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BMSC 208 > Digestive II > Flashcards

Digestive II Flashcards

1
Q

5.5 L of food, fluid and secretions enter the small intestine, what is this made up?

A

2 ingested +1.5 saliva+2 gastric

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2
Q

5.5 L of food, fluid and secretions enter the small intestine, an additional 3.5 L added from ?

A

hepatic (0.5), pancreatic (1.5) and intestinal (1.5) – accessory glands and intestinal wall

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3
Q

______ regulated to ensure proper digestion and absorption

A

Motility

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4
Q

A combination of _________ and __________ contractions mix the chyme with enzymes and expose digested nutrients to mucosal epithelium for absorption (7.5 L absorbed mainly in duodenum and jejunum).

A

segmental, peristaltic

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5
Q

Parasympathetic innervation, gastrin and cholecystokinin promote _______

A

motility

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6
Q

Sympathetic innervation _______

A

inhibits

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7
Q

Up until the _______ intestine, there is really no chemical digestion

A

small

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8
Q

Plicae and villi increase _______ _____

A

surface area

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9
Q

Villi increase surface area available for _________ and secrete ______

A

absorption, mucus

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10
Q

_______ contain hormone and fluid secretory cells + stem cells

A

Crypts

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11
Q

Most nutrients are absorbed into capillaries in the _____

A

villi

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12
Q

Fats enter _______ of lymphatics

A

lacteals

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13
Q

Venous blood from GI tract does/ does not go directly to heart

A

does not

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14
Q

What is the hepatic portal system?

A

where the liver acts as a biological filter

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15
Q

Hepatic artery brings _______ to the liver
Hepatic portal vein brings _______ blood and nutrients to the liver

A

oxygen, deoxygenated

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16
Q

Liver acts as a biological filter: contain a variety of enzymes that metabolize drugs and xenobiotics and clear them from the blood stream before it can proceed to _______ _______

A

systemic circulation

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17
Q

In the hepatic portal system, drugs given orally commonly have a ______ dose than IV

A

higher

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18
Q

What are the 4 main digestive enzymes?

A

Bile, bicarbonate, mucus, and isotonic saline

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19
Q

intestine epithelium: ______ ______ enzymes and pancreas

A

brush border

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20
Q

_____ (liver, stored in gallbladder), helps to digest fats

A

Bile

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21
Q

_________ (pancreas), need a large amount of in the duodenum to neutralize the acid

A

Bicarbonate

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22
Q

Mucus (_____ cells)

A

goblet

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23
Q

Isotonic saline (______ cells), lubricates contents of gut

A

crypt

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24
Q

Order these statements according to “isotonic saline:”
1. Cl- enters lumen through CFTR channel
2. Negative Cl- in lumen attracts Na+ by paracellular pathway. Water follows.
3. Na+, K+, and Cl- enter by cotransport
4. Na+ is reabsorbed

A

3, 2, 4, 2

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25
Q

The pancreas contains _________ secretory epithelium (islets): insulin and glucagon

A

endocrine

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26
Q

The pancreas contains _______ secretory epithelium: digestive enzymes and NaHCO3

A

exocrine

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27
Q

Stimuli for ______ include distension of small intestine, neural signals, CCK

A

exocrine

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28
Q

Pancreatic acini form the ________ portion of the pancreas

A

exocrine

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29
Q

Duodenum has an important sphincter called the sphincter of _____ that facilitates the passage of substances produced in the pancreas into the duodenum

A

oddi

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30
Q

Pancreatic acini cells that make up the clusters are important in making _________ enzymes

A

digestive

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31
Q

Duct cells that line the walls of the ducts themselves are important in making _________

A

bicarbonate

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32
Q

Many pancreatic digestive enzymes released as ________

A

zymogens

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33
Q

Trypsinogen converted to trypsin by ___________ (brush border enzyme)

A

enteropeptidase

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34
Q

_______ then activates zymogens

A

Trypsin

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35
Q

_________ produced in duct cells neutralizes acid entering from stomach

A

Bicarbonate

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36
Q

Order these statements according to “bicarbonate secretion:”
1. Calls that produce bicarbonate have high concentrations of carbonic anhydrase
2. Leaky junctions allow paracellular movement of ions and water. Negative ions in the lumen attract Na+ by the paracellular pathway. Water follows
3. Chloride enters cells by indirect active transport and leaves the apical side through a CFTR channel. Cl- then reenters the cell in exchange for HCO3-

A

1, 3, 2

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37
Q

What is the cause of Cystic Fibrosis?

