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clinical nutrition > Chapter 2 book notes > Flashcards

Chapter 2 book notes Flashcards

1
Q

gastrointestinal (GI) tract:

A

-flexible muscular tube extending from the mouth to the anus.
-digestive tract

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2
Q

What organs make up the GI tract?

A

-mouth(teeth & tongue)
-pharynx
-epiglottis
-esophagus
-stomach
-small intestine
-large intestine (colon)
-rectum
-anus

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3
Q

Mouth (teeth & tongue) function:

A

-chews and mixes food with saliva

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4
Q

Pharynx function:

A

-directs food from mouth to esophagus

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5
Q

epiglottis function:

A

-protects airway during swallowing

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6
Q

esophagus function:

A

-passes food from the mouth to the stomach

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7
Q

stomach function:

A

-churns, mixes, and grinds food to liquid mass
-adds acid, enzymes, and fluid

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8
Q

small intestine function:

A

-duodenum, jejunum, and ileum
-secretes enzymes that digest all energy- yielding nutrients to smaller nutrient particles
-cells of wall absorb nutrients into blood and lymph.

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9
Q

large intestine (colon) function:

A

-absorbs water and minerals
-passes waste (fiber, bacteria, and unabsorbed nutrients) along with water to the rectum

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10
Q

rectum function:

A

-stores waste prior to elimination

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11
Q

anus function:

A

-holds rectum closes
-opens to allow elimination

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12
Q

Accessory organs that aid digestion:

A

-salivary glands
-liver
-gallbladder
-pancreas

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13
Q

salivary glands function:

A

-secrete saliva

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14
Q

liver function:

A

-manufactures bile salts to help digest fats

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15
Q

gallbladder function:

A

-stores bile until needed

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16
Q

pancreas function:

A

-manufactures enzymes to digest all energy-yielding nutrients and releases bicarbonate to neutralize acidic chyme that enters small intestine.

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17
Q

what are the principle organs of the GI tract?

A

-stomach & intestines

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18
Q

Where does the physical process of digestion start?

A

-mouth

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19
Q

Saliva helps…

A

-helps dissolve food so that we can taste it.
-only particles in solution can react with taste buds.

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20
Q

When food is swallowed it passes through the?

A

-pharynx
-short tube shared by both digestive system and respiratory system

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21
Q

Bolus

A

-mouthful of chewed up and swallowed food

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22
Q

each bolus slides across your..

A

-epiglottis
-during each swallow the epiglottis closes off trachea, air passageway to lungs, so that we don’t choke

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23
Q

Sphincter (“cardiac sphincter”)

A

-muscle at the end of esophagus
-during a swallow, the upper esophageal sphincter opens, bolus slides down the esophagus so that it travels to the stomach.

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24
Q

The lower esophageal sphincter closes behind the bolus so that..

A

-it cannot slip back up

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25
Q

Bolus in stomach:

A

-stomach adds gastric juices and transforms it into chyme (semiliquid mass)

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26
Q

Stomach then transports chyme to:

A

-releases chyme into another sphincter (pyloric shincter) which opens into the small intestine and closes after chyme passes through.

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27
Q

Chyme in small intestine:

A

-in beginning of small intestine, chyme passes by opening from common bile duct, which secretes digestive fluids into small intestine from two organs outside GI tract.

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28
Q

2 organs outside GI tract that secrete digestive fluids into small intestine:

A

-gallbladder & pancreas

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29
Q

3 segments of small intestine

A

-duodenum, jejunum, ileum
-total of 10 feet of tubing coiled within abdomen

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30
Q

Where is digestion completed?

A

-small intestine

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31
Q

Sphincter between small intestine and large intestine:

A

-ileocecal valve

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32
Q

Where is the large intestine (colon) located?

A

-lower right hand side of abdomen

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33
Q

Upon entering the colon(large intestine) the contents pass another opening:

A

-the one leading to appendix (blind sac size of finger)
-contents bypass this opening and head to rectum

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34
Q

Food travels through digestive tract in this order:

A

-mouth
-esophagus
-lower esophageal sphincter
-stomach
-pyloric sphincter
-duodenum
-jejunum
-ileum
-ileocecal valve
-large intestine (colon)
-rectum
-anus

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35
Q

Gastrointestinal motility:

A

-spontaneous motion in the digestive tract accomplished by involuntary muscular contractions

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36
Q

two types of movements of gastrointestinal motility:

A

1)peristalsis
2)segmentation

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37
Q

The entire GI tract is ringed with…

A

-circular muscles are inside
-longitudinal muscles are outside.

