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S1 Pharmacology > Digestive System > Flashcards

Digestive System Flashcards

1
Q

What is the alimentary tract ?

A
  • tube extending from mouth to anus
  • muscular tube lined internally by epithelium
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2
Q

What are the functions of the alimentary tract ?

A
  • ingestion
  • processing
  • digestion
  • absorption
  • excretion
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3
Q

What is the journey through the alimentary tract ?

A
  • food
  • oral cavity
  • pharynx
  • epiglottis
  • oesophagus
  • stomach
  • duodenum
  • jejunum
  • ileum
  • caecum
  • ascending colon
  • transverse colon
  • descending colon
  • sigmoid colon
  • rectum
  • anus
  • faeces
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4
Q

What are the 4 abdominal quadrants and major organs in each ?

A
  • RUQ - liver
  • RLQ - caecum, appendix, intestine
  • LUQ- stomach
  • LLQ - intestine
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5
Q

What are the abdominal regions ?

A
  • right hypochondriac region
  • epigastric region
  • left hypochondriac region
  • right lumbar region
  • umbilical region
  • left lumbar region
  • right iliac region
  • hypogastric region
  • left iliac region
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6
Q

What are the layers of the wall of the alimentary tract ? (Refer to pic)

A
  • epithelium - inner most lining
  • lamina propria
  • muscularis mucosa
  • submucosa
  • circular muscle
  • longitudinal muscle
  • adventitia
  • serosa
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7
Q

What is the role of epithelium in mucous membrane ?

A
  • moistened by glandular secretions
  • type of epithelium differed with tissue function
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8
Q

What is the lamina propria ?

A
  • loose connective tissue
  • small blood vessels, nerve fibres, lymphatic’s
  • immune cells - e.g. macrophages + lymphocytes
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9
Q

What is the muscularis mucosa ?

A
  • thin muscle layer
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10
Q

List the 3 layer of mucosa ?

A
  • epithelium
  • lamina propria
  • muscularis mucosa
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11
Q

What is the submucosa ?

A
  • 2nd layer of connective tissue, between mucosa + main muscle layers
  • contains blood vessels, lymphatics, nerves
  • Neural tissue - SUBMUCOSAL PLEXUS which regulates contractions & glandular secretions
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12
Q

What is the muscularis externa made of ?

A
  • smooth muscle divided into 2 layers
  • inner circular layer
  • outer longitudinal layer
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13
Q

How are the layers of the muscularis externa arranged and what is their function?

A
  • circular layer is a compact spiral + longitudinal is an elongated helix
  • layers orientate in different directions
  • contractions propel materials along tract
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14
Q

What is the myenteric plexus and where is it located ?

A
  • 2nd nerve muscle plexus located between muscle layers of the muscularis external
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15
Q

What is the myentric plexus and where is it located ?

A
  • 2nd nerve muscle plexus located between muscle layers of the muscularis external
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16
Q

What covers the outside of the muscularis externa?

A
  • adventitia and/or serosa
  • Alimentary canal suspended in peritoneal cavity, covered in SEROSA
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17
Q

What is the difference between serosa + adventitia ?

A
  • serosa covers organs in the peritoneal cavity, allowing movement
  • retroperitoneal organs are covered in adventitia, but not serosa, and adventitia helps hold organ structures together.
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18
Q

What lines the oral cavity + what are it’s functions ?

A
  • lined by stratified squamous epithelium
    • Ingestion and fragmentation of food
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19
Q

Where are the small salivary glands located ?

A
  • in submucosa of oral cavity and tongue
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20
Q

What are 3 main groups of large salivary glands ?

A
  • Sublingual: beneath tongue, many ducts
  • Submandibular: floor of mouth, inner surface of mandible, ducts behind teeth
  • Parotid : Largest, empties at the 2nd Molar (gets inflamed if you have mumps)
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21
Q

What is oral drug administration ?

A
  • Given by mouth and swallowed
    • Easiest and safest method, but slow absorption
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22
Q

What is sublingual administration + limitation ?

