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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
TAGs are required in the body for absorption of ____?
Fat soluble vitamins
26
What provides constituent molecules for cellular membranes?
TAGs
27
What are the simple lipids?
Fatty acids: Sat/unsat/triacyglycerols
28
What compounds can join triacyglycerols to make compound lipids?
Phopholipds- FA+phosphorus+N Glycolipids- FA+carbs+N Lipoproteins
29
Where are functions of compound lipids?
Cell membrane Nerve sheath Helps w/ cellular recognition
30
Where are glycolipids found?
Cell membrane | Facilitate cell recognition
31
What are the types of Lipoproteins?
Chylomicrons VLDL LDL HDL
32
Define Derived Lipid
Simple+compound lipid
33
What are examples of derived lipids?
Steroids- especially cholesterol Terpenes Fat soluble vitamins Ketone bodies
34
Where are derived lipids synthesized?
Liver | Almost all cells including endothelial
35
What are the functions of Derived Lipids?
Plasma membranes Vit D synthesis precursor Androgen/sex hormone synth
36
In order to be absorbed at a cellular level, what has to happen to triglycerides first?
Hydrolyzed into FA/Monoglycerides by lipase enzymes
37
How are lipids transported?
``` Chylomicrons VLDL LDL HDL FFAs ```
38
During _____ state, blood can have so many chylomicrons that it can appear what color?
Absorbed | Turbid, yellow
39
During what state are chylomicrons going to be low or nonexistent?
Post-absorptive
40
What state are lipoproteins going to be most active?
Post-absorptive
41
Where are lipoproteins made? | What are they made from?
Liver | Lipids and proteins
42
What combine to make free fatty acids?
FA + albumin
43
During starvation state, what will free FA levels be?
Increased due to fat-catabolism
44
What is the largest/lowest density lipoprotein? | What is the smallest/heaviest density lipoprotein?
``` Largest- Chylomicron VLDL IDL (intermediate) LDL Smallest- HDL ```
45
Where are chylomicrons synthesized? | What is used to make them?
Enterocytes of small intestines | Fat and cholesterol from small intestine
46
How are chylomicrons transported so they can enter circulation?
Enter lacteals (lymphatic capillaries) -> thoracic duct -> circulation
47
Where are VLDLs synthesized? | What is used to make them?
Liver | Fats and cholesterol from portal circulation
48
How are LDLs made?
VLDLs are stripped of triglycerides, leftovers are remodeled into LDLs
49
What is the function of HDLs?
Reverse cholesterol transport, returns excess cholesterol to liver for recycling
50
Where are HDLs made?
Liver | Small Intestine
51
LIpogenesis/anabolism includes the formation of what lipids?
Triglycerides Phospholipids Cholesterol Prostaglandins
52
What word means protein hydrolysis?
Proteases- pepsin, trypsin
53
20 total aa, of these there are _ essential, _ conditionally essential and _non-essential
9 essential 7 conditional- illness/inc stress 4 nonessential
54
Every cell synthesizes its own _____ proteins
Structural
55
Digestive system is closely associated with what other system? Why?
Cardiovascular | Due to vessels involved in digestive process
56
How does the Cardiovascular System impact the digestive system?
Supply organ with O2 | Processes nutrients
57
How does the Endocrine System impact the digestive system?
Hormone regulate digestive system actions
58
How does the Integumentary System impact the digestive system?
Protects digestive organs | Vit D absorption
59
How does the Lymphatic System impact the digestive system?
MALT defense against pathogens | Lacteals absorb lipids
60
How does the Nervous System impact the digestive system?
Sensory/motor neurons regulate secretions and GI tract contractions
61
How does the Respiratory System impact the digestive system?
Provides O2 | Removes CO2
62
How does the Urinary System impact the digestive system?
Kidneys make calcitriol to aid w/ Ca+ absorption
63
How long is the GI tract in humans?
16-23 alive | 23-29 dead
64
What are the accessory digestive organs?
``` Teeth Tongue Salivary Glands Liver Gallbladder Pancreas ```
65
What are the 6 processes of the digestive system?
