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A&P2: Gastro Flashcards

1
Q

Define Metabolism?

A

Use of nutrients gained from food to build, maintain and provide energy
Interactive set of chemical pathways to make life possible

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2
Q

After food is digested, molecules are placed into which part of the circulatory system?

A

Portal vascular system

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3
Q

Define assimilation

A

When nutrient molecules enter cells and undergo chemical changes

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4
Q

How is thermal heat released into the body and for what purpose?

A

Frequent, small bursts

Homeostatic body temps

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5
Q

What has to happen to chemical energy before it can be used?

A

Transferred into ATP

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6
Q

What is the difference between Micro and Macro nutrients and their ability to be absorbed?

A

Micro- absorbed in original form

Macro- need to be catabolized into smaller forms

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7
Q

What is the largest size a protein can be and still be absorbed?

A

AAs
Dipeptide
Tripeptides
All can be absorbed as is

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8
Q

What length/form do carbohydrates need to be in order to be absorbed?

A

Monosaccharide

Glucose, fructose, galactose

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9
Q

What form/length do lipids need to be in order to be absorbed?

A

Fatty acids

Monoglycerides

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10
Q

What are examples of Micronutrients?

A

Vitamins
Minerals
Needed in SMALL quantities

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11
Q

How many essential micronutrients are there?

A

28

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12
Q

What is the major source of biological energy used by organisms?

A

Carbs

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13
Q

Carbohydrates come in what 3 forms?

A

Mono
Di
Poly

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14
Q

Digestion of carbohydrates requires what type of enzymes?

A

Amylases

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15
Q

What is the absorbable form of carbohydrates?

A

Monosaccharides
Glucose
Fructose
Galactose

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16
Q

What are the nonabsorbable forms of disaccharides?

A

Sucrose- glucose + fructose
Lactose- Glucose + galactose
Maltose

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17
Q

Which disaccharide is a byproduct of starch digestion?

A

Maltose

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18
Q

What are the polysaccharide forms that are unable to be absorbed as is?

A

Starches
Glycogen
Cellulose

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19
Q

What combines to make starches?

A

Amylose + amylopectin

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20
Q

Where is glycogen placed for storage?

A

Liver
Muscles
Glial cells of brain

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21
Q

What is the chemical name for fiber?

A

Cellulose

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22
Q

Carbs can be classified within the diet under what two categories?

A

Simple- mono and disaccharides

Complex- polysaccharides

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23
Q

What is the most common form of lipid found in the diet and in the body?

A

Triglycerides (TAGs)

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24
Q

Define TAGs

A

High energy nutrient synthesized and stored in adipocytes and hepatocytes

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25
Q

TAGs are required in the body for absorption of ____?

A

Fat soluble vitamins

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26
Q

What provides constituent molecules for cellular membranes?

A

TAGs

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27
Q

What are the simple lipids?

A

Fatty acids: Sat/unsat/triacyglycerols

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28
Q

What compounds can join triacyglycerols to make compound lipids?

A

Phopholipds- FA+phosphorus+N
Glycolipids- FA+carbs+N
Lipoproteins

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29
Q

Where are functions of compound lipids?

A

Cell membrane
Nerve sheath
Helps w/ cellular recognition

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30
Q

Where are glycolipids found?

A

Cell membrane

Facilitate cell recognition

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31
Q

What are the types of Lipoproteins?

A

Chylomicrons
VLDL
LDL
HDL

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32
Q

Define Derived Lipid

A

Simple+compound lipid

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33
Q

What are examples of derived lipids?

A

Steroids- especially cholesterol
Terpenes
Fat soluble vitamins
Ketone bodies

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34
Q

Where are derived lipids synthesized?

A

Liver

Almost all cells including endothelial

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35
Q

What are the functions of Derived Lipids?

A

Plasma membranes
Vit D synthesis precursor
Androgen/sex hormone synth

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36
Q

In order to be absorbed at a cellular level, what has to happen to triglycerides first?

A

Hydrolyzed into FA/Monoglycerides by lipase enzymes

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37
Q

How are lipids transported?

A 
Chylomicrons
VLDL
LDL
HDL
FFAs
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38
Q

During _____ state, blood can have so many chylomicrons that it can appear what color?

A

Absorbed

Turbid, yellow

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39
Q

During what state are chylomicrons going to be low or nonexistent?

A

Post-absorptive

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40
Q

What state are lipoproteins going to be most active?

A

Post-absorptive

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41
Q

Where are lipoproteins made?

What are they made from?

