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Gastrointestinal DF > BRS Physiology > Flashcards

BRS Physiology Flashcards

1
Q

layers of the GI tract

A 
epithelial cell
Lamina propria
muscularis mucosae
submucosal plexus
circular muscle
myenteric plexus
longitudinal muscle
serosa

ELMS CMLS

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2
Q

vagus nerve innervates

A

stomach, upper large intestine, pancreas, esophagus

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3
Q

pelvic nerve innervates the

A

lower large intestine, rectum, anus

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4
Q

myenteric plexus (auerbach plexus)

A

motility of GI smooth muscle

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5
Q

submucosal (meissner plexus)

A

controls secretion and blood flow

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6
Q

actions of gastrin

A

stimulates H+ release by parietal cells

stimulates growth of gastric mucosa

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7
Q

gastrin secreted by what cells

A

G cells of the gastric antrum

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8
Q

stimuli for gastrin secretion

A

small peptides and amino acids in lumen of stomach
distension of stomach
vagal stimulation, mediated by GRP

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9
Q

inhibition of gastrin secretion

A

H+ in the lumen of the stomach: negative feedback

somatostatin: Gi

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10
Q

Actions of CCK

A

1) HCO3- release from pancreas potentiation with secretin
2) growth of Exocrine pancreas
3) pancreatic enzyme secretion
4) inhibits gastric emptying
5) contraction of the gallbladder and relaxation of sphincter of Oddi

HEPIC

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11
Q

cells that release CCK

A

released from I cells of duodenal and jejunal muscosa

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12
Q

stimuli for release of CCK

A

small peptides and amino acids
fatty acids and monoglycerides
(no triglycerides)

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13
Q

Secretin is homologous to ____

A

glucagon

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14
Q

actions of secretin

A

coordinate to reduce amount of H+ in the lumen of SI

1) stimulates pancreatic HCO3- secretion and increases growth of exocrine pancreas
2) stimulates HC)3- and H20 secretion by liver and increases bile production
3) inhibits H+ secretion by gastric parietal cells

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15
Q

secretin from what cells

A

S cells of duodenum

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16
Q

stimuli for secretin release

A

H+ in duodenum

Fatty acids in lumen of duodenum

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17
Q

GIP is homologous to

A

secretin and glucagon

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18
Q

actions of GIP

A

1) stimulates insulin release

2) inhibits H+ secretion by gastric parietal cells

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19
Q

Stimuli for release of GIP and where secreted

A

secreted by duodenum and jejunum
fat, protein, carbs,
FA,AA,oral glucose

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20
Q

GLP-1 action

A

binds pancreatic B-cells and stimulates insulin secretion

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21
Q

somatostatin inhibits what

is inhibited by?

A

1) inhibits release of all GI hormones, inhibits gastric H+ secretion
2) inhibited by vagal stimulation

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22
Q

histamine action

A

increases H+ secretion directly

potentions effects of gastrin and vagal stimulation

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23
Q

VIP homologous to?

A

secretin

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24
Q

VIP action

A

relaxation of GI smooth muscle including lower esophageal sphincter
stimulates pancreatic HCO3- section, inhibits gastric H+ secretion

