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Toni Science > Digestive Systems & Crohns Disease > Flashcards

Digestive Systems & Crohns Disease Flashcards

1
Q

In which part of the digestive system does most chemical digestion occur?

A

Small intestine

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2
Q

Which part of the digestive system is primarily involved in the emulsification of fats?

A

Small intestine

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3
Q

By what process are amino acids absorbed into the blood stream from the small intestine?

A

Co-transport

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4
Q

How are fatty acids and monoglycerides absorbed into the cells of the small intestine?

A

Simple diffusion

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5
Q

What is the function of the pyloric sphincter?

A

Control the passage of chyme into the duodenum

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6
Q

Which part of the small intestine receives pancreatic juice and bile?

A

Duodenum

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7
Q

Which enzyme hydrolyses the glycosidic bonds in sucrose?

A

Sucrase

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8
Q

Which enzymes are involved in the final stage of protein digestion in the small intestine?

A

Dipeptidases

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9
Q

Which layer of the small intestine contains blood and lymph vessels?

A

Sub mucosa

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10
Q

What is the end product of starch digestion by maltase?

A

Glucose

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11
Q

What protects the stomach lining from being digested by its own acid?

A

Mucus layer

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12
Q

What is the primary function of the colon?

A

Reabsorption of water

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13
Q

How are monosaccharides absorbed from the ileum into cells?

A

Facilitated diffusion and co-transport

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14
Q

Where is bile stored until it is needed for digestion?

A

Gall bladder

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15
Q

What is the role of the pancreas in digestion?

A

Production of digestive enzymes

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16
Q

Which substance is NOT a component of bile?
Bile salts, Bile pigments, Insulin, Cholesterol

A

Insulin

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17
Q

Which part of the small intestine is primarily responsible for nutrient absorption?

A

Ileum

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18
Q

What is the main role of villi in the small intestine?

A

Increases surface area for absorption

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19
Q

Which hormone stimulates the production of stomach acid?

A

Gastrin

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20
Q

Which enzyme is denatured by stomach acid?

A

Amylase

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21
Q

What is a micelle in the context of digestion?

A

A small droplet of fat

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22
Q

Which enzyme is responsible for breaking down starch into maltose in the mouth?

A

Amylase

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23
Q

What type of muscle contractions move food through the oesophagus?

A

Peristalsis

24
Q

What is the function of the brush border in the small intestine?

A

Increase surface area for absorption

25
Q

Where does the majority of lipid digestion occur?

A

Small intestine

26
Q

What is the primary digestive function of the gall bladder?

A

Store and concentrate bile

27
Q

Which cells in the pancreas produce insulin?

A

Beta cells

28
Q

What is the role of bicarbonate in pancreatic juice?

A

Neutralise stomach acid

29
Q

Ingestion

A

• Ingestion is the act of taking in food or drink into the mouth.
• Our teeth cut and grind the food into smaller particles mixing saliva with food to moisten it (physical) and aid swallowing.
• Salivary amylase is released from the salivary glands which breaks down starch into maltose (Chemical)

30
Q

Oesophagus

A

• This is then swallowed by an involuntary reflex action through the pharynx (the back of the mouth).
• From here it travels to the stomach which is helped by muscles contracting and relaxing automatically, pushing the food onwards. This movement is known as peristalsis.

31
Q

Stomach

A

• Start of Protein digestion (Pepsin) but amylase denatured.
• Chemical - Glands secrete digestive enzymes and stomach acid which destroy pathogens and unravel proteins. Mucus layer protects the stomach itself
• Mechanical – muscle layers in the stomach churn the food.
• Valves at each end prevent the flow of digestive juices to the tissues
• Gastrin is a hormone secreted by G cells in the stomach in response to eating. It stimulates the production of stomach acid, production of mucus top protect the stomach from acid.

32
Q

The small intestines

A

Made up of three areas:

• Duodenum: This short section is the part of the small intestine that takes in semi-digested food from your stomach through the pylorus, and continues the digestion process. The duodenum also uses bile from your gallbladder, liver and pancreatic enzymes to help digest food.

• Jejunum: The middle section of the small intestine carries food through rapidly, with wave-like muscle contractions, towards the ileum.

• Ileum: This last section is the longest part of your small intestine. The ileum is where most of the nutrients from your food are absorbed before emptying into the large intestine.

33
Q

Pancreas

A

• Twin role
• Production of insulin (beta cells) and glucagon (alpha cells) in regulation of blood sugar

Produces pancreatic enzymes to support digestion:
• Lipase
• Protease
• Pancreatic Amylase

34
Q

Bile, the gallbladder and bile ducts

A

• Bile is a yellowish-green fluid made by the liver. Bile flows from the liver, through the ducts, and to the gallbladder, where it is stored.

Bile is mainly made up of:
• bile salts
• bile pigments (such as bilirubin)
• cholesterol
• water

• If the bile is not needed for digestion, it flows to the gallbladder, where it is stored. When bile is needed to digest food, the gallbladder contracts and releases bile into the small intestine, where it breaks down fats. Bile salt is then reabsorbed and recycled by the ileum

35
Q

Bile contents and digestion

A

• Bile salts help emulsify lipids by forming micelles - emulsification – increases surface area for lipase
• Bile is an alkaline substance so neutralises stomach acid as it enters the duodenum
• Acts as a bactericide to destroy microorganisms

36
Q

The Liver

A

• