Chp 23 PP Flashcards

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1
Q

Digestive Processes

A

1) Ingestion
2) Movement of food
3) Digestion
- Mechanical digestion
- Chemical digestion
4) Absorption
5) Defecation

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2
Q

Digestive organs divided into 2 main groups

A

1) GI (alimentary) tract
2) Accessory structures
- cheeks, teeth, tongue, salivary glands
- liver, gallbladder, pancreas

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3
Q

3 pairs salivary glands

A
  • Parotid glands
  • Submandibular glands
  • Sublingual glands
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4
Q

digests carbohydrates

A

salivary amylase

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5
Q

Functions of Saliva

A
  • Water dissolves food for taste and digestion
  • Mucous moistens and lubricates food
  • Mucous lubricates oral surfaces for smooth actions in swallowing and speech
  • Cl- ions activate amylase
  • HCO3- and PO4- ions buffer bacterial acids
  • IgA, lysozymes, cyanide, defensins: protect against microorganisms
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6
Q

what stimulates salivation

A

Food (mechanically, chemically)

behavioral – memories from cortex
starts digestion
continues after ingestion is complete
irritating foods or nausea

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7
Q

Functions of Saliva

A

Water dissolves food for taste and digestion

Mucous moistens and lubricates food

Mucous lubricates oral surfaces for smooth actions in swallowing and speech

Cl- ions activate amylase

HCO3- and PO4- ions buffer bacterial acids

IgA, lysozymes, cyanide, defensins: protect against microorganisms

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8
Q

Secretion of Saliva - 1-1.5 L l day is under what control

A

Primarily under nervous control

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9
Q

if your parasympathetic nervous system is turned on what happens to the salivary secretions

A

normal salivary secretions
saliva swallowed
most reabsorbed

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10
Q

if your sympathetic nervous system is turned on what happens to salivary glands

A

reduced flow (dry mouth)

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11
Q

mastication

A

Chewing

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12
Q

Food mixed with saliva

Shaped into a

A

bolus

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13
Q

salivary amylase breaks down and converts polysaccharides (starches

A

to disaccharides (maltose) and monosaccharides (glucose) [no enzymatic action with cellulose which is also a polymer of glucose]

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14
Q

how is bolus moved to the stomach

A

through three phases…
buccal
pharyngeal
Esophageal

facilitated by saliva

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15
Q

what parts of the body are used to move bolus from the mouth to stomach

A

mouth
pharynx
esophagus

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16
Q

buccal phase is

A

Voluntary

Moves bolus to oropharynx

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17
Q

Pharyngeal phase

A

-Involuntary

Receptors in oropharynx stimulate medulla and pons to:

1) Block mouth with tongue
2) Block nasopharynx with soft palate
3) Raise larynx to seal epiglottis, blocking airways
4) Relax upper esophageal sphincter

-Bolus is moved through pharynx into esophagus

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18
Q

Esophageal stage

A
  • Upper esophageal sphincter closes
  • Gastroesopaheal sphincter opens
  • Esophagus controls involuntary peristaltic movement
  • Epiglottis reopens
  • Bolus moves from esophagus to stomach
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19
Q

Peristalsis

A

Involuntary, rhythmic contraction of muscularis

Controlled by medullary centers

A movement activity: inner circular layer of smooth muscle contracts behind bolus to push it forward; outer longitudinal muscle contracts to pull esophagus wall up

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20
Q

Physiology of Esophagus

A

Upper esophageal sphincter

Peristalsis

Lower esophageal (“cardiac”) sphincter

Sharp transition from nonkeratinized stratified squamous epithelium to simple columnar epithilium

Esophageal epithelium resistant to abrasion but not to acid and proteolytic enzyme attack – acid reflux disease

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21
Q

Physiology of digestion - Mechanical digestion

A
  • peristaltic movement (mixing waves) back and forth between body and pylorus
  • 3 muscle layers: longitudinal, circular, and oblique
  • chyme
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22
Q

Physiology of digestion - Chemical digestion

A

parietal cells secrete intrinsic factor for B12 absorption

parietal cells secrete HCl by active transport

chief cells secrete pepsinogen (inactive precursor)

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23
Q

parietal cells secrete HCl by active transport

A
  • kills microbes, denatures proteins
  • causes some acid hydrolysis of food molecules
  • stimulates secretion of hormones for bile & pancreatic juice flow
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24
Q

chief cells secrete pepsinogen (inactive precurso)

