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A&P II IPAP 3-17 > Digestive Part II > Flashcards

Digestive Part II Flashcards

1
Q

What is clinically indicated when the lower esophageal sphincter fails to close adequately after food enters the stomach & contents reflux into the esophagus?

A

Gastroesophageal Reflux Disease (GERD)

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2
Q

This can be associated with esophageal cancer?

A

GERD

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3
Q

How many amino acids are considered essential because they cannot be produced in the body and must be part of our diet?

A

9

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4
Q

What is the form fat is usually found in the human diet?

A

Triacylglycerol (TAG)

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5
Q

What are the smaller components fat must be hydrolyzed into in order to be absorbed?

A

Free Fatty Acids

Monoglycerides

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6
Q

What are some of issues that arise concerning the aging GI System?

A
  • Hiatal Hernia
  • Gastritis
  • Peptic Ulcer Disease
  • Appendicitis
  • Gallbladder Problems
  • Acute Pancreatitis
  • Janundice/Cirrhosis
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7
Q

What is the reflex that is triggered by distention of the stomach while eating/immediately after triggers mass peristalsis in the colon?

A

Gastrocolic Reflex

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8
Q

The Gastrocolic Reflex is usually triggered how long after eating?

A

30-45 minutes

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9
Q

This reflex is activated with entry of feces into the rectum that causes distention, increased signals to descending & sigmoid colon (via myenteric plexus) increases peristalsis pushes fecal matter to anus and cause anal sphincter to relax?

A

Intrinsic Myenteric defecation reflex

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10
Q

What is the nerve impulse pathway for the defecation reflex pathway?

A
  • Sensory impulses to sacral spinal cord triggered by stretch receptors (mechanoreceptors) in rectum
  • Motor impulses travel along parasympathetic nerves to descending & sigmoid colon, rectum & anus
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11
Q

The motor impulses trigger a contraction of what muscle in regards to defecation?

A

Longitudinal rectal muscles

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12
Q

Voluntary contractions of diaphragm & abdominal muscles along with parasympathetic stimulation cause what to relax?

A

internal Anal Sphincter

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13
Q

What sphincter is completely voluntary and if it is relaxed feces exits the anus if constricted defecation is postponed?

A

External Anal Sphincter

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14
Q

What factors affect the frequency of Bowel Movements?

A

Diet
Health
Stress

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15
Q

The normal (typical) range of number of Bowel movements daily & weekly are?

A

1-3 per day

3-4 per week

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16
Q

What is defined by increase in frequency, volume, or fluid content caused by increased motility & decreased absorption by the intestines?

A

Diarrhea

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17
Q

Name some of the reasons for excessive motility of the intestines?

A

Lactose Intolerance
Stress
Microbes that irritate mucosa

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18
Q

What is defined by Infrequent or difficult defection caused by decreased motility of the intestines?

A

Constipation

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19
Q

What happens as feces remains in the colon for longer periods of time?

A

Excessive water reabsorption/absorption causing feces to become dry & hard

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20
Q

Name some of the causes of constipation?

A
  • Delaying defecation
  • Spasms of the colon
  • Insufficient fiber or water in diet
  • Lack of exercise
  • Emotional stress
  • Drugs (Narcotics)
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21
Q

Name some of the treatments for constipation?

A

Laxatives (habit forming)
Increasing Fiber
Increasing exercise
Increasing Water

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22
Q

What portion of the digestive tract is considered to be the terminal portion?

A

Large Intestine

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23
Q

What is the overall function of the Large Intestine?

A
  • Complete process of absorption
  • Produces vitamins (Vit. K & Biotin)
  • Forms feces
  • Excretes feces from body
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24
Q

What are the four major regions extending from ileum to anus?

A

Cecum
Colon
Rectum
Anal Canal

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25
Q

What is the length & diameter of the large Intestine?

A

approx. 5 feet long

approx. 2.5 in diameter

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26
Q

What is the Large Intestine attached to?

A

Posterior Abdominal wall by the Mesocolon (peritoneal fold)

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27
Q

This is the opening from the ileum to the large intestine & allows materials to pass from small intestine into the large intestine?

A

Ileocecal Sphincter (Value)

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28
Q

This is inferior to the ileocecal valve & is a small pouch (approx. 2.4 in long)?

