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Krause's Food & Nutrition Care Process > Chapter 1. Digestion, absorption, transport and excretion of nutrients > Flashcards

Chapter 1. Digestion, absorption, transport and excretion of nutrients Flashcards

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1
Q

The gastrointestinal tract is designed to complete 3 main tasks, which? (others tasks exists as well)

A
  1. Digest protein, carbohydrates, and lipids from ingested foods and drink
  2. Absorb fluids, micronutrients, and trace elements.
  3. Provide a physical and immunological barrier to microorganisms, foreign material, and potential antigens from food
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2
Q

Depending on the nature of the diet consumed, 90 to 97% of food is digested and absorbed, most of the unabsorbed material is of what origin?

A

Plant origin

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3
Q

The Gastrointestinal tract extends from… to where?

A

The mouth to the anus

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4
Q

What structures are included in the GIT?

A

Oropharyngeal structures, esophagus, stomach, liver and gallbladder, pancreas, and small and large intestine

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5
Q

Which structure in the human body has the largest amount of immune cells, and is also one of the most metabolically active tissues in the body?

A

GIT

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6
Q

Because of the unusually high metabolic activity and requirements of the GIT, the cells lining it are more susceptible than most tissues to….?

A

Micronutrient deficiencies; protein-energy malnutrition; and damage resulting from toxins, drugs, irradiation, or interruption of its blood supply.

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7
Q

What senses can start the secretions and movements of the GIT?

A

Sight, smell, taste, even thought of food

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8
Q

The movement of ingested and secreted material in the GIT is regulated primarily by…?

A

Peptide hormones, nerves, and enteric muscles

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9
Q

What does the small intestine absorb?

A

Macronutrients, minerals, vitamins, trace elements, and fluid

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10
Q

What does the colon absorb?

A

Electrolytes and small amount of remaining nutrients

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11
Q

Most nutrients of the GIT enter the portal vein for transport to what organ?

A

The liver

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12
Q

When nutrients are absorbed by the GIT and enter the liver, what does the liver do?

A

Stores it, or transforms it into another substance, or it releases it into circulation

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13
Q

Some of the carbohydrate and fiber resistant to digestion in the upper GIT serve as “prebiotic” material by producing SCFAs, what does this do?

A

Decreasing the colonic pH, and increasing the mass of helpful bacteria

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14
Q

Digestion of food is accomplished by?

A

Enzymatic hydrolysis

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15
Q

Which cofactors facilitate the digestive and absorptive process?

A

Hydrochloric acid, bile, and sodium bicarbonate

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16
Q

Digestion and absorption are essentially complated in the small intestine, except for which substances?

A

Fiber and some carbohydrates

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17
Q

In people with GI disease (e.g. infections, inflammatory bowel disease, irritable bowel syndrome), the enteric nervous system may be overstimulated, resulting in…?

A

Abnormal secretion, altered blood flow, increased permability, and altered immune function

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18
Q

Autonomic innervation is supplied by the symphatetic fibers that run along blood vessels and by the parasymphathetic fiber in which nerves?

A

Vagal and pelvic nerves

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19
Q

In general, what activates symphatetic neurones?

A

Fear, anger and stress

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20
Q

Which effect does the symphatetic neurones have on the GI contents?

A

Slows transit by Inhibiting secretions and muscle contraction

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21
Q

In what way does vagal activity affect the GI tract?

A

Secretes acid from parietal cells scattered along the walls of the stomach

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22
Q

Which kind of pains signals is translated by the vagal and spinal nerves from the GI tract?

A

Colicky pain, sharp pain, nausea, urgency or gastric fullness, or gastric emptiness

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23
Q

What is Ghrelin?

A

A neuropeptide secreted from the stomach

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24
Q

What is motilin?

A

Horomone secreted from the duodenum

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25
Q

What singal does Gherlin and motilin send to the brain?

A

“Hungry” message

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26
Q

Where is the site of the release of the neurotransmitter GABA?

A

CNS

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27
Q

Where is the site of release of the Norepinephrine?

A

CNS, spinal cord, symphatetic nerves

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28
Q

Where is the site of release of Acetylcholine?

A

CNS, autonomic system, other tissues

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29
Q

Where is the site of release of Neurotensin?

A

GI-tract, central nervous system

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30
Q

Where is the site of release of Serotonin?

A

GI-tract, spinal cord

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31
Q

Where is the site of release of Nitric oxide?

A

Central nervous system, GI tract

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32
Q

Where is the site of release of Substance P

A

Gut, CNS, GI tract

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33
Q

What is the primary function of GABA?

