Digestive I Flashcards

1
Q

What is the primary function of the digestive system?

A

move nutrients, water and electrolytes from the external environment into the body’s internal environment

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2
Q

The digestive system is central to regulation and integration of _______ processes throughout the body
and proper functioning necessary for whole-body __________

A

metabolic, homeostasis

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3
Q

The digestive system extends from ______
to the _____ intestine (~15 ft length in live person)

A

mouth, large

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4
Q

___ _____: a long tube with muscular walls lined by transporting and secretory epithelial cells

A

GI tract

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5
Q

Stomach to the anus = ___

A

GUT

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6
Q

________: mechanical and chemical breakdown of food primarily occurs in the gut (breakdown of macromolecules into smaller substances that can be transported across the epithelial cell layer

A

Digestion

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7
Q

The digestive system is joined by secretions from accessory glandular organs like the ______ ______, _____, ________, and ________

A

salivary glands, liver, gallbladder, pancreas

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8
Q

Technically GI tract is continuation of ______ environment (bacteria)

A

external

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9
Q

A lot of those bacteria in the large intestine serve functions that help us:
- breaking down certain _____ compounds
- creating certain _______
- releasing _________ into the body that are important in many processes like modifying the nervous system, angiogenesis, promoting the storage of fat, etc

A

food, vitamins, substances

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10
Q

____ refers to structures in the abdominal cavity, stomach down, most of digestion occurs here

A

Gut

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11
Q

Digestion begins in the mouth with ________ (chewing) and the addition of _____. Tongue and lips also helps manipulate food

A

mastication, saliva

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12
Q

Three pairs of salivary glands: ?

A

Parotid – at the hinge point of your jaw
Sublingual – under the tongue
Submandibular – along the mandible

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13
Q

Three pairs of salivary glands with multiple functions: ?

A
  1. Moisten and lubricate food
  2. Amylase partially digests polysaccharides
  3. Dissolve some food molecules (taste)
  4. Lysozyme kills bacteria
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14
Q

__________ also exist in the saliva

A

Immunoglobins

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15
Q

_______: passageway from mouth to stomach
-upper and lower esophageal sphincters

A

Esophagus

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16
Q

Esophagus wall: top 1/3 is ______ muscle, bottom 2/3 ______ muscle

A

skeletal, smooth

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17
Q

Esophagus moves food via _______ waves

A

peristaltic

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18
Q

Digestion continues in stomach, mixing food with acid and enzymes to create _____

A

chyme

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19
Q

What are the 3 main sections of the stomach (starting at the esophagus)?

A

Fundus, Body, Antrum

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20
Q

What and where is the pylorus?

A

At the end of the antrum, it is a valve/sphincter

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21
Q

_____ esophageal sphincter relaxes during swallowing
_____ esophageal sphincter permits the movement of food from esophagus into the stomach and prevents backflow

A

Upper, Lower

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22
Q

Majority of digestion and absorption takes place here ?

A

Small intestine

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23
Q

What are the 3 main portions of the small intestine (starting from the stomach)?

A

Duodenum (first 25cm)
Jejunum
Ileum

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24
Q

Liver and pancreas release exocrine secretions into the _______ (there’s another sphincter here that does this)

A

duodenum

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25
Q

What are the 5 main portions of the Large intestine (starting from the ileum)?

A

Cecum - initial pouch
Ascending colon
Transverse colon
Descending colon
Sigmoid colon

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26
Q

Feces entering the terminal section of the large intestine (rectum) trigger a __________ reflex

A

defecation

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27
Q

______ ________: 1.5 L of watery chyme pass into here each day; water and electrolytes removed to create semisolid feces

A

Large intestine

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28
Q

Basic structure of GI wall is similar in both the stomach and intestines with ______ variations from one section to another

A

slight

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29
Q

The four main GI layers:

A

mucosa, submucosa, muscularis externa, serosa

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30
Q

Starting from the lumen, it goes to mucosa, which is made up of three separate layers: ?

A

epithelial, lamina propria, and muscularis mucosa, not the normal muscle for digestion

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31
Q

Then we have the submucosa (contains the submucosal ______), next is the major muscle layer: muscularis ________.

A

plexus, externa

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32
Q

Finally, we have a dense connective tissue layer surrounding the entire outside of the GI tract called the _______.

