases in swallowing or deglutition

b) reflex mechanism where nasopharynx close to prevent regurgitation
c) palatopharyngeal folds are pulled medially to form passage for foor to move into the pharynx
d) primary peristalsis - follows swallow and its secondary peristalsis - food remain stuck in the esophagus (ENS senses this condition)

Oral Phase
pharyngeal phase
Esophageal phase

A

a) Oral Phase
pharyngeal phase
Esophageal phase

b) pharyngeal phase
c) pharyngeal phase
d) Esophageal phase

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40
Q

Prevents reflux of acidic gastric contents into the esophagus

VIP - vasoactive intestinal polypeptide
LES - lower esophageal sphincter
NO - nitric oxide
Interstitial cells of Cajal (ICC)

A

LES - lower esophageal sphincter

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41
Q

receptive relaxation is mediated by vagus nerve secretes _______ when food is brought by peristalsis into esophagus

VIP - vasoactive intestinal polypeptide
LES - lower esophageal sphincter
NO - nitric oxide
Interstitial cells of Cajal (ICC)
Fundus of the stomach
A

VIP - vasoactive intestinal polypeptide

NO - nitric oxide

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42
Q

Other than LES, this also relaxes to accommodate more food

VIP - vasoactive intestinal polypeptide
LES - lower esophageal sphincter
NO - nitric oxide
Interstitial cells of Cajal (ICC)
Fundus of the stomach
A

Fundus of the stomach

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43
Q

Closes the LES - lower esophageal sphincter

Coffee without the caffeine
GERD - gastroesophageal reflux disease
enterogastric reflex

A

Coffee without the caffeine

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44
Q

LES unable to maintain normal tone

Coffee without the caffeine
GERD - gastroesophageal reflux disease
enterogastric reflex

A

GERD - gastroesophageal reflux disease

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45
Q

In gastric motility, what occurs during

a. ) fundus enlarge as food enters the stomach
b. ) food in the body and antrum increases contraction: peristalsis and retropulsion
c. ) chyme is propelled through the polyric sphinctier into the intestines
d) synchronous contractions of fundus , body and antrum
e. fundus becomes quiescent, stores food

 between meals
 mixing
 emptying
 storage
 right after meal
A

a. storage
b. mixing
c. emptying
d. between meals
e. right after meal

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46
Q

contractions that goes towards the caudal end

enterogastric reflex
mixing reflex
lactating reflex
Peristaltic

A

Peristaltic

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47
Q

excitatory hormone in gastric emptying

mucus
bicarbonate
gastrin
pepsin
HCl
Ach
A

gastrin

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48
Q

Cholecystokinin and secretin are what type of gastric emptying hormone?

excitatory
inhibitory

A

inhibitory

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49
Q

local reflex taht streched the antrum and increase volume in gastric emptying

excitatory
inhibitory

A

excitatory

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50
Q

example of a inhibitory gastric emptying local reflex

enterogastric reflex
mixing reflex
lactating reflex
vomiting reflexes
Peristaltic
A

enterogastric reflex

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51
Q

They are for protection of gastric mucosa against acidic and peptic luminal environment

mucus
bicarbonate
gastrin
pepsin
HCl
Ach
A

mucus and bicarbonate

52
Q

It is consist of a gel-forming glycoprotein (mucins) and protective layer of epithelium

mucus
bicarbonate
gastrin
pepsin
HCl
Ach
A

mucus

53
Q

NaHCO3 a neutrulizer is increased by ____ and decreased by _____

stress
PNS
aspirin-NSAIDs
sympathetics (NE, Epi)
mucosal irritation
prostaglandins
empty stomach
smoking
A
increased by:  
mucosal irritation
PNS
prostaglandins
empty stomach
decreased by:
stress
sympathetics (NE, Epi)
aspirin-NSAIDs
smoking
54
Q