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38
Q

Peristalsis

A

-begins when bolus enters esophagus
-successive waves of involuntary muscular contractions passing along the walls of the GI tract that push the contents along

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39
Q

When tube is constricted:

A

-circular rings tighten and long muscles relax

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40
Q

when tube bulges:

A

-circular rings relax and long muscles tighten

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41
Q

What may interfere with normal GI tract contractions?

A

-stress
-medicines
-medical conditions

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42
Q

Segmentation:

A

-periodic squeezing of the intestine by its circular muscles that both mixes and slowly pushes contents along
-promotes close contact with mixing digestive juices and absorbing cells intestinal walls

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43
Q

The muscles of the GI tract also aide in ..

A

-liquefying process

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44
Q

Liquefying process

A

-GI tract help liquify bolus to chyme so that the digestive juices will have access to all their nutrients.
-initiated in mouth and finished in stomach

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45
Q

Which organ has the thickets walls and the strongest muscles of all the GI tract organs?

A

-the stomach

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46
Q

Third layer of muscles in stomach (in addition to the circular and longitudinal)

A

-diagonal muscles that alternately contract and relax.

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47
Q

All 3 muscles of stomach work together to :

A

-force chyme downward

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48
Q

The pyloric sphincter opens briefly…

A

-about 3 times a minute, to allow small portions through.

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49
Q

To digest food, how many organs secrete digestive juices?

A

-5
-salivary glands, stomach, small intestine, liver (via gallbladder), and pancreas

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50
Q

Digestion of carbs begins in:

A

-in mouth, where the salivary glands secrete saliva that breaks the bonds in the chains of starch.

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51
Q

Salivary glands

A

-exocrine glands that secrete saliva into the mouth

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52
Q

What does saliva consist of?

A

-water, salts, and enzymes (salivary amylase).

53
Q

Saliva also protects:

A

-tooth surfaces and linings of mouth, esophagus, and stomach from attack by molecules that might harm them.

54
Q

The enzymes in the mouth do not:-

A

-affect fats, proteins, vitamins, minerals, and fiber that are food.

55
Q

gastric glands

A

-exocrine glands in stomach wall that secrete gastric juice into the stomach

56
Q

gastric juice

A

-contains a mixture of water, hydrochloric acid, and enzymes.
-principle enzymes are pepsin (acts on proteins) and lipase (acts on emulsified fats)

57
Q

Acid in stomach is so strong that

A

-it can burn the throat if it happens to reflux into the upper esophagus and mouth
-prevents bacterial growth and kills most bacteria that enter the body with food

58
Q

What makes the stomach acid not attack the stomach itself?

A

-cells of stomach wall secrete mucus, a thick, slimy, white polysaccharide that coats and protects the stomachs lining.

59
Q

Major digestive event in the stomach is:

A

-initial breakdown of proteins
-acid uncoils protein strands so that stomach enzymes can attack the bonds

60
Q

pepsin

A

-protein digesting enzyme (gastric protease)
-circulates as precursor, pepsinogen, and is converted to pepsin by action of stomach acid

61
Q

Minor digestive events in stomach

A

-digestion of some fat by gastric lipase
-digestion of sucrose (small) by stomach acid
-attachment of a protein carrier to VB12.

62
Q

Which enzyme does not work well in the stomach acid?

A

-salivary amylase,
-it just becomes another protein to be digested

63
Q

By the time the food leaves the stomach the digestion of all

A

-3 energy yielding nutrients has begun, but process gains momentum in small intestine

64
Q

What digestive juices are secreted in the small intestine?

A

-pancreatic juice
-bile
-intestinal juice

65
Q

These juices contain digestive:

A

-enzymes, bile, and biocarbonate

66
Q

pancreatic juice

A

-exocrine secretion of pancreas, containing enzymes for the digestion of carbs, fat, and protein.
-juice flows from pancreas into small intestine through pancreatic duct.
-also contains sodium bicarbonate which neutralizes acidic chyme

67
Q

bile

A

-secreted by liver, stored in gallbladder
-bile is an emulsifier, not an enzyme, which prepares fats and oils for digestion

68
Q

All three energy-yielding nutrients are digested in:

A

-small intestine

69
Q

Rate of digestion of energy nutrients depends on:

A

-contents of the meal:
EX:if meal is high in simple sugars, digestion is rapid
,if meal is rich in fat, digestion is slower.