A

serosa

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33
Q

Within the muscularis externa, we have another plexus (nerve network) known as the _________ plexus

A

myenteric

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34
Q

Enteric is technically under peripheral but what is different is that the ENS can function ________, it does not need input from the CNS to function. It does receive input but it can function normally without to some degree

A

autonomously

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35
Q

The _________ plexus – tends to influence the mucosal layer and the epithelial cells
The _________ plexus – tends to influence the muscle as well as communicate with the submucosal plexus

A

submucosal, myenteric

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36
Q

Mucosa is divided into 3 further layers:
- The _________: the layer that lines the single layer of cells that lines the innermost portion. A variety of different cells exist in the epithelium which facilitates the transport of substances from the lumen into the interstitial fluid and into the blood vessels
- _______ ______: connective tissue layer, largely contains interstitial space as well as vasculature (small blood vessels) and small lymph vessels
- _______ ______: not the normal smooth muscle layer, thin layer of smooth muscle that believes to influence the amount for surface area available for absorption

A

epithelium, Lamina Propria, Muscularis Mucosa

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37
Q

Gastric folds increase surface area: ______

A

Rugae

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38
Q

In the stomach, surface area is increased by invagination called _______ _______

A

gastric glands

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39
Q

Intestinal surface area is enhanced by fingerlike villi and invaginations called _____

A

crypts

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40
Q

______ further increase surface area

A

Plicae

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41
Q

_____ increase surface area so that you can absorb large amounts

A

Villi

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42
Q

There are also gastric glands contain a large number of cells that are responsible for _______ secretion and _________ secretion

A

exocrine, endocrine

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43
Q

Epithelium changes depending on the _______ of the GI tract

A

region

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44
Q

Most transport is ________, but there are areas where there is higher amount of _________ transport

A

transcellular, paracellular

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45
Q

Massive turnover in epithelial cells in the GI tract due to constantly being exposed to _____ _______

A

harsh substances

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46
Q

Epithelium (most variable):
- Include transporting epithelial cells, endocrine and exocrine secretory cells
- Junctions very _____ in stomach and colon, ______ in small intestine
- _______ lifespan (a few days) GI stem cells constantly producing new cells.

A

tight, leaky, Short

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47
Q

The epithelium alternates between many kinds of cells including simple columnar epithelium with microvilli and _________ _____

A

enteroendocrine cells

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48
Q

Lamina propria
Subepithelial tissue containing _____ fibres, small _____ vessels and _____ vessels

A

nerve, blood, lymph

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49
Q

Muscularis mucosae
Thin layer of ________ muscle that can alter the surface area available for ________

A

smooth, absorption

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50
Q

____________: middle distensible layer containing larger vessels (lymph and blood) and the submucosal plexus; one of the major nerve networks in the enteric nervous system

A

Submucosa

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51
Q

Submucosa is another layer of connective tissue that is relatively ________ (loose)

A

distensible

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52
Q

_______ _____: 2 or 3 layers of smooth muscle: circular decrease diameter, longitudinal shortens the tube. Contains myenteric plexus

A

Muscularis externa

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53
Q

_______: outer covering of connective tissue that is a continuation of the peritoneal membrane, sheets of mesentery hold intestines in place

A

Serosa

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54
Q

These are the four basic functions and processes of the GI tract: ?

A

Digestion, Secretion, Absorption, and Motility

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55
Q

Secretion can mean a few different things in the Gi tract:
1. It can mean the movement of substances from the ____ into the ______ (classic secretion)
2. It can also be the movement of substances that are produced in ________ cells into the lumen

A

ECF, lumen, epithelial

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56
Q

Motility is necessary for _________ digestion

A

mechanical

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57
Q

3 main challenges of the digestive system: ?

A

avoiding autodigestion, defense, and maintaining mass balance

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58
Q

________ _______: breaking food down into small enough molecules to be absorbed without digesting the cells of the GI tract

A

Avoiding autodigestion

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59
Q

_______: absorbing water and nutrients while preventing bacteria, viruses and other pathogens from entering the body. Mechanisms to help with this defense include mucus, digestive enzymes, acid and the largest collection of lymphoid tissue

A

Defense

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60
Q

80% of lymphocytes in ______ intestine

A

small

61
Q

We _______ a lot more than we actually _______

A

secrete, ingest

62
Q

What are 3 fluid secretions?

