Alimentary Canal Physiology Pt.1 Flashcards
What is the digestive system
It is a system made up of the GIT and accessory organs
Names path of food going through the GIT
Oesophagus
Stomach
Duodenum
Jejunum
Ileum
Cecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Anus
Name the accessory organs in the alimentary canal
salivary glands
liver
pancreas
gallbladder
What are the 4 main functions of the digestive system
digestion
absorption
secretion
motility
Is lumen of the GIT considered external or internal to the body
external
What is the function of the mouth
Foodstuffs broken down by chewing
saliva added as lubricant
What is the function of the oesophagus
Conduit between mouth and stomach
What is the function of the stomach
Digestion of proteins
foodstuffs reduced to semi-liquid form
storage
sterilisation
What is the function of the pancreas
Digestive enzymes for digestion of fats, carbohydrates and proteins
What is the function of the liver
Bile salts for digestion/absorption of fats in small intestine
What is the function of the gallbladder
Stores and concentrates bile
What is the function of the small intestines
Final stages of chemical digestion and nutrient absorption
What is the function of the large intestines
Water absorption
bacterial fermentation
formation of faeces
What are the four layers (tunics) of the GIT
Mucosa
Sub mucosa
Muscularis externa
Serosa/adventitia
What are the 3 layers of the mucosa and functions
Epithelium - lining of GIT (protection), Synthesis and secretion of digestive enzymes, hormones, mucus, absorbs products of digestion (function changes through out the tract
Lamina propria - loose connective tissue containing glands, blood and lymph vessels
Muscularis mucosae - thin layer of smooth muscle
What structures are found in the sub mucosa
connective tissue
neurones (sub mucosal plexus), blood vessels
glands in oesophagus and duodenum
What are the layers of the muscularis externa
Oblique muscle (in stomach)
circular muscle (constricts lumen)
longitudinal muscle (shortens tube)
What two plexus’s makes up the ENS and where are they found
Myenteric (Auerbach’s) plexus - found between longitudinal and circular muscle
Sub mucosal (Meissner’s) plexus - found between the circular muscle and submucosa
What is the difference between serosa and adventitia
Adventitia is found out with the peritoneal cavity eg. oesophagus, rectum
Serosa is found within the peritoneal cavity eg. stomach, small intestines, large intestines
What type of tissue is serosa
Connective tissue
Are long and short reflexes parasympathetic or ENS
Long - parasympathetic
short - ENS
Which parasympathetic nerves innervate the GIT
Vagus (X)
salivary glands - facial (VII) + glossopharyngeal (IX)
What is the effect of parasympathetic innervation on the GIT
Stimulatory
- increased secretion
- increased motility
Which sympathetic nerves innervate the GIT
Splanchnic nerves
What is the effect of sympathetic innervation on the GIT
Inhibitory (except salvation)
- decrease secretion
- decreased motility
What are the
- 3 abdominal branches of the aorta
- their vertebral level
- which organs do they supply
Coeliac trunk (T12) - foregut
Superior mesenteric artery (L1) - midgut
Inferior mesenteric artery (L3) - hindgut
What are the 3 main branches of the coeliac trunk
Splenic artery
Left gastric artery
Common hepatic artery
What veins drain the GIT
Gastric vein
Splenic vein
Superior mesenteric vein
Inferior mesenteric vein
Where does venous drainage of GIT go
Hepatic portal vein => Hepatic vein => IVC
Why do we chew our food
Prolong tasting experience
Defence against respiratory failure
Is chewing involuntary or voluntary
Which nerves are used
Voluntary
Somatic nerves of skeletal muscle in jaw/mouth
How many salivary glands do we have
3 pairs
Sublingual glands
Submandibular glands
Parotid glands
What is in saliva
What is its function
Water - solvent
Mucins - added to water -> mucus
alpha amylase - breaks down polysaccharides
Electrolytes - tonicity/pH
Lysozymes - bactericidal
What do serious alveoli produce
Alpha amylase and lysosomes
What do mucous alveoli produce
Mucins
Histologicially, what are salivary glands similar to
Pancreatic cells
Is stimulation of salivary glands sympathetic or parasympathetic
Both
What is the difference between salivary glands stimulation in sympathetic and parasympathetic
Sympathetic
- small volume of viscous secretion
- high mucous content (a1 adrenoreceptors)
