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AP II B5 Digestive > Digestive Part II - slides 1 - 68 > Flashcards

Digestive Part II - slides 1 - 68 Flashcards

1
Q

Heaviest gland of the body?

A

Liver (3lbs)

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2
Q

Largest INTERNAL organ of the body?

A

Liver

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3
Q

Located inferior to the diaphragm, the Liver occupies most of the ___ _____ and part of epigastric region

A

Right Hypochondriac region

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4
Q

The Liver, almost completely covered by visceral peritoneum

Divided into two principal lobes by the ___ ____

A

Falciform Ligament

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5
Q

Which lobe of the Liver is smallest?

A

Right lobe Largest

Left lobe smallest

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6
Q

The Liver receives blood from two sources:

A

Hepatic artery (25%) – oxygenated blood

Portal vein (75%) – deoxygenated blood + nutrients

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7
Q

These compose the ___ ___:

  • Bile ducts inside the liver
  • Common hepatic duct (outside of the liver)
  • The gallbladder and its cystic duct
  • Common bile duct
  • Ducts of the pancreas
A

Biliary Tree

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8
Q

Functions of the Biliary Tree: (3)

A
  1. Make, store, and secrete bile
  2. Rids liver (and body) of some waste products
  3. Aids in digestion of foods in small intestine
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9
Q

Major functional unit of the Liver:

A

Hepatic Lobules

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10
Q

Hexagonal in shape

Comprise rows of hepatocytes

Perform a wide array of metabolic, secretory, and endocrine functions

A

Hepatic Lobules

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11
Q

Found in the corners of the Hepatic Lobules:

A

Portal Triads

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12
Q

These all comprise ___ ____:

  • A bile duct (flows away from central vein)
  • Branch of hepatic artery (flows toward central vein)
  • Branch of portal vein (flows toward central vein)

(see slide 7)

A

Portal Triads

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13
Q

Specialized epithelial cells interspersed throughout the liver
Make up ~80% of the mass of the liver

A

Hepatocytes

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14
Q

Forms a crucially important cell layer that separates sinusoidal blood from the canalicular bile

A

Hepatocytes

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15
Q

Location of synthesis of:

  • Many transport proteins like albumin, and fibrinogen
  • Lipoproteins, fatty acids, triglycerides
  • Cholesterol
  • Bile
A

Hepatocytes

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16
Q

Highly permeable blood capillaries between rows of hepatocytes

A

Hepatic Sinusoids

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17
Q

Hepatic Sinusoids:

Receives oxygenated blood from branches of ___ ___

Receives nutrient rich deoxygenated blood from the ___ ___

A

Hepatic Artery

Portal Vein

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18
Q

Fixed phagocytes found within sinusoids that help “clean” blood

Destroy worn-out red and white bloods cells, bacteria, and other foreign matter

A

Stellate reticuloendothelial (Kupffer) cells**

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19
Q

Functions of the Liver:

  • Carbohydrate (starch) metabolism
  • Lipid Metabolism
  • Protein Synthesis
  • Processes Drugs and -Hormones
  • Excretion of Bilirubin
  • Storage
  • Phagocytosis
  • Bile Synthesis
A

…further explained in other cards

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20
Q

Carb Metablolism:

Plasma glucose is low:

A

Glycogenolysis

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21
Q

Carb Metabolism:

Plasma glucose is high:

A

Glyconegesis

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22
Q

What function of the Liver involves:
Synthesizes and stores some triglycerides
Synthesizes certain lipoproteins
Synthesizes some cholesterol
-Adds some cholesterol to bile to aid in lipid metabolism

A

Lipid Metabolism

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23
Q

Bilirubin is reabsorbed from broken down RBC’s and excreted in the ___ produced within the liver

A

Bile

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24
Q

Most of the bilirubin in bile is metabolized in the __ ___ by bacteria and eliminated in feces

A

Small Intestine

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25
Q

In addition to glycogen, liver is prime site for storage of certain vitamins such as __, __, __, __ , __,

Also stores certain minerals such as ___ and ___.

