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GI Final > BRS GI > Flashcards

BRS GI Flashcards

1
Q

parasympathetic innervation to the GI tract is mediated by which two nerves

A

vagus and pelvic nerves

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2
Q

preganglionic parasympathetic fibers synapse where in the GI tract

A

in the hyenteric and submucosal plexuses

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3
Q

parasympathetic innervation of the stomach, esophagus, pancreas and upper large intestine

A

Vagus n

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4
Q

parasympathetic innervation of the lower LI, rectum, anus

A

pelvic n

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5
Q

postganglionic sympathetic fibers leave the _______ ganglia and synapse in the ______ and ______ plexuses
usually results in an _______ response

A

leave the prevertebral ganglia and synapse in the myenteric and submucosal plexuses
inhibitory response

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6
Q

four official GI hormones

A

gastrin
CCK
secretin
GIP (glucose-dependent insulinotropic peptide)

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7
Q

increases gastric H+ secretion

stimulates growth of gastric mucosa

A

Gastrin

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8
Q

Stimulates contraction of gallbladder and relaxation of sphincter of Oddi
increase HCO3 from pancreas
INcrease growth of exocrine pancreas/gallbladder
inhibits gastric emptying

A

CCK

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9
Q

increases pancreatic HCO3 secretion

increases biliary HCO3 secretion

A

Secretin

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10
Q

increases insulin secretion

decreases gastric H secretion

A

GIP

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11
Q

stimuli for gastrin

A

small peptides and AA in lumen of stomach
distension of stomach
vagal stimulation (via GRP)

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12
Q

inhibition of gastrin

A

H+ in the lumen of the stomach (negative feedback)

somatostatin

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13
Q

Syndrome when gastrin is secreted by non-Beta cell tumors of the pancreas

A

Zollinger-Ellison syndrome (gastrinoma)

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14
Q

stimuli for CCK

A

small peptides and AA

FA and monoglycerides in duodenum

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15
Q

stimuli for secretin

A

H+ and FA in lumen of duodenum

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16
Q

stimuli for GIP

A

released in response to fat, protein, carbohydrate

FA, AA, orally administered glucose

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17
Q

inhibits release of all GI hormones, stimulated by presence of H+ in lumen

A

somatostatin

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18
Q

increases gastric H+ secretion, produced by mast cells of the gastric mucosa

A

histamine

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19
Q

GI neurocrines (3) - neurocrines are synthesized in neurons and moved by axonal transport down the axon, released by AP in nerves

A

VIP - vasoactive intestinal peptide
GRP (Bombesin)
enkephalins

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20
Q

neurocrine that produces relaxation of GI smooth muscle, including the LES
Stimulates pancreatic HCO3 secretion
inhibits gastric H+ secretion

A

VIP - vasoactive intestinal peptide

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21
Q

neurocrine that is released from vagus n that innervate G cells
stimulates gastrin release from G cells

A

GRP (bombesin)

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22
Q

neurocrine that stimulates contraction of GI smooth muscle (esp. sphincters)
also inhibits intestinal secretion of fluid and electrolytes

A

Enkaphalins
met-enkaphalin
leu-enkaphalin

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23
Q

contraction of circular smooth muscle in the GI tract results in what movement

A

decrease in diameter (segmentation)

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24
Q

contraction of longitudinal smooth muscle in the GI tract results in what movement

A

decrease in length - inchworming that poop along

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25
Q

slow waves originate from

A

interstitial cells of cajal - pacemaker cells

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26
Q

the frequency of slow waves determines the ______ for any given section of the GI tube

A

determines the maximum frequency of contractions
lowest in stomach - 3/min
highest in duodenum - 12/min

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27
Q

where in the brain is the swallowing mechanism coordinated and what nerves carry it

A

the medulla

vagus and glossopharyngeal nerves carry info between GI and medulla

28
Q

three events of swallowing

A
  1. nasopharynx closes and breathing is inhibited
  2. Laryngeal muscles contract to close glottis and elevate larynx
  3. Peristalsis begins in the pharynx and UES relaxes to permit food bolus to enter esophagus
29
Q

because the esophagus is located in the thorax, intraesophageal pressure equals thoracic pressure, which is ______ than atmospheric pressure.

A

lower than atmospheric

30
Q

primary peristaltic contraction creates an area of ____ pressure behind the bolus that, along with gravity, propels the bolus towards the stomach

A

creates an area of high pressure

31
Q

relaxation of the LES is mediated by what neurotransmitter

A

VIP

32
Q

reflex that occurs when the orad region of the stomach relaxes to accommodate the ingested meal

A

receptive reflex

33
Q

caudad region of the stomach serves what two purposes

A

mix foods with gastric secretions and begins digestion process

34
Q

during fasting, do gastric contractions occur?