A
  • placed under the tongue – dissolves in saliva
    • Rapid absorption, higher circulating levels
    • limitation = not for bad-tasting or irritating medications
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23
Q

What is buccal drug administrations + disadvantage ?

A
  • Placed in mouth next to cheek (tablet form)
    • Rapid absorption, higher circulating levels
    • Disadvantage -Possibility of swallowing the pill
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24
Q

How long is the oesophagus + where does it pass through ?

A
  • 25cm long, through diaphragm to stomach
  • contracts rhythmically toward stomach
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25
Q

What is the role of the lower oesophageal sphincter ?

A
  • Prevents reflux, emesis and regurgitation
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26
Q

What is the type of epithelium in the oesophagus above + below the diaphragm ?

A
  • above diaphragm = stratified squamous epithelium
  • below diaphragm = columnar epithelium
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27
Q

What type of muscles are in the muscularis externa ?

A
  • Striated muscle in upper one third
  • Mixture of striated and smooth muscle in middle
  • Smooth muscle lower one third
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28
Q

What are the main components of the lower digestive tract ?

A

• Stomach
• Small Intestine (Duodenum, Jejunum, Ileum)
• Large intestine (Caecum, Appendix, Colon, Rectum)

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29
Q

What kinds of epithelial cells are found in the lower digestive tract ?

A
  • both absorptive & secretory
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30
Q

How is efficiency of absorption improved in the lower digestive tract ?

A
  • improved by increasing surface area of contact
    between epithelia and lumen
    – Intrusions/folding of epithelium (villi or plicae)
    – Inversions (tubular structures), the lumen of which communicate with main lumen
    – Formation of complex glands
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31
Q

What are the main functions of the stomach ?

A
  • Reservoir and Digestion
    • Mixes food it with gastric juices to form a semifluid mass called chyme
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32
Q

What specific processes occur in the stomach related to protein and vitamin B12?

A
  • initiates protein break down + absorption of vitamin B12 through the release of intrinsic factor
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33
Q

How well does the stomach absorb nutrients and drugs?

A
  • Low absorption of nutrients or drugs
    • Highly lipid-soluble substances e.g. alcohol and some drugs absorbed
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34
Q

What are the 4 anatomical regions of the stomach ?

A

– CARDIA (closest to heart)
– FUNDUS (upper area)
– BODY (middle portion)
– PYLORUS (narrow bottom)

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35
Q

What type of epithelium lines the gastric mucosa ?

A
  • columnar epithelium
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36
Q

What are the rugae in gastric mucosa ?

A
  • folds in the gastric mucosa that disappear when the stomach is distended.
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37
Q

What are the gastric pits ?

A
  • Shallow depressions on surface
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38
Q

What type of glands are found in the gastric mucosa?

A

• contains simple tubular gastric glands that open into the gastric pits.

39
Q

What are the cardiac glands responsible for in the stomach ?

A
  • mucus producing glands that provide alkaline layer
40
Q

What are the four cell types found in the corpus-fundic glands? (CEMP)

A
  • Chief (zymogenic) cells: Secrete pepsinogen (converted to pepsin at pH 2-3), gastric lipase (optimum pH 3-6), and chymosin.
    • Parietal (oxyntic) cells : Secrete gastric (hydrochloric) acid and intrinsic factor.
    • Mucous neck cells : Secrete mucus.
    • Endocrine cells: Stimulate secretion of other cell types.
41
Q

What is the function of pyloric glands in the stomach ?

A

• more endocrine cells and no chief cells

42
Q

What is Achlorhydria?

A
  • lack of gastric acid in the stomach.
43
Q

What is Dyspepsia ?

A
  • Difficulty digesting food
44
Q

What is gastritis ?

A
  • Stomach Inflammation
45
Q

What is Gastroenteritis ?

A
  • Inflammation of stomach and small intestine
46
Q

What is haematemesis ?

A
  • Vomiting of blood
47
Q

What is a Hiatal Hernia ?

