Digestion Shtuff Flashcards
What is the most common receptor that mediates salivary function?
M3 (muscarinic receptor-Ach)
What is the most common infection as a result of xerostomia?
Candidiasis
What are the three parts of a basic unit of a salivary gland?
1.An Acinus 2.An intercalated duct 3.A striated duct
What are the elongated or star-shaped non-secreting cells with long branching processes that contract to eject saliva in the mouth?
Myo-epi-thelial cells
QUICK: ACINUS TYPE, and % of SALIVA for the Parotid gland
SEROUS, 25% of saliva
QUICK: ACINUS TYPE, and % of SALIVA for the Submandibular gland
MIXED, 71% of saliva
QUICK: ACINUS TYPE, and % of SALIVA for the Sublingual gland
Mucous, 3-4% of saliva
QUICK: ACINUS TYPE, and % of SALIVA for the Minor (Buccal) glands
Mucous, Trace % of saliva
What duct drains the parotid gland? Where can I find it?
Stensen’s Duct…by the upper 2nd molar
What duct drains the submandibular gland? Where can I find it?`
Wharton’s Duct…Base of the underside of tongue
What duct(s) drain(s) the sublingual gland? Where can I find them?
Ducts of Riv-in-us..along the sublingual fold on the floor of the mouth
What are the three most important salivary proteins?
Salivary Alpha-Amylase, Lingual Lipase, Mucins
What type of bond does salivary alpha-amylase NOT cleave?
Salivary alpha-amylase does NOT cleave TERMINAL alpha-1,4 linkages NOR alpha-1,6 linkages.
Which saliva component attacks bacterial cell walls?
A Lysozyme
Which saliva component chelates iron and therefore prevents multiplication of organisms that require iron for growth?
LactoFerrin
Which salivary component is active against certain viruses and bacteria?
IgA
On activation, chemo and pressure receptors initiate impulses in ______ nerve fibers that carry the information to the salivary center of the _______.
afferent….medulla
What are the two CNs that control parasympathetic signals for salivation?
VII and IX
_______ and other cholinergic blocking agents reduce salivary secretion. (COOL can use it in the clinic on over salivating patients!)
Atropine
What type of receptors control parasympathetic pathways for salivation?
Muscarinic
What type of receptors control sympathetic pathways for salivation?
Beta-2
What nerves control sympathetic stimulation of salivary glands?
T1-T3
What regulates movement of contents of the common bile duct into the duodenum?
Sphincter of Oddi
What is the accumulation of peritoneal fluid?
Ascites (swelling) “Ass-eye-tee’s”`
What are the 4 tunics/layers of the GI from Lumen—>Out?
1.Mucosa 2.Submucosa 3.Muscularis Externa 4.Serosa (AKA Visceral Peritoneum
What are the two plexi that are termed the intrinsic nerve plexus or the ENTERIC nervous system?
1.Submucosal Plexus 2.Myenteric Plexus
What are the four parts of the GI tract innvervated by the VAGUS nerve? What % of the Vagus nerves are afferent?Efferent?
ALL UPPER! 1.Esophagus 2.Stomach 3.Small Intestine 4.Ascending Colon…75% Afferent…25%Efferent
What nerves innervate the lower GI tract (Transverse, Descending, and Sigmoid colons and the anal canal)? What are the origins of these nerves?
The Pelvic Nerves (Pelvic Splanchnic)…Origins:S2,S3,S4 (keep the poo off the floor)
What are the 5 taste qualities? What is an example of each?
Salty (NaCl), Sweet (Sucrose), Sour (Citric Acid), Bitter (QUININE hydrochloride), Umami (MSG)
What type of papillae is mushroom like, is scattered over entire tongue surface, but is most abundant at its tip and along its anterior sides?
FungiForm
What 2 tastes do fungiform papillae USUALLY respond to? What is the tertiary taste?
Sweet & Salty….also sour
What type of papilla are folded structures, is most abundant on the middle edges of the tongue, and mainly respond to SOUR?
Foliate Papillae
What CN AND BRANCH of that CN innvervates the anterior 2/3 of the tongue?
VII, Chorda Tympani
What papilla is the largest and least numerous and mostly responds to BITTER?
CircumVallate
Which papillae does CN IX innervate?
Circumvallate and foliate (post 1/3 of tongue)
Which CN innvervates the taste buds on the epiglottis?
CN X-VAGUS!
Which CN innervates the taste buds on the palate?
CN VII-FACIAL
What are the three types of cells in a taste bud?
1.Taste Receptor Cells (TRC) 2.Basal cells 3.Supporting cells
Taste receptor cells are technically NOT ______. Instead, taste receptor cells synapse onto afferent nerve endings of CNs ___, ___ and ___.
neurons…VII,IX, and X
Where do taste CN afferents terminate? Where is this located?
Nucleus of the solitary tract (solitary nucleus)…Located in the brainstem
Where in relation to the cervical vertebrae is the pharynxgoesophageal junction?
C5-C6
What type of epithelium is in the esophagus?
Non-Keratinized Stratified Squamous Epithelium
What is the condition where the LES (Lower Esophageal Sphinter) FAILS to relax? What is the main danger?
