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Chapter 23 (Lecture) Flashcards

1
Q

all GI tract movement stops and the gut appears to be paralyzed

A

ileus

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2
Q

extreme dryness of the mouth

A

xerostomia

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3
Q

grinding or clenching of the teeth

A

bruxism

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4
Q

what is the effect of whole proteins being absorbed and seen by the immune systme

A

allergies

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5
Q

produces lysozyme

A

paneth

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6
Q

change in the epithelium of the lower esophagus from stratified squamous to a columnar epithelia

A

Barrett’s esophagus

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7
Q

common causes of malabsorption

A
  • impaired nutrient absorption
  • anything that interferes with the delivery of bile
  • anything that interferes with the delivery of pancreatic juice
  • severe bacterial infections
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8
Q

major site for nutrient absorption

A

small intestine

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9
Q

which structure of the small intestine is known as the brush border

A

microvilli

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10
Q

contains a large number of bacteria

A

large intestine

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11
Q

bacterial flora in the large intestine produce

A
  • vitamin K
  • B vitamins
  • CO2
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12
Q

major site for nutrient absorption

A

small intestine

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13
Q

swallowing is hindered or prevented

A

achalasia

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14
Q

excess iron is deposited in the tissues, increasing skin pigmentation and the risk of hepatic cancer and liver cirrhosis

A

hemochromatosis

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15
Q

may result form excessively high levels of fat in the blood or excessive alcohol ingestion, but most acute cases arise from gallstones that block the bile duct

A

pancreatitis

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16
Q

abnormal accumulation of fluid within the peritoneal cavity

A

ascites

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17
Q

a noncontagious, periodic inflammation of the intestinal wall now understood to be an abnormal immune and inflammatory response to bacterial antigens

A

IBD

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18
Q

overeating followed by purging

A

bulemia

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19
Q

difficulty swallowing

A

dysphagia

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20
Q

brush border enzymes that act on disaccharides

A

sucrase, lactase, maltase

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21
Q

collects nutrient rich blood from the GI tract and delivers it to the liver

A

hepatic portal circulation

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22
Q

what structure of the small intestine contains the sphincter/valve that connects to the large intestine

A

ileum

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23
Q

inflammation of the intestine

A

enteritis

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24
Q

final product of carbohydrate digestion

A

monosaccharides

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25
Q

what causes the defection reflex

A

stretching of the rectal wall

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26
Q

first segment of the small intestine

A

duodenum

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27
Q

most water is absorbed in

A

small intestine

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28
Q

what type of breakdown would chewing food be classified as

A

mechanical breakdown

(segmentation, churning, mastication)

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29
Q

When we ingest large molecules such as lipids, carbohydrates, and proteins, they must undergo catabolic reactions whereby enzymes split these molecules. This series of reactions is called

A

digestion

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30
Q

true or false:

All the chemical and mechanical phases of digestion from the mouth through the small intestine are directed toward changing food into forms that can pass through the epithelial cells lining the mucosa into the underlying blood and lymphatic vessels.

A

true

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31
Q

Which layer of the alimentary canal is constructed from either stratified squamous or simple columnar epithelium?

A

mucosa

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32
Q

Which layer of the alimentary canal is responsible for segmentation and peristalsis?

A

muscularis externa

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33
Q

serous membrane that covers most digestive organs

A

visceral peritoneum

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34
Q

outermost layer of the walls of the intraperitoneal organs

A

serosa

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35
Q

sheets of peritoneal membrane that hold the digestive tract in place

A

mesentery

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36
Q

true or false:

the peritoneum is the most extensive serous membreane in the body

A

true

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37
Q

components of splanchnic circulation

A
  • celiac artery
  • hepatic portal vein
  • superior mesenteric artery
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38
Q

nervous control of gastric secretion is provided by

A
  • vagus nerve
  • enteric plexus
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39
Q

Your patient has had a total gastrectomy (removal of the stomach). What potential problem are you MOST concerned about

A

anemia

The parietal cells of the stomach produce intrinsic factor, which permits the absorption of vitamin B12, a nutrient required for the maturation of red blood cells. Unless your patient receives vitamin B12 replacement therapy, he or she will develop pernicious anemia.

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40
Q

what stimuli inhibits salivation

A

being stressed or frightened

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41
Q

how many total permanent teeth should an adult have, assuming none have been lost or removed

A

32

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42
Q

impacted wisdom teeth is a problem that is never observed in children because

A

they lack third molar teeth

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43
Q

which structures of the body play a part in swallowing

A

mouth, pharynx, and esophagus all take part in swallowing

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44
Q

where does the involuntary portion of swallowing takes place in

A

the pharynx

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45
Q

the voluntary phase of swallolwing takes place within

A

the mouth

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46
Q

what structure is found in the stomach but nowhere else in the alimentary canal

A

an oblique muscle layer

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47
Q

produced in the stomach and contributes directly to the absorption of vitamin B12

A

intrinsic factor

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48
Q

begins as chyme enters the duodenum

A

intestinal phase of gastric secretion

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49
Q

true or false:

Chief cells secrete inactive pepsinogen in order to prevent acid erosion inside of the chief cells.

