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BMS100 Clin Phys > Clin Phys 8 > Flashcards

Clin Phys 8 Flashcards

1
Q

The alimentary canal is a tubular structure that?

A
  • Makes direct contact with food (or former food)
  • Has a typical set of histologic layers that surround a lumen
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2
Q

What’s the alimentary canal composed of?

A
  • Oral cavity and pharynx (future lectures)
  • Esophagus
  • Stomach
  • Small Intestine: Duodenum, jejunum, ileum
  • Large intestine: Cecum, appendix, ascending, transverse, descending colon, rectum
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3
Q

How did the accessory digestive organs come about?

A

derived embryologically as “outgrowths” of the early alimentary canal

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4
Q

What do all the accessory digestive organs function as?

A

glands that secrete substances into the alimentary canal

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5
Q

What are the accessory digestive organs?

A
  • Salivary glands (future lectures)
  • Liver & gall bladder
  • Pancreas
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6
Q

What does the alimentary canal do?

A
  • propulsion
  • secretion
  • digestion
  • absorption
  • immune function
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7
Q

What is propulsion?

A

food is moved along the “tube” as it is digested

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8
Q

What are the two types of secretion?

A
  • Hormonal secretions that impact digestion, secretion, and overall metabolism
  • Fluid or mucous secretions that aid propulsion and digestion
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9
Q

What are the 2 types of digestion?

A
  • Chemical – enzymes and acid break chemical bonds in food material or substances facilitate enzymatic interactions
  • Mechanical – movements of the canal mix food, break it apart, and increase the SA:volume ratio of food
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10
Q

Where does movement occur in absorption?

A

lumen –> bloodstream

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11
Q

How much water do we ingest
and secrete into the canal per day?

A

ingest: 1L
secrete 4-6L

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12
Q

What is absorbed in the alimentary canal?

A

macro and micronutrients

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13
Q

What are the immune functions of the alimentary canal?

A
  • Protection from ingested microbes that are harmful
  • Aiding microbes that are useful
  • “Educating” the immune system about whether something that has been ingested is harmful or harmless
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14
Q

What are the layers of the alimentary canal?

A

mucosa: epithelial lining, lamina propria, muscularis
submucosa: loose connective tissue w/ larger blood vessels and lymphatics
muscularis - inner & outer layer
serosa/adventitia

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15
Q

T/F: Type of epithelium in the alimentary canal does not vary from organ to organ

A

False, varies

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16
Q

What is columnar with villi epithelial for in the alimentary canal?

A

absorption/secretion, cuboidal or squamous for protection from abrasion

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17
Q

Why are goblet cells present in the epithelial lining?

A

mucous secretion

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18
Q

Why are neuroendocrine cells present in the epithelial lining?

A

cells that are interspersed among the epithelium and release signals in response to different nutrients or chemical conditions in the lumen

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19
Q

What is lamina propria the site of?

A
  • blood and lymphatic vessels
  • Immune tissue (resembles loosely-structured lymphatic nodules, known as MALT)
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20
Q

What is the function of muscularis mucosa in the alimentary canal?

A

Alters the shape of the mucosa to optimize mixing and exposure of the epithelial cells to lumen contents

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21
Q

What does the submucosa contain?

A
  • larger blood vessels
  • larger glands
  • very large lymphatic nodules (in proximal small intestine)
  • plexus of neurons
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22
Q

What is the Meissner’s plexus?

A

submucosal plexus of neurons in the submucosa - tends to regulate secretions & convey sensory info about what’s in the lumen

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23
Q

Which layer of the muscularis is the “circular layer”? What does it contain?

A

inner layer - smooth muscle fibres concentrically surround the lumen

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24
Q

When the inner layer of the muscularis contracts, what happens?

A

squeezes the lumen shut

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25
Q

Which layer of the muscularis is the “longitudinal layer”? What does it contain?

A

outer layer - smooth muscle fibres run along the length of the canal

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26
Q

When the outer layer of the muscularis contracts, what happens?

A

it shortens the canal

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27
Q

What is the Auerbach’s (myenteric) plexus?

A

plexus in muscularis layer that regulates the movements of these muscular layers

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28
Q

Where is the Auerbach’s plexus found?

A

between inner and outer layer of muscularis layer

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29
Q

What is the outer layer of the alimentary canal?

A

serosa or adventitis

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30
Q

Where is adventitia? What is it made of? What is it’s job?

A

in esophagus - connective tissue that anchors esophagus in chest cavity

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31
Q

What is serosa made of?

A

loose connective tissue covered by simple squamous mesothelium

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32
Q

What does the simple squamous mesothelium in the serosa secrete?

A

fluid that collects in the abdominal (peritoneal) cavity

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33
Q

What is the source of peritoneal fluid?

A

serosa

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34
Q

What is the serosa continuous with?

A

visceral peritoneum

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35
Q

What is the peritoneal cavity?