A

Liver

Lipids and proteins

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42
Q

What combine to make free fatty acids?

A

FA + albumin

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43
Q

During starvation state, what will free FA levels be?

A

Increased due to fat-catabolism

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44
Q

What is the largest/lowest density lipoprotein?

What is the smallest/heaviest density lipoprotein?

A 
Largest- Chylomicron
VLDL
IDL (intermediate)
LDL
Smallest- HDL
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45
Q

Where are chylomicrons synthesized?

What is used to make them?

A

Enterocytes of small intestines

Fat and cholesterol from small intestine

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46
Q

How are chylomicrons transported so they can enter circulation?

A

Enter lacteals (lymphatic capillaries) -> thoracic duct -> circulation

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47
Q

Where are VLDLs synthesized?

What is used to make them?

A

Liver

Fats and cholesterol from portal circulation

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48
Q

How are LDLs made?

A

VLDLs are stripped of triglycerides, leftovers are remodeled into LDLs

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49
Q

What is the function of HDLs?

A

Reverse cholesterol transport, returns excess cholesterol to liver for recycling

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50
Q

Where are HDLs made?

A

Liver

Small Intestine

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51
Q

LIpogenesis/anabolism includes the formation of what lipids?

A

Triglycerides
Phospholipids
Cholesterol
Prostaglandins

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52
Q

What word means protein hydrolysis?

A

Proteases- pepsin, trypsin

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53
Q

20 total aa, of these there are _ essential, _ conditionally essential and _non-essential

A

9 essential
7 conditional- illness/inc stress
4 nonessential

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54
Q

Every cell synthesizes its own _____ proteins

A

Structural

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55
Q

Digestive system is closely associated with what other system? Why?

A

Cardiovascular

Due to vessels involved in digestive process

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56
Q

How does the Cardiovascular System impact the digestive system?

A

Supply organ with O2

Processes nutrients

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57
Q

How does the Endocrine System impact the digestive system?

A

Hormone regulate digestive system actions

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58
Q

How does the Integumentary System impact the digestive system?

A

Protects digestive organs

Vit D absorption

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59
Q

How does the Lymphatic System impact the digestive system?

A

MALT defense against pathogens

Lacteals absorb lipids

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60
Q

How does the Nervous System impact the digestive system?

A

Sensory/motor neurons regulate secretions and GI tract contractions

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61
Q

How does the Respiratory System impact the digestive system?

A

Provides O2

Removes CO2

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62
Q

How does the Urinary System impact the digestive system?

A

Kidneys make calcitriol to aid w/ Ca+ absorption

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63
Q

How long is the GI tract in humans?

A

16-23 alive

23-29 dead

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64
Q

What are the accessory digestive organs?

A 
Teeth
Tongue
Salivary Glands
Liver
Gallbladder
Pancreas
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65
Q

What are the 6 processes of the digestive system?

A 
Ingestion
Secretion
Mixing/propulsion
Digestion
Absorption
Defecation
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66
Q

Define motility

A

Mix and movement of material along tract

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67
Q

What are examples of substances that can be absorbed w/out chemical digestions?

A

Vitamins
Ions
Essential FA
Water

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68
Q

What are the 4 layers of the GI tract?

A 
Outer to Inner
Serosa/Adventitia
Muscularis
Submucosa
Mucosa
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69
Q

Adventitia layer of the GI tract starts and ends where?

A

Esophagus through proximal duodenum

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70
Q

What are the layers of the GI tract’s muscularis layer?

A

2-3 layers of smooth muscle

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71
Q

What structures are found in the GI tract’s submucosa layer?

A

CT
Glands
Vessels
Nerves

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72
Q

What are the layers of the GI tract’s mucosa layer?

A

Epithelium
Lamina propria
Muscularis mucosa

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73
Q

The serosa layer of the GI tract is AKA ?

A

Visceral periotneum

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74
Q

What parts of the GI tract’s muscularis layer is skeletal and smooth muscle?

A

Skeletal- mouth, pharynx, upper esophagus, external anal sphincter
Smooth- everywhere else

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75
Q

Where is the Myenteric Plexus located?

What is it AKA ?

A

Between circular and longitudinal muscle layers

Plexus of Auerbach

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76
Q

Where is the Submucosal Plexus located?

What is it AKA?

A

Submucosa layer of GI tract

Plexus of Meissner

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77
Q

What layer of the GI tract has the nerves and vessels?

A

Submucosa layer

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78
Q

The inner, mucosa layer of the GI tract is composed of that 3 layers?