A

false

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50
Q

roles of stomach acid

A
  • Stomach acid denatures proteins making the polypeptide chain more accessible to pepsin digestive enzymes.
  • Low pH converts pepsinogen to its active form of pepsin, preventing the protease enzyme from digesting the cells that produce it.
  • Many potentially harmful bacteria will be prevented entry to the small intestine by stomach acid.
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51
Q

true or false:

The major stimulus for production of intestinal fluid is distention or irritation of the intestinal mucosa by hypertonic or acidic chyme.

A

true

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52
Q

true or false:

most gastric ulcers are due to excessive production of HCl

A

false

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53
Q

which vessel delivers nutrient-rich blood to the liver from the digestive tract

A

hepatic portal vein

All blood from the digestive organs as well as the spleen is delivered to the liver in the hepatic portal vein before being returned to the general circulation.

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54
Q

secretion of the pancreas

A
  • bicarbonate
  • insulin
  • nutrient digesting enzymes
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55
Q

why are protease enzymes secreted in active forms

A

The cells producing inactive enzymes are themselves protected from the enzymes until they are safely within the lumen of the GI tract.

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56
Q

functions of hepatocytes

A
  • detoxify toxic chemicals
  • store fat-soluble vitamins
  • process nutrients
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57
Q

digestion and absorption of which type of molecule would be most affected if the liver were severely damaged

A

lipids

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58
Q

true or false:

the pancreas has both an endocrine and an exocrine function

A

true

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59
Q

what cells in the small intestine’s mucosa secrete mucus

A

goblet cells

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60
Q

first segment of the small intestine

A

duodenum

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61
Q

The absorptive effectiveness of the small intestine is enhanced by increasing the surface area of the mucosal lining. Which of the structures accomplish this task?

A

villi and microvilli

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62
Q

what propels food residue over large areas of the colon three to four times a day

A

mass movement

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63
Q

as wastes navigate the large intestine, which features do they pass through in order

A

right colic (hepatic), left colic (splenic), and sigmoid flexures

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64
Q

functions of the large intestine

A
  • absorption of water
  • absorption of electrolytes
  • synthesis of vitamins
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65
Q

can result if food passes too slowly through the large intestine

A

constipation

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66
Q

characteristics of the large intestine

A
  • exhibits external muscular bands called teniae coli
  • does not contain villi
  • it has pocket-like sacs called haustra
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67
Q

true or false:

most nutrients are absorbed through the mucosa of the intestinal villi by active transport

A

true

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68
Q

which enzymes is/are responsible for the chemical breakdown of carbohydrates

A

amylase

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69
Q

carbohydrates are digested into

A

monosaccharides

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70
Q

You have just eaten a meal high in complex carbohydrates. Which enzyme will help to digest the meal?

A

amylase

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70
Q

Bile salts break up the fat globule into smaller fat droplets. This role of bile salts is best described as

A

lipid emulsification

71
Q
  • inorganic molecules needed by the body
  • add strength to tissues
  • most are ionized and act as electrolytes
72
Q
  • not used for energy
  • most act as coenzymes
73
Q

water soluble vitamins

A

C, B complex

74
Q

fat soluble vitamins

A

A, D, E, K

75
Q

small amounts of DNA and RNA are broken down by what into sugars and bases

A

pancreatic nucleases and brush border nucleases

76
Q

most abundant lipid in diet

A

triglycerides

77
Q

functions of lipids

A
  • energy source
  • padding
  • cholesterol
  • phospholipids
78
Q
  • composed of glycerol and 3 fatty acid chains
  • milk, cheese, butter, plant, and animal oils
79
Q

vastly increases the surface area available to be attacked by pancreatic lipase

A

emulsification

80
Q

small phospholipid bubbles that allow the products of fat digestion to get close to the surface of the mucosa of the villi

81
Q

composed of the digestive tract through which food passes, and the accessory organs that add secretions to the digestive tract