- high amylase content (B2 adrenoreceptors)
Parasympathetic
- watery salivary secretion
Which parasympathetic nerves stimulate salivary glands
Facial (VII) nerves
Glossopharyngeal (IX) nerves
Does the oesophagus have skeletal or smooth muscle
Upper 1/3 - skeletal muscle
Lower 2/3 - smooth muscle
How many phases of swallowing are there
3 phases
Oral
Pharyngeal
Oesophagus
When swallowing why does the soft palate reflect backwards and upwards
Stops food going in to the nasopharynx
Why does the epiglottis cover larynx during swallowing
Prevents food from entering the trachea
What propels bolus (food) down the oesophagus
Peristaltic wave
How many oesophageal sphincters are there
2 sphincters
Upper oesophageal sphincter
Lower oesophageal sphincter
What is the stomach volume
How does the pressure change
50ml -> 1500ml
No change in pressure
What is the function of the stomach fundus
Storage
What is the function of the stomach body
Storage
Mucus
HCl
Pepsinogen
Intrinsic factor
What is the function of the stomach antrum
Mixing/Grinding
Gastrin production from G cells
Which cells in the stomach produce mucus
Mucus neck cells
Which cells in the stomach produce pepsinogen
Chief cells
Which cells in the stomach produce HCl and intrinsic factors
Parietal cells
What is the name of the sphincter that controls food movement from the stomach to the duodenum
Pyloric sphincter
In HCl production CO2 is absorbed from the blood and mixes with H20 to produce which compound
What enzyme catalyses the reaction
What does it dissociate to produce
H2CO3
Carbonic anhydrase
H+HCO3
In HCl production as bicarbonate is pumped out of the cell what is being pumped in to the cell
Chlorine Cl
To pump H ions in to the stomach what is being pumped in to the cell
Potassium K
How does parietal cell production of HCl affect pH of blood
Increases pH of blood slightly
>7.4
Which medications can inhibit the H/K proton pump in parietal cells (and stopping HCl production)
PPIs
E.g Omeprazole, esomeprazole, lansoprazole
Antihistamines
What process activates the parietal cells H/K pump
What enzyme causes this reactions
Phosphorylation
Kinase
What four chemicals alter the amount of kinase in the cell
Gastrin
Histamines
Prostaglandins
Acetylcholine
What receptor does gastrin bind to which alters the amount of kinase and how does the receptor work
How does it alter the amount of Kinase
Which type of kinase is produced
Cckb receptor - Increases Ca in the cell
Increases kinase
Protein kinase C
What receptor do histamines bind to which alters the amount of kinase and how does the receptor work
How does it alter the amount of Kinase
Which type of kinase is produced
H2 receptor - activates GS receptor->activates adenyl cyclase-> increase ATP converted to cAMP-> cAMP activates Kinase
Increase kinase
Protein Kinase A
What receptor do neurotransmitters (e.g. acetylcholine) bind to which alters the amount of kinase and how does the receptor work
How does it alter the amount of Kinase
Which type of kinase is produced
M3 muscarinic receptors (parasympathetic) - increases Ca in the cell
Increases kinase
Protein kinase C
What receptor do prostaglandins bind to which alters the amount of kinase and how does the receptor work
How does it alter the amount of Kinase
Which type of kinase is altered
EP3 receptors - activates G protein (GI)-> inhibits conversion of ATP to cAMP
Decreases kinase
Protein kinase A
Which three mechanisms control gastric acid secretion
Neurocrine - vagal/local reflex
Endocrine - gastrin
Paracrine - histamine
How many phases for gastric acid secretion stimulation are there
What are they
Two
Cephalic and gastric
Explain the cephalic phase for gastric acid secretion stimulation
Increased vagus nerve stimulation will produce acetylcholine and stimulate G cells to produce gastrin
Also ECL cells produce histamines
Explain the gastric phase for gastric acid secretion stimulation
Distension-> vagal/enteric reflex-> produces ACh
Peptides in lumen->G cells-> gastrin
Gastrin/ACh-> ECL cells-> histamines
Why does acid secretion have to start before we begin eating
To sterilise food as soon as it is in our stomach
How many phases for gastric acid secretion inhibition are there
What are they
Three
Cephalic, Gastric, Intestinal
Explain the cephalic phase for gastric acid secretion inhibition
Stop eating-> decreased vagal activity
Explain the gastric phase for gastric acid secretion inhibition