“AK-AH-LAY-SHA” —–Achalasia…Main danger is aspiration into the lungs when the person lies down
What is the result of decreased closing strength of the LES and therefore permitting acidic gastric contents into the esophagus?
GERD-GastroEsophageal Reflux Disease
What type of cancer is related to GERD?
Esophageal AdenoCarCinoma
What is the HALLMARK of Barrett’s Esophagus on a cellular level?
METAPLASIA of Squamous Epithelium to Columnar Epithelium
KEY TO DRUG understanding: What molecules play an important role in protecting the stomach mucosa from injury by enhancing mucus production?
PROSTAGLANDINS-Using NSAIDs block prostaglandin production and can cause weakening of the mucosal layer
The mucosal surface of the stomach is a ___________ epithelium.
Simple Columnar
Which cells secrete alkaline mucus?
Mucus Neck Cells
Which cells secrete HCl & Intrinsic Factor?
Parietal Cells—aka–“OX-IN-TIC (oxyntic)” cell
What are the two main functions of Intrinsic Factor?
Absorption and ErythroPoesis
Which cells secrete pepsinogen and Gastric Lipase?
Chief Cells–aka–“ZY-MO-GENIC” cell
Which cells secrete Gastrin (G cells) & Histamine (ECL cells)?
Endocrine Cells
The _____ junctions between the cells are also part of the mucosal barrier that protects the gastric epithelium from damage.
Tight
What hormone and cell stimulates parietal cells to produce IF and HCl?
Gastrin from Endocrine Cells (G cells)
Which hormone increases levels of HCl secretion from parietal cells?
HISTAMINE
What converts Pepsinogen to Pepsin?
HCl
What are the three hormones that INHIBIT gastric juice secretion in Intestinal Phase?
1.CCK (“Cole-E-sis-TA-K-eye-NIN”) 2. Secretin 3.Gastric Inhibitory Peptide
What are the three HORMONES that can stimulate H+ production in a Paritetal Cell?
- Histamine 2.Gastrin 3.Vagus Nerve-Acetylcohline
What enzyme does H. Pylori produce to survive in the stomach? What is the by product of that enzyme?
Urease….Ammonia (basic to neutralize the acidic gastric juice)
What does Intrinsic Factor bind to? Where does it do this?
IF binds to Vitamin B12 in the Small Intestine
What is the result of inadequate Vit B12 absorption? What do the RBCs look like?
Pernicous Anemia, Megaloblastic cells
What are the oral manifestations of pernicious anemia?
erythematous (red) mucosal lesions
How does Benedryl cause dry mouth?
the anti-histamine CROSS reacts with muscarinic receptors (especially high dose) causing blockage of the parasym activity
What does pancreas endocrine function refer to?
Insulin and Glucagon
What does pancreas exocrine function refer to?
Pancreatic Juice
What are the two main cell groups of the pancreas? What % composition?
1.Islets of Langerhans (endocrine)-5% 2.Ascinar cells (exocrine cells)-95%
What is the INFAMOUS region where the Bile Duct Sphincter, the Pancreatic Duct Sphincter, and the Sphincter of Oddi all join together?
the Papilla of Vater (NOT darth Vader)
What converts Trypsinogen to Trypsin? Where does this happen?
EnteroKinase(EnteroPeptidase)..At the entrance of the Duodenum
What are the two hormones controlling pancreatic juice secretion? What are their products like?
1.Secretin-Pancreatic Juice that’s RICH in HCO3- and LOW in enzymes. 2.CCK-Pancratic Juice that’s Rich in enzymes and Low in HCO3-
What CN stimulates secretion of pancreatic juice? How does this juice compare to to Secretin/CCK? What triggers this CN response?
VAGUS X! A juice rich in enzymes, but not as much as CCK. The SIGHT or SMELL of food can trigger this!
What are the two main causes for Pancreatitis?
1.Gallstones in the common bile duct 2.EtOH
The commonly used term “pancreatic cancer” usually refers to a _____________ of the pancreas (including its subtypes).
ductal adenocarcinoma
What does BLOOD use for transportation from the hepatic portal veins to the central vein of a lobule?….What does BILE use for transportation from the central vein area of the lobule to the blue duct?
A sinusoid…A Canaliculus
What makes up the almighty liver lobule?
ROWS and ROWS of Hepatocytes
What are the contents of the Portal TetRad?
1.A Portal Vein 2.A Hepatic Artery 3.A Bile Duct 4.A lymphantic vessel
Where do hepatic macrophages hang out? What are they called?
Kupffer Cells…they hang out in the blood SINUSOIDS
Where does the Common Hepatic Artery branch out of off the aorta?
The Celiac Trunk!
What are the three main branches supplying the portal liver vein with deoxygenated, nutrient rich blood?
Splenic Vein, Inferior Mesenteric, Superior Mesenteric
The sinusoids of the liver are lined by a ________ endothelium. An have NO _____________….THIS permits blood plasma to wash freely over the exposed surfaces of the hepatocytes in the ___________ (___________).
fenestrated—LATIN for window….NO underlying basement membrane…SPACE OF DISSE (perisinusoidal space)
LIVER-Sinusoidal blood flow is always ________ the central vein.