A

Relaxes lower esophagal sphincter

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34
Q

What is the primary action of Norepinephrine?

A

Decreases motility, increases contraction of sphincters, inhibits secretions

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35
Q

What is the primary action of Acetylcholine?

A

Increases motility, relaxes sphincters, stimulates secrection

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36
Q

What is the primary action of Neurotensin?

A

Inhibits release of gastric emptying and acid secretion

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37
Q

What is the primary action of Serotonin?

A

Facilitates secretion and peristalsis

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38
Q

What is the primary action of Nitric oxide?

A

Regulates blood flow, maintains muscle tone, maintains gastric motor activity

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39
Q

What is the primary action of Substance P

A

Increases sensroy awareness (Imainly pain) and peristalsis

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40
Q

What organ does Gastrin affect?

A

Stomach, esophagus, GIT in general

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41
Q

What organ does Secretin affect?

A

Pancreas, duodenum

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42
Q

What is the effect on the organs of gastrin?

A

Stimulates secretion of HCI and pepsinogen
Increases gastric antral motility
Increases lower esophagal sphincter tone
Weakly stimulates contraction of gallbladder
Weakly stimulates pancreatic secretion of bicarbonate

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43
Q

What organ does the hormone CCK affect?

A

Pancreas, Gallbladder, Stomach, Colon

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44
Q

What is the effect on the organs by CCK?

A 
Stimulates secretion of pancreatic enzymes
Causes contraction of gallbladder
Slows gastric emptying
Increases motility
May mediate feeding behavior
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45
Q

What organ is affected by the hormone GIP?

A

Stomach pancreas

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46
Q

What is the effect of the GIP hormone on the organ?

A

Stimulates insulin release

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47
Q

What is the effect of GLP-1 hormone on the organ?

A

Prolongs gastric emptying.
Inhibits glucagon release.
Stimulates insulin release

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48
Q

What organ is affected by the hormone Motilin?

A

Stomach, small bowel, colon

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49
Q

What is the effect of Motilin on the organ?

A

Promotes gastric emptying and GI motility

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50
Q

What stimulates release of Gastrin?

A

Peptides, amino acids, caffeine
Distention of the antrum
Som alcoholic beverages
Vagus nerve

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51
Q

What stimulates the release of Secretin?

A

Acid in small intestine

52
Q

What stimulates the release of CCK?

A

Peptides, amino acids, fats, HCI

53
Q

What stimulates the release of GIP?

A

Glucose, fat

54
Q

What stimulates the release of GLP-1

A

Glucose, fat

55
Q

What stimulates the release of Motilin?

A

Biliary and pancreatic secretions

56
Q

Small bowel mucosal “I” cells secrete what hormone?

A

Cholecystokinin (CCK)

57
Q

Cholecystokinin is released in the prescence of which substances?

A

Protein and fat

58
Q

What are the major functions of Cholecystokinin (CCK)?

A
  1. Stimulate the pancreas to secrete enzymes, some bicarbonate, and water
  2. Stimulate gallbladder contractions
  3. Increase colonic and rectal motility
  4. Slow gastric emptying
  5. Increase satiety
59
Q

What substances are released from the intestinal mucosa in the prescence of meals rich in glucose and fat, stimulating insulin synthesis and release?

A

GLP-1 and GIP

60
Q

What are some of the functions of GLP-1?

A

Decreases glucagon secretion, delays gastric emptying, and may help promote satiety

61
Q

GLP-1 and GIP are examples of of incretin hormones, which help keep….?

A

Blood glucose from rising excessively after a meal

62
Q

What is the most probable reason why glucose load received enterally results in less of an increase in blood glucose than when an equal amount of glucose is received intravenously?

A

Because incretin hormones such as GLP-1 and GIP in the digestive tract prevents blood glucose from rising excessively after a meal

63
Q

What hormone is released during fasting, where and why?

A

Motilin.
Endocrine cells in the duodenal mucosa.
To stimulate gastric emptying and intestinal motility

64
Q

Somatostatin is released by what, and where?

A

D cells in the antrum and pylorus

65
Q

What are Somatostatin’s primary roles?

A

Inhibitory and antisecretory.

It decreases motility of the stomach and intestine, and inhibits or regulates the release of several GI hormones

66
Q

Somatostatin and its analog, octreotide are being used to treat certain malignant diseases, as well as numerous GI disorders such as…?

A

Diarrhea, Short bowel syndrome, pancreatis, dumping syndrome, and gastric hypersecretion

67
Q

When eaten alone, which food nutrition leaves the stomach the most rapidly and which others follow?