A
  • activated to pepsin by HCl acid and by other pepsins
  • only an effective protease at acid pH
  • cleaves proteins into smaller peptides
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25
Q

Stomach: Mucosa contains

A

Gastric gland chief cells

Simple columnar epithelium with goblet cells and gastric pits

Simple columnar epithelium with goblet cells and gastric pits

Goblet & gastric pit mucous cells secrete mucin

Gastric gland G cells (enteroendocrine)

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26
Q

Gastric gland chief cells secrete

A

Secrete pepsinogen (inactive precursor)
Secrete rennin in neonates
Secrete gastric lipase in neonates

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27
Q
chief cells
Secrete pepsinogen (inactive precursor)
A

activated to pepsin by HCl acid and by other activated pepsin enzymes
only an effective protease at acid pH
cleaves proteins into smaller peptides

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28
Q

chief cells Secrete rennin in neonates

A

curdles milk to increase time for gastric processing

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29
Q

chief cells Secrete gastric lipase in neonates

A

splits short chain triglycerides common in milk

limited role in digestion since it works best at pH 5-6

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30
Q

Simple columnar epithelium with goblet cells and gastric pits
Secretes

A

2-3 L l day

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31
Q

Gastric gland parietal cells

Secrete

A

intrinsic factor for B12 absorption

HCl by active transport

  • kills microbes, denatures proteins
  • causes some acid hydrolysis of food molecules
  • stimulates secretion of hormones for bile & pancreatic juice flow
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32
Q

Goblet & gastric pit mucous cells secrete

A

mucin

1-3 mm mucus layer in the stomach prevents self-digestion

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33
Q

Gastric gland G cells (enteroendocrine)

Secrete

A

gastrin, histamine, serotonin, somatostatin

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34
Q

Absorption

of mucosa

A

Impermeable to diffusion of most molecules into the bloodstream

Absorbs a few lipid soluble compounds:
certain drugs (e,g., aspirin)
alcohol

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35
Q

Physiology of the liver - processes vital to life

A
  • Storage – oil-soluble vitamins, iron, other nutrients and minerals
  • Phagocytosis
  • Removal of dietary toxins, hormones, drugs
  • –detoxify or store or secrete compounds into bile
  • –metabolize thyroid, steroid hormones
  • Synthesis of bile salts
  • Excretion of bile - bilirubin
  • Activation of Vitamin D (?)
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36
Q

Pathologies of the liver –

A

hepatitis (viral, toxic), cirrhosis, cancer

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37
Q

Gall Bladder shape

A

Pear-shaped sac, 7-10 cm long

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38
Q

Gall Bladder physiology

A
  • stores and concentrates bile between meals
  • CCK stimulates bile release for fatty meals
  • when the small intestine is empty, the hepatopancreatic sphincter closes, forcing bile into the gallbladder for storage
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39
Q

cirrhosis

A

harden liver

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40
Q

Summary: Digestive Hormones

A
enteroendocrines
Gastrin
Gastric Inhibitory Peptide
Secretin
Cholecystokinin
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41
Q

Small Intestine: Segmentation

A

primary action of small intestine when food is present

a form of mechanical digestion

a mixing activity

alternate contraction, relaxation of antagonistic smooth (circular and longitudinal) muscle segments in the intestine

controlled by the autonomic nervous system

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42
Q

Small Intestine: Peristalsis

A

as absorption continues, distension decreases and true peristalsis starts

a movement which propels chyme onward

these weak movements which occur only after most nutrients have been absorbed

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43
Q

only fat soluble vitamins

A

ADEK

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44
Q

vitamins that can be toxic to the liver

A

ADEK

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45
Q

Stomach Regulated by combination of

A

neuronal and hormonal factors

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46
Q

3 phases of stomach

A

Cephalic
Gastric
Intestinal

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47
Q

Cephalic phase
stimuli
effect

A
Stimuli
sight
smell
taste
thoughts/memories

Effect
Parasympathetic impulses increase gastric secretion

48
Q

Gastric phase neural mechanism

A

negative feedback

49
Q

in the gastric phase distension activates

A

stretch receptors causing myenteric and vagovagal reflexes to release Ach
Ach stimulates gastric juice secretion