A

Reduced ability to produce saline in the pancreas – low amounts of chloride transported, mucus cells in the pancreas continue to produce mucus and eventually clog the ducts, results in pancreatitis as well as a reduction in digestive enzymes that make it into the small intestine

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38
Q

Cystic fibrosis alters ______ secretions

A

pancreas

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39
Q

The _____ is the largest of the internal organs in an adult

A

liver

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40
Q

Bile _______ – bile vessels that run go from hepatocytes to out portion of hepatic lobule

A

canaliculi

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41
Q

Bile: a non-enzymatic solution secreted from _________

A

hepatocytes

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42
Q

What are the 3 main components of bile?

A

Bile salts
Bile pigments
Cholesterol

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43
Q

bile salts (bile acid/amino acid) – from ___________

A

cholesterol

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44
Q

Bile pigments (bilirubin) – byproduct from _____ breakdown gives yellow color

A

heme

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45
Q

_________ and drugs excreted in bile

A

xenobiotics

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46
Q

Fats and related molecules include:
1. __________ (90%)
2. __________
3. ____________
4. long chain fatty _____
5. fat soluble _________

A

triglycerides, cholesterol, phospholipids, acids, vitamins

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47
Q

True or False: fats are not very water soluble?

A

true

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48
Q

A coarse emulsion of large fat droplets in chyme broken to smaller, stable particles by bile _______.

A

salts

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49
Q

Bile doesn’t digest fats it _______ them

A

emulsifies

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50
Q

_______- are what digest fats, but on its own cannot cross the bile salt border

A

Lipases

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51
Q

________ gets lipase into the small droplets

A

Colipase

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52
Q

_________ come in to contact with brush border: fatty acids and monoglycerides diffuse through enterocyte membrane

A

Micelles

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53
Q

____________ are a large lipoprotein structure transport vessel for fats, too large to get across the basolateral membrane so they are packaged by the Golgi into vesicle, and then exocytosed

A

Chylomicrons

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54
Q

Order these statements according to “fat digestion and absorption:”
1. Pancreatic lipase and colipase break down fats into monoglycerides and fatty acids stored in micelles
2. Absorbed fats combine with cholesterol and proteins in the intestinal cells to form chylomicrons
3. Monoglycerides and fatty acids move out of micelles and enter cells by diffusion
4. Bile salts from liver coat fat droplets
5. Chylomicrons are removed by the lymphatic system
6. Cholesterol is transported into cells

A

4, 1, 3, 6, 2, 5

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55
Q

__% bile salts excreted in feces

A

5

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56
Q

_________: hardened deposits likely due to excess cholesterol or bilirubin and causes upper right abdominal pain, jaundice

A

Gallstones

57
Q

People can live perfectly normal lives without the _________

A

gallbladder

58
Q

Carbohydrates ingested include: ______ and ______

A

starch, sucrose

59
Q

Glucose _______ (glycogen, cellulose), __________ (lactose, maltose), ______________ (glucose and fructose)

A

polymers, disaccharides, monosaccharides

60
Q

_______ (salivary and pancreatic) break down glucose polymers to disaccharides (maltose)

A

Amylase

61
Q

Disaccharides are then broken down by intestinal brush border enzymes known as ____________

A

disaccharidases

62
Q

Normally glucose is phosphorylated when entering a cell, but enterocytes primarily use ________ so glucose-6-phosphate is not formed and free [glucose] stays ______ facilitating basolateral transport

A

glutamine, high

63
Q

Glucose absorption within the small intestine, 2 apical transporters:
1. Responsible for glucose and galactose: _______-______ transporter
2. ________ transporter (GLUT5) through facilitated diffusion

A

sodium-glucose
Fructose

64
Q

Glucose absorption within the small intestine, 1 basolateral transporters:
Glucose, galactose, and fructose all use the same ________-___ transporter, allows facilitated diffusion

A

glucose-2

65
Q

True or False: all proteins equally digestible

A

False

66
Q

___-___% of digested proteins are not from ingested foods: dead cells, enzymes and mucus

A

30, 60

67
Q

Two broad categories of of enzymes for protein digestion:
1. _____________
2. _____________