70
Q

What nutrients are absorbed as they are?

A

-vitamins, minerals, and water

71
Q

Where does most absorption take place?

A

-small intestine absorptive surface area
-provides surface comparable to studio apartment (300ft)

72
Q

villi

A

-fingerlike projections from the folds of the small intestine
-singular form is villus

73
Q

Villi are in constant:

A

-motion.
-a thin sheet of muscle lines each villus so that it can wave, squirm, and wiggle like the tentacles of a sea anemone.

74
Q

A single villus, magnified still more, turns out to be composed of:

A

-several hundreds of cells, each covered with microscopic hairs called microvilli.

75
Q

microvilli

A

-tine, hairlike projections on each cell of every villus that can trap nutrient particles and transport them into the cells

76
Q

Specialization of the intestinal tract:

A

-nutrients ready for absorption early are absorbed near the top
-those that take longer to be digested are absorbed farther down

77
Q

What is the most elegantly designed organ systems in the body?

A

-lowly “gut”

78
Q

The myth of food combining

A

-idea that people should not eat certain food combinations (meat and fruit) at the same meal because the digestive system cannot handle more than one task at a time
-IT IS A MYTH

79
Q

Once the molecule (nutrient) has entered a cell in a villus, what is the next step?

A

-transmit it to a destination elsewhere in the body by two transport systems: bloodstream and lymphatic system

80
Q

Both systems supply…

A

-vessels to each villus.
-through these vessels the nutrients leave the cell and enter either the lymph or the blood (either case, nutrient ends up in blood for a while)

81
Q

Water soluble nutrients and the smaller products of fat digestion are released directly into the…

A

-bloodstream by way of the capillaries

82
Q

The larger fats and fat soluble vitamins find direct access into..

A

-capillaries impossible because these nutrients are insoluble in water (blood is mostly water).
-they require some packaging before they are released

83
Q

Intestinal cells assemble products of fat digestion into larger molecules called

A

-triglycerides
-these triglycerides, fat soluble vitamins, and other large lipids are clustered together with special proteins to from chylomicrons

84
Q

chylomicrons

A

-lipoprotein that transports lipids from the intestinal cells into the body.

85
Q

Cells release chylomicrons into the..

A

-lymphatic system.
-they glide through the lymph spaces until they arrive at the point of entry into the bloodstream near the heart

86
Q

What system arranges the deliverance of nutrients wherever they are needed?

A

-vascular/circulatory system

87
Q

Vascular/circulatory system:

A

-closed system of vessels through which blood flows continuously in a figure eight, with heart serving as a pump at the crossover point.
-blood goes from heart to arteries to capillaries to veins to heart.

88
Q

How is blood carried to digestive system (and every tissue in body):

A

-through artery, which branches into capillaries to reach every cell.

89
Q

How does blood leaving digestive system and where does it go?

A

-goes through hepatic portal vein and conducts it to capillaries of liver

90
Q

The hepatic portal vein branches into

A

-a network of small blood vessels( sinusoids) so that every cell of the liver has access to the newly absorbed nutrients that the blood is carrying.

91
Q

Blood leaving the liver then again collects into a vein called:

A

-hepatic vein, which returns blood to the heart.

92
Q

Blood flow from GI tract is:

A

-heart, to arteries, to capillaries (in intestine), to hepatic portal vein to sinusoids (in liver) to hepatic vein to heart.

93
Q

Liver is located in the circulation system at the point where..

A

-it will have the first chance at most of the materials absorbed from GI tract

94
Q

Lymphatic system

A

-one way route for fluids to travel from tissue spaces into the blood
-has no pump, lymph squeeze from one portion to another

95
Q

flow of lymph:

A

-flows into thoracic duct (large duct behind heart), this duct terminates into the subclavin vein
-which conducts the lymph into the right upper chamber of the heart

96
Q

When physicians measure a person blood lipid profile they are interested in:

A

-the types of fat present (such as triglycerides and cholesterol)
-the types of lipoproteins that carry them

97
Q

Chylomicrons transport newly absorbed lipids from intestinal cells to:

A

-the rest of the body
-as chylomicrons circulate through the body, cells remove their lipid contents, so chylomicrons get smaller and smaller
-liver picks up chylomicrons remnants

98
Q

Very-low-density lipoproteins:

A

-lipoprotein made by liver cells
-transport lipids to various tissues in body
-composed mainly of triglycerides

99
Q

low-density lipoproteins (LDL):

A

-lipoprotein derived from VLDL as cells remove triglycerides from them
-LDL carry cholesterol and triglycerides from the liver to the cells of the body and are
composed primarily of cholesterol.