A

Cecum

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29
Q

What is attached to the cecum & is approx. 3in long?

A

Appendix (vermiform appendix)

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30
Q

This is proceeded by obstruction of the lumen by chime, fecolith, foreign body, carcinoma, stenosis, or kinking, & characterized by high fever, elecvated WBC, neutrophil count >75%?

A

Appendicitis

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31
Q

What are the four portions of the colon?

A

Ascending
Transverse
Descending
sigmoid

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32
Q

This portion of the colon lies retroperitoneal, ascend on the right side of abdomen to lower border of the liver?

A

Ascending Colon

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33
Q

What is the abrupt left turn of the colon called at the transition of the ascending to transverse colon?

A

Right Colic (Hepatic) Flexure

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34
Q

This portion of the colon lies in the peritoneal & crosses the abdomen until on the left side it makes an abrupt turn inferiorly?

A

Transverse Colon

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35
Q

What is the abrupt inferior turn of the colon called at the transition of the transverse colon to descending colon?

A

Left Colic (Splenic) Flexure

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36
Q

This portion of the colon lies retroperitoneal and descends on left side to the level of the iliac crest?

A

Descending Colon

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37
Q

This portion of the colon lies in the peritoneal & begin near left iliac crest, projects medially to midline & terminates at the rectum (about 3rd sacral vertebra)?

A

Sigmoid Colon

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38
Q

What is the name of the digestive tract that is the last 8 inches, lies anterior to sacrum & coccyx with the terminal 1inch being called the anal canal?

A

Rectum

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39
Q

What are the folds created by the mucous membrane of the anal canal arranged longitudinally called?

A

Anal Columns

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40
Q

What is contained within the anal columns?

A

Arteries & veins

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41
Q

The opening of the anal canal is the anus and has two sphincters, what are they named?

A

Internal anal sphincter

External anal sphincter

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42
Q

This anal sphincter is made up of smooth muscle and we have involuntary control over it?

A

Internal Anal Sphincter

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43
Q

This anal sphincter is made up of skeletal muscle and we have voluntary control over it?

A

External Anal Sphincter

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44
Q

At the anus, what can be caused by Pregnancy, hard stool, pushing too hard?

A

Hemorrhoids

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45
Q

What are the four layers of the Large Intestine walls?

A

Serosa
Muscularis
Submucosa
Mucosa

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46
Q

This layer has Omental appendices that attach to teniae coli?

A

Serosa

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47
Q

What are Omental Appendices?

A

Small pouches of visceral fat attached to the teniae coli

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48
Q

The Muscularis layer; External & Internal smooth muscle layers run in which directions?

A

External: Longitudinal
Internal: Circular

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49
Q

What are the portions of the Muscularis layer that are thickened, forming three bands?

A

Teniae Coli

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50
Q

The Teniae Coli contract causing what to occur with the large intestine?

A

Gather together like pouches (Haustra)

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51
Q

What gives the colon it’s “puckered” appearance?

A

Haustra

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52
Q

What is not found within the large intestine?

A

Plicae (circular folds) or villi

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53
Q

This clinical finding arises from the mucosal layer of the colon & usually are benign growth, asymptomatic, but if symptoms occur usually cause diarrhea, blood in feces, &/or mucus being discharged from the anus?

A

Polyps

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54
Q

What sphincter is normally partially closed to regulate material transitioning from ileum to cecum, the Gastroileal reflex intensifies peristalsis in the ileum & forces material through this sphincter?

A

Ileocecal sphincter

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55
Q

What does the hormone gastrin secreted into bloodstream by the stomach help do?

A

Relax the Ileocecal Sphincter

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56
Q

What is the term given to the build up of material in the cecum & up the ascending colon until distension occurs triggering contraction of walls forcing material forward?

A

Haustral Churning

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57
Q

What is the rate in which peristalsis occurs in the large intestine?

A

3-12 per minute

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58
Q

This is the final type of movement in the colon & is a strong peristaltic wave that starts at middle of transverse colon & pushes material from colon into rectum?

A

Mass Peristalsis

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59
Q

On average many people have to evacuate bowels within what time frame after eating?

A

30-45 minutes

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60
Q

What is secreted by the cells of the colon & what is not secreted?