``` Ingestion Secretion Mixing/propulsion Digestion Absorption Defecation ```
66
Define motility
Mix and movement of material along tract
67
What are examples of substances that can be absorbed w/out chemical digestions?
Vitamins Ions Essential FA Water
68
What are the 4 layers of the GI tract?
``` Outer to Inner Serosa/Adventitia Muscularis Submucosa Mucosa ```
69
Adventitia layer of the GI tract starts and ends where?
Esophagus through proximal duodenum
70
What are the layers of the GI tract's muscularis layer?
2-3 layers of smooth muscle
71
What structures are found in the GI tract's submucosa layer?
CT Glands Vessels Nerves
72
What are the layers of the GI tract's mucosa layer?
Epithelium Lamina propria Muscularis mucosa
73
The serosa layer of the GI tract is AKA ?
Visceral periotneum
74
What parts of the GI tract's muscularis layer is skeletal and smooth muscle?
Skeletal- mouth, pharynx, upper esophagus, external anal sphincter Smooth- everywhere else
75
Where is the Myenteric Plexus located? | What is it AKA ?
Between circular and longitudinal muscle layers | Plexus of Auerbach
76
Where is the Submucosal Plexus located? | What is it AKA?
Submucosa layer of GI tract | Plexus of Meissner
77
What layer of the GI tract has the nerves and vessels?
Submucosa layer
78
The inner, mucosa layer of the GI tract is composed of that 3 layers?
Muscularis mucosae Lamina Propria Epithelium
79
What layer of the GI tract five the small intestine and stomach the folded appearance?
Mucosa, muscularis mucosae layer
80
Muscular movement within what layer of the GI tract ensured the absorption cells are fully exposed to the GI tract contents?
Mucosa muscularis mucosae
81
What layer of the GI tract contains the MALT defenses?
Lamina propria
82
Where is MALT tissue present in the GI tract?
Tonsils Small intestine Appendix Large intestine
83
What layer of the GI tract is thicker and provides the tract protection from scraping/damage of passing contents?
Mucosa layer
84
What are the functions of the exocrine and enteroendocrine cells in the mucosa layer?
Exo- mucus/fluid/enzyme secretion | Entero- secrete hormones
85
What part of the NS innervates the GI tract?
Regulated by intrinsic (enteric NS) and extrinsic (ANS)
86
What is considered the "brain" of the guy?
Enteric NS
87
Where does the enteric NS exist in the GI tract?
Mouth to anus
88
The enteric NS is broken up into what two parts within the GI tract? Both branches are composed of what structures?
``` Myenteric Plexus (Auerbach)- muscularis Submucosal Plexus (Meissner)- submucosa ``` Neurons, interneurons, sensory neurons
89
What is the function of the Myenteric plexus? | What is the function of the Submucosal plexus?
``` M= motor impulses to longitudinal/circular muscles of muscularis layer, GI tract motility (frequency/strength) S= secretory cells of mucosal epithelium ```
90
What structure connects the myenteric and submucosal plexuses?
Inerneurons
91
Sensory neurons supply which layer of the GI tract? | Some sensory neurons also act as what other function?
Mucosal epithelium | Chemo/baroreceptors
92
What is the Sympathetic NS and vagus nerve impact on the cardiovascular and GI system?
``` NS= Secretes NorEpi activating adrenergic receptors, stims cardiac activity; inhibits GI activity Vagus= secrete ACh activating cholinergic receptors, inihib cardiac and stim GI tract ```
93
What CN regulates the enteric NS?
CN10- supplies parasympathetic nerves to most of GI tract
94
Stimulation of the parasympathetic nerves that innervate the GI tract causes what result?
Increased GI secretions and motility by increasing enteric NS activity
95
How does the sympathetic nerves supplying the GI tract arise and connect?
From thoracic and lumbar regions of spinal cord
96
Stimulation of the sympathetic nerves in the GI tract causes what result?
Decreased GI secretion/motility by inhibiting enteric NS
97
What is the largest serous membrane in the body?
Peritoneum
98
What is the peritoneum divided into?