A

digestive system

82
Q
  • a continuous tube leading from the mouth to anus
  • consists of the oral cavity, pharynx, esophagus, stomach, small and large intestines, and anal canal
A

digestive tract / ailmentary canal

83
Q
  • teeth, salivary glands, liver, gallbladder, and pancreas
  • secrete fluids and enzymes into the digestive tract
A

accessory organs

84
Q

physical processes that take place in the digestive system

A
  • ingestion
  • mastication (chewing)
  • propulsion (deglutition followed by peristalsis)
  • mixing (segmental contractions in the SI
  • transport (circulatory or lymphatic)
  • elimination (defecation)
85
Q

chemical processes of the digestive system

A
  • secretions (mucus, water, enzymes)
  • digestion (enzymes)
  • absorption (nutrients through villi or lacteals)
  • regulation (nervous - vagus, hormonal, local)
86
Q

inflammation of the peritoneum

A

peritonitis

87
Q
  • serous membrane of the abdominopelvic cavity (visceral and parietal)
  • layers separated by namesake cavity that contains serous fluid
A

peritoneum

88
Q
  • a sheet of two fused serous membranes from the body wall to the digestive organs
  • provides a route for blood vessels, nerve, lymph vessels
  • holds organs in place
89
Q

organs not suspended by mesentery are

A

retroperitoneal

pancreas, some SI and LI

90
Q
  • include the arteries from the celiac trunk and the mesenteric arteries
  • also includes venous hepatic portal circulation
A

splanchnic circulation

92
Q
  • composed of three layers: the namesake epithelium, lamina propria, and namesake muscularis
93
Q

contains mucus glands

A

mucosal epithelium

94
Q

loose connective tissue

A

lamina propria

95
Q

thin smooth muscle

A

muscularis mucosa

96
Q

moderately dense CT containing nerves, blood vessels, small glands; submucosal plexus made of parasympathetic ganglionic fibers

97
Q
  • two major plexuses are myenteric and submucosal
  • control much of the activities of the GI tract
  • communicate w/ CNS via afferent visceral fibers and ANS sympathetic and parasympathetic fibers (motor)
  • capable of acting on its own w/ little or no CNS oversight
A

enteric NS

98
Q

arteries of splanchic circulation

A
  • celiac trunk (hepatic a., splenic a., gastric a.)
  • superior and inferior mesenteric a.
99
Q

veins of splanchic circulation

A

hepatic portal system

100
Q

digestive system typically receives about how much blood flow per minute

A

25% of total blood flow

101
Q
  • inner layer of muscularis
  • in some places pinches to form sphincters
A

circular layer

102
Q

outer layer of muscularis

A

longitudinal (smooth) layer

103
Q
  • outer CT layer
  • provides support and protection, also known as the visceral peritoneum
  • esophagus and some retroperitoneal organs lack this so it is known as adventitia
104
Q

bound by lips, cheeks, tongue, and the hard and soft palates

A

oral cavity

105
Q

dental formula

A

2123

  • 2 incisors
  • 1 canines
  • 2 premolars
  • 3 molars
106
Q

controlled by intrinsic and extrinsic muscles, help control bolus formation

107
Q

muscle that controls incisor biting

A

temporalis

108
Q

muscle that controls molar biting

109
Q

responsible for side to side motion

A

medial and lateral pterygoids

110
Q

swallowing reflex begins here

111
Q

actively absorbed into the capillaries of the SI and go to the liver via the hepatic portal vein for processing and possible reassembly into other proteins

A

amino acids

112
Q

proteins are broken down by

A

pepsin and HCl

113
Q

polypeptides and some dipeptides are brken down by

A

pancreatic proteases

114
Q

dipeptides are broken down by

A

brush border proteases

115
Q
  • 9 essential.11 nonessential amino acids are liberated from proteins
  • from meat, fish, poultry, legumes, nuts, seeds, etc
  • uses for building bones, muscles etc
  • regulatory uses such as enzymes, transporters, hormones, etc
116
Q

sources of carbohydrates

A

bread, cereal, pasta, candy, fruits, etc

117
Q

indigestible starches

118
Q

blood sugar

119
Q

isomers of glucose

A

galactose and fructose

120
Q

polysaccharides

A

starch (plants), glycogen (muscle)

121
Q

disaccharides

A

sucrose, maltose, lactose

122
Q

monosaccharides

A

fructose, galactose, glucose

123
Q

absorbed by facilitated diffusion

124
Q

absorbed in the capillaries in the intestines and sent to the liver via the hepatic portal vein

125
Q

actively cotransported with sodium ions

A

glucose and galactose

126
Q
  • process is started in the mouth, continues in the stomach and SI
  • a catabolic process in which large complex molecules are broken down into monomers and accomplished by the action of enzymes secreted from accessory glands and from the digestive tract itself
A

chemical digestion

127
Q

the name for the enzymatic breakdown of food molecules

A

hydrolysis

128
Q

a substance in food that is used to promote normal growth, maintenance, and repair