100
Q

high-density lipoproteins
(HDL):

A

-the type of lipoproteins that transport cholesterol back to the liver from peripheral cells
-composed primarily of protein.
-synthesized in liver

101
Q

Density of lipoproteins depends on:

A

-proportion of lipids and protein they contain

102
Q

more lipids in lipoprotein molecule:

A

-the lower the density

103
Q

The more protein in a lipoprotein:

A

-the higher the density

104
Q

Both LDL and HDL:

A

-carry lipids around in the blood
-BUT LDL are larger, lighter, and filled with more lipid.
-HDl are smaller, denser, and packaged with more protein.

105
Q

High LDL or Low HDL=

A

-increases risk of heart disease

106
Q

factors that lower LDL con. and raise HDL conc. include:

A

-weight management
-polyunsaturated or monounsaturated, instead of saturated fatty acids in diet
-soluble fibers
-physical activity

107
Q

Why do older adults experience constipation?

A

-because intestinal wall loses strength and elasticity with age, which slows GI motility.

108
Q

Two intricate and sensitive systems coordinate all digestive and adsorptive processes of GI tract:

A

-hormonal (endocrine) system
-nervous system

109
Q

Even before first bite of food is taken,

A

-the mere thought, sight, or smell of food can trigger a response from these systems.

110
Q

As food travels through GI tract the nervous & hormone system either

A

-stimulates or inhibits digestive secretions and motility by way of messages.

111
Q

EX: gastrin

A

-food entering stomach stimulates cells in stomach wall to release hormone gastrin

112
Q

Gastrin: target & response

A

-Target organ: the glands of the stomach.
-Response: secretion of gastric acid.

113
Q

When appropriate stomach acidity is reached:

A

-acid itself turns off the gastrin producing cells.
-they stop releasing gastrin, and the glands stop producing hydrochloric acid

114
Q

Most studied GI hormone:

A

-gastrin, but GI tract releases 50 hormones

115
Q

besides assisting with digestion and absorption, hormones also:

A

-regulate food intake and influence satiation

116
Q

A healthy GI tract is home to a:

A

-100 trillion microbes

117
Q

microbes (MY-krobes):

A

microscopically small organisms
including bacteria, viruses, fungi, and
protozoa; also called microorganisms.

118
Q

The different microbes in various parts of GI tract depends on factors such as:

A

-pH, peristalsis, diet, and other microbes

119
Q

Relatively few microbes can live in:

A

-low Ph and rapid peristalsis conditions found in the stomach

120
Q

condition that Microbes permit growth of diverse and abundant population:

A

-neutral Ph and slower peristalsis of lower small intestine and large intestine

121
Q

Changes in microbiota composition and activity are associated with:

A

-different diseases such as irritable bowel syndrome and obesity.

122
Q

Most recommended diet strategy to improve health:

A

-plant based
-promotes most favorable changes in GI microbiota.

123
Q

Diets high in fiber:

A

-cannot be digested by human body but can provide a major source of energy for bacteria, fostering their growth.

124
Q

As GI bacteria digest and metabolize fibers:

A

-they produce short fragments of fat, which influence metabolism, inflammation, and disease
-These actions may help to explain how dietary fiber protects against colon cancer

125
Q

prebiotics:

A

-indigestible substances in foods (such as fibers) that stimulate the growth of beneficial bacteria.
-may reduce risk of GI infections, inflammation, and disorders

126
Q

probiotics:

A

-live microorganisms found in foods and dietary supplements
-help changes conditions in GI tract that benefit health
-YOGURT

127
Q

Vitamins produced by bacteria in GI tract

A

-biotin, folate, pantothenic acid, riboflavin, thiamin, B6, B12, and vitamin K
-ESSENTIAL NUTRIENTS

128
Q

Lifestyle factors that affect GI tract health:

A

-sleep
-physical activity
-state of mind
-nutrition

clinical nutrition (26 decks)

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