Parietal- wall of abdominopelvic cavity | Visceral- covers some of the organs
99
What is the space in between the two peritoneum layers called?
Peritoneal cavity, contains lubricating fluids
100
Organs in the retroperitoneal space are covered by the peritoneum on what surface? What organs does this include?
``` Anterior Kidneys Ascending/Descending Colon Duodenum Pancreas ```
101
What are the 5 folds of the peritoneum?
``` Greater omentum Falciform ligament Lesser omentum Mesentery Mesocolon ```
102
What is the largest peritoneal fold? What organs does it cover? Where does it travel to/through?
Greater omentum Transverse colon and small intestine Attaches stomach and duodenum, anterior to small intestine, folds, extends to attachment on transverse colon
103
What part/fold of the peritoneum is a contributor to the term "beer belly"?
Greater Omentum
104
What part of the GI tract contains many lymph nodes that have macrophages and antibody producing cells to combat GI tract infections?
Greater omentum
105
The greater omentum is AKA what ligament?
Gastrocolic
106
What is the falciform ligaments function?
Attaches liver to ventral surface of abdominal wall
107
What does the free border of the falciform ligament contain?
Ligamentum teres (round ligament), remnant of umbilical vein
108
Where does the lesser omentum arise from? | What does is cover/hold?
Anterior fold of serosa of stomach/distal duadenum and connect to liver
109
What pathway for vessels entering the liver pass through which part of the peritoneum? What vascular structures does this sight contain?
``` Lesser omentum Portal vein Common hepatic artery Common bile duct Lymph nodes ```
110
What part of the peritoneum has a fan-shaped fold? | What organs does this part hold?
Mesentery | Jejunum and ileum to posterior wall
111
What two folds of the peritoneum add to abdominal growth during weight gain?
Mesentery | Greater omentum
112
Where does the mesentery fold start and end?
Posterior peritoneal wall (same as mesocolon), wraps around small intestine, returns to origin
113
What is the function of the mesocolon?
Two-part fold that holds transverse and sigmoid colon to posterior wall
114
What two folds holds the small intestines in place?
Mesocolon | Mesentery
115
What are the two frenula in the mouth?
Labial- mandible and maxillary | Lingual
116
What two structures form the hard palate in the mouth?
Palatine and maxillae
117
What is the soft palate in between?
Oropharynx | Nasopharynx
118
What is the function of the uvula?
Rises w/ soft palate to close off nasopharynx
119
What are the two muscular folds that run laterally along the uvula?
Palatoglossal arch- anterior, to base of tongue | Pataopharyngeal- posterior, side of pharynx
120
What are the different pairs of tonsils?
Palatine- between arches, most commonly infected/removed Lingual- singular, base of tongue Pharyngeal- aka adenoids, superior nasopharynx, commonly removed w/ palatine
121
What are the major glands that secrete most of the saliva?
Parotids Submandibular Sublingual
122
Where are Parotid glands located and what duct do they secrete through?
Inf/Ant to ears between skin and masseter muscle | Secrete via Parotid Duct (Stenson's Duct) to opposite second maxillary molar
123
What salivary gland pierces the buccinator muscle?
Parotid gland
124
Where are Submandibular glands located and what duct do they secrete through?
Floor of mouth, medial and inferior to mandible body | Submandibular glands open on side of lingual frenulum via Whartons Ducts
125
Where are Sublingual glands located and what duct do they secrete through?
Beneath tongue superior to submandibular glands | Lesser sublingual ducts open to floor of mouth lateral to opening of submandibular ducts
126
Chemically, saliva is __% water and _% solutes | What solutes are found here?
99.5 water .5 solutes Na K Cl HCO3 HPO4 IgA, lysozyme and salivary amylase
127
What type of saliva do the salivary glands secrete?
Parotid- water Submandibular- serous and mucous Sublingual- thicker fluid w/ small amount of salivary amylase
128
Water in saliva serves what 3 purposes?
Medium for dissolving Taste Digestive reactions to begin
129
Salivary amylase begins the digestion process of what part of food? What activated salivary amylase to start this process?
