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Medical Physiology I > Block 6 Exam > Flashcards

Block 6 Exam Flashcards

1
Q

Mouth

A

Mechanical homogenization of food

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2
Q

Salivary glands

A

Salivary secretion

Hydration, lubrication, Amylase

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3
Q

Esophagus

A

Propulsion of food

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4
Q

Stomach

A

Gastric acid & pepsinogen secretion, mechanical churning to reduce particle size

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5
Q

Pancreas

A

Pancreatic secretion of bicarbonate, propeptidases, amylase, prolipases

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6
Q

Liver and Gall bladder

A

Bile acid secretion

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7
Q

Small intestine

A

Digestion and absorption of nutrients (proteins, fats, sugars), electrolytes, and water

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8
Q

Anus

A

Defecation of fecal waste

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9
Q

Villi cells

A

Primarily nutrient and electrolyte absorption

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10
Q

Crypt or gland cells

A

Primarily secretion

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11
Q

Features that increase surface area of small and large intestine

A 
Folds of Kerckring
Semilunar folds
Villi
Crypts or glands
Microvilli
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12
Q

Transcellular

A

Through the cell

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13
Q

Paracellular

A

Between the cell

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14
Q

Blood flow in fasting state

A

30mL/min/100g of tissue

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15
Q

Blood flow after a meal

A

Can reach 250mL/min/100g of tissue

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16
Q

Which locally produced hormones and kinins cause vasodilation during digestion

A

Cholecystokinin

Neurotensin

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17
Q

Submucosal plexus

A

Meisner’s

Only found in small and large intestine

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18
Q

Myenteric plexus

A

Auerbach’s

Found throughout GI tract

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19
Q

Vagovagal reflex

A

Sensory afferents from chemoreceptors, osmoreceptors, and mechanoreceptors in the mucosa are carried by the vagus nerve to autonomic centers in the brain, which in turn sends efferents via the vagus nerve to change secretion and motility

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20
Q

Acetylcholine (ACh) source

A

Cholinergic neurons

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21
Q

Acetylcholine (ACh) Actions

A 
Contraction of smooth muscle in wall
Relaxation of sphincters
Increase salivary secretion
Increase gastric secretion
Increase pancreatic secretion
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22
Q

Norepinephrine (NE) source

A

Adrenergic neurons

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23
Q

Norepinephrine (NE) actions

A

Relaxation of smooth muscle in wall
Contraction of sphincters
Increase salivary secretion