These are all released when needed by the body

A

A, B12, D, E, K

Iron and Copper

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26
Q

The stellate reticuloendothelial (Kupffer) cells phagocytize aged RBC’s, WBC’s and some bacteria

A

Liver function: Phagocytosis

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27
Q

Bile synthesis involves the mixture of bile salts, ____ and ____

A

Bile Pigments and Cholesterol

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28
Q

Each day about how much bile is synthesized and secreted by hepatocytes:

A

600 - 1000mL

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29
Q

Bile is stored and concentrated in the:

A

Gallbladder

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30
Q

Bile is a yellow, brownish, or olive-green liquid

pH of ___-___

Plays important role in fat digestion and absorption

Serves as a means for excretion of waste products from blood (i.e. ____)

A

pH 7.6 - 8.6

i.e. blilirubin

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31
Q

Pear-shaped sac

Located in a depression of the posterior/inferior aspect of the liver

A

Gallbladder

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32
Q

Stores and concentrates bile made by the liver (up to 10x’s more concentrated)

Water and ions are reabsorbed by the ___ walls

A

Gallbladder

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33
Q

Between meals, bile is made and released by liver into common hepatic duct and down into ___ ___ ___

It accumulates here and starts to flow into the gallbladder when the ducts are full

A

Common Bile Duct

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34
Q

Large part of the immune system, tissue repair, Hematopoiesis, and RBC and Platelet destruction are functions of the ____

A

Spleen

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35
Q

As blood passes through sinusoids within ____, macrophages remove microorganisms and destroy them

A

Spleen

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36
Q

Monocytes and lymphocytes complete their development and become activated

During fetal development, RBC’s are also formed in the spleen

After birth, RBC’s only developed here in extreme cases of anemia

A

Hematopoiesis

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37
Q

Spleen Function:
Macrophages remove old RBC’s and imperfect platelets

Breaks apart the hemoglobin molecule to salvage the ___ and ___ for reuse

A

Iron and Globin

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38
Q

Where most digestion and absorption of nutrients occurs

A

Small Intestines

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39
Q

Small Intestines:
The length alone allows for a large surface area, but inside that length folds, ___ and ___ allow for even more surface area

A

Villi and Microvilli

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40
Q

Small Intstine begins immediately after the pyloric sphincter of the stomach

Ends at the ___ ___ (valve) where the large intestine begins

Length is ~10 ft in a living person
Diameter is ~1in

A

Ileocecal Sphincter

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41
Q

3 regions of small intestine:

A

Duodenum
Jejunum
Ileum

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42
Q

the shortest region, 10in

Retroperitoneal

Starts after pyloric sphincter, merges with jejunum

A

Duodenum

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43
Q

3 feet long

Starts at the end of duodenum and extends to the ileum

A

Jejunum

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44
Q

the longest region, 6 feet long

Starts at the end of the jejunum and extends to ileocecal sphincter (valve) merging with the large intestine

A

Ileum

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45
Q

AKA – Suspensory Ligament of the Duodenum

A

Ligament of Treitz

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46
Q

Important landmark as it signifies the anatomical difference between Upper GI and Lower GI

A

Ligament of Treitz (suspensory ligament of duodenum)

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47
Q

In the small intestine: Is actually a “suspensory muscle” covered by a fold of the peritoneum

Begins at the diaphragm, connects to the duodenojejunal flexure (DJ) suspending it upwards

A

Ligament of Treitz (supsensory ligament of Duodenum)

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48
Q

Important landmark as it signifies the anatomical difference between Upper GI and Lower GI

A

Ligament of Treitz (suspensory ligament of Duodenum)

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49
Q

Except for a minor portion (proximal aspect) of the duodenum, the small intestines are completely covered by ____ (visceral peritoneum)

A

Serosa

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50
Q

The ____ layer of small intestine

Contains the Myenteric plexus (Plexus of Auerbach) in between

A

Muscluaris

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51
Q

Contain Brunner’s glands that secrete alkaline mucous that neutralizes gastric acid in chyme

Also Contains the ____ nerve (Meissner’s) plexus

A

Submucosa Layer of Small Intestines

Submucosal

52
Q

Contains layer of epithelial cells, lamina propria, muscularis mucosae

see slide 29/30

A

Mucosa of Small intestines

53
Q

Deep crevices in the mucosal lining called intestinal glands (crypts of ____)
These crypts are lined with numerous types of cells with different functions

A

Crypts of Lieberkuhn

54
Q 
Sm. Intestine Mucosa:
Miscellaneous Cells (which absorb/secrete_
-Enterocytes
-Goblet
-Paneth
A

Absorptive (Enterocytes): absorbs nutrients from chyme

Goblet Cells: secrete mucuous

Paneth cells:
Secrete Lysozome (bactericidal enzyme, capable of phagocytosis)
55
Q