Carbs | Cl-
130
What two substances help buffer acidity in the mouth?
Bicarb and Phosphate | Makes saliva slightly acidic at 6.35-6.85
131
What are the chemical waste products that are secreted/excreted into saliva?
Urea | Uric acid
132
Salivation reflex is controlled by what NS? | Signals to promote are sent along what CNs?
ANS Parasympathetic keeps continuous secretion CN7 and 9
133
Define xerostomia
Dry mouth due to stimulation of Symp NS during stress
134
What divides the tongue in half?
Median septum
135
How is the tongue attached to the skull?
Hyoid bone Styloid process of temporal bone Mandible
136
What are Von Ebners glands and where are they located?
Lingual glands in lamina propria of the tongue that secrete serous fluid with lingual lipase (acts on triglycerides)
137
What surfaces of the tongue contain papillae?
Dorsal and lateral surfaces
138
What are the 4 types of papillae?
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
What are two enzymes that contribute to chemical digestion by secretion in the mouth?
Salivary amylase- carbs | Lingual lipase- lipids
140
Where is salivary amylase de/activated? | Where is lingual lipase activated?
SA- Cl in mouth activate, stomach acid deactivates | LL- activated by stomach acid
141
What is the first anatomical area a bolus passes after chewing?
Pharynx | Oropharynx then laryngopharynx
142
Where does the pharynx start and end?
Internal nares to posterior esophagus/anterior larynx
143
What are the 3 parts of the pharynx?
Nasopharynx- only respiration Oropharynx- digestion and respiration Hypo/laryngopharynx- digestion and respiration
144
Where does the esophagus begin and end?
Start- inferior end of hypo-laryngopharynx | End- superior stomach
145
What are the layers of the esophagus?
``` Adventitia Muscularis Submucosa Mucosa- muscularis mucosae lamina propria nonkeratinized ```
146
What are the two sphincters of the esophagus?
Upper- skeletal muscle regulating movement from hypopharynx to esophagus Lower- smooth muscle regulating movement from esophagus to stomach
147
What are 2 functions the esophagus does and does not do?
Does- secrete mucus and transport food | Not- produce enzymes, absorb
148
What are the three phases of deglutition?
Voluntary Pharyngeal Esophageal
149
What occurs during the Voluntary Stage of swallowing?
Starts when bolus is force to back of oral cavity | Up/backward movement of tongue moves bolus to oropharynx
150
What occurs during the Pharyngeal Stage of swallowing?
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
What events occur during the Esophageal Phase of swallowing?
Begins once bolus is in esophagus | Peristalsis takes over and allows lower sphincter to relax
152
Why is the stomach the most distensible part of the GI tract?
Mucosa lies in rugae
153
What are the 4 regions of the stomach?
Cardia Fundus Body Pyloric
154
What are the three parts of the pyloric part of the stomach?
Pyloric antrum- connects to stomach body Pyloric canal- leads to pylorus Pylorus- connects to duodenum via sphincter
155
What are the 4 layers of the stomach?
Serosa Muscularis- 3 layers of smooth Submucosa Mucosa- gastric and exocrine glands, enteroendocrine cell
156
What are the two parts of the stomach serosa?
Greater curvature continues as greater omentum | Lesser curvature continues as lesser omentum
157
What layer of the stomach has Mysenteric and Submucosal plexuses?
Muscularis- Auerbach/myenteric plexus | Submucosa- Meissner/submucosal plexus
158
What part of the stomach are gastric glands located?
Mucosa layer of mucosal layer (inner layer)
159
Gastric glands contain what three types of exocrine glands?
Mucous neck cells Chief cells Parietal cells (All within the mucosa layer of the mucosal layer)
160
Gastric glands also contain what enteroendocrine cells?
G-cell and Enterchromaffin-like cells- secrete hormone into bloodstream
161
What activates lingual lipase?
HCl
162
What does intrinsic factor do within the digestive system?
Aid w/ absorption of B12/cyanobalamin
163
What are the enteroendocrine cells within the digestive system?