A

Mucus is secreted

Enzymes are not secreted

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61
Q

What provides for chemical digestion in the colon?

A

bacteria

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62
Q

The bacteria ferment remaining carbohydrates and this process releases what?

A

Hydrogen, Carbon Dioxide, & Methane Gases

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63
Q

What is the term that describes excessive gas?

A

Flatulence

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64
Q

What gives feces its odor?

A

Bacteria breaking down protein into indole & Skatole

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65
Q

Bacteria help decompose this into stercobilin & it gives feces its brown color?

A

Bilirubin

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66
Q

How much of the remaining water is absorbed & excreted by the large intestine?

A

0.5-1.0L enter
900mL absorbed
100mL excreted

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67
Q

How long does Chyme remain in the large intestine on average?

A

3-10 hours

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68
Q

The chyme becomes a solid or semisolid due to water absorption/reabsorption and it is then called what?

A

Feces

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69
Q

What does feces chemically contain?

A 
Water
Epithelial Cells
Bacteria
Product of bacterial decomposition
Unabsorbed digested materials
Indigestible parts of food
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70
Q

What do lipids first have to undergo prior to digestion beginning on them?

A

Emulsification

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71
Q

This is produced in the liver & secreted into the small intestine where it mixes with lipids pulling them apart?

A

Bile

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72
Q

What enzyme starts to digest the emulsion droplets still in the lumen of intestine into FFA & MG?

A

Pancreatic Lipase

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73
Q

These are 200 times smaller than emulsion droplets?

A

Micelles

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74
Q

Micelles transport FFAs & MGs where?

A

Apical Surface of the enterocytes to be absorbed

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75
Q

Resynthesized FFAs & MGs into TAGs are packaged with cholesterol, vitamins, & proteins (apolipoproteins) into what?

A

Chylomicron

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76
Q

These are so large that they cannot enter blood capillaries & have to enter a lacteal & get transported to the subclavian veins to be circulated?

A

Chylomicrons

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77
Q

What are some of the functions of Cholesterol?

A 
Found in every cell 
-Essential for hormone production 
    Testosterone, progesterone, aldosterone
-Used to make Vit. D
-Part of Bile
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78
Q

The stomach serves as what?

A

Mixing chamber

Holding Chamber

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79
Q

What is the most distensible part of the GI tract & the mucosa lies in rugae?

A

Stomach

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80
Q

What is occurring to food (bolus) in the stomach?

A
  • Carbs stop breaking down due to amylase being deactivated by stomach acid
  • Lipids begin to break down (activation of lingual lipase)
  • Proteins begin to break down
  • Semisolid bolus converted to liquid
  • Some absorption
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81
Q

What are the 4 main regions of the Stomach?

A

Cardia
Fundus
Body
Pyloric (divided into three parts)

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82
Q

What are the three parts of the Pyloric region of the stomach?

A 
Pyloric Antrum (connects the body to stomach)
Pyloric Canal (Leads to third region)
Pylorus (connects duodenum via pyloric sphincter)
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83
Q

What is the Histology (Layers) of the stomach?

A

Serosa
Muscularis (3 layers of smooth muscle)
Submucosa
Mucosa

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84
Q

This layer of the stomach on the greater curvature of stomach continues as greater omentum & on lesser curvature projects upward towards the liver as lesser omentum?

A

Serosa

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85
Q

What are the three layer of smooth muscle that make up the Muscularis layer of the stomach?

A

Outer Longitudinal Layer
Middle Circular Layer
Inner Oblique Layer (only in stomach)

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86
Q

What kind of tissue makes up the Submucosa of the Stomach?

A

Connective Areolar Tissue

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87
Q

What are the three layers of the Mucosal Layer of the Stomach?

A 
Muscularis Mucosae (Smooth Muscle)
Lamina Propria (Connective Areolar Tissue)
Mucosa (Simple Columnar Epithelial Cells)
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88
Q

What are the simple columnar epithelial cells of the mucosa layer of the stomach called?

A

Surface mucous Cells

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89
Q

The Surface Mucous Cells form columns of secretory cells open into the lumen surface (gastric pits) these are called?

A

Gastric Glands

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90
Q

What are the three types of exocrine gland cells that are found in Gastric Glands?