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24
Q

Vasoactive intestinal peptide (VIP) source

A

Neurons of mucosa and smooth muscle

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25
Vasoactive intestinal peptide (VIP) actions
Relaxation of smooth muscle Increase intestinal secretion Increase pancreatic secretion
26
Gastrin-Releasing Peptide (GRP), or Bombesin source
Neurons of gastric mucosa
27
Gastrin-Releasing Peptide (GRP), or Bombesin actions
Increase gastrin secretion
28
Enkephalins (opiates) source
Neurons of mucosa and smooth muscle
29
Enkephalins (opiates) actions
Contraction of smooth muscle | Decrease intestinal secretion
30
Neuropeptide Y source
Neurons of mucosa and smooth muscle
31
Neuropeptide Y actions
Relaxation of smooth muscle | Decrease intestinal secretion
32
Substance P source
Cosecreted with ACh
33
Substance P actions
Contraction of smooth muscle | Increase salivary secretion
34
Cholecystokinin source
I cells in duodenum and jejunum | Neurons in ileum and colon
35
Cholecystokinin target
Pancreas | Gall bladder
36
Cholecystokinin action
``` Increase enzyme secretion (pancreas) Increase contraction (gall bladder) ```
37
Gastric inhibitory peptide source
K cells in duodenum and jejunum
38
Gastric inhibitory peptide target
Pancreas
39
Gastric inhibitory peptide action
Exocrine: decrease fluid absorption Endocrine: increase insulin release Suppresses glucagon secretion
40
Gastrin source
G cells, antrum of stomach
41
Gastrin target
Parietal cells in body of stomach
42
Gastrin action
Increase H+ release
43
Gastrin-releasing peptide source
Vagal nerve endings
44
Gastrin-releasing peptide target
G cells in antrum of stomach
45
Gastrin-releasing peptide action
Increase gastrin release
46
Guanylin source
Ileum and colon
47
Guanylin target
Small and large intestine
48
Guanylin action
Increase fluid absorption
49
Motilin source
Endocrine cells in upper GI tract
50
Motilin target
Esophageal sphincter Stomach Duodenum
51
Motilin action
Increase smooth-muscle contraction | Migrating motor complex
52
Neurotensin source
Endocrine cells | Widespread in GI tract
53
Neurotensin target
Intestinal smooth muscle
54
Neurotensin action
Vasoactive stimulation of histamine release
55
Peptide YY source
Endocrine cells in ileum and colon
56
Peptide YY target
Stomach | Pancreas
57
Peptide YY action
Decrease vagally mediated acid secretion (stomach) | Decrease enzyme and fluid secretion (pancreas)
58
Secretin source
S cells in small intestine
59
Secretin target
Pancreas | Stomach
60
Secretin action
Increase HCO3 - and fluid secretion by pancreatic ducts (pancreas) Decrease gastric acid secretion (stomach)
61
Somatostatin source
D cells of stomach and duodenum
62
Somatostatin target
Stomach Intestine Pancreas Liver
63
Somatostatin action
Decrease gastrin release (stomach) Increase fluid absorption/decrease secretion (intestine) Increase smooth-muscle contraction (intestine) Decrease endocrine/exocrine secretions (pancreas) Decrease bile flow (liver)
64
Substance P source
Enteric neurons
65
Substance P target
Enteric neurons
66
Substance P action
Neurotransmitter
67
VIP source
ENS neurons
68
VIP target
Small intestine | Pancreas
69
VIP action
Increase smooth-muscle relaxation (small intestine) Increase secretion by small intestine (small intestine) Increase secretion by pancreas (pancreas)
70
Peristalsis
Propulsion of chyme in the caudal direction
71
Segmentation
Mixing or churning of chyme
72
Gastric accommodation
Active dilation or relaxation of the fundus of the stomach in response to entry of food
73
Internal anal sphincter
Circular and longitudinal smooth muscle | Involuntary control
74
External anal sphincter
Striated muscle only | Voluntary and involuntary control
75
What portions of the human digestive system contain striated muscle
Upper esophageal sphincter Upper third of esophagus External anal sphincter
76
Principal functions of stomach
Stores and mixes food Secretes intrinsic factor for vitamin B12 absorption Secretes HCl and proteolytic enzymes
77
Exocrine secretions of stomach
Facilitate iron absorption | Secretes mucus to protect mucosa against noxious agents
78
Endocrine secretions of stomach
Miscellaneous functions
79
Gastric Sympathetic innervation function
Decrease motility Decrease secretion Constrict vasculature
80
Where is pepsinogen I released from
Oxyntic mucosa only
81
Where is pepsinogen II released from
Throughout gastric mucosa
82
Gastric endocrine cells neurotransmitters
``` Vasoactive intestinal peptide (VIP) Galanin Serotonin Pituitary adenylate cyclase activating peptide (PACAP) Gastrin-releasing peptide (GRP) ```