A
  1. Carbohydrates
  2. Protein
  3. Fat
  4. Fiber
68
Q

Bile salt insufficiency becomes clinically important in patients who have resections of the distal small bowel and diseases affecting the small intenstine, such as..?

A

Crohns disease
Radiation enteritis
Cystic fibrosis

69
Q

Where in the digestive tract is vitamin B12 absorbed?

A

Distal ileum

70
Q

Lipids are taken up and transported through the endoplasmic reticulum and Golgi apparatus where…?

A

Fatty acids are re-esterified to triglyceride

71
Q

Triglycerides are packaged, along with other lipids, into chylomicrons, which are released into the?

A

Lymphatic circulation

72
Q

Cholesterol absorption is facilitated by a..?

A

Protein transport system specific to cholesterol and not the other sterols

73
Q

In absoprtion, nutrients pass through the intestinal mucosal cells (enterocytes or colonocytes) and make their way into the… to the…?

A

Venous system to the liver or into the lymphatic circulation

74
Q

Random movment through openings in or between the membranes of the mucosal cell walls using channel proteins is known as what?

A

Passive diffusion

75
Q

Random movment through openings in or between the membranes of the mucosal cell walls using carrier/transport proteins is known as what?

A

Facilitated diffusion

76
Q

Some nutrients may share the same carrier and thus compete for absorption. Transport or carrier systems can also become saturated, leading to which effect?

A

Slowing the absorption of the nutrient

77
Q

What is Pinocytosis?

A

The ‘drinking in’ or engulfing, by the epithelial cell membrane of small drop of intestinal content

78
Q

What does Pinocytosis do?

A

Allows large particles such as whole proteins to be absorbed in small quantities

79
Q

How can Pinocytosis cause allergic reactions?

A

By allowing movement of foreign proteins across the GIT into the bloodstream

80
Q

The large intestine consists of them?

A

Cecum, colon, and rectum

81
Q

What protects the intestinal wall of the large intestine from excoriation and bacterial activity and provides the medium for binding feces together?

A

Mucus secreted by the mucosa

82
Q

The large intestine is ‘also’ the site of bacterial fermentation of remaining…?

A

Carbohydrates, amino acids, synthesis of small amount of vitamins, storage and excretion of fecal residues

83
Q

Mouth-to-anus transit time may vary from?

A

18-72 hours

84
Q

What organisms are the chief component of the GIT flora until an infant begins to eat solid foods?

A

Lactobacillus

85
Q

Following Lactobacillus organisms being dominant during infancy what organisms becomes dominant after this in the distal ileum?

A

Escherichia coli and genus Bacteroides

86
Q

Decreased gastric secretion can increase the risk of…?

A

Inflammation of the gastric mucosa (gastritis)
Increase the risk of bacterial overgrowth in the small intestine
Increase the numbers of microbes reaching the colon

87
Q

Which acid-tolerant bacterium is known to infect the stomach and may cause gastritis and ulceration in the host?

A

Helicobacter pylori

88
Q

Which part of the GIT is bacterial action most intense?

A

The large intestine

89
Q

Colonic bacteria continue the digestion of some materials
that have resisted previous digestive activity. During the
process, several nutrients are formed by bacterial synthesis. What are some examples of these nutrients?

A

Vitamin K, vitamin B12, thiamin, and riboflavin

90
Q

Increased consumption of prebiotic material may lead to what and which of the species are thought to be beneficial?

A

Increase in SCFAs and in the microbial mass, in particular, indigenous Bifidobacteria and Lactobacailli (both beneficial)

91
Q

What are Prebiotics?

A

Oligosaccharide components of the diet that are preferred energy substrates of ‘friendly’ microbes in the GIT

92
Q

What are Synbiotics?

A

A combination of probiotics and prebiotics

93
Q

The disposal of residual substrates through production of SCFAs is called?

A

Colonic salvage

94
Q

What is the function of SCFAs?

A

They serve as fuel for the coloncytes and gut microbes
Stimulates coloncyte proliferation and differentiation
Enhance the absorption of electrolytes and water
Reduce the osmotic load of malabsorbed sugars

95
Q

The ability to salvage carbohydrates is limited in humans. Colonic fermentation normally disposes of how many grams of carbohydrates over 24 hours?

A

20-25 gram of carbohydrates

96
Q

Excess amounts of carbohydrates and fermentable fiber in the colon can cause…?