A

Endopeptidase, Exopeptidase

68
Q

____________: classic proteases that cleave peptide bonds and convert larger proteins into peptides. Important ones include pepsin, trypsin and chemotrypsin

A

Endopeptidases

69
Q

____________: release single amino acids from peptides one at a time, cut off single amino acids at either the amino/carboxy terminal end

A

Exopeptidase

70
Q

____________: amino-terminal end, brush border enzyme

A

Aminopeptidases

71
Q

______________: carboxy-terminal end. Pancreatic A1, A2 and B

A

Carboxypeptidases

72
Q

Are aminopeptidases and carboxypeptidases endo/exopeptidases?

A

Exopeptidase

73
Q

After digestion, proteins are absorbed mostly as free ______ _____. A few di- and tripeptides are absorbed.

A

amino acids

74
Q

Most single AA’s on Na cotransporters (______) and Na exchangers (_________)

A

apical, basolateral

75
Q

Di and tripeptides on oligopeptide transporter (H+ ___________)

A

cotransporter

76
Q

Most oligos digested to single AA’s in cell (__________) and exit via Na-AA exchanger

A

peptidases

77
Q

Cotransporters are based on ____ and ______

A

size, charge

78
Q

Some peptides larger than 3 AA’s transported via _______ (followed by receptor mediated endocytosis, vesicular transport, then exocytosis) after binding to a receptor on the luminal surface

A

transcytosis

79
Q

Small peptides could potentially act as ______ stimulating antibody production causing an allergic reaction

A

antigens

80
Q

Peptide absorption ____ when infant (villi are small), may play a role in food intolerances or allergies

A

high

81
Q

Fat soluble vitamins (___, ___, ___ and ___) absorbed with fats

A

A, D, E, K

82
Q

Water soluble (___ and most ___) are absorbed by mediated transport

A

C, B

83
Q

____ is absorbed in the ileum after forming a complex with intrinsic factor released from parietal cells – important in DNA synthesis

A

B12

84
Q

Mineral absorption is usually by _____ transport

A

active

85
Q

_____ absorption is somewhat controlled because high levels in the body can cause toxicity; ______ is also somewhat regulated

A

Iron, Calcium

86
Q

Most _____ absorbed in the small intestine, and moves through the paracellular pathway

A

water

87
Q

Regulated by _______, ______, and _______ products in the small intestine through short and long reflexes and endocrine signaling. Reduces motility and secretions in the stomach, increases in the intestine

A

distention, acidity, digestive

88
Q

Intestinal motility primarily regulated by ____ neurons

A

ENS

89
Q

S cell: ________

A

secretin

90
Q

I cells: __________

A

cholecystokinin

91
Q

K cells: ?

A

glucose-dependent insulinotropic peptide (GIP)

92
Q

L cells: ?

A

glucagon-like peptide 1 (GLP-1)

93
Q

S cells, I cells, K cells and L cells are all considered ____________- cells

A

enteroendocrine

94
Q

The migrating motor complex (MMC) is a series of contractions that begin in the _____ stomach and end in the _____ intestine

A

empty, large

95
Q

Mo cells - _______

A

motilin

96
Q

Mo cells are possibly stimulated by _______ pH

A

alkaline

97
Q

Secretions (from accessory organs):
____ reflexes

A

Long

98
Q

S, I, K, and L cells are all also considered ____ _______

A

GI peptides

99
Q

Pancreatic secretions begin during the _____ and _____ phases

A

cephalic, gastric

100
Q

Pancreatic secretions includes the _________ reflex

A

enteropancreatic

101
Q

________: stimulated by acid entering the duodenum from the stomach

A

Secretin

102
Q

Secretin’s primary role in regulation of pH
1. Stimulates ______ secretion from pancreas
2. Inhibition of ______ acid secretion

A

bicarbonate, gastric

103
Q

____________ reflex: the presence of different food components will send sensory info back to the CNS and will further increase parasympathetic output into those acinar cells as well as those duct cells

A

Enteropancreatic

104
Q

_____________: stimulated by the presence of fatty acids and amino acids in chyme

A

Cholecystokinin

105
Q

Cholecystokinin’s primary role
1. Regulates _______ enzyme secretion
2. Regulates _____ secretion

Also inhibits gastric acid production and emptying

A

pancreatic, bile

106
Q

What is the % of maximum enzyme secretion of the cephalic phase?

