Digestive System Flashcards

1
Q

Name all the parts of the GI tract in order

A

Oral cavity –> pharynx –> oesophagus –> stomach –> duodenum –> jejunum –> illium –> caecum –> ascending colon –> transverse colon –> descending colon –> sigmoid colon –> rectum

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2
Q

What are the four major functions of the GI system?

A

Digestion - chemical and mechanical breakdown of food into absorbable units

Absorption - movement of material from GI lumen to ECF

Motiltiy - movement of material through the GI tract as a result of muscle contraction

Secretion - movement of material from cells into lumen or ECF

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3
Q

Describe the genreal structure of the GIT wall

A

All digestive organs have the same four basic layers:

  • Mucosa
  • Submucosa
  • Muscularis externa
  • Serosa
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4
Q

Explain how each of the components of the GIT wall contribtue to the four basic functions of the GIT

A

Modicfications in the mucosa increase the SA for absorption

Muscularis externa contain 2 different smooth muscle orientations to allow for lumen constriction (circular) and extension/contraction (longitudinal). This allows for digestion and motility via phasic contractions.

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5
Q

Compare and contrast tonic vs phasic contractions and paristalsis vs segmentation and explain how they each contribute to GI motility

A

Tonic contractions occurs in some smooth muscle sphinters and the anterior portion of the stomach. They are sustained for minutes or hours and function to stop bolus from moving backwards (exception anus)

Phasic contractions occur in the posterior region of the stomach and in the small intestine. They last a few seconds.

Peristalisis and segmentation are both types of phasic contractions. Peristalisis is responsible for forward movements via successive contractions, moving food, while segmentation is responsible for mixing via alternate contractions, moving but also breaking down food

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6
Q

What is meant by the enteric nervous systyem?

A

The GI tract has its own nervous system, reffered to as the enteric nervous system, also called the gut brain

Digestive activity is provoked by a range of mechanical and chemical stimuli:

  • Stretch (distention)
  • Changes in osmolarity and pH
  • Presence of substrate and end products of digestion

Effectors of digestive activity are smooth muscle and glands

  • Upon stimulation, receptors initiate reflexes that stimulate smooth muscle to mix and move lumen contents

Neurons (intrinsic and extrinsic) and hormones control digestive activity

  • Both nervous system and hormonal (endocrine) control
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7
Q

Explain the differnece between long and shot reflexes in the GIT

A

Short reflexes- mediated by enteric nerve plexuses (gut brain); respond to stimuli in GI tract

Long reflexes- respond to stimuli arising inside or outside of the gut, such as from autonomic nervous system

  • The parasympathetic system enhances the digestive process
  • The sympathetic system inhibits digestion
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8
Q

LIst the internal and external stimuli to the GIT that affect GIT functions via the enteric nervous system

A
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9
Q

What way do the elements of the upper GIT move in swallowing to pervent food going down the trachea?

A

Deglutition (the swallowing reflex) makes sure food goes into the oesophagus. Its steps are:

  1. tongue pushes blous against soft palate and back of mouth, triggering swallowing reflex
  2. breathing is inhibited as the blous passes the closed airway
  3. food moves downward into the oesophagus, propelled by perostaltic waves and aided by gravity
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10
Q

List the 3 functions of the stomach

A
  1. Storage - regulates passage of food into the intestine
  2. Digestion - of lipids and protions, by acid and enzymes, regulates by paracrine signal molecules and hormones
  3. Defence against swallowed pathogens
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11
Q

Describe the six types of secretory cells of the stomach mucosa

A

Exocrine cells:

  • Mucous cells
  • Parietal cells
  • Chief cells

Endocrine/paracrine cells:

  • Enterochromaffin-like (ECL) cells
  • D cells
  • G cells
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12
Q

Explain the role of mucus and bicarbonate in protecting the gastric mucosa

A

Mucus (physical barrier) and bicarbonate (chemical barrier) secretion in the stomach by mucus cells protect the stomach wall from being digested

Breakdown of these protective measures can result in inflammation (gastritis) and peptic ulcer as pepsin and HCL erode the stomach wall

The acid-resistant bacterium Helicobacter pylori causes inflammation of the gastric mucosa leading to gastritis and peptic ulcer disease

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13
Q

Explain the difference between the cephalic and gastric phase of digestion

A

Cephalic phase is anticipatory. Slight, smell, taste and thought of food trigger long reflexes via vagus nerve which serves to prepare the stomach to receive food

Gastric phase is responsive. Presence of food triggers short reflexes via enteric plexus wherin distension of the gut wall and presence of peptides and amino acids in the gastric lumen activate endocrine cells and enteric neurons

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14
Q

Describe how acid is secreted by parietal cells

A

Parietal cells pump H+ (from carbonic acid breakdown) into stomach lumen via H+/K+ ATPase (proton pumps).