A

Muscularis mucosae
Lamina Propria
Epithelium

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79
Q

What layer of the GI tract five the small intestine and stomach the folded appearance?

A

Mucosa, muscularis mucosae layer

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80
Q

Muscular movement within what layer of the GI tract ensured the absorption cells are fully exposed to the GI tract contents?

A

Mucosa muscularis mucosae

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81
Q

What layer of the GI tract contains the MALT defenses?

A

Lamina propria

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82
Q

Where is MALT tissue present in the GI tract?

A

Tonsils
Small intestine
Appendix
Large intestine

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83
Q

What layer of the GI tract is thicker and provides the tract protection from scraping/damage of passing contents?

A

Mucosa layer

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84
Q

What are the functions of the exocrine and enteroendocrine cells in the mucosa layer?

A

Exo- mucus/fluid/enzyme secretion

Entero- secrete hormones

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85
Q

What part of the NS innervates the GI tract?

A

Regulated by intrinsic (enteric NS) and extrinsic (ANS)

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86
Q

What is considered the “brain” of the guy?

A

Enteric NS

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87
Q

Where does the enteric NS exist in the GI tract?

A

Mouth to anus

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88
Q

The enteric NS is broken up into what two parts within the GI tract?
Both branches are composed of what structures?

A 
Myenteric Plexus (Auerbach)- muscularis
Submucosal Plexus (Meissner)- submucosa

Neurons, interneurons, sensory neurons

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89
Q

What is the function of the Myenteric plexus?

What is the function of the Submucosal plexus?

A 
M= motor impulses to longitudinal/circular muscles of muscularis layer, GI tract motility (frequency/strength)
S= secretory cells of mucosal epithelium
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90
Q

What structure connects the myenteric and submucosal plexuses?

A

Inerneurons

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91
Q

Sensory neurons supply which layer of the GI tract?

Some sensory neurons also act as what other function?

A

Mucosal epithelium

Chemo/baroreceptors

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92
Q

What is the Sympathetic NS and vagus nerve impact on the cardiovascular and GI system?

A 
NS= Secretes NorEpi activating adrenergic receptors, stims cardiac activity; inhibits GI activity
Vagus= secrete ACh activating cholinergic receptors, inihib cardiac and stim GI tract
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93
Q

What CN regulates the enteric NS?

A

CN10- supplies parasympathetic nerves to most of GI tract

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94
Q

Stimulation of the parasympathetic nerves that innervate the GI tract causes what result?

A

Increased GI secretions and motility by increasing enteric NS activity

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95
Q

How does the sympathetic nerves supplying the GI tract arise and connect?

A

From thoracic and lumbar regions of spinal cord

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96
Q

Stimulation of the sympathetic nerves in the GI tract causes what result?

A

Decreased GI secretion/motility by inhibiting enteric NS

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97
Q

What is the largest serous membrane in the body?

A

Peritoneum

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98
Q

What is the peritoneum divided into?

A

Parietal- wall of abdominopelvic cavity

Visceral- covers some of the organs

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99
Q

What is the space in between the two peritoneum layers called?

A

Peritoneal cavity, contains lubricating fluids

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100
Q

Organs in the retroperitoneal space are covered by the peritoneum on what surface?
What organs does this include?

A 
Anterior
Kidneys
Ascending/Descending Colon
Duodenum
Pancreas
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101
Q

What are the 5 folds of the peritoneum?

A 
Greater omentum
Falciform ligament
Lesser omentum
Mesentery
Mesocolon
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102
Q

What is the largest peritoneal fold?
What organs does it cover?
Where does it travel to/through?

A

Greater omentum
Transverse colon and small intestine
Attaches stomach and duodenum, anterior to small intestine, folds, extends to attachment on transverse colon

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103
Q

What part/fold of the peritoneum is a contributor to the term “beer belly”?

A

Greater Omentum

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104
Q

What part of the GI tract contains many lymph nodes that have macrophages and antibody producing cells to combat GI tract infections?

A

Greater omentum

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105
Q

The greater omentum is AKA what ligament?

A

Gastrocolic

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106
Q

What is the falciform ligaments function?

A

Attaches liver to ventral surface of abdominal wall

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107
Q

What does the free border of the falciform ligament contain?

A

Ligamentum teres (round ligament), remnant of umbilical vein

108
Q

Where does the lesser omentum arise from?

What does is cover/hold?

A

Anterior fold of serosa of stomach/distal duadenum and connect to liver

109
Q

What pathway for vessels entering the liver pass through which part of the peritoneum?
What vascular structures does this sight contain?