G-Cells- secrete gastrin to bloodstream | Enterochromaffin-like cells- secrete histamine
164
Where are G Cells located?
Pyloric antrum
165
What does release of Gastrin into the bloodstream stimulate?
HCl production (with histamine) Gastric motility Chief cells to produce pepsin
166
What activates parietal cells to produce HCl?
Histamine
167
What is the function of the mixing waves?
Peristaltic waves that aid with macerating food | At this point, chyme
168
Define Gastric emptying
3mL of chyme ejected to small intestine w/ each mixing wave
169
What is the only proteolytic (protein digesting) enzyme in stomach?
Pepsin
170
Where is Pepsin made? | What kind of environment is it most effective in?
Prepared as pepsinogen in Chief Cells HCl/pepsin activates pepsinogen in lumen Most efficient in acidic environment
171
What prevents pepsin from digesting proteins found in the stomach's epithelial cells?
Alkaline mucous layer
172
When is Gastric Lipase released? | What does it digest?
Very small quantities, usually during pancreatic insufficiency Triglycerides
173
Where does the majority of the digestion of lipids occur?
Small intestine from pancreatic juies
174
What can be absorbed in the stomach?
``` Water Ions Short chained FA Some drugs ETOH ```
175
What molecules spend the least and most time in the stomach?
Carbs- least Protein- longer Fat- longest
176
Where is the pancreas located?
Retroperitoneal, behind great curvature
177
What are the two functions of the pancreas?
Exocrine- Acini, clusters of glandular cells producing enzymes/fluids Endocrine- Pancreatic islets, hormones
178
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?
Duct of Wirsung Merges w/ Common Bile Duct Hepatopancreatic ampulla (Ampulla of Vater) Controlled by Sphincter of Oddi
179
What is the accessory duct of the pancreas?
Duct of Santorini | Branches off of pancreatic duct, drains to duodenum proximally to ampulla of vater
180
What is the sequence of ducts from the liver?
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
What causes pancreatic juices to be slightly alkaline?
Sodium Bicarbonate | pH 7.1-8.2
182
What stops the action of pepsin leaving the stomach?
Sodium Bicarbonate
183
What enzymes and their digestive functions are in pancreatic juice?
Trypsin- protein Chymotrypsin- protein Carboxypeptidase- protein Elastase- protein Pancreatic amylase- carbs Pancreatic lipase- principle triglyceride Phospholipase- phospholipid Cholesterol esterase- cholesterol
184
_____ digesting enzymes are produced in zymogenic form
``` Protein digesting Trypsinogen Chymotrypsinogen Procarboxypeptidase Prolastase ```
185
Liver is located in which abdominal quadrants?
R hypochondriac | Part of epigastric region
186
What part of the peritoneum covers the liver?
Visceral
187
What ligament divides the liver into lobes?
Falciform ligament
188
Liver receives blood from what two sources?
``` Hepatic artery Portal vein (majority 75%) ```
189
What are the components of the Biliary Tree?
``` Bile ducts in liver Common hepatic duct Gallbladder and cystic duct Common bile duct Pancreatic ducts ```
190
What are the functions of the biliary tree?
Make/store/secrete bile and pancreatic enzymes Rids body of waste products Aids small intestine w/ digestion
191
What is the major functional unit of the liver?
Hepatic lobule
192
What and where are Portal Triads?
Corners of hepatic lobules | Consists of bile duct, portal vein and hepatic artery
193
What type of cell makes up 80% of the liver's mass? | Why are their abundance so important?
Hepatocytes | Form layer that separates sinusoidal blood from canalicular bile
194
Hepatocytes are the location of synthesis of what things?
``` Transport proteins (albumin, fibrinogen) Lipoproteins FAs Triglycerides Cholesterol Bile ```
195
Location and function of hepatic sinusoids
Permeable capillaries between hepatocytes | Receive oxygenated blood from hepatic artery and nutrient deoxygenated blood from portal vein
196
What is the location and function of Stellate Reticuloendothelial cells?
Kupffer cells | Phagocytes w/in liver sinusoids that destroy R/WBCs, bacteria and debris
197
What are the functions of the liver?
