Ch. 11: GI Digestion & Absorption Flashcards
What regulates secretory & absorptive activities of GI tract?
Hormones
Layers of GI tract (IN ➡️ OUT)?
Mucosa
Submucosa
Muscularis
Serosa
Saliva: pH?
principle ions?
pH 7.0 (hypotonic)
Na+, K+, Cl-, HCO3-
Catalytic fxn of amylase?
Hydrolysis of alpha (1➡️4) glycosidic linkages of starch & glycogen
What cell form & secrete bile? Shape of cells?
Hepatocytes
Polygon
What does bile contain?
Bile acids Bile pigments Cholesterol Phosphatidylcholine Electrolytes
⬆️ conjugated bilirubin = problem with?
Gallbladder ➡️ duodenum pathway
⬆️ unconjugated bilirubin = problem with?
Liver
Endocrine hormones of pancreas?
Insulin
Glucagon
Somatostatin
Exocrine fxn of pancreas?
Synthesize & secrete digestive enzymes & HCO3- rich fluid
Proenzymes in pancreatic juice?
Trypsinogen
Chymotrypsinogen
Procarboxypeptidase
Proelastase
What converts trypsinogen ➡️ trypsin?
Where?
Enteropeptidase
Brush border of jejunal mucosa
Fxn of trypsin inhibitor in pancreatic juice?
Protects against indiscriminate autodigestion from intraductal activation of trypsinogen
Major fxn of large intestine?
Absorb water, Na+ & other electrolytes
What type of bacteria is in large intestine?
Fxn?
Anaerobic
Metabolize CHO ➡️ lactate, short chain FAs, & gases
Gastrin: Sources?
G cells (gastric antrum, duodenum)
Gastrin: Released due to chem, mech, neuronal stimulation of G cells
Ex?
Hypoglycemia
⬆️ Ca2+
What suppresses gastrin?
Acidification of antral mucosa
All members of secretin family
Gastrin: fxn?
HCl secretion (parietal cells) Pepsin secretion (chief cells) Histamine secretion (enterochromaffin-like cells) ⬆️ gastric mucosal blood flow Gastric motility Proliferation of gastric mucosa
What is Zollinger-Ellison syndrome?
Tumors in stomach (keep secreting acid)
Ghrelin: Sources?
Fxn?
A cells of gastric fundus, other GI tract segments, hypothalamus
Promote food intake
Promote gastric motility
Stimulate growth hormone secretion
Cholecystokinin: Sources?
Fxn?
I cells of duodenum & jejunum, CNS
stimulate gall bladder & pancreatic secretions
Decrease appetite
Gastric Inhibitory Peptide (GIP) / Glucose-dependent insulinotropic polypeptide: Sources?
Fxn?
K cells (duodenum & jejunum)
Insulin secretion (beta-cells of pancreas)
Inhibits gastric secretion & motility
Stimulate FA synthesis in adipose tissue
Secretin: Sources?
Fxn?
S cells (upper portions of small intestine)
Secretion of bicarb-rich fluid (duct cells & biliary tract)
Augments action of CCK
⬇️ gastric acid secretion
Polypeptide YY: Sources?
Fxn?
L-cells (distal small & large intestines)
Inhibits food intake
Somatostatin: Sources?
Fxn?
D-cells (pancreas & GI tract), hypothalamus
Inhibits secretion of GI tract hormones, growth hormone, & thyrotropin
Glucagon-like peptide-1 (GLP-1): Sources?
Fxn?
L-cells (small & large intestines)
Promotes insulin secretion from beta-cells (pancreas)
Promotes beta-cell growth
Suppresses glucagon secretion from alpha-cells (pancreas)
Delays gastric emptying
Glucagon-like peptide-2 (GLP-2): Sources?
Fxn?
L-cells (distal small & large intestines)
Promotes intestinal mucosal growth & repair
Inhibits gastric secretion
Oxyntomodulin: Sources?
Fxn?
L-cells (distal small & large intestines)
Inhibits food intake
Inhibits gastric motility & acid production
Endopeptidases: Digest ? ➡️ Into ?
Interior peptide bonds ➡️ peptides
Exopeptidase: Digest ? ➡️ Into ?
Terminal peptide bonds ➡️ a.a.
What things stimulates acid secretion?
Ach
Gastrin
Histamine (H2 receptor)
Bombesin
What things suppress acid secretion?