A

fluid filled gap b/w wall of abdomen & organs contained within the abdomen

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36
Q

What is the visceral peritoneum formed by?

A

serosa of the alimentary canal and capsule of the livr

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37
Q

What secretes the fluid that collects in the abdominal cavity?

A

mesothelium in visceral peritoneum

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38
Q

What is the parietal peritoneum?

A

inner lining of abdominal wall

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39
Q

What is the parietal peritoneum sensitive to?

A

sensitive to inflammation and other chemical irritants

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40
Q

What is the esophagus?

A

Tube that extends from the pharynx to the stomach

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41
Q

What is the only role of the esophagus?

A

propulsion of food to the stomach

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42
Q

How long is the esophagus, where is it located?

A

25 cm long tube located retrosternally

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43
Q

What is the function of the upper esophageal sphincter?

A

when it closes, it pushes food from the pharynx to the esophagus

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44
Q

What is the function of the lower esophageal sphincter?

A

limits movement of stomach acid into the esophagus –> relaxes to receive swallowed food

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45
Q

What is the esophagus made of?

A

Stratified squamous epithelium, adventitia

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46
Q

What is the stomach?

A

sack that can expand to receive and store ingested food

47
Q

What are the movements of the stomach, what does this accomplish?

A

Muscular movements accomplish mechanical digestion (churning and breaking up food into acidic chyme) and propulsion into the small intestine

48
Q

What is the role of the stomach in chemical digestion?

A
  • Acid denatures proteins and kills ingested bacteria
  • Secreted enzymes help to digest protein (collagen in particular)
49
Q

T/F: Stomach has no role in regulating food - i.e., tells you when you are full

A

False, has role - tells you when you are full

50
Q

What is the mucosa of the stomach made of?

A

low columnar cells

51
Q

What is the function of the columnar cells in the mucosa of the stomach?

A
  • Parietal cells – secrete acid and intrinsic factor (IF is needed for absorption of B12)
  • Other cells secrete mucous to protect the lining or digestive enzymes specialized for digesting proteins
52
Q

What is needed in the mucosa layer of the stomach for absorption of B12?

A

parietal cells - intrinsic factor

53
Q

How many layers does the muscularis layer have in the stomach? What is the innermost layer?

A

Innermost layer is the oblique layer

54
Q

What does the pyloric sphincter do in the stomach?

A

regulates the amount of acidic chyme that enters the duodenum

55
Q

What is the main digestive organ?

A

small intestine

56
Q

What is the small intestine the site of?

A

most chemical digestion, absorption, and secretion in the alimentary canal

57
Q

Which GI organ has the largest surface area?

A

small intestine

58
Q

What are the 3 separate components of the small intestine?

A
  • duodenum
  • jejunum
  • ileum
59
Q

What is the shape and function of the duodenum?

A

short, C-shaped tube that receives chyme from the stomach and overlies the head of the pancreas

60
Q

What two components of the small intestine have specialized immune tissue (Peyer’s patches)?

A

dudodenum and jejunum

61
Q

What is the shape and function of the ileum?

A

longest portion, main function is reabsorption of bile salts, micronutrients/vitamins, and water

62
Q

What is the lining of the small intestine made of? What does this optimize?

A

Highly folded epithelium (microvilli), mucosa (villi) and submucosal layers (circular folds) meant to optimize surface area

63
Q

The small intestine has columnar epithelium with many?

A

microvilli

64
Q

What is the small intestine interspersed with?

A

goblet cells and cells that secrete chemical messengers into the blood

65
Q

What do the chemical messengers help regulate that are secreted in the small intestine?

A

regulate propulsion, overall metabolic function, secretions from the pancreas or liver

66
Q

What is the main function of the large intestine?

A

absorption of water from stool, storage of stool, and housing the majority of the microbes in the gut (Negligible role in nutrient absorption)

67
Q

What cells do the large intestine have?

A

Low columnar cells with fewer microvilli, plenty of goblet cells

68
Q

What is unique about the muscular layer of the large intestine?

A
  • Continuous circular muscle layer
  • Longitudinal muscle layer is separated into bands that do not completely surround the canal
69
Q

Which organs do not contact ingested substances directly?

A

accesorry organs - liver, gallbladder, pancreas

70
Q

What do all accessory organs have? Why?

A

ducts that convey their secretions to the lumen of the duodenum

71
Q

Which accessory organ has important endocrine functions related to overall nutrient metabolism?

A

pancreas

72
Q

Which accessory organ has very wide array of important metabolic functions?

A

liver

73
Q

What are roles of the liver?

A
  • Carbohydrate metabolism
  • Protein synthesis and degradation
  • Most proteins secreted into the bloodstream are from the liver
  • Lipid metabolism
  • Detoxification of molecules so that they can be secreted into the bile and defecated
  • Making hydrophobic molecules water soluble so that they can be eliminated by the kidney
  • Storage of vitamins and minerals
  • Synthesis of bile – essential for lipid digestion
  • Endocrine – secretion of IGF-1, important hormone regulating growth
74
Q

What is the endocrine role of the liver?