A

yes, they clear the stomach of residual food

mediated by motilin

35
Q

gastric emptying is the fastest when the contents are what tonicity compared to (iā€™m not sure what actually)

A

isotonic emptying is fastest though

36
Q

FA are able to slow gastric emptying by prompting the release of which hormone

A

CCK

37
Q

describe the gastroileal reflex

A

presence of food in the stomach triggers increase in peristalsis in the ileum and relaxation of the ileocecal sphincter

38
Q

characteristics of saliva
____ HCO3, K
____-tonic
major enzymes (2)

A

high HCO3, K
Hypotonic
alpha-amylase
lingual lipase

39
Q

characteristics of gastric secretions

A

HCL
pepsinogen
intrinsic factor

40
Q

characteristics of pancreatic secretion
____ HCO3
___-tonic
major enzymes (3)

A

high HCO3
isotonic
pancreatic lipase, amylase, proteases

41
Q

major characteristics of bile

A

bile salts
bilirubin
phospholipids
cholesterol

42
Q

at the lowest flow rate, what is the composition of saliva?

A

low osmolarity and lowest Na, Cl and HCO3 concentrations

highest K concentration

43
Q

at the highest flow rates, what is the composition of saliva?

A

composition resembles saliva

44
Q

which part of the a saliva gland modifies its composition?

A

ducts (as they are impervious to water)

45
Q

what hormone acts on ductal cells to increase reabsorption of Na and secretion of K (recall)

A

aldosterone

46
Q

atropine (anticholinergic) has what effect on the production of saliva?

A

inhibits its production
causes dry mouth
parasympathetic innervation Ach ā€“> muscarinic receptor signal blocked by atropine

47
Q

secondary messenger of parasympathetic innervation to acinar and ductal cells

A

IP3 and Ca (from DAG)

48
Q

secondary messenger of sympathetic innervation to acinar and ductal cells

A

cAMP

49
Q

what stimuli increase the production of saliva?

A

food in mouth, smells, conditioned reflex and nausea

50
Q

what stimuli decrease the production of saliva?

A

sleep, dehydration, fear and anticholinergic drugs

51
Q

cell type that secretes HCL (and reabsorbs HCO3) and intrinsic factor

A

parietal cells

52
Q

cell type in stomach that secretes pepsinogen

A

chief cells

53
Q

cell type in stomach that secretes gastrin

A

G cell

54
Q

pump in parietal cells that excretes H

A

H+,K+ ATPase (antiporter, exchanges H and K)

55
Q

omeprazole inhibits what ion transporter in the stomach

A

H+, K+ ATPase of parietal cells, blocking H secretion

56
Q

drug that blocks H secretion by inhibiting the H+. K+ ATPase in the stomach

A

omeprazole

57
Q

what is the MoA for vomiting to induce metabolic alkalosis?

A

gastric H+ never arrives in the small intestine, no stimuli for pancreatic HCO3 secretion, arterial blood becomes alkaline

58
Q

stimulation of gastric H+ secretion occurs 2 ways:

A
  1. vagus n innervates parietal cells and stimulates secretion directly (ACh to muscarinic, IP3 and DAG)
  2. vagus n innervates G cells and stimulates gastrin secretion, which then indirectly stimulates H secretion (NT::GRP)
59
Q

atropine blocks which pathway of gastric H+ secretion

A

direct pathway, atropine is a cholinergic muscarinic antagonist

60
Q

atropine is unable to completely stop gastric H+ secretion for what reason?

A

since indirect stimulation of gastric H+ secretion relies on G cells being stimulated by the NT GRP, the cholinergic muscarinic antagonist, atropine, is unable to completely inhibit H+ secretion

61
Q

what surgical intervention would be effective in total inhibition of gastric H+ secretion

A

vagotomy (vagus n innervates parietal cells directly and G cells, which produce gastrin [induces H+ secretion])

62
Q

signal released from ECL cells in the gastric mucosa that stimulates H+ secretion by activating H2 receptors

A

histamine

63
Q

histamine is able to induce gastric H+ secretion through activation of which receptor and cascade in parietal cells

A

H2 receptor
adenylyl cyclase
cAMP

64
Q

cimetidine primarily blocks which receptor and signalling molecule

A

blocks H2 receptors on parietal cells that normally bind histamine to produce H+

65
Q

inhibitory drug that works on the H2 receptor

A

cimetidine

66
Q

term that refers to the response of simultaneous administration of two stimulants is greater than the sum of responses to either agent given alone

A

potentiation

GI Final (8 decks)

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