Ch 62-65 GI Physiology Flashcards
What types of electrical activity occur in GI smooth muscle?
- Slow waves: undulating changes in resting membrane potential, caused by interstitital cells of Cajal. Only causes contractions in the stomach (sometimes)
- Spike potentials: True action potentials, when resting mp rises > -40 mv. Caused by stretch, acetylcholine, and parasympathetics that allow Ca++ and Na+ to enter the cell and cause the action potentials
What factors depolarize the membrane in GI smooth muscle?
- Muscle stretch
- Acetylcholine release
- GI hormonal stimulation
What factors cause hyperpolarization of the GI smooth muscle?
- Nor/Epi
- SNS stimulation
What causes tonic contraction of GI smooth muscle?
- Continuous repetitive spike potentials
- Hormones
- Continuous Ca++ entry into cells
What are the two plexuses comprising the enteric nervous system?
- Outer/Myenteric (Auerbach’s) plexus between longitudinal and circular muscle layers. Controls GI movement
- Inner/submucosal plexus (Meissner’s) in the submucosa. Controls local secretions and blood flow
To where do GI sensory fibers send afferent fibers?
- The prevertebral ganglia of the SNS
- The spinal cord
- Vagus nerves (to brainstem)
What are the effects of stimulating the myenteric plexus (4 ways the contactions are modified)?
- Increased tonic contraction of the gut wall
- Increased intensity of rhythmical contractions
- Slightly increased rate of the rhythm of contraction
- Increased excitatory wave conduction along the GI wall (speedier contractions)
Where does the myenteric plexus have mainly inhibitory effects?
Especially at sphincters muscles, via release of inhibitory neurotransmitter
Where does the submucosal plexus have effects in the GI tract?
Sensory signals from GI epithelium are integrated into the submucosal plexus to control local intestinal secretion, absorption, and local submucosal muscle contractions
Which are the main neurotransmitters that control GI function? What effects do they have?
- Acetylcholine excites
- NorEpi and Epi inhibit
What parts of the GI tract do the cranial and sacral divisions off the PSNS each control?
Cranial: Via vagus. Esophagus, stomach, pancreas, some intestines and a little bit of colon
Sacral: From the pelvic nerves in the 2-4th sacral SC segments. Controls the Distal half of large intestine and to the anus
What effect does stimulation of the postganglionic neurons of the GI PSNS have?
These are in the myenteric and submucosal plexuses. Stimulation is excitatory to the whole enteric nervous system
How does the SNS exert its effects on the enteric nervous system?
- Slightly via direct effect of secreted norEpi to inhibit smooth muscle
- Majorly via NorEpi’s inhibitory effect on neurons of the entire ENS
Where do SNS fibers to the ENS originate(which section of spinal cord and which ganglia)?
Between segments T5 to L2. Preganglionic fibers enter the sympathetic chains then pass to the celiac and mesenteric ganglia
What stimulates the sensory nerves of the GIT?
- Gut mucosal irritation
- Excessive gut distension
- Specific chemicals in the gut
What are the types of gastrointestinal reflexes?
- Those entirely within the GI wall : secretion, peristalsis, mixing, local inhibition
- Those connecting the gut to the prevertebral SNS ganglia: gastrocolic, enterogastric, colonoileal
- Those between the spinal cord/brainstem and GI tract: gastric motor and secretory action, pain & corresponding inhibition, defecation reflexes
Gastrin: what stimulates secretion, where is it secreted, and what does it do?
- protein, distension, and nerves stimulate. Acid inhibits.
- Secreted at G cells of antrum, duodenum, and jejunum
- Action: stimulates gastric acid secretion and mucosal growth
Cholecystokinin: what stimulates secretion, where is it secreted, and what does it do?
- Stimulated by protein, fat, and acid
- Secreted at the I cells of the small intestine
- Action: Stimulates pancreatic enzyme and bicarb secretion, gallbladder contraction, exocrine pancreatic growth, and inhibits gastric emptying
Secretin: what stimulates secretion, where is it secreted, and what does it do?
- Acid and fat
- S cells of whole sm intestine
- Stimulates pepsin and pancreatic bicarb secretion, biliary bicarb secretion, exocrine pancreas growth, and inhibits gastric acid secretion
Gastric inhibitory peptide: what stimulates secretion, where is it secreted, and what does it do?
- Protein, fat, carbs
- K cells of duodenum and jejunum
- Stimulates insulin release. Inhibits gastric acid secretion
Motilin: what stimulates secretion, where is it secreted, and what does it do?
- Fat, acid, nerves
- M cells of duodenum and jejunum
- Stimulates gastric motility and intestinal motility
What causes GI peristalsis and how does it normally occur?
Stimulated by GIT distension, chemical or physical irritation of the epithelial lining or strong PSNS signals.
Effectual peristalsis requires an active myenteric plexus
What kind of GIT movement would occur, if any, if forward propulsion was blocked?
Mixing movement would still occur to churn the contents but no forward propulsion could occur
How does blood flow through the splanchnic circulation, and to what benefit?
Blood flows through the gut itself, through the spleen and pancreas, and then immediately into the liver via the portal vein. From there, it passes through liver sinusoids and leaves through hepatic veins to empty into the vena cava. By flowing through the liver, the reticuloendothelial cells can remove bacteria and harmful particulates before they enter systemic circulation