50
Q

In the gastric phase chemoreceptors respond to

A

partially digested proteins, caffeine and rising pH

Stimulate gastrin secretion from G cells

51
Q
Gastric phase (cont.)
Gastrin
A
Inhibited at pH < 2 
Gastrin transported in the blood to the gastric glands
Greatly stimulates HCl secretion
Stimulates histamine secretion
Slightly stimulates pepsinogen secretion
Contracts lower esophageal sphincter
Increases gastric motility
Relaxes pyloric sphincter
52
Q

Control of HCl secreting parietal cells happens in what phase

A

Gastric phase

53
Q

gastric phase is stimulated by three signal chemicals

A

gastrin
acetylcholine
histamine

54
Q

All three needed for strong H+ secretion

A

gastrin
acetylcholine
histamine

55
Q

blockage of the histamine H2 receptor decreases

A

HCl secretion

56
Q

Intestinal phase has

A

excitatory and inhibitory components:

57
Q

Intestinal phase…. Excitatory

A

Very short phase

Initiated by chyme entry into duodenum

Stretch receptors stimulate release of intestinal (enteric) gastrin

Chemoreceptors detect fatty acids, & glucose in the duodenum
Stimulate enteric gastrin release

58
Q

Intestinal phase…

Inhibitory

A

Enterogastric reflex:

Enterogastrone secretion

59
Q

Enterogastric reflex

A

stretch receptors, chemoreceptors trigger 3 reflexes that

1) Inhibit vagoval reflex
2) Inhibit myenteric reflex
3) Activate sympathetic nervous system to close pyloric sphincter
- Inhibit gastric secretion

60
Q

Enterogastrone secretion

A

Enteroendocrine cells in the small intestine release:

  • Cholecystokinin (CCK)
  • Gastric inhibitory peptide (GIP)
  • Secretin
  • Vasoactive intestinal peptide (VIP)

Hormones inhibit gastric secretion

61
Q

Food normally passes through stomach in

A

4 hours

62
Q

regulate gastric emptying

A

Hormonal/neuronal reflexes

63
Q

Large meals and large amounts of liquid increase stomach

A

stomach distension  increasing rate of emptying

64
Q

Stomach emptying inhibited by the

A

enterogastric reflex, enterogastrones, and fat in the duodenum

65
Q

Pancreatic juice

A

Mostly water some salts, bicarbonate, enzymes

alkaline, pH 7.1-8.2

buffers acidic gastric juice, stops pepsin activity, creates proper alkaline pH for enzymes acting in the intestine

66
Q

pancreatic juice enzymes include

A

pancreatic amylase

trypsinogen,

chymotrypsinogen,

procarboxypeptidase (inactive zymogens)

pancreatic lipase

ribonuclease and deoxyribonuclease

67
Q

Regulation of Pancreatic Secretion is done by

A

Neural control from parasympathetic division of ANS via vagus nerve

Autoregulation by sensing the presence of fatty acids and amino acids in the acidic chyme

Hormonal control by the secretion of enteroendocrines from duodenum
Secretin – stimulates secretion of water, HCO3-
CCK – stimulates secretion of enzymes

68
Q

Liver: Blood Supply- two sources

A

Hepatic artery - oxygenated blood from aorta

Hepatic portal vein -deoxygenated blood:

  • absorbed nutrients and toxins from the stomach and intestines
  • hormones from the pancreas
  • breakdown products of RBCs from the spleen

Blood mixes in the sinusoids

69
Q

(liver cells) modify and exchange molecules with the blood

A

Hepatocytes

70
Q

livers central veins return blood to

A

the systemic circulation via the hepatic vein and inferior vena cava

71
Q

Liver bile secretion Bile from the hepatocytes enters

A

bile capillaries (canaliculi)

Canaliculi empty into small bile ducts

Hepatic ducts join the cystic duct from the gallbladder to form the common bile duct

Gallbladder stores bile

Common bile duct meets pancreatic duct at the hepatopancreatic ampulla (of Vater)

72
Q

Bile

A

800-1000 ml/day

Yellow, brownish, or olive-green liquid

pH 7.6-8.6, mostly water, bile salts, bile acids, cholesterol, lecithin (phospholipid), bile pigments, ions

Part digestive secretion, part excretory product

  • bile salts help in emulsification of ingested fats
  • bilirubin and other bile pigments are wastes from lipid catabolism
73
Q