A 
Lesser omentum
Portal vein
Common hepatic artery
Common bile duct
Lymph nodes
110
Q

What part of the peritoneum has a fan-shaped fold?

What organs does this part hold?

A

Mesentery

Jejunum and ileum to posterior wall

111
Q

What two folds of the peritoneum add to abdominal growth during weight gain?

A

Mesentery

Greater omentum

112
Q

Where does the mesentery fold start and end?

A

Posterior peritoneal wall (same as mesocolon), wraps around small intestine, returns to origin

113
Q

What is the function of the mesocolon?

A

Two-part fold that holds transverse and sigmoid colon to posterior wall

114
Q

What two folds holds the small intestines in place?

A

Mesocolon

Mesentery

115
Q

What are the two frenula in the mouth?

A

Labial- mandible and maxillary

Lingual

116
Q

What two structures form the hard palate in the mouth?

A

Palatine and maxillae

117
Q

What is the soft palate in between?

A

Oropharynx

Nasopharynx

118
Q

What is the function of the uvula?

A

Rises w/ soft palate to close off nasopharynx

119
Q

What are the two muscular folds that run laterally along the uvula?

A

Palatoglossal arch- anterior, to base of tongue

Pataopharyngeal- posterior, side of pharynx

120
Q

What are the different pairs of tonsils?

A

Palatine- between arches, most commonly infected/removed
Lingual- singular, base of tongue
Pharyngeal- aka adenoids, superior nasopharynx, commonly removed w/ palatine

121
Q

What are the major glands that secrete most of the saliva?

A

Parotids
Submandibular
Sublingual

122
Q

Where are Parotid glands located and what duct do they secrete through?

A

Inf/Ant to ears between skin and masseter muscle

Secrete via Parotid Duct (Stenson’s Duct) to opposite second maxillary molar

123
Q

What salivary gland pierces the buccinator muscle?

A

Parotid gland

124
Q

Where are Submandibular glands located and what duct do they secrete through?

A

Floor of mouth, medial and inferior to mandible body

Submandibular glands open on side of lingual frenulum via Whartons Ducts

125
Q

Where are Sublingual glands located and what duct do they secrete through?

A

Beneath tongue superior to submandibular glands

Lesser sublingual ducts open to floor of mouth lateral to opening of submandibular ducts

126
Q

Chemically, saliva is __% water and _% solutes

What solutes are found here?

A

99.5 water .5 solutes
Na K Cl HCO3 HPO4
IgA, lysozyme and salivary amylase

127
Q

What type of saliva do the salivary glands secrete?

A

Parotid- water
Submandibular- serous and mucous
Sublingual- thicker fluid w/ small amount of salivary amylase

128
Q

Water in saliva serves what 3 purposes?

A

Medium for dissolving
Taste
Digestive reactions to begin

129
Q

Salivary amylase begins the digestion process of what part of food?
What activated salivary amylase to start this process?

A

Carbs

Cl-

130
Q

What two substances help buffer acidity in the mouth?

A

Bicarb and Phosphate

Makes saliva slightly acidic at 6.35-6.85

131
Q

What are the chemical waste products that are secreted/excreted into saliva?

A

Urea

Uric acid

132
Q

Salivation reflex is controlled by what NS?

Signals to promote are sent along what CNs?

A

ANS
Parasympathetic keeps continuous secretion
CN7 and 9

133
Q

Define xerostomia

A

Dry mouth due to stimulation of Symp NS during stress

134
Q

What divides the tongue in half?

A

Median septum

135
Q

How is the tongue attached to the skull?

A

Hyoid bone
Styloid process of temporal bone
Mandible

136
Q

What are Von Ebners glands and where are they located?

A

Lingual glands in lamina propria of the tongue that secrete serous fluid with lingual lipase (acts on triglycerides)

137
Q

What surfaces of the tongue contain papillae?

A

Dorsal and lateral surfaces

138
Q

What are the 4 types of papillae?

A

Vallate (circumvallate)- inverted V in posterior tongue
Fungiform- mushroom shaped
Foliate- lateral margins, degenerate in childhood
Filiform- entire surface of tongue, no taste, tactile only

139
Q

What are two enzymes that contribute to chemical digestion by secretion in the mouth?

A

Salivary amylase- carbs

Lingual lipase- lipids

140
Q

Where is salivary amylase de/activated?

Where is lingual lipase activated?

A

SA- Cl in mouth activate, stomach acid deactivates

LL- activated by stomach acid

141
Q

What is the first anatomical area a bolus passes after chewing?