A

Water, Digestive enzymes, and Mucus

63
Q

________: Ions are transported from ECF into the lumen, creates osmotic gradient for water movement

A

Water

64
Q

________ ______:
Exocrine glands (salivary and pancreas)
Epithelial cells in stomach and small intestine

A

Digestive enzymes

65
Q

Some enzymes are released in an inactive form: ________ (stock pile without cellular damage)

A

zymogen

66
Q

_______: Viscous glycoprotein (mucins) secretions that protect GI cells and lubricate the contents; Serves as a protective function; Mucus cells in stomach and salivary glands, goblet cells in intestine

A

Mucus

67
Q

Most fluids facilitate _______

A

digestion

68
Q

Epithelial cells in one area may release certain enzymes and epithelial cells in certain areas may release different one and the reason for that is basically to suit where the enzymes _______ best

A

function

69
Q

What is the total input into the lumen from the digestive system?

A

9.0L

70
Q

________: movement of material through the GI tract as a result of muscle contraction

A

Motility

71
Q

Motility has two purposes: ?

A

Moves food from mouth to anus
Mechanically mixing food breaks it into uniformly small particles

72
Q

GI motility determined by properties of ______ muscle and modified by ______ input from nerves, hormones and paracrine signals

A

smooth, chemical

73
Q

When we are looking at motility in the digestive tract, most of the smooth muscle is arranged in single unit, or unitary formation where you have the presence of ______ junctions which allow contraction to occur in a uniform manner

A

gap

74
Q

True or False: the entire digestive tract is liked by gap junctions?

A

False, there are small sections throughout the digestive tract that would be linked together

75
Q

The cycles of contraction in the GI tract are driven by pacemaker cells that create _____ waves that can lead to contraction, they are depolarizations followed by repolarizations that will occasionally reach threshold and cause an action potential to fire

A

slow

76
Q

_____ waves: alternations of depolarization and repolarization that occur due to presence of a variety of ion channels

A

Slow

77
Q

Slow waves are almost always occurring, it’s the addition of ________ stimuli will cause threshold to be reached and contraction to occur

A

additional

78
Q

A tonic smooth muscle that is usually contracted. This is usually in the shape of a singular V and is found in _______

A

sphincters

79
Q

A phasic smooth muscle that cycles between contraction and relaxation. This is usually found in the _______ region of stomach, small, and large intestines

A

posterior

80
Q

_____ waves modified by chemical input from neurons, hormones and paracrine signals

A

Slow

81
Q

The force and duration of muscle contraction are directly related to the _____ and frequency of action potentials

A

amplitude

82
Q

Slow waves likely originate in a network of cells known as the ? (ICC)

A

interstitial cells of cajal

83
Q

? :modified smooth muscle cells serving as the pacemaker for slow wave activity

A

ICC

84
Q

Slow waves begin ________ in ICC and spread to adjacent smooth muscle through gap junctions, and are electrically coupled. 3-12 waves/min

A

spontaneously

85
Q

Three basic patterns of contraction occur in the GI system bringing about different types of movement: ?

A
  1. Migrating motor complex (motilin)
  2. Peristaltic Contractions
  3. Segmental Contractions
86
Q

? : between meals, when the GI tract is empty; usually begins in the stomach and passes from section to section, terminating at the ileum. Sweeps food remnants and bacteria out of the upper GI tract and into the large intestine

90-120 minutes (first 45-60 minutes quiescent) in between meals. 20-30 min period of infrequent peristaltic contractions. 5-15 minute cycle rapid forceful contractions

A

Migrating motor complex (motilin)

87
Q

__________ _________: contractions that cause forward movement, contraction of circular muscle behind a bolus of food and relaxation in front of the bolus to push the bolus forward. You would see this in the stomach and esophagus

A

Peristaltic Contractions

88
Q

__________ _________: in the small and large intestine during a meal and after a meal, serve as a mixing function, alternating contraction between circular and longitudinal

A

Segmental Contractions

89
Q

Motility is mainly consisted of ________ with a bit of __________ contractions mixed in

A

segmental, peristaltic

90
Q

_______ and ________ are the primary regulated functions in the GI system

A

Motility, secretion

91
Q

Two categories of regulation of GI function: ?