Main digestive enzyme

mucus
bicarbonate
gastrin
pepsin
HCl
Ach
A

pepsin

55
Q

Pepsins secreted as inactive ___________ is activated by decrease in pH (HCl).

gastric and intestinal phases
mucus and bicarbonate
pepsinogen I and II

A

pepsinogen I and II

56
Q

_____ provides optimal pH for pepsins, it kills ingested bacteria and it stimulates the flow of bile

mucus
bicarbonate
gastrin
pepsin
HCl
Ach
A

HCl

57
Q

Increased Vit B12 leads to increase ____ secretion

mucus
bicarbonate
gastrin
pepsin
HCl
Ach
A

HCl

58
Q

It binds Vit B12 and aids its absorption in the ileum

Intrinsic Factor (IF)
Extrinsic Factor
A

Intrinsic Factor (IF)

59
Q

Stimulus for all the phases in the mechanisms of stimulating gastric secretions

mucus
bicarbonate
gastrin
pepsin
HCl
Ach
A

Ach

Gastrin

60
Q

Chewing and swallowing are stimuls for what?

gastric phase
cephalical phase
intestinal phase

A

gastric and intestinal phases

61
Q

Distension and digested protein are stimulus for?

gastric phase
cephalical phase
intestinal phase

A

gastric and intestinal phases

62
Q

Organs of the body that have all the phases of gastric secretion

esophagus
stomach
pancrease
small intestine
colon
A

stomach and pancreas

63
Q

What ar the phases of gastric secretion

gastric phase
cephalical phase
intestinal phase

A

gastric
cephalic
intestinal

64
Q

TRUE or FALSE
In the cephalic phase
a. presence of food in the mouth inhibits gastric secretion
b. increase in appetite also increase stimulation
c. increase sympathetic stimulation (stress ) mucsla lining decreases

A

a. FALSE, it stimulates gastric secretion
b. TRUE
c. TRUE

65
Q

Accounts for 60% (1.5L) of total gastric secretion associated with eating meals

gastric phase
cephalical phase
intestinal phase

A

gastric phase

66
Q

Accounts for 10% of total gastric secretion associated with eating meals

gastric phase
cephalical phase
intestinal phase

A

intestinal phase

67
Q

Distended intestines ________ gastric emptying

stimulate
inhibit

A

inhibits

68
Q
increase or decrease ???
cephalic phase
a. loss of appetite
b. stimulation of taste and smell receptors
c. sight and thought of food
d. depression
gastric phase
e. excessive acidity in stomach
f. stomach distention
g. emotion upset
h. food chemicals
intestinal phase
i. presence of partially digested food in the duodenum when stomach begins to empty
j. presence of acidic, hyper or hypotonic chime/irritants in the duodenum
A

a. dec
b. inc
c. inc
d. dec
e. dec
f. inc
g. dec
h. inc
i. inc
j. dec

69
Q

The three agonist of parietal cells in gastric secretion

gastrin
bicarbonate
histamine
pepsin
ranitidin
Ach
A

gastrin
histamine
acetylcholine

70
Q

blocks H2 receptors wherein 90% of acid production is inhibited

gastrin
bicarbonate
histamine
pepsin
ranitidin
Ach
A

ranitidin

71
Q

type of receptor

acetycholine: __
histamine: __
gastrin: __
somatostatin: ___

H2 receptor
muscarinic receptor
inhibitor; secreted by D cells
CCKB receptor

A

: muscarinic receptor
: H2 receptor
: CCKB receptor
: inhibitor; secreted by D cells

72
Q

Taking Lozec premanently inhibits the ______ but the stomach produces new parietal cells daily so these drugs are taken daily to dec acidity and not totally terminated