83
Gastric endocrine cells paracrine mediators and hormones
Ghrelin Gastrin Somatostatin
84
Loss of sonic hedgehog
Loss of acidity Diminished production of somatostatin Increase in serum gastrin levels
85
What do parietal cells release
intrinsic factor | HCl
86
What do chief cells release
pepsinogen
87
What do ECL cells release
histamine
88
What do G cells release
gastrin | GF
89
What do D cells release
somatostatin
90
What cells does ACh act on
Parietal cell ECL cell D cell
91
ACh receptor
M3
92
What cells does GRP act on
G cell
93
Atropine
Blocks M3 receptor
94
Cimetidine, Ranitidine (-dine)
Block H2 receptor
95
Omeprazole, Pantoprazole (-azole)
PPI
96
ANTGIP effect on plasma insulin
Decreases
97
ANTGIP effect on serum glucose levels
Decrease
98
Gastrin's role in duodenal ulcer
Basal levels slightly elevated Meal-stimulated elevated, prolonged Autoregulatory defect Increased responsiveness of parietal cells to circulating gastrin
99
Somatostatin Inhibits which GI functions
GI peptides Gastric acid secretion Motility Pancreatic enzyme and HCO3- secretion
100
Somatostatin mode of action
Neurotransmitter Hormone Paracrine
101
Duodenal ulcer phenotype
Antral predominant gastritis High gastrin and acid secretion Impaired inhibitory control of acid secretion Protection from gastric cancer
102
Simple gastritis phenotype
Mild mixed gastritis High gastrin but normal acid secretion No gastric atrophy No significant clinical outcome
103
Gastric cancer phenotype
``` Corpus-predominant gastritis Multi-focal atrophic gastritis High gastrin Hypo/achlorhydria Low pepsinogen I and pepsinogen I/II ratio Increased risk of gastric cancer ```
104
Invasive methods to diagnose H. pylori
Histology Culture Rapid urease test (CLOtest)
105
Serology to diagnose H. pylori
ELISAs detect IgG
106
Best test for evaluating eradication of H. pylori
Urea breath tests
107
Past treatment of peptic ulcer
No acid, no ulcer | Acid suppression
108
Present treatment of peptic ulcer
Cure H. pylori, heal ulcer | H. pylori eradication and acid suppression
109
Future treatment of peptic ulcer
No H. pylori, no ulcer | Prevent ulcer by preventing H. pylori
110
What are incretins
Hormones mediating the enteroinsular axis
111
Incretin stimulus
Glucose containing meal
112
Site of release of incretins
Small intestine
113
Effect of incretin release
Stimulated pancreatic beta islet cells to release insulin
114
Pathologies of Gastric Inhibitory Polypeptide
Obesity and type 2 Diabetes mellitus | Cushing's syndrome
115
GIP synthestized/secreted by what?
K cells in upper small intestine
116
GIP biological properties
Delays gastric emptying | Stimulates insulin release in response to glucose
117
Effects of GIP on metabolism
Increase insulin release Increase glucose absorption Decrease lipolysis Increase lipogenesis/fat storage
118
Effects of ANTGIP on metabolism
Decrease GIP stimulated insulin release Decrease serum glucose levels Decrease d-glucose absorption from the small intestine Increase lipolysis
119
Metabolic syndrome characterized by
Obesity Nonalcoholic fatty liver disease (NAFLD) Insulin resistance with hyperinsulinemia
120
Duodenal ulcer
Damage to duodenal mucosa via excessive gastric acid secretion
121
Gastric ulcer
Damage to gastric mucosa via cytotoxic atrophy
122
H. pylori in Duodenal ulcer
Inhibits somatostatin and HCO3- secretion
123
Hypersecretory states in duodenal ulcer
Elevated basal gastrin | Significantly increased postprandial gastrin secretion
124
H. pylori in gastric ulcer
Release cytotoxins that damage gastric mucosa
125
Decrease in gastric [H+] in gastric ulcer
H. pylori migrates to corpus and damages/inhibits parietal cells and increases gastric secretion
126
Functions of saliva
``` Moisten and lubricate foodstuffs Facilitate speech Dissolve food for taste Begin digestion of carbohydrates and lipids Antibacterial/immunologic Retards dental caries Washes out substances ```
127
Types of acinar cells
Serous | Mucus
128
Serous acinar cell
water salts protin
129
Mucus acinar cell
Mucins
130
Exocrine pancreas function
Secretion of bicarbonate to neutralize gastric acid | Secretion of digestive enzymes
131
Ductal cell bicarbonate secretion inhibited by
substance p
132
Ductal cell bicarbonate secretion stimulated by
ACh | Secretin
133
Parotid acinar cell
alpha-amylase
134
Sublingual acinar cell
Mucin glycoprotein
135
Aldosterone effect on salivary ductal cells
Increase absorption of NaCl and secretion of K+ | Increase ENaC
136
Most important regulator of Protein secretion by pancreatic acinar cells
ACh
137