A

Pharynx

Oropharynx then laryngopharynx

142
Q

Where does the pharynx start and end?

A

Internal nares to posterior esophagus/anterior larynx

143
Q

What are the 3 parts of the pharynx?

A

Nasopharynx- only respiration
Oropharynx- digestion and respiration
Hypo/laryngopharynx- digestion and respiration

144
Q

Where does the esophagus begin and end?

A

Start- inferior end of hypo-laryngopharynx

End- superior stomach

145
Q

What are the layers of the esophagus?

A 
Adventitia
Muscularis
Submucosa
Mucosa- muscularis mucosae
               lamina propria
               nonkeratinized
146
Q

What are the two sphincters of the esophagus?

A

Upper- skeletal muscle regulating movement from hypopharynx to esophagus
Lower- smooth muscle regulating movement from esophagus to stomach

147
Q

What are 2 functions the esophagus does and does not do?

A

Does- secrete mucus and transport food

Not- produce enzymes, absorb

148
Q

What are the three phases of deglutition?

A

Voluntary
Pharyngeal
Esophageal

149
Q

What occurs during the Voluntary Stage of swallowing?

A

Starts when bolus is force to back of oral cavity

Up/backward movement of tongue moves bolus to oropharynx

150
Q

What occurs during the Pharyngeal Stage of swallowing?

A

Bolus passes into oropharynx and laryngopharynx and into esophagus
Bolus triggers receptors to send signals to deglutition center in medulla oblongata and lower pons
Signals cause soft palate/uvula to close nasopharynx and epiglottis to cover trachea
Once bolus is through laryngopharynx esophageal sphincter relaxes

151
Q

What events occur during the Esophageal Phase of swallowing?

A

Begins once bolus is in esophagus

Peristalsis takes over and allows lower sphincter to relax

152
Q

Why is the stomach the most distensible part of the GI tract?

A

Mucosa lies in rugae

153
Q

What are the 4 regions of the stomach?

A

Cardia
Fundus
Body
Pyloric

154
Q

What are the three parts of the pyloric part of the stomach?

A

Pyloric antrum- connects to stomach body
Pyloric canal- leads to pylorus
Pylorus- connects to duodenum via sphincter

155
Q

What are the 4 layers of the stomach?

A

Serosa
Muscularis- 3 layers of smooth
Submucosa
Mucosa- gastric and exocrine glands, enteroendocrine cell

156
Q

What are the two parts of the stomach serosa?

A

Greater curvature continues as greater omentum

Lesser curvature continues as lesser omentum

157
Q

What layer of the stomach has Mysenteric and Submucosal plexuses?

A

Muscularis- Auerbach/myenteric plexus

Submucosa- Meissner/submucosal plexus

158
Q

What part of the stomach are gastric glands located?

A

Mucosa layer of mucosal layer (inner layer)

159
Q

Gastric glands contain what three types of exocrine glands?

A

Mucous neck cells
Chief cells
Parietal cells
(All within the mucosa layer of the mucosal layer)

160
Q

Gastric glands also contain what enteroendocrine cells?

A

G-cell and Enterchromaffin-like cells- secrete hormone into bloodstream

161
Q

What activates lingual lipase?

A

HCl

162
Q

What does intrinsic factor do within the digestive system?

A

Aid w/ absorption of B12/cyanobalamin

163
Q

What are the enteroendocrine cells within the digestive system?

A

G-Cells- secrete gastrin to bloodstream

Enterochromaffin-like cells- secrete histamine

164
Q

Where are G Cells located?

A

Pyloric antrum

165
Q

What does release of Gastrin into the bloodstream stimulate?

A

HCl production (with histamine)
Gastric motility
Chief cells to produce pepsin

166
Q

What activates parietal cells to produce HCl?

A

Histamine

167
Q

What is the function of the mixing waves?

A

Peristaltic waves that aid with macerating food

At this point, chyme

168
Q

Define Gastric emptying

A

3mL of chyme ejected to small intestine w/ each mixing wave

169
Q

What is the only proteolytic (protein digesting) enzyme in stomach?

A

Pepsin

170
Q

Where is Pepsin made?

What kind of environment is it most effective in?

A

Prepared as pepsinogen in Chief Cells
HCl/pepsin activates pepsinogen in lumen
Most efficient in acidic environment

171
Q

What prevents pepsin from digesting proteins found in the stomach’s epithelial cells?

A

Alkaline mucous layer

172
Q

When is Gastric Lipase released?

What does it digest?