A

Mucous Neck Cells/Mucous Cells
Chief Cells
Parietal Cells

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91
Q

Which cells secrete mucous?

A

Mucous Cells/ Neck Cells

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92
Q

These cells secrete pepsinogen & gastric Lipase?

A

Chief Cells

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93
Q

These cells secrete hydrochloric acid & intrinsic factor?

A

Parietal Cells

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94
Q

What is the importance of Intrinsic factor?

A

Needed to aid in absorption of Vitamin B12/Cyanocobalamin

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95
Q

What will occur if B12/Cyanocobalamin is not absorbed?

A

Pernicious Anemia

96
Q

Approx. how much Gastric Juice is secreted by all three gland cells per day?

A

2000-3000mL per day

97
Q

What other cell is included with the gastric glands and is an enteroendocrine cell?

98
Q

Where are G-cells found?

A

Only in the Pyloric Antrum

99
Q

What do G-cells do?

A

secrete Gastrin into the bloodstream (hormone)

100
Q

What role does gastrin have in digestion?

A

Signals Ileocecal Sphincter to relax

101
Q

How often do Peristaltic waves occur in the stomach?

A

Every 15-20 seconds

102
Q

The Mixing waves help macerate food, mix it with gastric secretions & reduce it to a soupy liquid called?

103
Q

The process of approx. 3mL of chyme being ejected into the duodenenum with each wave & the remainder being pushed back into the body of the stomach where mixing continues is called?

A

Gastric Emptying

104
Q

What is significant about Pepsin?

A

Only proteolytic (Protein Digesting) Enzyme in the stomach

105
Q

How is Pepsin activated and inactivated?

A

Active in an acidic environment

Inactivated by alkalytic environment

106
Q

The stomach epithelial cells (protein containing) are protected by what?

A

1-3mm thick layer of alkaline mucous

107
Q

What is absorbed in the stomach?

A

Water, ions, short-chain fatty acids & some drugs

108
Q

How long does it take for the stomach to empty its contents into the duodenum?

A

2-4 hours after ingesting a meal

109
Q

This gland is retroperitoneal, approx. 5-6in long & 1in thick & lies posterior to the greater curvature of the stomach?

110
Q

The pancreas consist of what?

A

Head- portion near duodenal curve
Body- Superior to & to the left of the head
Tail- Tapering, left most portion

111
Q

The pancreatic Duct is also known as?

A

Duct of Wirsung

112
Q

What does the Pancreatic Duct join with & form?

A

Common Bile duct from Liver & Gallbladder to enter the duodenum as Hepatopancreatic Ampulla

113
Q

The Hepatopancreatic Ampulla is also known as?

A

Ampulla of Vater

114
Q

Where is the Ampulla of Vater located?

A

Opens Approx. 4in inferior to pyloric sphincter

115
Q

How is the Hepatopancreatic Ampulla (Ampulla of Vater) regulated?

A

Mass of smooth muscle called Sphincter of the Hepatopancreatic Ampulla

116
Q

The Sphincter of the Hapatopancreatic Ampulla is also known as?

A

Sphincter of Oddi

117
Q

What is the name of the other major duct of the pancreas that comes off the pancreatic duct & empties into the duodenum approx. 1in superior to the Ampulla of Vater?

A

Accessory Duct

118
Q

The Accessory Duct is also known as?

A

Duct of Santorini

119
Q

What is the Pancreas made up of?

A 
Acini Cluster Cells (Exocrine)
Pancreatic Islets (Islets of Laangerhans) (endocrine)
120
Q

What type of cells & how much of the pancreas is made up of Acini?

A

Small clusters of glandular epithelial cells 99% (exocrine)

121
Q

The Pancreatic Islets (Islets of Laangerhans) make up how much of the pancreas?

A

1% they are the endocrine portion

122
Q

How many mL’s per day of pancreas juice is produced?

A

1200-1500mL

123
Q

What are the characteristics of pancreas juice?

A 
Clear, colorless liquid
Water
Salts
Sodium Bicarb 
Enzymes
124
Q

What role does the Sodium Bicarb play in the pancreatic juice?

A

Alkaline pH 7.1-8.2

  • Buffers acidic gastric juices in chyme
  • Stops action of pepsin from stomach
  • Creates proper pH for digestive enzymes in small intestine
125
Q

What enzymes are part of the pancreatic juice?