Most potent regulator of Protein secretion by pancreatic acinar cells
CCK
138
Most potent 2nd messenger of Protein secretion by pancreatic acinar cells
Ca2+
139
Ductal cell Cl- secretion facilitated by
Apical CFTR and CaCC
140
Basolateral channels on ductal cells
Sodium bicarb co-transporter | Bicarb from CO2 and carbonic anhydrase
141
Apical channels on ductal cells
Leaves by anion exchanger
142
Pancreatic secretion cephalic phase regulated by
ACh
143
Pancreatic secretion intestinal phase regulated by
CCK Secretin Vagovagal enteropancreatic reflex
144
What does CCK cause exocrine pancreas
Maximal acinar release of digestive enzyme
145
What does secretin cause exocrine pancreas
Maximal ductal secretion of HCO3- and fluid
146
CCK effect on bile release
Contraction of gallbladder | Relaxes sphincter of Oddi
147
ACh effect on bile release
Contraction of gall bladder
148
Principle roles of bile
Gastric acid neutralization | Assist with lipid absorption
149
Nutrients that trigger GIP release
Proteins Lipids Carbohydrates
150
Nutrients that trigger Secretin release
H+ | Fatty acids
151
Nutrients that trigger Gastrin release
Amino acids/peptones | Vagal stimulation
152
Nutrients that trigger CCK release
Fatty acids >> proteins
153
Na/glucose or Na/Amino acid cotransporters timing
Primary mechanism after a meal
154
Na/glucose or Na/amino acid cotransporters location
Duodenum Jejunum (main) Ileum
155
Na-H exchanger timing
Postprandial
156
Na-H exchanger location
``` Duodenum Jejunum (main) ```
157
Parallel Na-H and Cl-HCO3 exchanger timing
primary mechanism during interdigestive period
158
Parallel Na-H and Cl-HCO3 exchanger location
Ileum | Proximal colon
159
Epithelial Na+ channel (ENaC) location
Distal colon
160
Passive K+ absorption location
Jejunum | Ileum
161
Passive K+ secretion location
``` Proximal colon Distal colon (main) ```
162
Active K+ secretion location
``` Proximal colon (main) Distal colon ```
163
Active K+ absorption location
Distal colon
164
Na/Glucose or Na/Amino acid cotransporters enterotoxin effect
No effect
165
Parallel Na-H and Cl-HCO3 exchanger enterotoxin effect
Decreases Na+ absorption
166
What inhibits ENaC
Amiloride
167
What enhances ENaC
Aldosterone
168
Active K+ secretion stimulation
cAMP, Ca2+
169
Active K+ secretion enhanced by
Aldosterone
170
Small intestine K+ transport
Net absorption
171
Large intestine K+ transport
Net secretion
172
Passive Cl- absorption timing
During a meal
173
Passive Cl- absorption location
Jejunum (main) Ileum (limited) Distal colon (main)
174
Cl-HCO3 exchanger timing
Interdigestive
175
Cl-HCO3 exchanger location
Ileum Proximal colon (main) Distal colon
176
Cl- Secretion location
``` Duodenum Jejunum Ileum Proximal colon Distal colon ```
177
Bacterial enterotoxins secretagogue
Cholera toxin E. coli; heat labile and heat stable Yersinia toxin Clostridium difficile toxin
178
Cholera toxin second messenger
cAMP
179
E. coli heat labile second messenger
cAMP
180
E. coli heat stable second messenger
cGMP
181
Yersinia toxin second messenger
cGMP
182
Clostridium difficile toxin second messenger
Ca2+
183
Hormones and neurotransmitters secretagogue
``` VIP Guanylin Acetylcholine Bradykinin Serotonin (5-HT) ```
184
VIP second messenger
cAMP
185
Guanylin second messenger
cGMP
186
Acetylcholine second messenger
Ca2+
187
Bradykinin second messenger
Ca2+
188
Serotonin (5-HT) second messenger
Ca2+
189
Immune cell products secretagogue
Histamine | Prostaglandins
190
Histamine second messenger
cAMP
191
Prostaglandins second messenger
cAMP
192
Laxatives secretagogue
Bile acids | Ricinoleic acid
193
Bile acid second messenger
Ca2+
194
Lamina Propria cells affect on intestinal ion transport Macrophages
Prostaglandins | O2 radicals
195
Lamina Propria cells affect on intestinal ion transport Mast cells
Histamine
196
Lamina Propria cells affect on intestinal ion transport neutrophils
Eicosanoids | Platelet-activating factor
197
Lamina Propria cells affect on intestinal ion transport fibroblasts
Eicosanoids | Bradykinin
198
Sucrose
Glucose + fructose
199
Lactose
Glucose + Galactose
200
Maltose
2 glucose
201
Maltotriose
3 glucose
202
Lactase deficiency causes
Physiological Familial Decreased mucosal surface area Damage to enterocytes
203
Lactase deficiency problems
Milk intolerance Flatulence/distention Diarrhea Cramps
204
Trypsinogen activating agent
Enteropeptidase | Trypsin
205
Trypsinogen active enzyme
Trypsin
206
Trypsinogen action
endopeptidase
207
Trypsinogen products
Oligopeptides (2-6 amino acids)
208
Chymotrypsinogen activating agent
Trypsin
209
Chymotrypsinogen active enzyme
Chymotrypsin
210