TOWARDS
How does Bile drain the liver? (3 steps)……Which duct leads bile from the liver to the Gall Bladder?
1.R/L Hepatic Duct 2.Common Hepatic Duct 3.Common Bile Duct……..Cystic Duct
You ready for the BOOM?! How bad do you want that A?! WHAT ARE THE 13 MAJOR LIVER FUNCTIONS? This is a mastery type flashcard..
1.GlycogenoLYSIS 2.Glycogenesis 3.Protein Metabolism 4.Urea Synthesis 5.Lipid Metabolism 6.Hormone Metabolism 7.Iron Metabolism/Storage 8.Vitamin Storage 9. Drug Detoxification 10. Vitamin D Activation 11. Plasma Protein Synthesis 12. Clotting Factor Synthesis 13. Bile Synthesis
What 2 enzymes are required for the first step in amino acid degradation?
1.Aspartate TransAminase (AST) 2.Alanine TransAminase (ALT)
What is the name of the cycle where ammonia is converted into urea?
the Anders ÖRN-ith-ine Cycle!
What is a BUN? What is a normal BUN range? What is the most common reason for increase in BUN?
Blood Urea Nitrogen…5-26 mg/dL in adults…impaired liver function
Which lipoproteins are carrying cholesterol/fats from the liver to the body? (2 types)
VLDLs and LDLs
Which lipoproteins carry cholesterol/fats from the body and bring it to the liver?
HDL
WHAT IS THE CATALINA WINE MIXER of endogenous cholesterol synthesis?
HMG-CoA REDUCTASE!!
REVIEW: What are the three Ketone Bodies?
1.Acetone 2.Beta-Hy-droxy-but-yric Acid 3.Aceto-Acetic Acid
What molecule STORES iron in the liver?
Ferritin
What is the form of iron in the blood?
Transferrin
What three vitamins are stored in LARGE quantities in the liver?`
Vitamins A, B12, and D
What DDI results in DECREASED metabolic activity of CP450 enzymes, leading to DECREASED metabolism of drugs?
CP450 INHIBITION…Grapefruit juice inhibits the metabolism of cocaine!
Which DDI results in INCREASED activity of CP450 enzymes leading to INCREASED metabolism of the drugs?
CP450 INDUCTION…Ethanol speeds up the metabolism of tylenol or BROCCOLI speeds up the metabolism of caffeine!
What is the final, active product of Vit D activation? What hormone stimulates the final steps?
1,25-Di-Hydroxy-chol-e-cal-ciferol…PTH
WHAT ARE THE 9 clotting factors synthesized in the liver?
1,2—–5——7, 8, 9, 10, 11, 12…EASY as PIE!
REVIEW: What are the three MAIN types of plasma proteins? Are these the only proteins found in the blood?
- Albumin 2.Globulin 3.Fibrinogen…HELL NAW, not the only proteins found in the blood!
What are the two PRIMARY Bile Acids? What are they synthesized by? What are the two AA’s used to turn bile acid into bile salt?
Cho-Lic Acid and Chen-o-deoxy-Cho-Lic Acid…Synthesized by the liver….GLYCINE or TAURINE
Bilirubin is a waste product of _______ degradation.
Hemoglobin
Which stomach enzyme is inactivated in the duodenum because of the increased pH?
Pepsin!
What are the mucus producing cells of the SI?
Goblet Cells
What epithelial cell type composes the majority of enterocytes in the SI?
Simple Columnar Epithelial cell
Glucose and galactose are ABSORBED (via _______ _______ transport) through a ___-dependent cotransporter known as _____.
secondary active…Na+…..SGLT1
Fructose ENTERS by _______ _______ via ______ ______ ___ (_____) that does not require ___.
facilitated diffusion…..glucose transporter 5 (GLUT5)….Na+
ALL monosaccharides are transported OUT of the enterocytes and into the capillaries by ____’s (via ______ ______).
GLUT2’s…(via facilitated diffusion)
What is the size limit for bringing peptides/AA’s into an enterocyte?
Tripeptides, Dipeptides, and single AAs can enter the cell
What is the drug aimed at increasing HDL? What does this drug REDUCE?
Niacin (Nicitinic Acid, Vitamin B3)..Also reduces VLDL production
What are the two inflammatory intestinal disorders that make up Inflammatory Bowel DISEASE (not syndrome!!)
1.Crohn’s Disease 2.Ulcerative Colitis (UC)
WHAT IS THE HALLMARK OF CROHN’S DISEASE?
COBBLESTONE
Which IBDisease has oral manifestations?
Crohn’s!
Which OMENTUM connects the lesser curvature of the stomach and the first part of the duodenum to the liver?
Lesser Omentum!
Which OMENTUM connects the transverse colon to the stomach?
Greater Omentum!
Common hepatic artery is a branch of ______
celiac trunk
Epithelial cells of the small intestine show surface modification known as
the striated border
which one passes thru the diaphragm: the aorta or the esophagus?
esophagus
Enterogastric reflex = decrease in _______
gastric mobility