A 
Pancreatic Amylase- starch digestion
Trypsin- Protein digestion
Chymotrypsin- Protein digestion
Carboxypeptidase- Protein digestion
Elastase- Protein digestion
Pancreatic Lipase-Principle Triglyceride digestion
Ribonuclease- Digests RNA
Deoxyribonuclease- Digest DNA into nucleotides
126
Q

What are the names inactivated names of the protein digesting enzymes produced in the pancreas?

A

Trypsinogen- Trypsin (active)
Chymotrypsinogen- Chymotrypsin (active)Procarboxypeptidase- Carboxypeptidase (active)
Proelastase- Elastase (active)

127
Q

This is a severe condition in which pancreatic cells release trypsin instead of trypsinogen or insufficient amount of trypsin inhibitor, causing digestion of the pancreatic cells leading to bleeding, severe inflammation, & fat necrosis?

A

Acute Pancreatitis

128
Q

What are some causes of Acute Pancreatitis?

A 
Alcoholism (70%, ages 30-40 usually)
Cystic Fibrosis
Hypercalcemia
Hyperlipidemia
Drugs
Autoimmune diseases
129
Q

What brings fresh blood from the heart to the Liver?

A

Hepatic Artery

130
Q

What brings blood from the intestines to the Liver?

A

Portal Vein

131
Q

What vessel returns blood to the heart from the Liver?

A

Hepatic Vein

132
Q

This organ is almost completely covered by visceral peritoneum & divided into two principal lobes by the Falciform Ligament?

133
Q

Which lobe of the liver is largest right or left?

A

Right Lobe

134
Q

This portion associated with the Liver extends from the undersurface of the diaphragm between the two lobes of the liver & allows attachment to the ventral surface of the abdominal cavity?

A

Falciform Ligament

135
Q

What extends from within the free aspect from Falciform Ligament to umbilicus?

A

Ligamentum Teres (round ligament)

136
Q

What is significant about the round Ligament (Ligamentum Teres)?

A

Remnant of umbilical vein of fetus

137
Q

What enzymes are part of the pancreatic juice?

A 
Pancreatic Amylase- starch digestion
Trypsin- Protein digestion
Chymotrypsin- Protein digestion
Carboxypeptidase- Protein digestion
Elastase- Protein digestion
Pancreatic Lipase-Principle Triglyceride digestion
Ribonuclease- Digests RNA
Deoxyribonuclease- Digest DNA into nucleotides
138
Q

What are the names inactivated names of the protein digesting enzymes produced in the pancreas?

A

Trypsinogen- Trypsin (active)
Chymotrypsinogen- Chymotrypsin (active)Procarboxypeptidase- Carboxypeptidase (active)
Proelastase- Elastase (active)

139
Q

This is a severe condition in which pancreatic cells release trypsin instead of trypsinogen or insufficient amount of trypsin inhibitor, causing digestion of the pancreatic cells leading to bleeding, severe inflammation, & fat necrosis?

A

Acute Pancreatitis

140
Q

What are some causes of Acute Pancreatitis?

A 
Alcoholism (70%, ages 30-40 usually)
Cystic Fibrosis
Hypercalcemia
Hyperlipidemia
Drugs
Autoimmune diseases
141
Q

What brings fresh blood from the heart to the Liver?

A

Hepatic Artery

142
Q

What brings blood from the intestines to the Liver?

A

Portal Vein

143
Q

What vessel returns blood to the heart from the Liver?

A

Hepatic Vein

144
Q

This organ is almost completely covered by visceral peritoneum & divided into two principal lobes by the Falciform Ligament?

145
Q

Hepatocytes form a crucially important cell layer that separates what?

A

Sinusoidal blood from Canalicular Bile

146
Q

This portion associated with the Liver extends from the undersurface of the diaphragm between the two lobes of the liver & allows attachment to the ventral surface of the abdominal cavity?

A

Falciform Ligament

147
Q

What extends from within the free aspect from Falciform Ligament to umbilicus?

A

Ligamentum Teres (round ligament)

148
Q

What is significant about the round Ligament (Ligamentum Teres)?

A

Remnant of umbilical vein of fetus

149
Q

What is included in the first part of the Biliary tree?