A

Neural
GI Peptides

92
Q

_______: through the ENS, the reason why the ENS can be almost considered independent is due to the short reflexes that can drive motility and secretion without influence from the CNS

A

Neural

93
Q

___ ________: cytokines can act as paracrines or autocrines

A

GI Peptides

94
Q

The ENS shares similarities with the CNS:

_______ neurons: entirely within the ENS
~30 ____________ many identical to CNS
______ support cells: similar to astrocytes
_______ barrier: like BBB
Integrating center: can function __________

A

Intrinsic, neurotransmitters, Glial, Diffusion, autonomously

95
Q

_______ reflexes originate in the enteric nervous system and are carried out entirely within the wall of the gut

______ reflexes are integrated in the CNS. Some long reflexes originate outside the GI tract, but others originate in the enteric nervous system

A

Short, Long

96
Q

_________ plexus: motility
___________ plexus: secretion from GI secretory cells

A

Myenteric, Submucosal

97
Q

If a long reflex begins in the brain it is a ________ reflex (feedforward and emotional)

A

cephalic

98
Q

ENS receives information from the CNS via __________ neurons

A

autonomic

99
Q

__________ increases/enhances GI function
__________ parasympathetic output causes increased motility and increased secretion
________ sympathetic output is inhibitory

A

Parasympathetic, Increased, Increased

100
Q

___ _________: Can act as hormones or paracrine signals; Excite or inhibit motility and secretion; Can be secreted in to lumen to act on apical membrane receptors or ECF to act on neighboring cells

A

GI Peptides

101
Q

True or False: GI peptides only act in the GI tract?

A

False, some act in the brain

102
Q

What are the 3 main hormone families?

A

Gastrin, Secretin, and Other

103
Q

Hormones are put into families based on similar _____ _____ structure or _______ receptors

A

amino acid, identical

104
Q

Integrated function within the digestive system is often described in three phases: ?

A

Cephalic/oral phase
Gastric phase
Intestinal phase

105
Q

_______ phase: digestive processes occurring before food enters the stomach and are reinforced once food enters the GI tract. Long reflexes beginning in the brain. Increased ___________ output from medulla to salivary glands and to the enteric nervous system

A

Cephalic, parasympathetic

106
Q

_______ phase: digestive processes in the stomach. 3.5 liters of food, drink and saliva enter the stomach each day. Motility and secretion initiated during cephalic phase now reinforced

A

Gastric

107
Q

_________ phase: digestive processes in the intestines

A

Intestinal

108
Q

Saliva is an _______ secretion

A

exocrine

109
Q

1.5 L/day of ______ is produced: 99.5% water, 0.5% solutes (Na+, Cl-, K+, HCO3-, PO4-)

A

saliva

110
Q

Secretory cells found in clusters known as _____

A

acini

111
Q

Glands are not identical:
_______: watery solution with amylase
__________: similar to parotid plus some mucus
_______: mainly mucus

A

Parotid, Submandibular, Sublingual

112
Q

Saliva tends to be __________

A

hypoosmotic

113
Q

Saliva is primarily under __________ control

A

parasympathetic

114
Q

When looking at salivary glands, there are 2-3* main types of cells:
_______ Cell: produces mucous
_______ Cell: produces a thinner, more liquid component
*_________ Cell: smooth muscle-like cell, contracts to squeeze saliva out of the lumen of the acini into the duct

A

Mucous, Serous, Myoepithelial

115
Q

__________ is a reflex that pushes a bolus of food or liquid into the esophagus

A

Deglutition

116
Q

Pressure against soft palate and back of mouth (voluntary) activate sensory neurons going to the ________

A

medulla

117
Q

________ (swallowing center): somatic motor outputs to pharynx and upper esophagus and autonomic outputs to the lower esophagus

A

Medulla

118
Q

Soft palate closes off nasopharynx, contraction moves larynx up and forward, glottis closes trachea, upper esophageal ________ relaxes and opens

A

sphincter

119
Q

Deglutition begins as a ________ reflex then turns into a largely involuntary reflex once it is initiated, means its hard to stop

A

voluntary

120
Q

Order these in accordance with “deglutition:”
1. Food moves downward into the esophagus, propelled by peristaltic waves and aided by gravity. Lower esophageal sphincter tension relaxes
2. Breathing is inhibited as the bolus passes the closed airway. The epiglottis covers airways
3. Tongue pushes bolus against soft palate and back of mouth, triggering swallowing reflex

A

3, 2, 1

121
Q

? : churning action of stomach contraction can cause backflow; negative intrapleural pressure during inspiration can cause esophagus to expand drawing gastric acid and pepsin from the stomach

A

Gastroesophageal reflux disease (heartburn)

122
Q

Lower Esophageal Sphincter technically not a true anatomical ________ as it does not have a circular thickening of muscle