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25
GRP (bombesin) action and released from
released from vagus nerves that innervate G cells | stimulates gastrin release from G cells
26
Enkephalins secreted from
secreted from nerves in mucosa and SM of GI tract
27
enkephalins action
stimulate contraction of GI smooth muscle | inhibit intestinal secretion of fluid and electrolytes
28
Satiety center location
ventromedial nucleus of hypothalamus
29
feeding center
lateral hypothalamic area
30
anorexigenic neurons release
POMC and decrease appetite
31
orexigenic neurons release
neuropeptide Y and stimulate appetite
32
leptin
secreted by fat cells, decrease appetite
33
ghrelin
secreted by gastric cells, increase appetite
34
location of highest freq slow wave contraction and low
high is in duodenum | low is in stomach
35
achalasia
lower esophageal sphincter does not relax during swallowing and food accumulates in the esophagus
36
orad region of stomach
fundus and proximal body | contains oxyntic glands and responsible for receiveing ingested meal
37
caudad region of stomach
distal body and antrum | responsible for contactions that mix food and propel it into the duodenum
38
what is the regulator of contractions every 90 mintues even under fasting conditions
motilin
39
when is the rate of gastric emptying the fastes
when the stomach contents are isotonic
40
fat ___ gastric emptying by stimulating the release of ___
inhibits, CCK
41
H+ in the duodenum ___ gastric emptying
inhibits
42
segmetation contractions
mix intestinal contents with back and forth motion of chyme
43
when food in the intestinal lumen is sensed by __ they release ___ which bind to __ and initiate the peristaltic relex
enterochromaffin cells, 5-HT, intrinsic primary afferent neurons (IPAN)
44
gastroileal relex
mediated by extrinsic ANS and possibly gastrin | triggered by food in stomach
45
where in the colon is most water absorbed
proximal colon
46
initial starch digestion is done by what in saliva
a-amylase (ptyalin)
47
initial triglyceride digestion is done by what in saliva
lingual lipase
48
composition of saliva
``` high volume high K+ and CO3- low Na and Cl hypotonic a-amylase, lingual lipase, kalikrein ```
49
at the lowest flow rate
lowest osmolarity, lowest Na+ and Cl- and HCO3- | highest K+ concentration
50
at highest flow rate
composition of saliva is closest to that of plasma
51
saliva is formed by 3 glands
parotid, submandibular, sublingual
52
STRUCTURE OF GLAND: Acinus branching duct system myoepithelial cells
acinus, secrete initial saliva BDS, lined with columnar epithelial cells, modify saliva myoepithelial cells, line acinua and initial ducts, contract and eject saliva into mouth
53
ducts modify initial isotonic saliva reabsorb secrete
reabsorb Na+ and Cl- | secrete K+ and HCO3-
54
aldosterone working on ducts
reabsorb Na+ and secrete K+
55
why does saliva become hypotonic
ducts are relatively impermeable to water
56
parasympathetic stimulation of saliva production | NT and receptor and second messenger
Ach binds muscarinic receptors on acinus and ductal cells | second messenger is IP3 and increased Ca2+
57
what is an anticholinergic drug that inhibits production of saliva and causes dry mouth
atropine
58
sympathetic stimulation of saliva production | NT and receptor and second messenger
NE binds B adrenergic receptors on acinar and cutal cells and the second messenger is cAMP
59
what increases saliva production
food in mouth smells conditioned relex nausea
60
what decreases saliva production
sleep dehydration fear, anticholinergic drugs
61
parietal cells secrete __ and _ | where and resbsorb __
HCL and intrinsic factor | into lumen of stomach, absorb HCO3- into bloodstream
62
in parietal cells how is H+ transported into the lumen of the stomach?
through the H+/K+ ATPase | Cl- is also transported into the lumen as well = HCl
63
what drug inhibits the H+/K+ ATPase
omeprazole (proton pump inhibitor)
64
what is the HCO3- that is reabsorbed in parietal cells exchanged for?
Cl-
65
HCO3- is secreted in pancreatic secretions to neutralize H+ ions in SI effect of vomiting
if vomiting occurs H+ never in SI and no HCO3- secretion causes metabolic alkalosis
66
vagal stimulation of gastric H+ secretion: | Direct and indirect