includes: carbs, proteins, fats, vitamins, minerals, and water

129
Q

perfect conditions for gallstones

A

5 Fs

Fair, FAT, Forty, Female, Fertile

130
Q

neutralizes the acidic chyme coming out of the stomach

A

alkaline pancreatic juice

131
Q

pancreatic secretions are regulated by

A

intestinal hormones and the vagus nerve

132
Q

opening into the small intestine

A

major duodenal papilla

133
Q

pancreatic duct joins common bile duct at

A

hepatopancreatic ampulla

134
Q

digestive enzymes + bicarbonate ion

A

pancreatic juice

135
Q
  • site of hiatial hernias
  • LUQ of abdomen, usually 15-25 cm long; can hold upwards of 2-4 L of food when filled
136
Q

sites of omentum attachment

A

lesser and greater curvature

137
Q

produce insulin and glucagon

A

pancreatic islet cells

138
Q

pancreatic enzymes are produced by

A

acinar cells

139
Q

stores and concentrates bile, releasing it upon a signal from the duodenum

A

gallbladder

140
Q

aid in cholesterol excretion and emulsify lipids

A

bile salts

141
Q

buffer duodenal contents

A

bicarbonate ions

142
Q
  • 4 lobes
  • processes nutrient laden blood, manufactures bile, and secretes substances like angiotensinogen and albumin
  • extracts nutrients from blood and sends bile to the gallbladder for storage
143
Q

secrete saliva containing mucin and salivary amhylase to initiate starch digestion

A

salivary glands

144
Q

functions of the LI

A
  • consolidates and moves unusable fecal material out of the body
  • site of vitamin B and K manufacture by bacterial flora
  • reclaims water and electrolytes from undigested food
  • mass movements occur 3-4x a day to facilitate the movement of fecal material
145
Q

controls the flow of material between the small and large intestines

A

ileocecal valve

146
Q

chemical secretions of the stomach

A
  • mucus (protection)
  • HCl (decrease pH)
  • intrinsic factor (vitamin B12)
  • pepsinogen (pepsin)
147
Q

regulation of gastric secretions (cephalic phase)

A
  • Stimulated by sensations of taste, smell, and thoughts of food, chewing, and swallowing.
    ▪ The vagus carries this information to the nerves within the stomach wall.
    ▪ These Parasympathetic nerves in the stomach wall release ACH and this stimulates thenrelease of gastrin - which comes back around to stimulate additional release of pepsinogen
    and HCL by the stomach.
148
Q

secrete mucus

A

mucus neck cells

149
Q

secretes HCl, intrinsic factor

A

parietal cells

150
Q

secretes pepsinogen

A

chief cells

151
Q

secrete regulatory hormones such as gastrin, histamine, endorphins, serotonin, CCK, etc

A

endocrine cells

152
Q
  • triggered by: stomach distention, amino acids and proteins in stomach + rising pH in stomach due to food
  • causes local receptors to trigger reflexes and release more gastric secretions
  • gastrin released in a positive feedback loop
A

gastric phase

153
Q

regulation of gastric secretions phase

A
  1. cephalic phase
  2. gastric phase
  3. intestinal phase
154
Q
  • chyme released into the duodenum, stimulates both neural and hormonal mechanisms
  • as long as pH remains >3 gastric secretions are continued with gastrin being released fro the duodenum and causing the stomach to continue its secretions
A

intestinal phase

155
Q

main cells of the liver that process nutrient laden venous blood

A

hepatocytes

156
Q

liver attached to diaphragm via

A

falciform ligament

157
Q

hexagonal in appearance, are the smallest functional units of the liver

158
Q

stores, concentrates bile which is released upon a signal from the duodenum (CCK)

A

gallbladder

159
Q

small pouches of visceral peritoneum filled with adipose tissue

A

epiplotic appendages

160
Q

small sacs, caused by bunching of smooth muscles

161
Q

muscularis layer reduced to 3 longitudinal bands

A

teniae coli

162
Q

can result from water not being reclaimed from fecal matter

163
Q

hydrolytic digestion via enzymes in SI

164
Q

active or passive transport across the epithelium of SI

A

absorption

165
Q

physical processes that take place in the SI

A

segmentation and peristalsis

166
Q

products of lipid digestion are absorbed by

167
Q

how are the products of proteins and carbohydrate digestion absorbed

A

absorbed into submucosal capillaries in submucosal layer

168
Q

common bile duct + pancreatic duct

A

hepatopancreatic ampulla

169
Q

hydrolytic enzymes are bound to the microvilli to effect digestion

A

brush boder enzymes

170
Q

part of the SI that is responsible for absorption and compaction

171
Q

part of the SI that continues chemical digestion and absorption

172
Q

part of the SI that does the majority of chemical digestion

173
Q

inhibits gastric secretions but also the secretions of the pancreas and gall bladder in order to. digest fats

A

cholecystokinin (CCK)

174
Q

inhibits gastric secretions when there are fatty acids present in SI

A

gastric inhibitory peptide (GIP)

175
Q

released when SI becomes too negative and inhibits gastric secretions

A+P 2 (21 decks)

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