Decreased pH (increased HCl concentration) -> decreased gastrin production
Explain the intestinal phase for gastric acid secretion inhibition
Acid in duodenum-> ENS reflex and secretin release-> decreased secretion and stimulation of parietal cells
Fat/CHO in duodenum -> GIP release-> decreased secretion and stimulation of parietal cells
What are enterogastrones
Name the three enterogastrones
Hormones released from gland cells in duodenal mucosa, released in response to acid, hypertonic solutions, fatty acids and monoglycerides in duodenum
Seretin, chloecystokinin (CCK), gastric inhibitory peptide (GIP)
How do enterogastrones prevent further acid build up
Inhibits gastric acid secretion
Reduce gastic emptying (inhibits motility)
What is a zymogen
Give an example
Inactive form of an enzyme
Pepsinogen, trypsinogen
What is the zymogen pepsinogen converted into
What is the function of the enzyme
Pepsin
Digests proteins in ingested food
What conditions are required to convert pepsinogen to pepsin
Is the process reversible
Why
pH <3 (acidic)
Yes (at neutral pH)
To protect the duodenum from damage
What is the role of gastric mucus
Cytoprotective role
Protects mucosal surface from mechanical injury
Neutral pH protects against gastric acid corrosion and pepsin digestion
What is produced by parietal cells and is essential for vitamin B12 absorption
Intrinsic factor
Where in the stomach do peristaltic waves take place
Weak in body
Strong in the antrum
How many peristaltic waves are there a minute
Approx. 3/minute
What is the slow peristaltic wave rhythm called
Basic electrical rhythm (BER)
What generates the peristaltic rhythm
Where are they found
Pacemaker cells in the longitudinal muscle
What determines contraction strength of peristaltic waves
The number of action potentials/wave
What types of control are there for peristaltic waves of the GIT
Neural - wall distention-> long/short reflexes-> increases contraction force
Hormonal - gastrin
Fat/amino acids/acids/hypertonicity in duodenum - motility inhibited
Why must acid be neutralised in the duodenum
Acid can damage duodenal walls and pancreatic enzymes
Where is bicarbonate (HCO3) produced
Duodenum - Brunner’s glands
What causes HCO3 secretion
what happens once acid is neutralised
Long (vagal) and short (ENS) reflexes
Release of secretin from S cells (HCO3 secretion from liver and pancreas)
Secretin inhibition (negative feedback)
What two types of hormones are produced by the pancreas
Exocrine and endocrine
Name the endocrine hormones and function of the pancreas
Where in the pancreas are they produced
Insulin - decrease blood glucose
Glucagon - increase blood glucose
Somatostatin - controls insulin and glucagon secretion
Pancreatic islets
Where do endocrine hormones from the pancreas go to
How do they move there
Bloodstream
Vein
What are endocrine hormones
What are exocrine hormones
Endocrine - hormones go to bloodstream
Exocrine - go to an epithelial surface
Name exocrine proteins of the pancreas and its function
Pancreatic amylase - breakdown of starch into maltose
Digestive enzymes
Where are exocrine products of the pancreas produced
Acinar cells in lobules
Where do pancreatic exocrine products go
How do they move there
Duodenum
Via pancreatic duct
(accessory duct in case of problems)
What is trypsinogen converted into
What enzyme aids this process
Trypsin
Enterokinase
What is the function of trypsin
Converts zymogens to enzymes
What are the categories of pancreatic enzymes
Protease
Nuclease
Elastase
Phospholipase
Lipase
Alpha amylase
What does CKK control
How does it achieve this
Digestion of fats and proteins
Increases enzyme secretion
What does Secretin control
How does it achieve this
Acid neutralisation
Increases bicarbonate secretion
What is the largest internal organ
Liver
What are the four lobes of the liver
Left
Right
Caudate
Quadrate
Portal hepatic vein-> ? -> IVC
Hepatic veins
What is the function of the liver
Production and secretion of bile
What are the 6 components of bile
Where are they synthesised
Bile acids
Lecithin
Cholesterol
Bile pigments
Toxic metals
Bicarbonate HCO3
Synthesised by hepatocytes except HCO3 (duct cells)
What are bile pigments produced from
Haemoglobin (damaged erythrocytes)
What is the most common bile pigment
What colour does it make bile
what extracts it
Bilirubin
Yellow
Hepatocytes
What causes the yellow colour of urine
Reabsorbed bilirubin that is excreted in the urine
What are bile acids synthesised from