A
  • Bile ducts inside the Liver
  • Common Hepatic Duct (outside of the Liver)
  • Gallbladder & its cystic duct
  • Common Bile Duct
  • Ducts of the Pancreas
150
Q

What are the Functions of the Liver?

A 
Carbohydrate (Starch) Metabolism
Lipid Metabolism
Protein Metabolism
Bile Synthesis
Activation of Vitamin D
Processes drugs & hormones
Excretion of bilirubin
Storage
Phagocytosis
151
Q

What are the two sources the Liver receives blood and approx. how much(%)?

A

Hepatic Artery 25% Oxygenated

Portal Vein 75% Deoxygenated + Nutrients

152
Q

What organ is like a factory & warehouse that packages goods & sends it out to the rest of the body where needed or stores it right there for later use?

153
Q

The Liver is a common site of what from GI tract since it receives so much blood from digestive system?

A

Metastasis

154
Q

What are the major functional units of the Liver called?

A

Hepatic Lobules

155
Q

These are Hexagonal in shape, comprise rows of hepatocytes that radiate out from a central point & perform a wide array of metabolic, secretory, & endocrine functions in the Liver?

A

Hepatic Lobules

156
Q

What makes up 80% of the mass of the Liver & are specialized polygonal epithelial cells interspersed throughout the Liver?

A

Hepatocytes

157
Q

Hepatocytes are the location of synthesis of what?

A
  • Transport proteins like albumin & fibrinogen
  • Lipoproteins, fatty acids, trigylcerides
  • Cholesterol & Bile
158
Q

What do the Portal Triads found at the corners of the hepatic lobules consist of?

A

Bile Duct (flows away from central vein)
Branch of hepatic artery (flows towards central vein)
Branch of portal vein (flows towards central vein)

159
Q

What is the part of the Liver internal anatomy that is highly permeable blood capillary between rows of hepatocytes that receives oxygenated blood from branches of hepatic artery & receives nutrient rich deoxygenated blood from the portal vein?

A

Hepatic Sinusoids

160
Q

These are fixed phagocytes found within sinusoids that help “clean” blood & destroy worn-out red & white blood cells, bacteria, & other foreign matter?

A

Stellate Reticuloendothelial (Kupffer) Cells

161
Q

What are the Functions of the Liver?

A 
Carbohydrate (Starch) Metabolism
Lipid Metabolism
Protein Metabolism
Bile Synthesis
Activation of Vitamin D
Processes drugs & hormones
Excretion of bilirubin
162
Q

What role does the carb metabolism play for the body within the liver?

A

Keeps blood sugar at normal levels

163
Q

What occurs within the Liver if Plasma Glucose is low?

A

Glycogenolysis

Liver breaks down glycogen to glucose & releases it

164
Q

What occurs within the Liver if Plasma Glucose is High?

A

Glycogenesis

Liver converts glucose to glycogen & triglycerides as storage

165
Q

What role does the Lipid metabolism play for the body within the Liver?

A 
Synthesizes & stores triglycerides
Breaks down fatty acids to generate ATP
Synthesize lipoproteins
Synthesize cholesterol
Uses cholesterol to make bile salts
166
Q

In protein metabolism within the Liver what do the Hepatocytes do?

A

Deaminate AA’s (remove Amino group) for use for ATP production or converted to carbs or fat

167
Q

Protein metabolism within the Liver includes doing what with the ammonia ion left after deamination?

A

Converted to urea & transported to kidneys to be excreted in urine or used for osmotic gradient

168
Q

Protein metabolism within the Liver synthesizes what?

A

Plasma proteins (Alpha & Beta Globulins, Albumin, Prothrombin, & Fibrinogen)

169
Q

Liver excretion of Bilirubin occurs how?

A

Bilirubin is reabsorbed from broken down RBC’s & excreted in the bile, which is then metabolized in small intestine by bacteria & eliminated in feces

170
Q

What is clinically indicated if the skin, mucous membranes, & sclera of eyes have a yellowish color?

171
Q

What is the medical term for stones in the gallbladder?

A

Cholelithiasis

172
Q

How much bile is secreted by hepatocytes daily?

A

600-1000mL each day

173
Q

What are the characteristics of Bile?