Regulation of bile production/secretion

nervous control from

A

parasympathetic division of ANS via vagus nerve

74
Q

Regulation of bile production/secretion

autoregulation by sensing the

A

resence of fatty acids and amino acids in the acidic chyme

75
Q

Regulation of bile production/secretion

hormonal control by

A

the secretion of the enteroendocrines, CCK and secretin, from the duodenum

76
Q

Liver Lipid metabolism

A

stores, metabolizes some triglycerides

synthesizes new cholesterol

degrades excess cholesterol for bile salt production

77
Q

Liver Carbohydrate metabolism

A

regulates blood glucose levels

glycogenesis (insulin)

glycogenolysis (glucagon)

gluconeogenesis (glucagon)

78
Q

Liver protein metabolism

A

deaminates AA’s by removing amino groups (-NH2) from AA’s

deaminated AA’s used for ATP production or changed to carbohydrates or fats as needed

detoxifies ammonia (NH3) by synthesizing urea (1 CO2 + 2 NH3 = urea)

can convert AA’s from one to another (transamination)

synthesizes and secretes most plasma proteins

79
Q

Liver metabolize three things

A

carbohydrate
lipid
protein

80
Q

Physiology of the liver - processes vital to life

stores

A

oil-soluble vitamins, iron, other nutrients and minerals

81
Q

Liver removes

A

dietary toxins, hormones, drugs

detoxify or store or secrete compounds into bile

metabolize thyroid, steroid hormones

82
Q

Liver synthesis

A

bile salts

83
Q

Liver uses what to break down things

A

phagocytes

84
Q

Liver excretes

A

bile - bilirubin

85
Q

Pathologies of the liver

A

hepatitis (viral, toxic), cirrhosis, cancer

86
Q

Pear-shaped sac, 7-10 cm long

A

gall bladder

87
Q

gall bladder stores concentrates

A

bile between meals

88
Q

what stimulates bile release for fatty meals

A

CCk

89
Q

when the small intestine is empty, the hepatopancreatic sphincter

A

closes, forcing bile into the gallbladder for storage

90
Q

pathology for the gall bladder is

A

gall stones

91
Q

what are your digestive hormones aka enteroendocrines

A

Gastrin

Gastric Inhibitory Peptide

Secretin

Cholecystokinin

92
Q

a form of mechanical digestion in the small intestine

A

Segmentation

93
Q

primary action of small intestine when food is present

A

segmentation

94
Q

a mixing activity in the small intestine

A

segmentation

95
Q

alternate contraction, relaxation of antagonistic smooth (circular and longitudinal) muscle segments in the small intestine

A

segmentation

96
Q

what system is segmentation controlled by

A

autonomic nervous system

97
Q

as absorption continues, distension does what and what starts

A

distension decreases and true peristalsis starts

98
Q

a movement that propels chyme onward

A

peristalsis

99
Q

these weak movements which occur in the small intestine only after most nutrients have been absorbed

A

peristalsis

100
Q

Primary active transport electrolyte in the small intestine

A

Na+

101
Q

facilitated diffusion electrolyte in the small intestine

A

K+

102
Q

Active Transport electrolyte in the small intestine

A

Fe

103
Q

which electrolyte in the small intestine is Active transport, vitamin D is a cofactor?

A

Ca2+

104
Q

Fat-soluble vitamins in the small intestine

A

ADEK

105
Q

water soluble vitamins in the small intestine

A

BC

106
Q

What nutrients does the small intestine absorb

A

Lipids are emulsified by bile salts, forming micelles

107
Q

Small intestine absorbs how many L /day

A

8.3

108
Q

Total volume of water absorption added to the small intestine/day

A

9.3
~2.3 L from ingestion
~7.0 L from secretions

109
Q

The rest of the water that isn’t absorbed in the small intestine is reabsorbed as

A

The rest of the water (~1.0L/day) passes to large intestine where most is reabsorbed (~0.9 L/day)

110
Q

Completion of absorption, especially final absorption of H2O

A

Large Intestine

111
Q

Normal flora manufacture certain vitamins (B complex, K)

Formation and expulsion of feces

A

Large Intestine

112
Q

What 4 areas is the large intestine divided into

A

cecum
colon
rectum
anal canal

113
Q

Chyme passage regulated by?

A

ileocecal sphincter

114
Q

when the cecum is full, the sphincter is?

A

contracted

115
Q

Colon movements start when

A

chyme passes sphincter

116
Q

what does the large intestine digest and through what mechanism

A

digestion of chyme by bacteria

117
Q

following a meal what occurs in the large intestine

A

gastroileal reflex: ileal motility increases, sphincter relaxes, chyme moves to the cecum

when the cecum is full, the sphincter contracts