A
  • Protrusion of the stomach through opening in diaphragm
48
Q

What is Eructation ?

A
  • belching/ burping
49
Q

What is Flatulence ?

A
  • passing gas / farting
50
Q

What is the main function of the small intestine ?

A
  • digestive & absorptive functions (including drugs)
51
Q

What are the 3 subdivisions of the small intestine ?

A
  • Duodenum, Jejunum, Ileum
52
Q

What are the 3 subdivisions of the small intestine ?

A
  • Duodenum, Jejunum, Ileum
53
Q

Where do the pancreatic + bile duct empty into in the small intestine ?

A
  • empty into duodenum
54
Q

What does the small intestine secrete ?

A
  • secretes digestive enzymes, hormones and mucous
55
Q

What are the plicae in the small intestine ?

A
  • folds of mucosa and submucosa (increase area x3)
    – Permanent structures (not distension dependent)
    – Absent from start of duodenum and distal ileum
56
Q

What are intestinal villi and their function?

A
  • cover entire intestinal mucosa
    – Increase surface area by x10
    – Main cell type – Enterocyte - has an absorptive function
57
Q

What are microvilli and their role in the small intestine?

A
  • found on enterocytes, increase area by x20
58
Q

What are tubular glands (crypts of Lieberkuhn) in the small intestine?

A
  • from base of villi through lamina propria to muscularis mucosae
    – Secretion of “intestinal juice”
  • Paneth cells at base of crypt – secretion, control of infection
59
Q

What features of the small intestine enhance absorption?

A
  • Rich blood supply and large absorption/ surface area
60
Q

Where does most drug absorption occur in the small intestine?

A

• most drug absorption occurs in the upper portion of the small intestine

61
Q

What does secretin do in the small intestine?

A
  • released when chyme enters the small intestine - stimulates the release of bicarbonate from the pancreas to neutralize the chyme.
62
Q

What happens in the duodenum during digestion and absorption?

A
  • carbohydrates are broken down into simple sugars
  • proteins are broken down
    – fat emulsified by bile salts, broken down by pancreatic lipase into free fatty acids and monoglycerides, forming micelles for absorption
    – Most minerals (except. Na+, K+ and Cl-) absorbed
63
Q

What is absorbed in the jejunum?

A

• monosaccharides and amino acids are absorbed.
- water-soluble vitamins are absorbed into the bloodstream.
• Fat-soluble vitamins are absorbed into the lymph.

64
Q

What is absorbed in the ileum?

A

– Bile salts are reabsorbed
– Vitamin B12 absorption

65
Q

How does the surface of the large intestine differ from the small intestine?

A
  • Surface relatively smooth – no plicae or villi
    • Crypts of Lieberkuhn – present and longer than Small Intestine
    • Goblet (mucous) cells more numerous than Small Intestine
66
Q

What are the main sections of the large intestine?

A

• Caecum (including the appendix, which contains large amounts of lymphoid tissue).
• Colon : Ascending, Transverse, Descending, and Sigmoid.
• Rectum: (including the anal canal, with an external anal sphincter under voluntary control).

67
Q

What are the primary functions of the large intestine?

A
  • Absorption of fluids and electrolytes (Na+, Cl-)
    • Secretion of electrolytes (K+ and HCO3-) and mucus
    • Bacteria synthesize vitamin K and some B vitamins
    • Peristalsis slow and irregular
    • Formation, storage and periodic elimination of faeces
68
Q

What are the stages in defecation ?

A

• Faeces enters rectum
• Rectum distends, stimulating mass peristalsis
• Levator ani muscle relaxes
• Internal and external sphincter muscles relax
• Anus is pulled up and over faecal mass
• Faecal mass is expelled

69
Q

How is water absorbed ?

A
  • a passive process driven by the transport of solutes (particularly Na+) from the lumen of the
    intestines to the bloodstream
70
Q

What does an antacid do ?

A
  • neutralises stomach acid
71
Q

What does an antidiarrheal do ?

A
  • control loose stools
72
Q

What does antispasmodic do ?