A

Yellow, Brownish, or olive-green liquid
pH 7.6-8.6
Important role in fat digestion & absorption
Means for excretion of waste products from blood

174
Q

What does bile consist of?

A
  • Bile solids (bile salts/acids, phospholipids, cholesterol, bilirubin)
  • Water
  • Electrolytes
175
Q

Where is Bile stored & concentrated?

A

Gallbladder

176
Q

What is the pear shaped sac located in a depression of the posterior/inferior aspect of the Liver?

A

Gallbladder

177
Q

What is the function of the Gallbladder?

A

Stores & concentrates bile made by the Liver

up to 10x’s more concentrated

178
Q

Bile is made in the Liver and released into what?

A

Common Hepatic Duct & into common bile duct

179
Q

Name the parts of the Gallbladder?

A

Fundus (projects inferiorly)
Body
Neck
Cystic Duct (duct from gallbladder neck joins common hepatic duct)

180
Q

What is the histology of the Gallbladder & what does it lack?

A

-Mucosa: simple columnar epithelium arranged in rugae
(-Walls lack submucosa)
-Smooth muscle
-Visceral Peritoneum/Serosa

181
Q

How is the gallbladder supplied with blood and returns blood to systemic supply?

A
  • Branch of Hepatic artery into cystic artery that feeds gallbladder walls
  • Venous blood drains into portal vein directly
182
Q

What is the medical term for stones in the gallbladder?

A

Cholelithiasis

183
Q

What are some causes of Cholelithiasis?

A 
Bile contains insufficient bile salts or lecithin
Excess cholesterol (may crystallize)
184
Q

Medical term for Stones in common bile duct?

A

Choledocholithiasis

185
Q

Medical term for Biliary tree inflammation & infection?

A

Cholangitis

186
Q

What are the layers of the Small Intestine?

A

Serosa
Muscularis
Submucosa
Mucosa

187
Q

How does the spleen provide for the immune system?

A
  • Arterial blood flows into spleen via trabecular artery
  • Peri-arterio Lymphatic Sheath (PALS) filter the blood
  • Bacteria detected signal initiation/mobilization of Ab’s
188
Q

How does the spleen Recycle RBC’s?

A
  • Filtered into Large venous sinusoids

- RBC’s migrate through & are scanned by macrophages

189
Q

Where does the most of digestion & absorption of nutrients occur?

A

Small Intestine

190
Q

What increases the surface area of the Small Intestine?

A

Folds, VIlli, & Microvilli

191
Q

Where does the Small Intestine Begin & end?

A

Pyloric Sphincter of stomach

Ileocecal Sphincter

192
Q

What is the approx. length & diameter of the Small Intestine in a living person?

A

10ft long

1in diameter

193
Q

What are the three regions of the small intestine?

A

Duodenum
Jejunum
Ileum

194
Q

This portion of the small intestine is the shortest (10in) & is retroperitoneal, starting after the pyloric sphincter & merges with jejunum?

195
Q

This portion of the Small Intestine is 3 feet long and is between the duodenum & Ileum?

196
Q

This portion of the Small Intestine is the longest 6 feet, begins at the end of the jejunum & extends to ileocecal sphincter?

197
Q

What portion of the Small Intestine does not have Serosa Layer?

A

Proximal Aspect of Duodenum

198
Q

The Serosa is also known as?

A

Visceral Peritoneum

199
Q

What are the characteristics of the Muscularis Layer?

A 
Inner Layer circular fibers of smooth muscle
Myenteric Plexus (Plexus of Auerbach) in between
Outer Layer longitudinal fibers of smooth muscle
200
Q

What is contained within the Submucosa of the Small Intestine?

A 
Brunner's Glands
Submucosal nerve (Meissner's) Plexus
201
Q

What do Brunner’s Glands do?

A

Secrete alkaline mucous that neutralizes gastric acid in chyme

202
Q

What are the layers of the Mucosa Layer of the Small Intestine?

A

Epithelial Cells
Lamina Propria
Muscularis Mucosae

203
Q

What does the Muscularis layer of the Mucosal layer consists of?

A

Smooth Muscle

204
Q

What is does the Lamina Propria Contain of the Mucosal Layer of the Small Intestine?

