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Physiology Kerry > 8. GI Physiology > Flashcards

8. GI Physiology Flashcards

1
Q

Gastric acid secrtion
which cells
where in stomach

A

Parietal cell secrete H and CL
located fundus and body stom

also secrete intrisnic factor
necc abs B12 term Il

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2
Q

How is H prod

how secrete

A

Rxn Co2 + H20 by carbonic anhydrase

active tpor by h k atpase

hco3 bl membrane exchange Cl - antiport

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3
Q

Max H grad accross

A

Ph 7.4 and gastric Ph 1.4 - gradient 6 ph units
H grad 1,000,000 (10^6)

max grad could be higher as ph can be as low .87

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4
Q

What is the alkaline tide

agstric resp quiotient

A

Alakine state gastric ven blood - suffc prod alk urine
lvel gastric acid resul large amt bic - secrete vessel drain stom

max acid secretion in partietal - net consump co2 sotmahc

resp quitient - negative neg co2 production

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5
Q

Humoral factos act parietal stim gatric acid secretion

A

Hist H2 rec
(AC )

Ach M1

Gastrin gastrin rec -

act BLMembr

Ach & gastrin - increase intra cell Ca

both Ca inc and cAMP increase - act pro kin increase act H pump

PGE2 inhbi AC via Gi - decrease gastric secretion

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6
Q

Where is gastrin produced

Main action

A

Gastrin prod G cell - located antrum

neuroendocrine cell - derived neural crest

Stim acid sec - partietal into lum

stim pensinoogen - chief cell in lumen

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7
Q

Main actions gastric acid

A

Activate pensinogen to prod pepsin

assit protien dgiestion pepsin req low pH acivity

Help rpevent infectio

Inhib gastri antral G cell

Increase secretion bile and panc juice

Fail iron absorption

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8
Q

Bile acids

whats bile

A

Fluid secreted by the liver into th ehpeatic ducts

comppostion undergoes modifcation in the gallbladder

Contrains
Water
Salts
Pigments
Electrolytes
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9
Q

What are the bile salts

A

Steroid compound prod liver from cholesterol

conj taurine / glycine and excreted in bile

Form Salts Na + K
BIle acids classify intro primary and secodnary bile acids

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10
Q

Primary bile acids

Secondary bile acids

A

Primary - produce liver
cholic acid
chenodeoxycholic acid

daiyl syhtn - .5g day - may net faecal loss acids

PRod intest action bacteria - prim
small int normally no except ileum
colon - huge bac load
secondary acids
deoxycholic
litholchilic acid
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11
Q

Whats the circulation of acids

A

95% reabs term ileum return liver in portal vein - maint low prod

If lost (eg fistual) - liver can increase rate synthesis of salts

TOtal bile acid pool 2.5 -3gm

Pool circ 2-3 per meal for 2 meals d - effective bile acid pool 27g day

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12
Q

What is the fxn of bile acid

A

Facil absorption lipds sml int
abesence 50% ignested fat in faceas

1 Emulsifying - detergnet action on fats
monoglyc plip - fat to break into large number - minute fat partciles

decrease surf tension fat particles

2 Formation of lipid micells

Cause fat form sml highly solube discs micells
acid amphipathic
hydrohpilic outside - tport bruse border lipid diffuse across lip membrane

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13
Q

Fat sol bitains

A

ADEK

Defici - abesent bile salt

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14
Q

Functions of liver

A

1 Lipid metab
-fatty acid oxid
synth chol + PLipd
prod ketoacids

2 Carb metab
Glycogen metab
gluconeo
glucstat fxn

3 protein metab
aa metab
turonvover prote
synthesis - alb coag carri

4 Urea

5 Bile

6 Drugs & xenobitiics

7 RES - kupffer

8 Endocrine
synth 25 hydroxycalc
inact some hormone 
precursos sythn
metaob steroid
somatemedins
epo

9 Haemotopoesis

10 Blood resevoir

11 Storage xn

12 Role AB bal

Nearly all plasma prot cept ig - prod liver

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15
Q

How does liver act as a resevoir

A

10% tbv normall liver

hypervol/rhf increase to 15000
hypo - exercise / ep sym stim deliver 350 mls

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16
Q

What is reticuloendothelial system

A

Tissue macrophage and monocytes - distrb various sties around body

Moncyote - bm progenitor cell - rel bstream migrat tissue differentiate to cell RES

Tissue macrophage in system -
Kuppfer cell lining hepatic sinusoids

Macrophage lining sinusoids bm + spleen

Pulmonary alveolar macrophage

Macrophage in LN

Migrolial cell CNS

Osteoclasts

Major fxn
1 antigen process and presse esp cII MHC

Phagocytosis - Bact cell dbri

R/O bacteria old RCC other debri

Secr vary cytokine - response infect regulation haemoeisis

maco - attract acute inflam - involved paho savengin antigen process

17
Q

How are liver and spleen involved

A

Kuppfer in liver - improtant component of RES _ line sinusoids - effective removing all ivnetivale number colonic bact enter portal bood