HCl is secreted by parietal cells under stimulatation from 3 chemicals: Ach, gastrin and histamine. All three chemicals need to be present and bind to initate large production of HCl. HCl activates pepsinogen (a zymogen [enzyme precursor]), converting it to pepsin

Acid contributes to nonspecific disease resistance by destroying most ingested pathogens

1-3L secreted per day

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15
Q

Name the major excitatory neurotransmitter in the enteric nervous system

A

Acetylcholine

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16
Q

Explain how peristaltic movements cause mixing and slow release of gastric contents into the small intestine

A

Peristaltic contractions in the stomach originate in the upper fundus and sweep down toward the pyloric sphincter

The contraction becomes more vigorous as it reaches the thick-muscles antrum

The strong antral peristaltic contraction propels the chyme forward

A small portion of chyme is pushed through the partially opened pyloric sphincter; slow release

When pyloric sphincter is closed; mixing

17
Q

Explain how carbs and proteins are broken down to monosaccharides and amino acids

A

Carbohydrates are broken down to, and absorbed as, monosaccharides, which are taken up into capillaries

  • Salivary amylase (in mouth) breaks down approximately 50% of the starch, but stops working below pH 4.5
  • Pancreatic amylase converts oligosaccharides and maltose in ~10mins
  • Brush border enzymes (maltase, sucrase, lactase) complete digestion of disaccharides and oligosaccharides to monosaccharides
  • Indigestible carbohydrates (e.g. cellulose) pass out as fibre

Proteins are broken down to, and absorbed as, short peptides and amino acids, which are taken up into capillaries

  • Endopeptidases digest internal peptide bonds. They include pepsin in the stomach, and trypsin and chymotrypsin in the small intestine
  • Exopeptidases digest terminal peptide bonds to release individual amino acids. They include aminopeptidase and carboxypeptidase
18
Q

Compare and contrast the funtions of the small and large intestine

A

SI plays the principal role in digestion and absorption of nutrients (90% OVER 3-6hrs). LI functions to store waste, reabsorb water and defecate

19
Q

Describe the GI hormones

A
20
Q

How does bile assist in the digestion and absorption of fats?

A

Bile is an alkaline solution containing bile salts, bile pigments, cholesterol, neutral fats, phospholipids, and electrolytes. Bile salts emulsify large fat particles into tiny particles which can be attacked by lipiases. The liver produces and secretes 600-1200ml/day

21
Q

What is meant by a chylomicron?

A

Cholesterol + triglycerides + protein

22
Q

Compare and contrast the absorption of the breakdown producs of protein, carbs and fats

A

Protein and carbs broken down into amino acids and monosaccharides. Absorbed directly into the bloodstream via capillaries in the GIT walltem

Fats broken down into chloromicrons and absorbed into the lymphatic system and then move into the bloodstream

23
Q

How does the liver and hepatic portal system protect the body from ingested toxins?

A

The liver recieves blood directly from the GIT via the hepatic portal vein before it goes into systemic circulation. This allows the liver to detoxify the blood (first pass metabolism)

24
Q

Describe the types of cells within the pancreas

A

Exocrine cells: chemical digestion

  • Acinar cells - clusters of secretory cells in acini whihc contain zymogen granules with digestive enzymes
  • Ductal cells (epithelial cells) - produce alkaline secretion (bicarbonate) and transport all secretions

Endocrine cells of pancreatic islets (Islets of Langerhans)

  • Secrete insulin and glucagon into bloodstream
25
Q

Describe the different types of motility in the lower GIT

A

Chyme is released from the stomach in a controlled manner. Little chemical digestion has occurred so need to avoid overwhelming the SI. Slow passage maximises chances of absorption of nutrients

Both segmental and peristaltic contractions occur in the SI and serve to mix and move chyme

Migrating motor complex (MMC): Contractions that begin in the empty stomach and end in the large intestine; Housekeeping function - serves to ‘sweep out’ foor and bacteria from the upper GIT into the colon

Mass movement: 3-4/day in large intestine; Waves of contraction that send bolus of material forward

Defecation

26
Q

What is meant by the terms: vitamin, major essential mineral and minor essential mineral?