Cholesterol
Bile acids conjugate with glycine or taurine
What is the product
Why do they conjugate
Bile salts
Increase solubility
How are secreted bile salts recycled
Enterohepatic circulation
Where is bile stored and concentrated
How is it concentrated
How many times concentrated is it
Gallbladder
Na and H20 are absorbed into the gallbladder
5-20x concentrated
Fat in the duodenum leads to the release of CCK
How does CCK work
Relaxes sphincter of Oddi
Contracts the gallbladder
Bile is discharged into the duodenum
Solubilises fat
How long is each section of the small intestines
Duodenum - 25cm
Jejunum - 2.5m
Ileum - 3.5m
Name functions of each part of the small intestines
Duodenum - Gastric acid neutralisation, digestion, iron absorption
Jejunum - Nutrient absorption (95%)
Ileum - NaCl/H20 absorption -> chyme dehydration, Vit B12 absorption
What increases surface area of the small intestines
Why is this important
Fold, villi, microvilli
Increases absorption
What is absorbed in the small intestines
NaCl, peptides, mineral, vitamins, fats, monosaccharides, amino acids, water,
Where does secretion take place in the small intestines
Crypts
What is secreted by crypts of the intestines
Chorine
Water (1500ml/day) - reabsorbed by villi
What is the purpose of water secretion in the intestines
Maintains liquid state of luminal contents
Promotes mixing of enzymes with digestive contents
Aids nutrient presentation to absorbing surface
Dilutes + washes away potential injurious substances
What are the two types of intestinal motility and there functions
Segmentation
- provide mixing of contents and enzymes
- brings chyme into contact with surfaces
Peristalsis
- Migrating motility complex (MMC)
- gastric antrum -> terminal ileum (1 wave at a time)
- moves undigested material
- limits bacterial colonisation
Does segmentation get stronger or weaker as it travels towards the rectum
Weaker
What hormone causes peristalsis
MMC hormone - motilin
Do peristalsis and segmentation take place at the same time
When do they start
No
Segmentation starts once food reaches the stomach
Peristalsis begins once segmentation ends
What plexus mediates the intestinal motility
Myenteric plexus (between circular and longitudal muscle layers of muscularis externa
What leads to increased segmentation activity in the ileum
Gastric emptying
Explain the gastroileal reflex
Ileolcecal valve opens
Chyme enters the large intestines
Colon distends
Reflex contraction of ileocecal sphincter (prevents back flow)
How long is the colon
1.5-1.8m
Which muscle layer of the colon is complete and which is incomplete
Complete - circular
Incomplete - longitudinal
What are the three bands of muscle the run the full colon called
Tenaie coli
What are the pouches in the colon called
Haustra
What type of epithelium is found in the colon mucosa
Simple columnar epithelium
What are the sections of the colon called
Cecum
Ascending
Transverse
Descending
Sigmoid
What is the rectum
Straight muscular tube
Is the muscularis externa of the rectum thicker or thiner compared to the rest of the GIT
Thicker
What type of epithelium is found in the rectum mucosa
Simple columnar epithelium
What type of epithelium is found in the anal canal mucosa
Simple columnar->stratified squamous
How long is the anal canal
2-3cm
Is the external anal sphincter smooth or skeletal muscle
Is the sphincter under voluntary or involuntary control
Skeletal muscle
Voluntary control
Does the colon have a role in nutrient absorption
No
What are the functions/characteristics of the colon
Transports Na from the lumen to the blood->osmotic absorption of water->chyme dehydration->solid faecal pellets
Long residence time in the colon - bacterial colonisation
How many bacteria are found in the colon
1000000000000000 (10 to the power of 14)
(approx. 1kg)
What is the function of the bacteria in the colon
Fermentation of undigested carbohydrates
- short chain fatty acids
- vitamin K
- gas flatus
What gases are produced by the bacteria of the colon
Nitrogen, CO2, hydrogen, methane, hydrogen sulphide
What is the function of vitamin K
Blood clotting
Is the internal anal sphincter smooth or skeletal muscle
Is the sphincter under voluntary or involuntary control
Smooth
Automatic/involuntary
What cause the defection reflex
Rectal wall distention->mechanoreceptors->reflex-> defecation urge
Which parasympathetic nerves control the defecation reflex
Pelvic splanchnic nerves