A

secretion of IGF-1, important hormone regulating growth

75
Q

What does the synthesis of bile that occur in the liver essential for?

A

lipid digestion

76
Q

What is the function of the gallbladder?

A

storage and modification of bile

77
Q

What happens when the gallbladder contracts?

A

bile release into the duodenum

78
Q

What is the exocrine function of the pancreas?

A

secretes digestive enzymes that are crucial for carbohydrate, protein, and lipid chemical digestion which are secreted into pancreatic duct, which drains into duodenum

79
Q

What is the endocrine function of pancreas?

A

secretes hormones that impact glucose, protein, and lipid metabolism into the bloodstream

80
Q

What hormones does the pancreas secrete?

A

Insulin, glucagon, and somatostatin

81
Q

Bowel sounds may be?

A

increased (hyperactive) or decreased (hypoactive)

82
Q

What does it mean if there is increased (hyperactive) bowel sounds?

A
  • Diarrhea, gastroenteritis, inflammatory bowel disease, laxative use, gastrointestinal bleed
  • early bowel obstruction (often described as a high-pitched “tinkling” sound
83
Q

What does it mean if there is decreased (hypoactive) bowel sounds?

A
  • Often suggests more emergent conditions
  • Bowel obstruction, peritonitis, intestinal ischemia
84
Q

How long should we listen before assuming absence of bowel sounds?

A

at least 2 minutes

85
Q

Abdominal pain is present regardless of?

A

whether you palpate (press) the abdomen

86
Q

What is tenderness?

A

pain in a region where you palpate

87
Q

What is one of the most challenging presentations?

A

abdominal pain

88
Q

What can “deep” or visceral pain of the abdomen come from?

A

stretching, ischemia, or chemical irritation of a component of the alimentary tract or accessory organ

89
Q

What pathologies can also present as abdominal pain?

A

pathologies in the thorax (heart attacks, pneumonia)

90
Q

What is guarding?

A

voluntary contraction of the abdominal musculature due to abdominal discomfort

91
Q

What is guarding exacerbated by?

A

anxiety

92
Q

T/F: Guarding can be less serious, but is often more serious

A

False, Guarding can be more serious but is often less serious

93
Q

What is rigidity?

A

involuntary contraction of the abdominal musculature, usually accompanied by severe pain

94
Q

T/F: Rigidity is a less serious pathology

A

False, more serious

95
Q

How does rigidity occur?

A

Due to chemical irritation of the parietal peritoneum lining or “rubbing” of an inflamed organ against it

96
Q

What chemical irritation can cause rigidity?

A

Bile (ruptured cholecystitis), infected material (ruptured or ischemic intestinal wall), pancreatic secretions (pancreatitis), gastric or duodenal contents (perforated peptic ulcer)

97
Q

Appendicitis and diverticulitis can cause what?

A

Rigidity - inflamed structure rubbing against the parietal peritoneum

98
Q

What type of abdominal pain in the three areas in the “centre” occurs? What is it caused by?

A

can be visceral pain from the alimentary tract or accessory organs
- Can also be due to irritation of the parietal peritoneum

99
Q

What is abdominal pain in the six regions on the “sides” caused by?

A

often due to irritation of the parietal peritoneum
- Can also be due to visceral pain from non-GI organs

100
Q

What does the epigastric region of the abdomen contain?

A

stomach, esophagus, duodenum, pancreas, bile ducts, sometimes liver

101
Q

What does the left hypochondriac region of the abdomen contain?

A

stomach

102
Q

What does the right hypochondriac region of the abdomen contain?

A

liver, gallbladder

103
Q

What does the umbilical region of the abdomen contain?

A

small intestine, cecum, appendix

104
Q

If there is abdominal pain in the lumbar region, what is it due to?

A

splenic injury, renal disease

105
Q

If there is abdominal pain in the right iliac region of the abdomen, what is this due to?

A

appendicitis

106
Q

If there is abdominal pain in the left iliac region of the abdomen, what is this due to?

A

diverticulitis (large intestine)

107
Q

What do the right and left iliac region contain?

A

reproductive organs

108
Q

What does the hypogastric region contain?

A

most of large intestine
bladder

109
Q

A __ liver does not necessarily indicate hepatomegaly (an enlarged liver)

A

palpable

110
Q

What is hepatomegaly?

A

enlarged liver

111
Q

What are pathological consistencies that could be noted in hepatomegaly?

A

from the normal softness to an abnormally firm or hard liver

112
Q

What pathologies cause hepatomegaly?

A
  • Liver cirrhosis – large liver with firm, nontender edge
  • Hepatocellular carcinoma – large liver that is firm and an irregular edge. May or may not be tender
113
Q

What type of pathologies are associated with the right and left iliac regions in women?

A

endometriosis, ovarian cysts

BMS100 Clin Phys (8 decks)

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