A 
Incerased gas production,
Abdominal distention
Bloating
Pain
Increased flatulence
Decreased colonic pH
Diarrhea
97
Q

In the mouth, there is an enzyme which operates at a neutral or slightly alkaline pH and starts the digestive action by hydrolyzing a small amount of the starch molecules into smaller fragments. Which enzyme is this?

A

Salviary amylase (ptyalin)

98
Q

When does Amylase deactivate?

A

After contact with hydrochloric acid

99
Q

What is amylase?

A

An enzyme, found chiefly in saliva and pancreatic fluid, that converts starch and glycogen into simple sugars

100
Q

Pancreatic amylase breaks the large starch molecules at 1-4 linkages to create…?

A

Maltose, maltotriose, and “alphalimit” dextrins

101
Q

What are examples of monosaccharides?

A

Glucose, galactose, and fructose

102
Q

The monosaccharides pass through the mucosal cells and into the bloodstream via the cappilaries of the vili, where they are carried by the potal vein to the…?

A

Liver

103
Q

At low concentrations glucose and galactose are absorbed by active transport, primarily by a sodium-dependent transporter called the…?

A

Glucose (galactose) cotransporter

104
Q

At high luminal concentrations of glucose or galactose which transporter becomes the primary facilitative transporter into the intestinal cell?

A

Glucose transporter 2 (GLUT 2)

105
Q

Fructose is more slowly absorbed and uses which transporter from the lumen?

A

GLUT 5

106
Q

What is the reason why sodium-glucose drinks are used to rehydrate infants with diarrhea or athletes who have lost too much fluid?

A

The sodium-dependent transport of monosaccharides

107
Q

Glucose is transported from the liver to…?

A

The tissues, some of it is stored in the liver and others stored in muscles as glycogen

108
Q

Consumption of large amounts of lactose (especially in individuals with a lactase deficiency), fructose, stachyose, raffinose, or alcohol sugars (e.g., sorbitol, mannitol, or xylitol) can result in considerable amounts of these sugars…?

A

Passing unabsorbed into the colon, and may cause increased gas and loose stool

109
Q

Which sort of protein is more efficiently digested, plant proteins or animal proteins?

A

Animal proteins

110
Q

Protein digestion begins in the stomach, where some of the proteins are split into…?

A

Proteoses, peptones, and large polypeptides

111
Q

Inactive pepsinogen is converted into the enzyme….. when it contacts hydrochloric acid and other pepsin molecules

A

Pepsin

112
Q

Unlike any of the other proteolytic enzymes, pepsin digests…?

A

Collagen, the major protein of connective tissue

113
Q

Where does most of the digestion of protein take place?

A

Upper portion of the small intestine, but it continues throughout the GIT

114
Q

What happens to any residual protein fractions which is not digested?

A

It is fermented by colonic microbes

115
Q

Contact between chyme and the intestinal mucosa stimulates the release of?

A

Enterokinase

116
Q

What is Enterokinase?

A

An enzyme that transforms inactive pancreatic trypsinogen into active trypsin, the major pancreatic protein-digesting enzyme. Trypsin in turn activates the other pancreatic protelytic enzymes.

117
Q

Which enzymes break down intact protein and continue the breakdown started in the stomach until small polypeptides and amino acids are formed?

A

Pancreatic trypsin, chymotrypsin and carboxypeptidase

118
Q

Proteolytic peptidase located on the brush border also act on polypeptides, breaking them down into?

A

Amino acids, dipeptides and tripeptides

119
Q

The final phase of protein digestion takes place in the brush border, where some of the
dipeptides and tripeptides are hydrolyzed into their constituent amino acids by…?

A

Peptide hydrolase

120
Q

End products of protein digestion are absorbed as both…?

A

Amino acids and small peptides

121
Q

How much of the protein is absorbed by the time it reachs the jejunum and how many % is found in the feces?

A

Almost all, 1%

122
Q

How many % of dietary lipids are in the form of Triglycerides, and phospholipids and cholesterol

A

97%, phospho and cholesterol remaining 3%

123
Q

Most of the fat digestion takes place in the?

A

Small intestine

124
Q

The entrance of fat and protein into the small intestine stimulates the release of? Which inhibit?

A

CCK and enterogastrone, which inhibit gastric secretions and motility, thus slowing the delivery of lipids

125
Q

As a result of the release of CCK and enterogastrone, a portion of a large, fatty meal may remain in the stomach for how long?

A

4 hours or longer

126
Q

Bile is a secretion from the?

A

Liver

Krause's Food & Nutrition Care Process (1 decks)

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