Chymotrypsinogen action
Endopeptidase
211
Chymotrypsinogen products
Oligopeptides (2-6 amino acids)
212
Proelastase activating agent
Trypsin
213
Proelastase active enzyme
Elastase
214
Proelastase action
Endopeptidase
215
Proelastase products
Oligopeptides (2-6 amino acids)
216
Procarboxypeptidase A activating agent
Trypsin
217
Procarboxypeptidase A active enzyme
Carboxypeptidase A
218
Procarboxypeptidase A Action
Exopeptidase
219
Procarboxypeptidase A products
Single amino acids
220
Procarboxypeptidase B activating agent
Trypsin
221
Procarboxypeptidase B active enzyme
Carboxypeptidase B
222
Procarboxypeptidase B action
Exopeptidase
223
Procarboxypeptidase B products
Single amino acids
224
Peyer's patches
Aggregated lymphoid tissue in lamina propria
225
Detergents
Amphipathic molecules that are water-soluble below CMC and form micelles above CMC
226
Emulsifiers
Amphipathic molecules that can be incorporated into micelles
227
Surfactants
Amphipathic molecules that helps stabilize two non-mixable fluids
228
Why do we need cholesterol
Makes membranes pliable, yet tight
229
Where does cholesterol come from
Synthesized by liver | Diet
230
How do we get rid of cholesterol
Predominantly by bile acid synthesis
231
Bad properties of cholesterol
Insoluble in water Limited lipid solubility Forms crystals when lipids are saturated
232
Gut derived lipoproteins
Chylomicrons | Remnant chylomicrons
233
Liver derived lipoproteins
VLDL LDL HDL
234
Chylomicrons core
TAGs Vitamins A, E, and K Cholesterol Cholesterol esters
235
Chylomicrons surface
Apolipoprotein A1 Phospholipids Cholesterol
236
Cl- secretion stimulators
cAMP cGMP Ca2+
237
Carbohydrate absorption
Duodenum (main) Jejunum Ileum
238
Alpha-amylase produces:
Maltose Maltotriose alpha-limit dextrins
239
SGLT1 functions
Mediates glucose and galactose into enterocytes
240
GLUT5 function
Facilitated diffusion of fructose into enterocytes
241
GLUT2 function
Facilitated diffusion of all three monosaccharides out of the enterocytes
242
Isomaltase function
Breaks alpha 1,6 linkages
243
Oligopeptide abosrption
H/oligopeptide cotransporter
244
Amino acid absorption
Na/AA cotransporter
245
Where is cobalamin absorbed
Ileum
246
What stimulates intrinsic factor release
Histamine ACh Gastrin
247
Ca2+ absorption
Passive throughout small intestine | Active in duodenum
248
How does Ca2+ enter enterocyte
TRPV6 channel
249
How does Ca2+ exit enterocyte
Ca-H pump | Na-Ca exchanger
250
What is required for active Ca2+ absorption
Vitamin D
251
Calbindin
Keeps [Ca2+]i low Driving force for more absorption Ca2+ crucial second messenger to many pathways
252
Absorption of Folate location
Duodenum
253
Which form of iron is absorbed
Ferrous (Fe2+)
254
How does Fe2+ exit enterocyte
Ferroportin
255
Water soluble vitamins
B and C
256
Fat soluble vitamins
A D E K
257
Anabolic functions in fed state
Glycogen synthesis Lipogenesis Protein synthesis
258
Catabolic functions in fasting state
Glycogenolysis Lipolysis + Ketogenesis Proteolysis
259
What ketone bodies do our bodies produce
Acetone Acetoacetate 3-beta hydroxybutyrate
260
Glucose Homeostasis phase I
Brain uses glucose Excess stored as glycogen Cutoff @ 4 hours
261
Glucose Homeostasis Phase II
Short-term fasting between meals Glycogen is used for glucose synthesis Cutoff @ 16 hours
262
Glucose Homeostasis Phase III
Glycogen is depleted Gluconeogenesis increases Cutoff @ 2 days
263
Glucose Homeostasis Phase IV, V
Fuel sparing Gluconeogenesis dips Body relies on fats (keto acids)
264
What important gluconeogenic enzyme is the muscle missing
Glucose-6-Phosphatase
265
Phosphoglycerate kinase
1,3-BPG => 3-phosphoglycerate
266
Pyruvate kinase
PEP => Pyruvate
267
Glucokinase and Hexokinase
Glucose => Glucose-6-P
268
Phosphofructo-kinase-1
Fructose-6-P => Fructose-1,6-BP
269
Pyruvate dehydrogenase
Pyruvate => Acetyl CoA
270
Pyruvate carboxylase
Pyruvate => OAA
271
PEP carboxykinase
OAA => Phosphoenolpyruvate
272
Fructose bisphosphatase
Fructose-1,6-P => Fructose-6-P
273
Glucose 6-Phosphatase
Glucose-6-P => Glucose
274
Rate limiting step of glycolysis
PFK-1
275
Glucokinase glucokinase affinity
Low | Not easily saturated
276
Hexokinase glucose affinity
High | Saturable
277
Which enzyme is inhibited by G6P
Hexokinase
278
What upregulated PFK-1
F-2,6-BP
279
Malate-aspartate shuttle location
Liver and heart
280
What does the malate-aspartate shuttle produce
NADH
281
alpha-Glycerol phosphate shuttle location
Brain and muscle
282
What does the alpha-glycerol phosphate shuttle produce
FADH2

Medical Physiology I (8 decks)

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