A

Very small quantities, usually during pancreatic insufficiency
Triglycerides

173
Q

Where does the majority of the digestion of lipids occur?

A

Small intestine from pancreatic juies

174
Q

What can be absorbed in the stomach?

A 
Water
Ions
Short chained FA
Some drugs
ETOH
175
Q

What molecules spend the least and most time in the stomach?

A

Carbs- least
Protein- longer
Fat- longest

176
Q

Where is the pancreas located?

A

Retroperitoneal, behind great curvature

177
Q

What are the two functions of the pancreas?

A

Exocrine- Acini, clusters of glandular cells producing enzymes/fluids
Endocrine- Pancreatic islets, hormones

178
Q

What is the primary duct in the pancreas?
What other duct does it merge with?
What duct does this merger form?
What sphincter controls the merger duct?

A

Duct of Wirsung
Merges w/ Common Bile Duct
Hepatopancreatic ampulla (Ampulla of Vater)
Controlled by Sphincter of Oddi

179
Q

What is the accessory duct of the pancreas?

A

Duct of Santorini

Branches off of pancreatic duct, drains to duodenum proximally to ampulla of vater

180
Q

What is the sequence of ducts from the liver?

A

Hepatic ducts-> common hepatic duct
Common hepatic + cystic duct= common bile duct
Common bile + pancreatic duct= hepatopancreatic ampulla
Hepatopancreatic ampulla drains into duodenum @ major juodenal papilla
Accessory pancreatic duct empties pancreatic secretion into duodenum @ minor duodenal papilla

181
Q

What causes pancreatic juices to be slightly alkaline?

A

Sodium Bicarbonate

pH 7.1-8.2

182
Q

What stops the action of pepsin leaving the stomach?

A

Sodium Bicarbonate

183
Q

What enzymes and their digestive functions are in pancreatic juice?

A

Trypsin- protein
Chymotrypsin- protein
Carboxypeptidase- protein
Elastase- protein

Pancreatic amylase- carbs
Pancreatic lipase- principle triglyceride
Phospholipase- phospholipid
Cholesterol esterase- cholesterol

184
Q

_____ digesting enzymes are produced in zymogenic form

A 
Protein digesting
Trypsinogen
Chymotrypsinogen
Procarboxypeptidase
Prolastase
185
Q

Liver is located in which abdominal quadrants?

A

R hypochondriac

Part of epigastric region

186
Q

What part of the peritoneum covers the liver?

A

Visceral

187
Q

What ligament divides the liver into lobes?

A

Falciform ligament

188
Q

Liver receives blood from what two sources?

A 
Hepatic artery
Portal vein (majority 75%)
189
Q

What are the components of the Biliary Tree?

A 
Bile ducts in liver
Common hepatic duct
Gallbladder and cystic duct
Common bile duct
Pancreatic ducts
190
Q

What are the functions of the biliary tree?

A

Make/store/secrete bile and pancreatic enzymes
Rids body of waste products
Aids small intestine w/ digestion

191
Q

What is the major functional unit of the liver?

A

Hepatic lobule

192
Q

What and where are Portal Triads?

A

Corners of hepatic lobules

Consists of bile duct, portal vein and hepatic artery

193
Q

What type of cell makes up 80% of the liver’s mass?

Why are their abundance so important?

A

Hepatocytes

Form layer that separates sinusoidal blood from canalicular bile

194
Q

Hepatocytes are the location of synthesis of what things?

A 
Transport proteins (albumin, fibrinogen)
Lipoproteins
FAs
Triglycerides
Cholesterol
Bile
195
Q

Location and function of hepatic sinusoids

A

Permeable capillaries between hepatocytes

Receive oxygenated blood from hepatic artery and nutrient deoxygenated blood from portal vein

196
Q

What is the location and function of Stellate Reticuloendothelial cells?

A

Kupffer cells

Phagocytes w/in liver sinusoids that destroy R/WBCs, bacteria and debris

197
Q

What are the functions of the liver?

A 
Carbohydrate/lipid metabolism
Protein synthesis
Drug/hormone processing
Bilirubin excretion
Storage of glycogen/ADEKs
Phagocytosis
Bile synthesis
198
Q

What liver function occurs when plasma glucose is low? When it’s high?

A 
Low= glycogenolysis
High= glycogenesis
199
Q

What type of lipid synthesis occurs in the liver?

A

Triglycerides
Lipoproteins
Cholesterol

200
Q

What transport proteins are synthesized in the liver?