``` Carbohydrate/lipid metabolism Protein synthesis Drug/hormone processing Bilirubin excretion Storage of glycogen/ADEKs Phagocytosis Bile synthesis ```
198
What liver function occurs when plasma glucose is low? When it's high?
``` Low= glycogenolysis High= glycogenesis ```
199
What type of lipid synthesis occurs in the liver?
Triglycerides Lipoproteins Cholesterol
200
What transport proteins are synthesized in the liver?
``` Haptoglubin IGF binding Sex-hormone binding Thyroxin binding Transferrin Vi-D binding ```
201
Which hormones does the liver alter/deactivate?
Thyroid/steroid like T3/T4, estrogen, aldosterone
202
Where is a majority of the bilirubin in bile metabolized and eliminated?
Metabolized in small intestine | Eliminated w/ feces
203
What minerals does the liver store?
Fe | Cu
204
Bile synthesis in the liver is the combination of what 3 things?
Bile salts Bile pigments Cholesterol
205
Amount, color and pH of normal bile?
600-1000mL/day Yellow/brown/olive green 7.6-8.6
206
What is the importance of bile?
Fat digestion and absorption | Means for excretion of waste products from blood
207
What can the gallbladder walls reabsorb?
Water | Ions
208
Spleen acts as a large reservoir of what WBC?
Macrophage
209
Hematopoiesis of the spleen includes?
Mono/lymphocyte development and activation Fetal RBC development Adult RBC development during extreme anemia
210
What cells does the spleen remove from circulation?
Old RBCs Imperfect platelets Breaks apart Hgb molecule to save iron and globin
211
Where does the small intestine begin and end?
Start- after pyloric sphincter | End- ileocecal sphincter
212
What are the 3 regions of the small intestine?
Duodenum- shortest Jejunum Ileum- longest
213
What valve merges the small and large intestine?
Ileocecal Sphincter
214
What is the Ligament of Treitz and what is it's function?
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
All of the small intestine is covered by the serosa (visceral peritoneum) except for where?
Proximal portion
216
Muscularis layer of the small intestine contains which plexus?
Myenteric (Auerbach)
217
Submucosa layer of the small intestines contain which plexus and glands?
Submucosal (Meissner) | Brunner's glands- alkaline mucus secretors
218
What and where are Crypts of Lieberkuhn?
AKA for intestinal glands | Deep crevices in mucosal lining of small intestine
219
What are the miscellaneous cells within the mucosa layer of the Small Intestine?
Absorptive- enterocytes, absorb nutrients from chyme Goblet- secrete mucus Paneth- secrete lysozomes capable of phagocytosis
220
What are the enteroendocrine cells of the small intestine?
S cells CCK cells K cells
221
What do the S cells in the small intestine do?
Secrete secretin | Stims pancreatic juice/inhibs gastric juice
222
What do CCK cells do in the small intestine?
Secrete cholecystokinin Helps satiety Stims pancreatic juice flow Relaxes sphincter of Oddi Stims gallbladder contraction
223
What do K cells in the small intestine do?
Secrete glucose dependent insulinotropic polypeptide AKA gastric inhib polypeptide Dec gastric emptying rate
224
Define Plicae Circulares and where are they located
Circular folds in the small intestine Permanent ridges beginning near proximal duodenum, ending midpoint of ileum Increases SA and causes chyme to spiral
225
What are the special features of the small intestine?
Plicae circulares Villi Microvilli
226
What structures within the small intestine give the walls of the lumen a velvet appearance?
Villi
227
What makes the brush border of the small intestine?
Microvilli- projections of apical membrane of absorptive cells
228
What special features of the small intestine also produces digestive enzymes? What are these enzymes called?
Microvilli | Brush-border enzymes
229
What are the brush border enzymes and what do they digest?
``` Carbs- a-dextrinase maltase sucrase lactase ``` Peptidases- aminopeptidase dipeptidase Lipase- phospholipase b1
230
How are carbs digested in the small intestine?