A

25%

107
Q

What is the % of maximum enzyme secretion of the gastric phase?

A

10-20%

108
Q

What is the % of maximum enzyme secretion of the intestinal phase?

A

50-80%

109
Q

___ Cells: normal function is promoting insulin secretion

A

K

110
Q

GLP-1 also plays a role in ______ secretion

A

insulin

111
Q

Acid, enzymes and digested food results in ________ chyme that inhibits gastric emptying

A

hyperosmotic

112
Q

The _____ intestine concentrates waste

A

large

113
Q

Approximately 1.5 L of chyme proceed through ________ valve, which relaxes as contraction proceeds through ileum

A

ileocecal

114
Q

________ Reflex: food in stomach causes contraction of ileum and relaxation of ileocecal valve

A

Gastroileal

115
Q

_______ is now thought to act as a reservoir for good bacteria

A

Appendix

116
Q

_________: minimal and primarily consists of mucus from goblet cells

A

Secretions

117
Q

__________: Traditionally believed that zero digestion occurs in the large intestine.

A

Digestion

118
Q

Indigestible complex carbohydrates, fats and proteins are broken down by _______ through fermentation processes

A

bacteria

119
Q

__________ produces lactate and short chain FA’s used by colonocytes for energy production; produces absorbable vitamins (Vit K); produces gases

A

Fermentation

120
Q

Incomplete _________ muscle causes different forms of contraction to occur

A

longitudinal

121
Q

Taenia Coli are always in a semi _______ state

A

contracted

122
Q

Motility has 3 components:
1. Slow ________ contractions (contraction of circular muscle)
2. ________ rolling or churning
3. Mass ________

A

segmental, Haustral, peristalsis

123
Q

Haustral rolling or churning is characterized by thickened bands of longitudinal muscle layer ______ ____ and create pouches called _______

A

taenia coli, haustra

124
Q

Mass peristalsis: ________ reflex, stimulated by food in stomach 2-3 times/day

A

gastrocolic

125
Q

Two reflexes initiated by distension of the rectum: ?

A

Short reflex
Long reflex

126
Q

______ reflex:
-local peristaltic waves
-relaxation of internal sphincter (smooth muscle

A

Short

127
Q

______ reflex
-more forceful peristaltic contractions from parasympathetic input

A

Long

128
Q

Defecation is completed by ________ relaxation of external sphincter (skeletal) and aided by ________ contractions

A

voluntary, abdominal

129
Q

________: an increase in the frequency, volume and fluid content of the feces due to increased secretion, reduced absorption or increased motility

A

Diarrhea

130
Q

________: osmotic, secretory, inflammatory, motility induced

A

Diarrhea

131
Q

_______ causes extreme diarrhea

A

Cholera

132
Q

The use of _________ based antibiotics can alter the normal bacterial flora. The remaining bacteria have reduced __________ for space and nutrients and leaves you prone to infection by C. difficile

A

penicillin, competition

133
Q

_______: watery diarrhea, fever, nausea, and abdominal pain

A

Colitis

134
Q

________: contents of the stomach and occasionally the small intestine are forcefully expelled through the mouth and is associated with nausea

A

Vomiting

135
Q

Vomiting center in the medulla causes three primary responses:

  1. _________ contractions in the small intestine and stomach
  2. contraction of ________ and inspiratory muscles (diaphragm) increases gastric pressure
  3. relaxation of esophageal ________
A

retrograde, abdominal, sphincters

136
Q

Some of the causes of vomiting:
1. Disturbances of _______
2. ______ input from drugs, toxins, metabolites
3. Input from _______ receptors in stomach and intestines carried by afferent fibers

A

balance, Direct, sensory

137
Q

______ _____: accumulation of lymphoid tissue

A

Peyer’s patch

138
Q

___ cells play a big role in immune responses: sample lumen contents

A

M

139
Q

M cells play a big role in immune responses:
1. receptor mediated ________
2. transport ______ to macrophages, lymphocytes, and dendritic cells
3. release ______ to attract more immune cells to attack invaders
4. cytokines can also trigger increased Cl- secretion (diarrhea) to flush out _______

A

endocytosis, antigens, cytokines, pathogens

BMSC 208 (11 decks)

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