H-K pumps
Na-glucose cotransporter
Na-K pumps

A

H-K pumps

73
Q

Is triggered by stimulation of vomiting center (medulla), chemoreceptor trigger zone and duedenal receptor (intestines)

enterogastric reflex
mixing reflex
lactating reflex
vomiting reflexes
Peristaltic
A

vomiting reflexes

74
Q

Sequence of events during emesis / vomiting

  • reverse peristalsis
  • LES relaxes
  • forceful contraction of abdominal muscle - increased intraabdominal pressure
  • pyloric sphincter and stomach relax
  • forced inspiration on closed glottis - dec intrathoracic pressure
  • UES relaxes
A
  1. reverse peristalsis
  2. pyloric sphincter and stomach relax
  3. forced inspiration on closed glottis - dec intrathoracic pressure
  4. forceful contraction of abdominal muscle - increased intraabdominal pressure
  5. LES relaxes
  6. UES relaxes
75
Q

Continous vomiting results in:

  • increase acidity in lumen
  • decrease acidity in lumen
  • increase activity of H-K pump
  • decrease activity of H-K pump
  • metabolic alkalosis
  • metabolic acidosis
A
  • decrease acidity in lumen
  • increase activity of H-K pump
  • metabolic alkalosis (loss of H+)
76
Q

what are the origin of vomitus and determine their determined by color

stomach
intestines - yellowish and greenish

A

stomach

intestines - yellowish and greenish

77
Q

movements of intestines that does mixing contractions is __a__ and movement that does propulsive contractions is __b__?

segmentation
perstalsis

A

a. segmentation

b. perstalsis

78
Q

keeps the bacterial concentration low in the small intestines

A

ileocecal junction

79
Q

It occurs in between meals.

A

migrating myoelectric complex

80
Q

In migrating myoelectrical complex, peristalsis occurs in _____

A

circular to longitudal muscle contraction

81
Q

_____ and _____ inhibit small intestines motility

A

secretin ; glucagon

82
Q

This is a localized stimulation of the SI at a certain point will produce a contraction at the area near the oral end and relaxation at the area near the anal end

A

Peristaltic reflex

83
Q

A response where it removes blockage and distention occur

A

intestinointestinal reflex

84
Q

The stomach stimulates the ileum to increase motility

A

gastroileal reflex

85
Q

A reflex , when stomach is full the ileum will increase motility, if the ileum is full the stomach stop moving

A

ileogastric reflex

86
Q

in anointestinal reflex, a full anus inhibits ____

A

intestinal motility

87
Q

the only part of the large intestine taht is complete in all the layering would be ____

A

the part near the rectum

88
Q

What are the principal function of the colon?

A
  • absorption of water and electrolytes from the chyme to form solid feces
  • storage of fecal matter until it can be expelled
89
Q

Large intestine motility is regulated primarily by the

A

ENS - neural pathways

90
Q

The only movement when we are asleep which is more prominent in the sigmoid colon and rectum

A

rectal motor complex

91
Q

Phases of migrating myoelectric complex

A

phase 1: Quiescent pahse - there is no significant elec and mech activity. SI is still

Phase 2: Increasing action potential frequency - period of small disorganized contraction

Phase 3: Peak electrical and mech activity - large or intense contraction

92
Q

Hormone responsible for peak electrical and mechanical activity of the mograting myoelectric complex

A

motilin

93
Q

Secreted by the upper duodenum during fasting

A

motilin

94
Q

it is the most important reflex

A

peristaltic reflex

95
Q

gastrocolic and duedenocolic reflexes are transmitted by way of ____

A

ANS

96
Q

Reflex contraction of the rectum and relaxation of the internal and external anal sphincter

A

defacation

97
Q

Strongly inhibits the excitatory nerves and thereby causes intestinal paralysis, especially in patients with peritonitis

A

peritoneointestinal reflex

note: results from irritation of peritoneum

98
Q

inhibit intestinal activity as a result of kidney irritation

A

renointestinal reflex

99
Q

inhibit intestinal activity as a result of bladder irritation

A

vesicointestinal reflex

100
Q

contraction of puborectalis muscle forms

A

anorectal angle

101
Q

it maintains fecal continence

A

puborectalis muscle

102
Q

In the pancreas, the digestive enzyme are secreted _______ and the large volumes of bicarbonate solution are secreted by the _________

A
  • pancreatic acini

- small ductules and larger ducts leading to the acini

103
Q

Pancreas secretes insulin and glucagon from where

A

Islets of langerhans

104
Q

The liver secretes ____ which can be stored in the ______

A
  • bile

- gallbladdes

105
Q

What is the quantity of Bile production of the liver

A

600-1000 ml/day

106
Q

what are the function of bile?