A 
Haptoglubin
IGF binding
Sex-hormone binding
Thyroxin binding
Transferrin
Vi-D binding
201
Q

Which hormones does the liver alter/deactivate?

A

Thyroid/steroid like T3/T4, estrogen, aldosterone

202
Q

Where is a majority of the bilirubin in bile metabolized and eliminated?

A

Metabolized in small intestine

Eliminated w/ feces

203
Q

What minerals does the liver store?

A

Fe

Cu

204
Q

Bile synthesis in the liver is the combination of what 3 things?

A

Bile salts
Bile pigments
Cholesterol

205
Q

Amount, color and pH of normal bile?

A

600-1000mL/day
Yellow/brown/olive green
7.6-8.6

206
Q

What is the importance of bile?

A

Fat digestion and absorption

Means for excretion of waste products from blood

207
Q

What can the gallbladder walls reabsorb?

A

Water

Ions

208
Q

Spleen acts as a large reservoir of what WBC?

A

Macrophage

209
Q

Hematopoiesis of the spleen includes?

A

Mono/lymphocyte development and activation
Fetal RBC development
Adult RBC development during extreme anemia

210
Q

What cells does the spleen remove from circulation?

A

Old RBCs
Imperfect platelets
Breaks apart Hgb molecule to save iron and globin

211
Q

Where does the small intestine begin and end?

A

Start- after pyloric sphincter

End- ileocecal sphincter

212
Q

What are the 3 regions of the small intestine?

A

Duodenum- shortest
Jejunum
Ileum- longest

213
Q

What valve merges the small and large intestine?

A

Ileocecal Sphincter

214
Q

What is the Ligament of Treitz and what is it’s function?

A

AKA Suspensory Ligament of Duodenum
Suspensory muscle
Begins at diaphragm, connects to duodenojejunal flexure and suspends it upward
Landmark of importance, anatomical difference between Upper and Lower GI

215
Q

All of the small intestine is covered by the serosa (visceral peritoneum) except for where?

A

Proximal portion

216
Q

Muscularis layer of the small intestine contains which plexus?

A

Myenteric (Auerbach)

217
Q

Submucosa layer of the small intestines contain which plexus and glands?

A

Submucosal (Meissner)

Brunner’s glands- alkaline mucus secretors

218
Q

What and where are Crypts of Lieberkuhn?

A

AKA for intestinal glands

Deep crevices in mucosal lining of small intestine

219
Q

What are the miscellaneous cells within the mucosa layer of the Small Intestine?

A

Absorptive- enterocytes, absorb nutrients from chyme

Goblet- secrete mucus

Paneth- secrete lysozomes capable of phagocytosis

220
Q

What are the enteroendocrine cells of the small intestine?

A

S cells
CCK cells
K cells

221
Q

What do the S cells in the small intestine do?

A

Secrete secretin

Stims pancreatic juice/inhibs gastric juice

222
Q

What do CCK cells do in the small intestine?

A

Secrete cholecystokinin
Helps satiety
Stims pancreatic juice flow Relaxes sphincter of Oddi
Stims gallbladder contraction

223
Q

What do K cells in the small intestine do?

A

Secrete glucose dependent insulinotropic polypeptide
AKA gastric inhib polypeptide
Dec gastric emptying rate

224
Q

Define Plicae Circulares and where are they located

A

Circular folds in the small intestine
Permanent ridges beginning near proximal duodenum, ending midpoint of ileum
Increases SA and causes chyme to spiral

225
Q

What are the special features of the small intestine?

A

Plicae circulares
Villi
Microvilli

226
Q

What structures within the small intestine give the walls of the lumen a velvet appearance?

A

Villi

227
Q

What makes the brush border of the small intestine?

A

Microvilli- projections of apical membrane of absorptive cells

228
Q

What special features of the small intestine also produces digestive enzymes?
What are these enzymes called?

A

Microvilli

Brush-border enzymes

229
Q

What are the brush border enzymes and what do they digest?

A 
Carbs- 
a-dextrinase
maltase
sucrase
lactase

Peptidases-
aminopeptidase
dipeptidase

Lipase-
phospholipase b1

230
Q

How are carbs digested in the small intestine?

A

Pancreatic amylase

Once split into monosaccharides they are absorbable

231
Q

Pancreatic amylase can not digest what carbohydrate which causes a large bulking of feces?

A

Cellulose

232
Q

Which pancreatic juices perform protein digestion in the small intestine?
When is protein digestion considered complete?

A 
Trypsin
Chymotrypsin
Carboxypeptidase
Elastase
Ends w/ small/single chained AAs
233
Q

What pancreatic juices complete lipid digestion in the small intestine?