SPelen - senecent red cell and plt

Kuppfer - iron recycle

18
Q

Liver in ab metab

A

Net prod / consuer H ion

CO2 prod - oxidation
20% use o2 = 20% co2 production

Metab acid anion
Lactate / keto or citrate tfusi

endog - not result prod H - exog = prod bic

AA metab - incomp metab net fix acid prod

Ammonium Nh4 to rurea -

19
Q

Vomiting

what diff bom reguarg

A

Vom active muscular contract

regurg - passive

VOm centre
autonom sym / nausea

Inspire - hold breat mid insp glottis closed - prtect airway
soft palat - eleavted nasal airway soil

LOesSph + Up releax
abdominal muscle cotnrat - rise IAP compress stomach - gatri content force expell oes exit motuh

20
Q

Whats Nausea

A

Unpleasant concious sensation a.w vomiting

occur prodmal to vom

Vom Can also occur without N

21
Q

WHat stimli cause vom
how act
what causees vom if swallow gastric irritant

A

BOdy mech rid gastric and bowel content - adbant ingest toxin

Most stim bowel brain
bowel - mus irrital trav vom - sym vagal aff - CTZ not involved

SOme circ chem - CTZ

Vestibular system - ctz and driect to vom
anticholinergic more effective rx type nausea

Other area - ptoent input
odours
psyhogenic / pain

22
Q

Wht CTZ

A

ARea postream later wall 4th venticle

lies outside BBB circunticular organ

Var sub circ stim CTZ = vom

23
Q

What is the adeverse conseq persistent vomiting

A

Water electrolyte and ab balncetypical finding vom pyoloric steno -
hypoCl
Na
K
Met alk
hypovl
VOm direct loss fluid acid - contract alkaslois

RAAS _ active secon hypoaldo

kidney conserve water Nad NA presisten - loss K
hypo - due to renal loss

24
Q

ACid base effect

A

Met alk
Plasam bic elvated

Nroamlly kidney excrete bic but there is avolme contract
cl defic - impair kid excrete

Loss gastric acid initate alkolis
second effect kidney maint high bic

25
Q

Is it alway alkalois

A

Perist vom - signif alkaline sb conent bile

comon vom - no dev plasma ph or met acidosis if acid loss excess gatric acid

26
Q

What fluid for severe pyloric stenois

A

FLuid
Na replace loss assis iv vol def

K

CL

NaCl with ad potassium

27
Q

Digestion and absoprtion of carbohydrates

A

Digestion - bdwon dietary macromol in tosmaller readily absor compound

Staches - amylopetin

oilgosacch - disacch sucroese lactose

Only monosach - abosrb bowel - all dig

End prod dig -
GLucose
Galactose
Fructose

Enzymes
Saliv a amy
panc a amylase
sucrase
mamlstase
lacta
a lim dextrinase
thehalase

Starch moslt ingest amyopectin

All plant starch polymer gluc

Storage animal - glycogen
glucose polymer

Saliv amylast - mouth min dig short time

active stoma - contrib as ph drop inavt

act in dup ph rise

Panc A amylase - dig starch in SI
not bdown complete

28
Q

How Monosacch produced

A

Brush border - intest cell 5 oligosaccharidases - Respons 0 final breakdwon oligosach to mono

Sucrase- prod fructose and glucose sucrose
lactase- prod gluc and galact - lastose
a lmit dextrianse - gluc from a limit dextrin
maltase - gluc maltose and amtlotriose
trehlaase -< trehalose

29
Q

How abosorb

A

Only monosachh - small intent

GLuc + Na - cotport
secondar active - energy is prodice low intracell Na
dt act tport na blm membrane

Gluc can always be uptaken - cause cotport sodium

Galactose - comepte glucose - smame co por

Membrane Na indep tport - GLut 1-5
Frciose GLut 5
GLu 2 - Glucose and frcutose

Gluc Na cotport - eneterocytes - unrel to glucose tport portein GLut 4 stim insulin in adipose and muslce
insulin no direct effect on glucose uptake bowel

Diet pentose sugar - ribose abosrb simple diffusion

30
Q

Summary Dig and absorb carb

A

Gluc is abs Na GLuc co tport

Galactose - uses same tport

Fructose absorbed na Indep tport

Gluc and fructose use same Na indep gluc tport crosee blm

Activeity tport not affected insulin

31
Q

Abdominal pressure

What fxn ant abdo wall

A

Layers muscle fat ct skin

1 protect abdominal viscrea

Muscular contract 0 IAP phy act
defecatin vom micturit cough sneeze

Ventilaton - relax imporat diaphragm breathing

Route easy surgical acces to periotenal cavity -

allows change during preg

32
Q

What happens during a cough

A

Cough - protect mech irway
expel irritait mat airway - catch 0 high velolcity turbulent gas stream

1 - Inspiration
epiglsottis cord close tightly
abod forcefuly contract - pressure chest >100mmhg - 
Finall cords and epilgottis open
ALow rapid exit high pressure

Bornchi collpase - intratho high
cords open gas squeeze thru slits - collapsed bronch trachea - squeeze - aids removal materials on walls airway

Pressure - squeeze heart - VF- cardiac cath - cough - cause low co - prevent LOC

Physiology Kerry (17 decks)

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