Digestive System-upper

Question 1

The digestive system is a layered hollow tube, generally consisting of mucosa, submucosa, ______ ____ and serosa, when continuous with mesentery, and ____ where fixed to the wall of the cavity

Answer 1

muscularis externa

adventitia

Question 2

The esophagus is lined by a stratified squamous ________ epithelium

Answer 2

nonkeratinized

Question 3

The mucosa of the esophagus consists of mucous secreting esophageal ____ glands and esophageal glands _____ in the submucosa. ____ glands are more abundant.

Answer 3

cardiac
proper
proper.

The esophageal glands proper are primarily mucous secreting but also have some serous cells.

Question 4

The muscularis mucosa of the mucosal layer consists of a single ____ layer of ____ muscle

Answer 4

longitudal

smooth

Question 5

In the upper third of the muscalris externa, ____ muscle occurs. In the middle third, both smooth and striated muscle occur. In the distal 3rd, there is _____ muscle

Answer 5

skeletal

smooth

Question 6

The two physiological sphincters of the esophagus are the upper ______ and the _____ located in the lower portion of the esophagus. Both sphincters are found in this layer: __________

Answer 6

pharyngeoesophageal
gastroesophageal
muscularis externa

Question 7

The upper sphincter initiates ___ and the lower esophageal sphincter prevents _____ ___ from stomach to esophagus

Answer 7

swallowing

acid reflux

Question 8

Persistant acid reflux can lead to _____

Answer 8

GERD

gastroesphageal reflux disease

Question 9

Throughout the GI tract, we have the _____ plexus found between the muscle layers of the muscularis externa

Answer 9

myenteric (Auerbach’s)

Question 10

At the gastro-esophageal junction, the epithelium switches from _____ to _____ abruptly

Answer 10

stratified squamous

columnar

Question 11

_____ Esophagus is caused by an abnormal growth of simple columnar cells into the lower esophagus. This causes them to be more easily injured by stomach acid. It is a risk factor for _____ of the esophagus, and is 3x more common in this gender _____

Answer 11

Barrett’s
adenocarcinoma
males

Question 12

If the esophageal hiatus in the diaphragm does not close entirely during development, a ____ _____ results. This causes reflux esophagitis and ulceration often, leading to difficulty swallowing and a feeling of a lump in the throat.

Answer 12

hiatal hernia

Question 13

Longitudinal folds of the mucosa and submucosa called rugae are found in the _____ and disappear when distended.

Answer 13

stomach

Question 14

The stomach has numerous gastric pits that are deepest in the _____ and shallowest in the ____

Answer 14

pylorus

cardia

Question 15

Gastric pits produce ____ rich in ____

Answer 15

mucous

bicarbonate

Question 16

The _____ part of the stomach is the primary contributor to gastric juice. It has simple tubular glands, shallow gland pits with abundant ____ and ____ cells

Answer 16

fundus
parietal
chief

Question 17

The ____ part of the stomach consists of tubular glands with a coiled end. These glands are _____ _____

Answer 17

cardia

mucous secreting

Question 18

The ____ part of the stomach consists of deep gastric pits with _____ glands. This part of the stomach also contains ____ secreting G-cells

Answer 18

pyloric
branched
gastrin

Question 19

The gastric mucosa consists of _____ epithelium that are mucous producing. The rest of the mucosa includes the lamina propria, ___ glands, and muscularis mucosae

Answer 19

simple columnar

gastric

Question 20

The muscularis mucosae of the stomach consists of a poorly defined inner ____ layer and an outer ____ layer of smooth muscle

Answer 20

circular

longitudinal

Question 21

The gastric submucosa consists of dense irregular _____ CT with fibroblasts, mast cells, and lymphoid elements. It also contains _____ plexus

Answer 21

collagenous

meissner’s

Question 22

The gastric muscularis externae consits of 3 layers: an incomplete inner ____; a thick middle _____; and an outer ____ layer. The _____ layer forms the pyloric sphincter

Answer 22

oblique
circular
longitudinal
middle

Question 23

Chyme characteristics such as viscosity, pH, lipid content, osmolality, and caloric density influence the stomach _____ _____

Answer 23

emptying rate

Question 24

Gastric _____ covers the external surface of the stomach

Answer 24

serosa

Question 25

The epithelium of the ____ and ____ regions of the stomach consits of mucous secreting surface lining cells

Answer 25

body, fundus

Question 26

Gastric glands are _____ tubuluar and consist of an _____ that connects the gland to the base of a gastric pit, a neck, and a ____

Answer 26

simple isthmus base

Question 27

Gastric glands consist of 5 types of cells:

Answer 27

``` parietal chief mucous neck enteroendocrine regenerative ```

Question 28

regenerative cells are located primarily in the ____ and ____ of gastric glands and replace all other cells in the gland, pit, and luminal surface

Answer 28

neck, isthmus

Question 29

The surface lining cells of the stomach consist of simple columnar cells that contain apically located ____ granules. These cells secrete a cloudy, viscous mucous with a high _____ content that protects from acid

Answer 29

mucinogen | bicarbonate

Question 30

Mucous neck cells are found in the neck of _____ _____

Answer 30

gastric glands

Question 31

Mucous neck cells have short _____, apical mucous granules, and a prominent _____

Answer 31

microvilli | golgi

Question 32

Mucous neck cells secrete a solubule mucous upon _____ stimulation that is not as thick as mucous produced by _____ ____ cells

Answer 32

vagal | surface lining

Question 33

____ cells are pyramidal shaped cells found in the upper half of gastric glands that stain red-pink with H and E

Answer 33

parietal

Question 34

parietal cells secrete _____ and gastric ____ ____ (needed for Vit B12 absorption)

Answer 34

HCl | intrinsic factor

Question 35

Parietal cells are an intracellular _______ system, contain many mitochondria, and have secretary intracellular canaliculi that are deep invaginations of the apical plasma membrane lined by ____

Answer 35

tubulovesicular | microvilli

Question 36

When stimulated to secrete HCl, the number of microvilli ____ and the complexity of the tubulovesicular system _____ in parietal cells

Answer 36

increase | decreases

Question 37

Parietal cell secretion: Histamine binds to histamine __ receptor and increases the effects of ____ and ____ on parietal cell secretion. Histamine is produced by ______-like cells in the lamina propria around gastric glands

Answer 37

H2 Acetycholine gastrin enterochromaffin

Question 38

Anti-acid drugs like cimetidine _____ histamine-dependent acid secretion. Others such as omeprazole bind to H+, K+-dependent _____ and _____ acid secretion

Answer 38

inhibit ATPase inactivate

Question 39

Carbon dioxide produced by the blood and parietal cells combines with hydroxyl ions to form _____ ___. This dissociates to bicarbonate ions and hydrogen ions. Bicarbonate diffuses out of the cell and is picked up by _____. This affects blood and mucus ____ on the surface

Answer 39

carbonic acid capillaries pH

Question 40

____ cells are pyramidal shaped cells in the lower half of fundic glands. These stain blue with H and E

Answer 40

CHIEF

Question 41

Chief cells secrete _____, ____, and ___ precursors

Answer 41

pepsinogen rennin lipase

Question 42

Chief cells have abundant basally located rER, a supranuclear _____ and apical secretory granules that release _____

Answer 42

GOLGI | zymogens

Question 43

Enteroendocrine cells belong to a population of ______ _____ cells (DINES). They are also called APUD cells or ______ precursor _____ ___ cells, although not all enteroendocrine cells take up these _____ precursor

Answer 43

Diffuse neuroendocrine amine precursor and decarboxylation amine

Question 44

There are more than a dozen different cell types of _____ cells that contain small hormone-containing granules, although a given cell only secretes one hormone.

Answer 44

enteroendocrine

Question 45

Gastric juices are very _____.This facilitates activation of ____ to ____ to catalyze the partial hydrolysis of proteins

Answer 45

acidic | pepsinogen, pepsin

Question 46

Gastric secretion is affected by neural (____ nerve) and ____ activity

Answer 46

vagal | hormonal

Question 47

_____ is released by cells in the duodenum when ph is less than 4.5. This stimulates pancreatic ___ and fluid secretion, and stimulate chief cells to ____

Answer 47

secretin bicarbonate secrete pepsinogen

Question 48

_____ is produced by G-cells in the pylorus and duodenal mucosa. It stimulates _____ secretion

Answer 48

gastrin | HCl

Question 49

Somatostatin is produced by D cells of the pylorus and _____. It inhibits _____ release and directly inhibits _____ secretion

Answer 49

duodenum gastrin HCl

Question 50

_____ ____ peptide (urogastrone) is produced by cells in the duodenum and jejunum. It directly inhibits HCl secretion and stimulates ____ release

Answer 50

gastric inhibitory | insulin

Question 51

____ is produced in the duodenum and jejunum. It stimulates gall bladder contraction when fat is in the ____ intestine

Answer 51

Cholescystekinin (CCK) | small

Question 52

___ is released cyclically during fasting from cells in the upper GI tract. It stimulates _____

Answer 52

motilin | motility

Question 53

_____ is gastric mucosal inflammation common in middle aged and older individuals

Answer 53

gastritis

Question 54

______ syndrome occurs when patients with gastrin secreting tumors have hyperplasia and hypertrophy of the fundus.____ acid secretion also occurs.

Answer 54

Zollinger-ellison | high

Question 55

Gastric and Peptic ulcers are areas of gastric and duodenal mucosa being destroyed by gastric secretions, They commonly occur in ____ and ____ regions and the first part of the duodenum

Answer 55

cardiac, pyloric

Question 56

Gastric/Peptic ulcers are caused by excessive ___ secretions, ____ irritation, reduced vascular supply, reduced ____ secretion, infection, and ______ such as aspirin

Answer 56

HCl nervous mucous NSAIDS

Question 57

The three phases of H. Pylori Infection are:

Answer 57

active stationary colonization

Question 58

In the active phase of H. pylori infection, gastric pH is ____ by producing ammonia via _____

Answer 58

increased | urease

Question 59

In the ____ phase of H. Pylori infection, bacteria attach to ____ containing receptors on the surface of mucous cells in the pylorus, releasing proteases that kill surface cells

Answer 59

stationary | fructose

Question 60

In the ____ phase of H. pylori infection, bacrteria detach and replicate in mucus blanket.

Answer 60

colonization