A
  • emulsify fat particles

- aid in absorption of digested fats

107
Q

what are the stages of bile secretion

A
  • initial portion is secreted by the hepatocytes
  • bile flows in the canaliculi -> interlobular septa -> terminal bile ducts -> larger ducts -> hepatic duct and common bile duct
108
Q

What is the bile capacity of the Gallbladder?

A

30-60ml

109
Q

What are the endocrine function of the pancreas?

A

insulin

glucagon

110
Q

what are the exocrine functions of the pancreas?

A
enzyme
lipase
amylase
protease
bicarbonate
111
Q

Pancreatic enzymes are used for?

A

Starch, protein, fat and DNA digestion

112
Q

Pancreas secretion are inactivated but are activated by a ?

A

neural or basic pH blood supply

113
Q

Secretions by this organ are quantitatively the largest contributors to enzymatic digestion of the meal

A

Pancreas

114
Q

It attaches lipase to fat molecule

A

colipase

115
Q

It prevents activation of trypsinogen to trypsin

A

PSTI (Pancreatic Secretory Trypsin Inhibitor)

116
Q

Whys is PSTI (Pancreatic Secretory Trypsin Inhibitor) important?

A

Prevents pancreatitis (while trypsin is activated while in the pancreas)

117
Q

A trypsin activator secreted by the intestinal mucosa when chyme comes in contact with mucosa

A

Enterokinase

118
Q

___ are the most important enzymes in the pancreas for digesting protein

A
  • trypsin
  • chymotrypsin
  • carboxypeptidase

note:
pancreatic amylase - digest carbohydrates
pancreatic lipases - digests fats
trypsin is the most abundant enzyme

119
Q

It neutralizes the HCL acid emptied into the duodenum from the stomach

A

bicarbonate

120
Q

Secretin is secreted by the ___

A

intestine (S Cells)

121
Q

_____ stimulates the ductal cells of the pancreas to secrete/produce bicarbonate

A

secretin

122
Q

Cholecystokin is secreted by the

A

intestine (I cell)

123
Q

It stimulates the acinar cells of the pancreas leads to the secretion/production of pancreatic digestive enzyme

A

cholecystokinin

124
Q

Factors regulating pancreatic secretion after a meal

A

Cephalic phase - stimulated by thought of food -> mediated by release of Ach and gastrin by vagal stimulation -> inc. secretion, with greater effect on enzyme output

Gastric phase - stimulus is protein in food -> mediated by gastrin -> inc. secretion with greater effect on enzyme output
- stimulated by gastric distention -> mediated by vago-vagal reflex -> inc. secretion with greater effect on enzyme output

Intestinal phase -
-stimulated by acid in chyme -> mediated by secretin secreted by duodenal S-cells -> inc. water and bicarbonate secretion

  • stimulated by Long chain fatty acid -> mediated by cholecystokini and vago-cagal reflex -> inc. secretion with a greter effect on enzyme output
  • stimulated by amino acids and peptides -> mediated by vago-vagal reflex and cholecystokinin -> inc. secretion with greater effect on enzyme output
125
Q

What are the digestive function of the liver

release bile acids and bicarbonate

A

release bile acids and bicarbonate

126
Q

Responsible for the feces’ yellowish or golden brown color

A

bile

127
Q

what are the primary and secondary bile acids?

deoxycholic and lithocholic acid
chenodeoxycholic and cholic acid

A

primary: chenodeoxycholic and cholic acid
secondary: deoxycholic and lithocholic acid