A

Lipase- begins in stomach

Pancreatic lipase- continues in small intestine

234
Q

What are the overall functions of the large intestine?

A

Complete absorption
Produce Vit K and biotin
Form feces
Excrete solid wastes

235
Q

What are the 4 regions of the large intestine?

A 
Extending from ileum to anus:
Cecum
Colon (Ascend/transverse/descend/sigmoid)
Rectum
Anal canal
236
Q

How is the large intestine held to the posterior abdominal wall?

A

Mesocolon fold

237
Q

What is the sphincter between the small and large intestine?

A

Ileocecal

238
Q

Where does the cecum of the large intestine begin?

A

Inferior to ileocecal valce

239
Q

Where is the vermiform appendix attached to on the large intestine?

A

Cecum

240
Q

What are the 4 portions of the colon?

A

Ascending- R side to border of liver, turns at hepatic flexure
Transverse- turns inferior at splenic flexure
Descending- L side to iliac crest
Sigmoid- projects medially, ends at rectum

241
Q

What parts of the colon are peritoneal and retroperitoneal?

A

Retro: ascending, descending
Peri: transverse, peritoneal

242
Q

Rectum is at what vertebral level?

A

3rd sacral vertebrae

243
Q

Mucus membranes of the anal canal are arranged into folds called?
What do the formations contain?

A

Longitudinal folds called columns

Contain arteries and veins

244
Q

What are the two sphincters of the anal canal?

A

Internal: smooth/involuntary
External: skeletal/voluntary

245
Q

Define Pectinate (dentate) Line

A

Inferior portion of anal column
Above the line= upper 2/3, only sensitive to stretch
Below the line= lower 1/3, sensitive to pain, temp and touch

246
Q

What does the serosa layer of the large intestine contain?

A

Omental appendices

247
Q

What are the thickened bands on the large intestine called?

What layer do they occupy?

A

Teniae coli

Muscularis

248
Q

What is the function of teniae coli?

A

Contract to form haustra= puckered/pouched appearance

249
Q

What is the difference between the external and internal layer of the large intestines muscularis layer?

A 
External= longitudinal smooth muscle
Internal= circular smooth muscle
250
Q

How is digestion accomplished in the small intestine?

What is secreted here?

A

Symbiotic bacteria

Mucus

251
Q

What gases are produced in the large intestine?

A

H, CO2, methane= gas

Indole, skatole, H2S= odor

252
Q

How does feces accomplish it’s normal brown color?

A

Bacteria breakdown of bilirubin to stercobilin

253
Q

Chemically speaking, what does feces contain?

A

Water
Epithelial cells
Bacteria/decomposition
Unabsorbed/indigestible material

254
Q

What are the two types of movement that occur in the GI tract?

A

Peristalsis- wavelike ripple triggered by bolus stretch

Segmentation- mixing, forward/backward movement, aids w/ mechanical digestion

255
Q

How is gastric emptying regulated?

A

Hormonal

NS- enterogastric reflex

256
Q

What causes GDIP to be released?

A

Fats/nutrients in duodenum

Inhibits gastric muscle, decreases peristalsis and slows gastric emptying

257
Q

What stimulates/triggers the enterogastric reflex?

A

Chem/baroreceptors in duodenum

Inhibits gastric peristalsis, slows gastric emptying

258
Q

What are the different types of motility that occur within the GI tract?

A

Gastric motility
Intestinal motility
Reflexes

259
Q

What are the two types of intestinal motility?

A

Peristalsis

Segmentation

260
Q

What are the motility reflexes?

A

Gastroileal
Enterogastric
Gastrocolic
Defecation

261
Q

Define the Gastroileal Reflex

A

Secretory and motor activity of stomach signals distal ileum early in meal, accelerates movement through ileocecal sphincter

262
Q

Define the Enterogastric Reflex

A

Small and large intestine distension inhibit stomach motility and secretion

263
Q

Define the Gastrocolic Reflex

A

Excess stomach activity causes feces in colon to move forward

264
Q

Define the Defecation Reflex

A

Distension of rectum trigger baroreceptors that signal colon and anal canal to contract

265
Q

What are the pressures needed during the defecation triggering process?

A

18mmHg- conscious desire
55mmHg- internal sphincter relaxes, external sphincter held tight consciously
80mmHg- external sphincter may fail

266
Q

“Normal” bowel movement frequency and influencing factors

A

Diet Health Stress
1-3/day
3-4/week

ipap (212 decks)

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