A

Areolar Connective Tissue

Mucosa-Associated Lymphatic Tissue (MALT)

205
Q

What are the deep crevices found in the epithelial layer of the Mucosal Layer of the Small Intestine Called?

A

Intestinal Glands (Crypts of Lieberkuhn)

206
Q

These are fingerlike projection in mucosa (1-5mm long), 20-40 per square millimeter & vastly increase surface area?

A

Villi (Gives velvety appearance)

207
Q

These cells digest & absorb nutrients from chyme?

A

Absorptive Cells

208
Q

These cells secrete Mucous?

A

Goblet Cells

209
Q

These cells secrete lysozyme (bactericidal enzyme), are capable of phagocytosis & may play a role in microbial population?

A

Paneth Cells

210
Q

What are the three types of enteroendocrine cells in the small intestine?

A

S Cells
CCK Cells
K Cells

211
Q

These cells secrete secretin that stimulates pancreatic juice flow & inhibits gastric juice flow?

212
Q

These cell secrete Cholecystokinin which help satiety & stimulates pancreatic juice flow & stimulates gallbladder contraction?

213
Q

These cells secrete glucose-dependent insulinotropic peptide (GIP)?

214
Q

This structural feature are permanenet ridges (folds of mucosa & submucosal layers) 10mm in length begin near proximal portion of duodenum & end near mid-portion of ileum?

A

Plicae Circulares (Circular Folds)

215
Q

The Plicae Circulares allow for what regarding surface area & how chyme moves in the small intestine?

A

Increases surface area for reabsorption

Causes chyme to spiral, allowing more dissolution

216
Q

These are fingerlike projection in mucosa (1-5mm long), 20-40 per square millimeter & vastly increase surface area?

A

Villi (Gives velvety appearance)

217
Q

These make up the Brush border & are projections of the apical membrane of the absorptive cells & contain several enzymes?

A

Microvilli

218
Q

Approx. how many microvilli per square millimeter are there?

A

200 Million

219
Q

What continues digestion of proteins & is provided inside the pancreatic juice?

A

Trypsin, Chymotrypsin, Carboxypeptidase, & Elastase

220
Q

What are the characteristics of the small intestine juice?

A

Clear, yellow liquid
Slight alkaline at pH 7.6
Absorptive cells synthesize digestive enzymes
Absorptive cells slough off 5-7 days

221
Q

The absorptive cell digestive enzymes called Brush border enzymes are?

A 
Carb Digesting
   -Alpha-Dextrinase
   -Maltase   
   -Sucrase
   -Lactase
Protein Digesting (Peptidases)
   -Aminopeptidase
   -Dipeptidase
Lipid Digesting
   -Phospholipase B1
222
Q

What are the two components of Mechanical Digestion within the Small Intestine?

A

Segmentation Movements

Migrating Motility Complex (MMC)

223
Q

These are localized contraction/relaxation of intestine when distended by large amount of chyme?

A

Segmentation Movements

224
Q

Apporx. how many Segmentation Movements occur per minute near the duodenum & the more towards the ileum?

A

12 per min near duodenum

8 per min towards ileum

225
Q

This peristaltic wave starting at lower portion of stomach in pyloric antrum, pushes chyme forward, slow taking 90-120 minutes to reach the end of the ileum & after one completes another begins?

A

Migrating Motility Complex

226
Q

What provides for chemical digestion in the Small Intestine?

A

Pancreatic Juice
Bile
Intestinal Juices

227
Q

What cleaves the leftover carbs found in chyme within the small intestine?

A

Pancreatic Amylase

228
Q

This is indigestible plant fiber & is a large component of feces, coming from vegetable/fruit skin, whole grains (brown rice)?

229
Q

Protein is absorbable & digestion of protein ends when it is in what form?

A

Single AA’s

230
Q

How much of the absorption occurs in the small intestine?

A

90%. the rest is in the stomach & large intestine

231
Q

What are the total amounts of water that enters the small intestine daily?

232
Q

Approx. how much water comes from ingestion of food & liquids?

233
Q

Approx. how much water comes from various gastrointestinal secretions?

234
Q

The small intestine absorbs approx. how much water?

235
Q

The Large intestine absorbs approx. how much water?

236
Q

Approx. how much water is excreted in feces each day?

A

0.1L (100mL)

A&P II IPAP 3-17 (12 decks)

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