A
  • controls GI spasms
73
Q

What does antiemetic do ?

A
  • prevents regurgitation
74
Q

What does cathartic do ?

A
  • causes vomiting or relieves constipation
75
Q

What does laxative do ?

A
  • relieves constipation
76
Q

What are the main characteristics of the pancreas?

A
  • Pink/Grey organ with no distinct capsule,
    • retroperitoneal organ
    • both Exocrine and Endocrine Functionality
77
Q

What is the endocrine function of the pancreas?

A
  • pancreas produces and secretes insulin, glucagon, and somatostatin via the islets of Langerhans.
78
Q

What is the exocrine function of the pancreas?

A

pancreas secretes digestive enzymes, including:
• Trypsin, Chymotrypsin, Carboxypeptidase
• Pancreatic amylase (requires HCO₃⁻, max activity at pH 7.0)
• Pancreatic lipases (optimal activity pH 7.0–9.0)

79
Q

What are the 4 main cell types in the islets of Langerhans, and what do they secrete?

A

• β-cells: Secrete insulin (70%), lowers BGL
• α-cells: Secrete glucagon (20%), raises BGL
• δ-cells: Secrete somatostatin (5%), inhibits other endocrine cells
• PP/F cells: Secrete pancreatic polypeptide, inhibit bile secretion (2%)

80
Q

What cells secrete pancreatic juice ?

A
  • acini
81
Q

What is the composition of pancreatic juice?

A

• clear, isosmotic alkaline fluid (pH 8) containing digestive enzyme precursors

82
Q

Where is the bulk of the pancreatic juice and bicarbonate secreted from?

A
  • The bulk of the fluid and bicarbonate is secreted by intercalated duct cells, rather than acini.
83
Q

How are enzymes secreted in the pancreas?

A

• Enzymes are secreted from acinar cells as zymogen granules.

84
Q

What induces enzyme-rich secretion from acini?

A
  • Cholecystokinin (CCK) induces enzyme-rich secretion from acini.
85
Q

What stimulates the secretion of bicarbonate from ductal cells?

A
  • Secretin, released in response to pH < 3.0 in the duodenum, causes HCO₃⁻-rich secretion from ductal cells.
86
Q

What is the role of vagal stimulation in pancreatic secretion?

A

• Vagal stimulation is a minor stimulus for pancreatic secretion.

87
Q

What is the ductal system of the pancreas?

A
  • Acini Duct (cuboidal) → Interlobular duct (columnar) → Intercalated duct (columnar) → Pancreatic Duct
88
Q

Role of glucagon, stimulation + inhibition ?

A

• Secreted by α-cells of endocrine pancreas
• Prevents hypoglycaemia by elevating blood glucose levels
• promotes glycogenolysis & gluconeogenesis
• Stimulated by cholinergic system, β-sympathetic fibres
• Inhibited by glucose, insulin, somatostatin, α-sympathetic system

89
Q

Role of insulin + degradation?

A

-synthesised in B cells of islets of langerhans
- degraded by insulinase, primarily in the liver
- increases glucose transporter activity in muscle/adipose tissue (more glucose uptake so more used, so dec glucose)
- minor effect on neuronal tissue

90
Q

What are the effects of low and high glucose levels on the body ?

A
  • low = decreased brain activity
  • high = osmotic water loss, damaged blood vessels
91
Q

What triggers the secretion of somatostatin?

A

• Increased blood glucose
• Increased blood amino acids
• Increased blood fatty acids
- Increased concentrations of upper GI hormones (gastrin, secretin, CCK, VIP) in response to food intake

92
Q

What are the actions of somatostatin ?

A
  • inhibit insulin and glucagon secretion
    • Paracrine with glucagon to regulate insulin secretion
    • Decreases GI tract secretions and absorption
    • Decreased gastric acid secretion
93
Q

What are the 3 types of gastric glands ?

A
  • cardiac glands
  • corpus- fundic glands
  • pyloric glands

S1 Pharmacology (29 decks)

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