digestion - lecture 5 Flashcards

1
Q

describe enterogastric reflex

A

factors in duo also control rate of gastric emptying /antral peristalsis

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2
Q

what is vomiting

A

emptying of the contents of upper git

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2
Q

what does vomiting result from

A

increase in intraabdominal pressure due to action of diaphragm and abdominal pressures - git is mostly passive - not reverse peristalsis

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3
Q

describe vomiting steps

A

oral direction - to mouth
proximal stomach and above relax
upper duo and distal stomach contract
gradient of pressure due to concerted contraction of abdominal muscles = diagram lowers (decreases barrier of les) and abdominal muscles contract
intraabdominal pressure increases bc muscles contract and overcomes les resistance

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4
Q

describe regulation of vomiting - afferent

A

pharyngeal stimulation - gag reflex
git or urogenital distension - contents go too quickly to duo
pain, cardiac ischemia - childbirth
biochemical diseq
vestibular signals
psychogenic factors = site or smell of something

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5
Q

what precedes and accompanies vomiting

A

Imbalance between parasymp and symp
sweating, vasoconstriction, salivation, alternating bradychardia, tachycardia

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6
Q

describe regulation of vomiting - efferent

A

widespread autonomic discharge
nausea
retching
emesis
need vomitting center to vomit

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7
Q

what helps emesis

A

high resistance at distal end of stomach = relaxation of upper gi tract and spasm of plyoric antrum and duodenum
contraction of abdominal muscles and diaphragm

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8
Q

where do afferent impulses to vomiting center come from

A

can arise from many places

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9
Q

what is ctz

A

chemoreceptor trigger zone = in medulla, outside blood brain barrier
agents in bloodstream can act on this = toxins or emetic substances
distinct from vomiting center
sends signals to vomiting center
chemotherapy drugs activate ctz

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10
Q

name the 3 stages of vomiting

A

nausea
retching
emesis

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11
Q

describe nausea - stages of vomiting

A

pyschic experience

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12
Q

describe retching - stages of vomiting

A

abrupt
uncoordinated respiratory movements with glottis closed

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13
Q

describe emesis - stages of vomiting

A

actual expulsion of contents of upper git

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14
Q

what happens during emesis

A

person takes deep breath, glottis closes, abdominal muscles contract and exert pressure on gastric contents

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15
Q

when is emesis completed

A

with the reversal of thoracic pressures from neg to pos
as diaphragm displaced upwards = forces eso contents to be expelled through the mouth

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16
Q

describe small intestine - function

A

most digestion and ALL absorption of nutrients occur in si

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17
Q

describe small intestine - regions

A

duodenum - mostly digest and absorb
jejunum
Ileum - some things can only be absorbed here

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18
Q

what are functions of upper si

A

neutralization
osmotic equilibration
digestion
absorption

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19
Q

describe neutralization

A

chyme from stomach is v acidic
must be rapidly neutralized
stomach mucosa protected from acid but si mucosa isnt

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20
Q

describe osmotic equilibrium

A

chyme will be isotonic by time it leaves duodenum

21
Q

what are motor activities of si

A

effective mixing = bring stuff to absorptive cells
slow propulsion = 2-6 hrs needs times

22
Q

describe intestinal contractions - gen

A

governed by electrical characteristics of sm

23
Q

describe intestinal contractions - frequency

A

governed by ber

24
Q

describe intestinal contractions - spikes

A

phase locked to ber
initiated by stretch or ach

25
Q

describe intestinal contractions - amplitude of contraction

A

related to number of spikes/burst of era (spikes)

26
Q

describe intestinal ber - eca

A

intrinsic f of ber varies in diff cells of si = declines from prox to distal intestine
duo f = 12
jejunum f = 10
Ileum f = 8/min
pacemakers present along entire lenght of si, each group of pacemaker cells drives ~1000 cells

27
Q

describe proximal vs distal stomach

A

f ber is greater
excitability of sm greater=easier to excite, need less ach
thickness of smooth muscle greater
both frequ and amplitude of muscle contractions greater in proximal si

28
Q

describe mechanism regulating intestinal mobility

A

ber generated by muscle fibers in si show aborally declining freq gradient - highest duo and lowest terminal illuem

29
Q

what is frequency gradient determined by

A

series of pacemaker regions along intestine - each with slightly lower freq than preceding one

30
Q

what does distribution of ber in time and space long intestine establish

A

distribution of spikes and contractions = thus the proximal portions of intestine show more activity than distal ones

31
Q

describe maximal contractile activity in si

A

cannot exceed ber freq of that gut segment

32
Q

what is most common type of contractile activity in si after meal

A

segmentation

33
Q

what is segmentation initiated by

A

Initiated by myogenic response to distension = response of circular muscle for effective mixing
ens organizes = coordinates and organizes contraction over length of si
ans and hormones modulate = parasymp increases and symp decreases

34
Q

what is function of segmentation

A

mixing and propulsion

35
Q

describe slow propulsion of segmentation of si

A

more contraction and stronger proximally = slow net aboral propulsion of contents

36
Q

describe proximal and distal segmentation

A

prox = more and stronger contractions
dist = fewer and weaker contractions
net aboral movement

37
Q

describe peristalsis in small intestine

A

Infrequent and irregular
weak, shallow
travels for short distances only a few cm = not over whole length

38
Q

describe intestinal peristalsis

A

mediated by series of local reflexes
involves interaction of longitudinal and circular muscles = max f cannot exceed f of ber
integrity of ens needed
modulated by ans and hormones

39
Q

describe the law of the intestine

A

radial stretch –> receptors –> neurally mediated =

ahead of bolus = contraction of longitudinal muscle and relaxation of circular muscle ahead of bolus - shorten the tube, low resistance
behind bolus = contraction of circular muscle and relaxation of longitudinal muscle behind bolus

40
Q

describe colon

A

ileocecal sphincter mostly closed 1500ml/d enters
cecum –> ascending colon –> transverse colon –> descending colon –> sigmoid colon
200ml/d = expelled from rectum, rest absorbed

41
Q

describe colon contractile activity

A

similar to si but slower, more sluggish and irregular
digestion and absorption of nutrients completed by SI
but some water and ions absorbed by COLON

42
Q

describe functions of colon

A

mixing = promotes absorption of water and ions
propulsion = slow 50-60h for conversion of chyme to feces
Storage= stored while absorbing

43
Q

describe motor activity of colon

A

segmentation and peristalsis governed by irregular ber

44
Q

how and when does li empty contents

A

2-3 times a day
Corresponding to intake of new meal
increase activity in colon and distal si

45
Q

name reflexes after intake of meal

A

gastroileal
gastrocolic
ileocolic

46
Q

describe gastroileal reflex

A

activate gastric region of stomach = increase activity in ileum
opening of illeocecal sphincter

47
Q

describe gastrocolic reflex

A

as stomach has new meal = stretch and increase activity of sigmoid colon if enough pressure = activate defacation reflex

48
Q

describe ileocolic reflex

A

small
increase activity in ileum = increase activity at distal end of colon

49
Q

describe interdigestive period

A

gi motility organized into intense pattern of cyclic myoelectric motor activity
reccuring at regular intervals = 90 mins
moving sequentially over distal stomach and si up to distal ileum = 2-10cm/min
MMC = migrating myoelectric (motor) complex

50
Q

what happens if have diarrhea

A

peristalsis in si to move contents along