A

Vitamins are micronutrient organic compunds found in small amounts within food that cannot be synthesised in the body but are essential for health. There are 13 essential vitamins: 4 fat-soluble and 9 water-soluble

A major essential mineral is a micronutrient which is required by the body in concentrations over 100mg/day

A minor essential mineral is a micronutrient which is required by the body in concentrations under 100mg/day

27
Q

What are the two most common mineral deficiencies in Australia and what factors can alter the balance of minerals in the body?

A

Most common mineral deficiencies in Australia are:

  • Calcium, leading to osteoporosis
  • Iron, leading to anaemia

Balance of minerals in the body may be impacted by:

  • Certain diseases
  • An unbalanced diet
  • Taking mineral supplements
  • Removing certain goods or food groups from the diet
28
Q

What constitutes fibre in the diet and how does it improve GIT function?

A

Fibre is a class of plant substance that is resistant to digestion and absorption in the SI but undergoes complete or partial fermentation in the large intestine. There are 2 types: soluble (forms gels in water) and insoluble. RDI - men 30g, women 25g

Fibre improves GIT function since the body needs to ‘have something left’ after digestion and absorption to form a normal stool

Fibre normalises transit time through the gut by absorbing water

  • Softens faeces so stool moves more easily. A soft but bulky stool is easier to pass (helps avoid constipation)
  • Also bulks up stools - slows transit time so allows time for water reabsorption in colon (helps avoid diarrhoea)

Helps maintain bowel health

  • Lowers risk of developing haemorrhoids
  • And diverticular disease (colon balloons out)
29
Q

How can fibre be beneficial to overall health?

A

Soluble fibre may lower total blood cholesterol levels by lowering LDL

May reduce BP and inflammation (better CV health)

Increases longevity - reduces risk of death from CVD and all cancers (especially colorectal cancer)

Improved control of blood glucose in diabetes

  • Soluble fibre slows the absorption of sugar
  • Insoluble fibre in diet may reduce the risk of type 2 diabetes

Helps achieve a healthy weight

  • More filling so likely to eat less and feel fuller
  • High fibre foods tend to be less energy dense and to take longer to eat
  • Fewer calories for the same volume of food
30
Q

List the factors which stimulate hunger and cause satiety

A

Two competing behavioural states: appetite and satiety

Hypothalamus contains two control centres: Feeding centre and Satiety centre

Sensory input from the nervous system also impacts regulation of food intake: Psychological factors and Stress

2 theories:

  • Glucostatic theory - glucose metabolism by hypothalamic centres regulates food intake
  • Lipostatic theory -signals from fat stores to the brain modulate eating behaviour to maintain a particular weight
31
Q

Explain the role of leptin and neuropeptide Y in the regulation of food intake

A
32
Q

How are micronutrients absorbed in the SI?

A

Fat-soluble vitamins are absorbed with fats (Vitamin A, D, E, K)

  • Through lymphatic system and them into blood

Water-soluble vitamins are absorbed by mediated transport

  • Vitamin B12 is absorbed when complexed to intrinsic factor and absorbed in the ileum

Mineral absorption usually occurs by active transport

  • Iron and calcium absorption is actively regulated
  • Sodium is absorbed by enterocytes and colonocytes
33
Q

Give an overview of how nutrients are absorbed in the body

A

Macromolecular nutrients are broken down by enzymes to their component parts prior to absorption

Hydrophilic nutrients are taken up into the blood stream

Lipophilic nutrients are taken up into the lymphatic system

Indigestible fibre is not broken down or absorbed so passed out in faeces

34
Q

How are monosaccharides and peptides absorbed?

A
35
Q

Why and how are digestive enzymes acitivated after release into the duodenum?

A