Direct: vagus nerve innervates parietal cells with Ach binding M3 receptor and IP3 and increased Ca2+ cause release H+ indirect: vagus n innervates G cells of antrum with GRP which secrete gastrin, bind to CCKb receptor and stimulate release of H+ from parietal cells - IP3 and ca2+
67
atropine effect
anticholernergic drug blocks direct pathway of H+ secretion only
68
gastrin stmiulates which cells
parietal--H+ | enterochromaffin-like cells (ECL)---> histamine secretion---> H+ secretion
69
Histamine action
released from ECL cells and binds H2 receptor on parietal cells, coupled to Gs protein, cAMP
70
H2 receptor blocking drug
cimetidine
71
inhibition of gastric H+ secretion
low pH of less than 3.0 | somatostatin
72
somatostatin direct and indirect pathways
direct: binds to receptor on parietal cell coupled to Gi, inhibits adenylyl cyclase and cAMP - antogonist of histamine Indirect: inhibits release of gastrin and histamine
73
prostaglandins action
inhibit H+ secretion by Gi protein, inhibit adenylyl cyclase and decrease cAMP
74
Peptic ulcer disease and damaging factors
ulcerative lesion of gastric or duodenal mucosa | H+, pepsin, H. pylori, NSAIDs, smoking, stress, alcohol
75
gastric ulcer
H+ secretion decreased bc secreted H+ leaks back through damaged gastric mucosa--> more gastrin levels increase -cause is H. Pylori converts urea to NH3 with urease so less acidic and can live here
76
test for H. pylori
give person 13C-urea which is converted to 13CO2 by urease and measeured in expired air H. Pylori have urease
77
zollinger-ellison syndrome
gastrin secreting tumor of the pancreas causes increased H+ secretion, no negative feedback
78
pancreatic secretion contains high concentration of what
HCO3-, also enzymes for digestion of protein, carbs, and fat
79
pancreatic juice is characterized by
1) high volume 2) about same Na+ and K+ as plasma 3) higher HCO3- than plasma 4) lower Cl- concentration than plasma 5) isotonicity 6) pancreatic lipase, amylase, and proteases
80
flow rate pancreas juice comp:
``` high = Na+ and HCO3- mainly, isotonic low= Na+ and Cl- mainly, isotonic ```
81
formation of pancreatic secretion
acinar cells secrete initial Na+ and Cl- | ductal cells reabsorb Cl- and secrete HCO3-
82
secretin and pancreas and second messenger
acts on pancreatic ductal cells to increase HCO3- secretion happens when H+ goes from stomach to duodenum -cAMP is second messenger
83
CCK and pancreas
acts on pancreatic acinar cells to increase enzyme secretion (amylase, lipase, proteases) -potentiates effect of secretin on ductal cells to stimulate HCO3- secretion second messengers are IP3 and increased CA2+
84
Ach and pancreas
released in response to H+, small peptides, aa, FA in duod lumen stimulates enzyme secretion by acinar cells potentiates effect of secretin on HCO3- secretion
85
a-amylases
hydroloze 1,4 glycosidic bonds in starch, yield maltose, maltotriose, and a-limit dextrins
86
maltase, a-dectrinase, sucrase
in intestinal brush border hydrolyze oligosaccharides to glucose
87
lactase degrades
lactose to glucose and galactose
88
trehalase degrades
trehalose to glucose
89
sucrase degrades
sucrose to glucose and fructose
90
glucose and galactose from lumen to cells then cells to blood
1) SGLT 1 with Na+ down gradient and glucose uphill | 2) GLUT2 from cell to blood
91
fructose transport
exclusively by facilitated diffusion, cannot be absorbed against concentration gradient
92
lactose intolerance
absence of brush border lactase so lactose cannot be converted to glucose and galactose for absorption noabsorbed lactose and H2O remain in lumen and cause osmotic diarrhea
93
endopeptidases
degrade proteins by hydrolyzing interior peptide bonds
94
exopeptidases
hydrolyze one amino acid at a time from C terminus proteins and peptides
95
pepsin
activated from pepsinogen by H+ optimal at pH between 1 and 3 if above 5 pepsin is denatured
96
trypsinogen to trypsin by what enzyme
enterokinase
97
what does trypsin work on
chymotrpsinogen, proelastase, and procarboxypeptidase A and B and also trypsinogen to make more trypsin
98
free amino acid absorbtion
cotransported from lumen to intestinal cell with Na+, then aa to blood via facilitated diffusion
99
dipeptide and tripeptide absorbtion
cotransported with H+ from lumen to cell | cyctoplasmic peptidases hydrolyze them to aas and then aas to blood via facilitated diffusion

Gastrointestinal DF (14 decks)

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