Sm. Intestine Mucosa:
Enteroendocrine Cells:

  • Secretes secretin
  • Stimulates pancreatic juice flow
  • Inhibits gastric juice flow
A

S Cells

56
Q

Sm. Intestine Mucosa:
Enteroendocrine Cells:

  • secretes cholecystokinin (CCK)
  • Helps satiety (feeling full)
  • Stimulates pancreatic juice flow
  • Relaxes sphincter of Oddi
  • Stimulates gallbladder contraction
A

CCK Cells

57
Q

Sm. Intestine Mucosa:
Enteroendocrine Cells:

  • secretes glucose dependent insulinotropic polypeptide (GDIP)
  • AKA gastric inhibitory polypeptide (GIP)
  • Decreases the rate at which gastric emptying occurs
A

K Cells

58
Q

Begin near proximal portion of duodenum, end near midportion of ileum
Some extend circumferentially, others only part way
Increases surface area for absorption
Causes chyme to spiral, allowing for more dissolution

A

Circular Folds (Plicae Circulares)

Permanent ridges about 10mm in length

59
Q

Vastly increases surface area
Gives the mucosal lining of small intestines a velvety appearance
20-40 per square millimeter

A

Villi (fingerlike projections in mucosa about 1-5mm long)

60
Q

When viewed even through a microscope, they are seen as a fuzzy border, this is called the brush border
Estimated 200million microvilli per square millimeter
This brush border also produces several enzymes that have digestive functions

A

Microvilli - projections of apical membrane of absorptive cells

61
Q

When ____ enters the small intestine, it contains partially digested carbohydrates, proteins and lipids

The digestion of the rest of this is a collaborative effort by pancreatic juice, bile, and intestinal juices

A

Chyme

62
Q

~1 – 2 liters of intestinal juice is secreted each day
Clear, yellow liquid
Slightly alkaline at pH of __(#)

A

pH 7.6

63
Q

Cells within the microvilli synthesize several digestive -____ enzymes called ___=

These cells slough off every 5-7 days into the luminal contents

They break apart and release enzymes to help digest nutrients in chyme

A

Brush-border enzymes

64
Q

What percent of absorption occurs in the small intestine:

A

90%

65
Q

Once chyme enters the small intestine, the leftover carbohydrates are digested by pancreatic ____

It has no effect on cellulose (indigestible fiber)
Large component of feces

After ____ (whether salivary or pancreatic) has split carbohydrates into monosaccharide molecules, they become absorbable

A

Amylase

66
Q

Pancreatic juices – trypsin, chymotrypsin, carboxypeptidase, and ____ continue protein digestion

Digestion of proteins ends with single or small chains of amino acids (absorbable)

A

Elastase

67
Q

____ (lingual, gastric) begins the digestion of lipids in the stomach

Pancreatic ____ continues this digestion in the small intestine

Breaks lipids down to fatty acids and monoglycerides (absorbable

A

Lipase

68
Q

Total volume that enters small intestines daily ~9.3L
~2.3L comes from ingestion of food and liquids
~7.0L from various gastrointestinal secretions

Small intestine absorbs ~8.3L of the fluid
Large intestine absorbs ~0.9L of the fluid
Leaves only ~0.1L (100mL) that is excreted in feces each day

A

Small Intestine water absorption:

69
Q

Terminal portion of the GI tract:

A

Large Intestine

70
Q
  • Completing the process of absorption
  • Produces certain vitamins (vitamin K and biotin)
  • Forms feces for excretion
  • Excretes the solid waste products from the body
A

Functions of Large Intestine

71
Q

Large Intestine:

Has four major regions extending from ileum to anus:

A

Cecum
Colon
Rectum
Anal Canal

72
Q

Large Intestine:
~5 ft long, ~2.5inches in diameter

Attached to the posterior abdominal wall by the _____ (peritoneal fold)

A

Mesocolon

73
Q

Opening from the ileum to the large intestine

Allows materials to be passed from small intestine into the large intestine

A

Ileocoecal Sphincter (valve)