Pancreatic amylase | Once split into monosaccharides they are absorbable
231
Pancreatic amylase can not digest what carbohydrate which causes a large bulking of feces?
Cellulose
232
Which pancreatic juices perform protein digestion in the small intestine? When is protein digestion considered complete?
``` Trypsin Chymotrypsin Carboxypeptidase Elastase Ends w/ small/single chained AAs ```
233
What pancreatic juices complete lipid digestion in the small intestine?
Lipase- begins in stomach | Pancreatic lipase- continues in small intestine
234
What are the overall functions of the large intestine?
Complete absorption Produce Vit K and biotin Form feces Excrete solid wastes
235
What are the 4 regions of the large intestine?
``` Extending from ileum to anus: Cecum Colon (Ascend/transverse/descend/sigmoid) Rectum Anal canal ```
236
How is the large intestine held to the posterior abdominal wall?
Mesocolon fold
237
What is the sphincter between the small and large intestine?
Ileocecal
238
Where does the cecum of the large intestine begin?
Inferior to ileocecal valce
239
Where is the vermiform appendix attached to on the large intestine?
Cecum
240
What are the 4 portions of the colon?
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
What parts of the colon are peritoneal and retroperitoneal?
Retro: ascending, descending Peri: transverse, peritoneal
242
Rectum is at what vertebral level?
3rd sacral vertebrae
243
Mucus membranes of the anal canal are arranged into folds called? What do the formations contain?
Longitudinal folds called columns | Contain arteries and veins
244
What are the two sphincters of the anal canal?
Internal: smooth/involuntary External: skeletal/voluntary
245
Define Pectinate (dentate) Line
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
What does the serosa layer of the large intestine contain?
Omental appendices
247
What are the thickened bands on the large intestine called? | What layer do they occupy?
Teniae coli | Muscularis
248
What is the function of teniae coli?
Contract to form haustra= puckered/pouched appearance
249
What is the difference between the external and internal layer of the large intestines muscularis layer?
``` External= longitudinal smooth muscle Internal= circular smooth muscle ```
250
How is digestion accomplished in the small intestine? | What is secreted here?
Symbiotic bacteria | Mucus
251
What gases are produced in the large intestine?
H, CO2, methane= gas | Indole, skatole, H2S= odor
252
How does feces accomplish it's normal brown color?
Bacteria breakdown of bilirubin to stercobilin
253
Chemically speaking, what does feces contain?
Water Epithelial cells Bacteria/decomposition Unabsorbed/indigestible material
254
What are the two types of movement that occur in the GI tract?
Peristalsis- wavelike ripple triggered by bolus stretch | Segmentation- mixing, forward/backward movement, aids w/ mechanical digestion
255
How is gastric emptying regulated?
Hormonal | NS- enterogastric reflex
256
What causes GDIP to be released?
Fats/nutrients in duodenum | Inhibits gastric muscle, decreases peristalsis and slows gastric emptying
257
What stimulates/triggers the enterogastric reflex?
Chem/baroreceptors in duodenum | Inhibits gastric peristalsis, slows gastric emptying
258
What are the different types of motility that occur within the GI tract?
Gastric motility Intestinal motility Reflexes
259
What are the two types of intestinal motility?
Peristalsis | Segmentation
260
What are the motility reflexes?
Gastroileal Enterogastric Gastrocolic Defecation
261
Define the Gastroileal Reflex
Secretory and motor activity of stomach signals distal ileum early in meal, accelerates movement through ileocecal sphincter
262
Define the Enterogastric Reflex
Small and large intestine distension inhibit stomach motility and secretion
263
Define the Gastrocolic Reflex
Excess stomach activity causes feces in colon to move forward
264
Define the Defecation Reflex
Distension of rectum trigger baroreceptors that signal colon and anal canal to contract
265
What are the pressures needed during the defecation triggering process?
18mmHg- conscious desire 55mmHg- internal sphincter relaxes, external sphincter held tight consciously 80mmHg- external sphincter may fail
266
"Normal" bowel movement frequency and influencing factors
Diet Health Stress 1-3/day 3-4/week

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