A

sphincter

123
Q

Stomach has three general functions:

________: stores food and regulates its passage into the small intestine
________: chemical and mechanical digestion into chyme
________: Destroys bacteria and other pathogens in food and pathogens trapped in airway mucus (mucociliary escalator)

A

Storage, Digestion, Defense

124
Q

A lot of the digestive processes that are regulated, motility and secretion, within the stomach are driven by _________

A

distension

125
Q

Upon swallowing food, parasympathetic neurons to the ENS cause the fundus of the stomach to relax: ________ _______

A

receptive relaxation

126
Q

Distension of stomach enhances _______

A

motility

127
Q

Weak peristaltic waves that increase in force proceeding down to the antrum moves chyme toward pylorus (_________) and then larger particles are moved back to the body (_________). Mixes food with acid and digestive enzymes, small amounts of chyme squeeze through pylorus

A

propulsion, retropulsion

128
Q

Gastric secretions _______ and ______

A

protect, digest

129
Q

G-cells release ________ (hormone) in response to amino acids, peptides and distension (short reflex-GRP)

A

gastrin

130
Q

____________ neurons→ ENS: stimulate gastrin production during cephalic phase (long reflex). This stimulates gastric acid secretion directly from _______ cells

A

Parasympathetic, parietal

131
Q

_______: gastrin will go to parietal cells and simulate acid secretion from parietal cells
_________: Stimulates histamine release from enterochromaffin-like cells (ECL), which then stimulates parietal cells

A

Directly, Indirectly

132
Q

___ cells: stimulates gastric acid secretion

A

G

133
Q

________ Cells: activates pepsin; kills bacteria

A

Parietal

134
Q

_______ Cells: 1-3L of gastric acid (HCl) produced daily with a pH as low as 1. Stimulated by gastrin from G-cells, histamine from enterochromaffin-like cells (ECL) or ACh from from ENS neurons via long and short reflexes

A

Parietal

135
Q

______ acid stimulates release of pepsinogen from chief cells, cleaves pepsinogen to pepsin (digests proteins)

A

Gastric

136
Q

Gastric acid denatures proteins making it easier for _____ to function and kills bacteria and other ingested microorganisms

A

pepsin

137
Q

Gastric acid inactivates _______ from saliva and stimulates D cells to release somatostatin

A

amylase

138
Q

Pepsinogen is the inactive form of ______

A

pepsin

139
Q

Order these statements in accordance with “acid secretion:”
1. HCO3- exchanged for Cl- at basolateral membrane
2. Water dissociates to H+ and OH- freeing up more H+ to be actively transported
3. Cl- diffuses across apical membrane through open channels following electrochemical gradient
4. OH- combines with CO2 via CA to generate HC03-
5. Free H+ actively transported across apical membrane

A

5, 2, 4, 1, 3

140
Q

In acid secretion:

H/K ATPase is important as a ______ pump
Bicarbonate/Cl transporter on the __________ membrane

A

proton, basolateral

141
Q

Here are 3 stimuli for acid secretion:

  1. ______ H+/K+ ATPase, Cl- and K+ transporters stored in vesicles
  2. Stimuli cause _______ and insertion of apical transporters
  3. Excessive _____ treated with H2 receptor antagonists or proton pump inhibitors
A

Apical, exocytosis, acid

142
Q

_________ hormones can also inhibit acid secretion

A

Intestinal

143
Q

Gastric digestive enzyme secretion is stimulated by acid secretion via ______ reflex

A

short

144
Q

_______ Cells: primarily produce pepsinogen, and small amounts of gastric lipase

A

Chief

145
Q

Primarily the digestion of proteins that occurs in the stomach is in response to _______

A

pepsin

146
Q

Paracrine secretion:

____: Histamine; activates H2 receptors on parietal cells to stimulate HCl secretion
________ cell: intrinsic factor; forms a complex with Vit B12 so it can be absorbed
___ cell: somatostatin; negative feedback for acid secretion (G cells, parietal cells and ECL cells); inhibits pepsinogen release

A

ECL, Parietal, D

147
Q

Mucus and HCO3- secreted from ______ cells. Mucus secretion stimulated by _________ input and irritation. HCO3- by parasympathetic input and H+

A

mucous, parasympathetic

148
Q

_____ _____: a sore or break in the lining of the stomach or duodenum

A

Peptic ulcer

149
Q

_____ ______ are caused by excessive acid production and gastrin secreting tumors

A

Peptic ulcers