74
Q

Just inferior to the ileocecal valve

Small pouch ~2.4 inches long

Open end merges with the colon

A

Cecum

75
Q

Attached to the cecum

~3 inches long

A

Appendix (vermiform appendix)

76
Q

Colon is divided into 4 portions:

A

Ascending
Transverse
Descending
Sigmoid

77
Q

Ascending Colon: Retroperitoneal

Ascends on right side of abdomen to lower border of liver

Turns abruptly to the left at the ___ ___ and continues on as the transverse colon

A

Hepatic Flexure

78
Q

Transverse Colon:
Peritoneal

Crosses the abdomen until left side where it turns inferiorly at the ____ ____

A

Splenic Flexure

79
Q

Descending Colon:
Retroperitoneal

Descends on left side to the level of the ___ ___

A

Iliac Crest

80
Q

Sigmoid Colon:
Peritoneal

Begins near left iliac crest, projects medially to midline
Terminates at rectum ( ___ ___ vertebra)

A

~3rd sacral vertebra

81
Q

The last 8 inches of the GI tract

Lies anterior to the sacrum and coccyx

Terminal 1 inch of the ____ is called the anal canal

A

Rectum

82
Q

Mucous membrane of this canal is arranged in longitudinal folds called anal columns

Columns contain arteries and veins

A

Anal Canal

83
Q

Brush border enzymes:

α-dextrinase
Maltase
Sucrase
Lactase

A

Carbohydrate digesting:

84
Q

Brush border enzymes:

Aminopeptidase
Dipeptidase

A

Protein digesting (PEPTIDASES)

85
Q

Brush border enzymes:

Phospholipase B1

A

Lipid digestion

86
Q

____ (dentate) line- lies at the inferior most portion of the anal columns

A

Pectinate Line

87
Q

Above this line, the upper 2/3rd of the canal is only sensitive to ___

Below this line, the lower 1/3rd of the canal is sensitive to ___, ___, ____

A

Upper 2/3 - Stetch

Lower 1/3 - pain, temperature, temp

88
Q

Knowing Pectinate (dentate) line demarcations is important when discussing ____

A

Hemorrhoids

89
Q

Large Intestine wall contains 4 layers:

A

Serosa
Muscularis
Submucosa
Mucosa

90
Q

In the Serosa:

____ ____ - small pouches of visceral fat attached to the teniae coli

A

Omental Appendices

91
Q

Large Intestine, ___ has two layers:

External layer of longitudinal smooth muscle

Internal layer of circular smooth muscle

A

Muscluaris

92
Q

Portions of this layer are thickened, forming three bands called teniae coli

A

External Muscularis of Large Intestine

93
Q

Teniae coli contract causing the large intestine to gather together forming ____

These give the colon it’s “puckered” or “pouched” appearance

A

Haustra

94
Q

Large Intestine, _____ is areolar connective tissue

A

Submucosa

95
Q

Large Intestine, Mucosa has 3 tissues:

A

Simple columnar epithelium

Lamina propria

Muscluaris mucoasae

96
Q

Large Intestine, Mucosa-
Simple columnar epithelium:
Mostly absorptive and goblet cells (located in crypts of ____ in intestinal glands)

A

Lieberkuhn

97
Q

Large Intestine:
Mucosa-
Lamina Propria

Solitary ___ ___ found in this layer extending to the submucosa

A

Lymphatic nodules

98
Q

There are not ___ ___ (___) or villi in the Large intestine

A

Circular folds (plicae)

99
Q

Mucus is secreted by cells in the colon

No ___ are secreted

Chemical digestion in colon occurs through the activity of ___

A

Enzymes

Bacteria

100
Q

Large Intestine:
Releases hydrogen, carbon dioxide, methane gases
Leads to flatus (gas)

Releases indole, skatole, ___ ___
Gives odor to feces

A

Hydrogen sulfide

101
Q

Bacteria also breakdown remaining ____ into stercobilin

Gives feces normal brown color

A

Bilirubin

102
Q

Although 90% is absorbed in small intestine, ___ ___ continues to absorb water

Usually only 0.5-1.0L of water enters the large intestine daily
~900mL is absorbed
~100mL is excreted

A

Large Intestine

103
Q

As chyme remains in large intestine (3-10 hours), it becomes a solid or semisolid due to water absorption/reabsorption

At it becomes more solid, it is no longer called chyme, it is called ___

A

Feces

104
Q

Feces chemically contains:

  • Water
  • Epithelial cells
  • Bacteria
  • Products of bacterial decomposition
  • Unabsorbed digested materials
  • Indigestible parts of food
A

its poo

105
Q

Smooth muscle is responsible for the movement of food from the lower esophagus to the rectum

Two types of movement occur:

A
  1. Peristalsis

2. Segmentation

106
Q

Wavelike ripple of muscle of hollow organ
A bolus stretches the lumen walls triggering a reflex contraction of muscle that pushes the bolus forward
Each time bolus pushed forward, this cycle repeats itself in that new location

A

Peristalsis

107
Q

A mixing movement
Digestive reflexes cause a forward and backward movement within single segment
Helps to mechanically break down food and mix with digestive juices

A

Segmentation

108
Q

2 different types of motility:

A

Gastric Motility

Intestinal Motility

109
Q

Gastric Motility:
Emptying the stomach takes approximately 2-6 hours after ingestion of a meal

The ___ ___ opens briefly every 20 seconds, allowing 2-3mL of chyme to pass through

A

Pyloric Sphincter

110
Q

Gastric Motility: Hormonal Regulation-

Fats and other nutrients in the duodenum stimulate the intestinal mucosa to release ___ ___ ___ ___ into bloodstream

AKA GIP (Gastric Inhibitory Polypeptide)

When it reaches stomach via circulation, it has an inhibitory effect on gastric muscle, decreasing the peristalsis motions (this slows gastric emptying)

A

glucose dependent insulinotropic polypeptide (GDIP)

111
Q

Gastric Motility: Nervous system regulation-

Chemoreceptors and baroreceptors stimulated in duodenal mucosa cause a reflex inhibition of gastric peristalsis known as ___ ____

This causes slowing of gastric emptying

A

Enterogastric Reflex

112
Q

Motility where Peristalsis occurs and

Segmentation occurs

A

Intestinal Motility

113
Q

Reflexes of GI system:

A

Gastroileal Reflex

Enterogastric Reflex

Gastrocolic Reflex

Defecation Reflex

114
Q

Secretory and motor activity of the stomach send signals to the terminal/distal portion of the ileum early in the meal causing acceleration of movement through the ileocecal sphincter

A

Gastroileal Reflex

115
Q

Signals from the small and large intestine distension inhibit stomach motility and secretion to allow for more time to move contents forward

A

Enterogastric Reflex

116
Q

Signals from excessive stomach activity (late meal, completion) cause movement of feces in the colon to move forward into the rectum

If paying attention to it, many people can evacuate bowels 45-60 min after a meal

A

Gastrocolic Reflex

117
Q

Distention of the rectum triggers baroreceptors that signal the colon and anal canal to contract

This occurs at a rectal pressure of ~18mmHg

A

Defecation Reflex

118
Q

At ~55mmHg of anal pressure, the internal sphincter relaxes

At this time, the only thing keeping feces inside is the external anal sphincter being voluntarily contracted

Between 18-55mmHg of pressure, you can voluntarily defecate by straining

____ ____ increases abdominal pressure, mechanically pushing fecal matter forward allowing for a bowel movement

Once pressure nears 80mmHg, depending on the person, the external anal sphincter may fail, allowing feces to pass through

A

Valsalva

119
Q

Aging and the GI system:

A

review slides 65 / 66 / 67!

120
Q

Kupffer cells AKA

A

Stellate Reticuloendothelial cells

121
Q

Fixed phagocytes found within sinusoids that help “clean” blood

A

Kupffer cells AKA Stellate Reticuloendothelial cells

122
Q

Destroy worn out red and white blood cells, bacteria, and other foreign matter

A

Kupffer cells AKA Stellate Reticuloendothelial cells

123
Q

Liver functions in carbohydrate (starch) metabolism?

A

glycogenolysis (in low blood plasma glucose)
OR
glycogenesis (high blood plasma glucose)

124
Q

Liver functions in lipid metabolism?

A

synthesize and store triglycerides
synthesize certain lipoproteins
synthesizes some cholesterol
-adds some cholesterol to bil to aid in lipid metabolism

125
Q

Liver functions in protein synthesis?

A

synthesis of transport proteins

-examples: haptoglobulin, IGF binding, sex-hormone binding, thyroxin binding, transferrin, vitamin-D binding

AP II B5 Digestive (4 decks)

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