Anticholinergic agents (atropine)
H2 receptor antagonists (cimetidine, ranitidine)
Prostaglandin E derivatives
Substituted benzimidazoles (omeprazole, pantoprazole)
Digestion & absorption: CHO
Step 1?
Intraluminal hydrolysis via alpha-amylase:
starch & glycogen ➡️ oligosaccharides
Digestion & absorption: CHO
Step 2?
Brush-border surface hydrolysis via oligosaccharidases:
Oligosaccharides & disaccharides ➡️ monomers
Digestion & absorption: CHO
Step 3?
Transport of monosaccharides ➡️ enterocytes (Na/K-ATPase, semi-active transport)
3 examples of CHO intolerance?
Lactose
Sucrose
Alpha-limit dextrin
3 types of endogenous proteins? Grams per day digested?
1) secreted from GI tract organs & glands (20-30 g/d)
2) turnover of GI epithelium (30 g/d)
3) plasma proteins diffusing ➡️ intestinal tract (1-2 g/d)
Major products of intraluminal digestion of protein?
a.a. (30-40%) small peptides (60-70%)
4 active, carrier-mediated, Na+ dependent transport systems for free a.a.? Disorders associated with defects in each?
1) neutral a.a. ➡️ Hartnup disease
2) basic a.a. & cystine ➡️ cystinuria
3) asp & glu ➡️ dicarboxylic aminoaciduria
4) gly & imino acids ➡️ aminoglycinuria
How are dipeptides & tripeptides transported into enterocytes?
Actively transported by Na-dependent mechanism
Neonates have ability to absorb intact proteins after birth ➡️ allows them to do what?
Acquire passive immunity (absorbs Igs in colostrum)
3 phases of lipid digestion?
1) luminal
2) intracellular
3) secretary
4 diff phospholipases?
A1, A2, C, D
What is celiac disease (gluten-sensitive enteropathy)?
Gliadins ➡️ production of Ab to endomysium of smooth muscle
What is cystic fibrosis?
Multiple exocrinopathy & malabsorption due to lack of pancreatic enzymes ➡️ SI
What is chronic alcoholism?
Malabsorption of foods & vitamins (due to liver and pancreas involvement, mucosal dysfunction)
Lipid digestion abnormalities: rapid gastric emptying
Biochem disturbance & ex of disease?
⬇️ efficiency of lipid interaction w/bile & pancreatic secretions
Gastrectomy (Tx ulcers or neoplasms in stomach)
Lipid digestion abnormalities: acidic duodenal pH
Biochem disturbance & ex of disease?
Inactivate pancreatic lipase
⬇️ ionization of bile acids
Zollinger-Ellison syndrome
Lipid digestion abnormalities: ⬇️ CCK
Biochem disturbance & ex of disease?
Deficiency of bile & pancreatic secretions
Mucosal destruction disorders
regional enteritis
gluten enteropathy
Lipid digestion abnormalities: congenital lipase/colipase deficiency
Biochem disturbance?
Defective lipolysis
Lipid digestion abnormalities: pancreatic insufficiency
Biochem disturbance & ex of disease?
Defective lipolysis
Chronic pancreatitis
pancreatic duct obstruction (CF)
Lipid digestion abnormalities: absent/⬇️ bile salts
Biochem disturbance & ex diseases?
⬇️ lipolysis (due to impaired micelle formation)
See table 11.3
Define diarrhea? (Volume)
Amt of water excreted in feces > 500 mL
Describe process of water absorption
Passive process
Coupled to transport of organic solutes & electrolytes (glucose & a.a.)
What regulates absorption of Na+?
Aldosterone
How is K+ absorbed?
Passive diffusion
Impact of cholera & pertussis toxins on cell regulation pathways? (disorders of fluid/electrolyte absorption)
Cholera: ADP-ribosylation of Gs-alpha
Pertussis: ADP-ribosylation of Gi-alpha
Impact of diphtheria toxin on cell regulation pathways? (disorders of fluid/electrolyte absorption)
ADP-ribosylation of EF2 ➡️ inhibits euk pro synthesis
Disorders of fluid/electrolyte absorption: impact of E. coli?
Non-bloody diarrhea
Hemorrhagic colitis
Hemolytic uremic syndrome
Death
Disorders of fluid/electrolyte absorption: pancreatic islet-cell tumor
Impact?
severe watery diarrhea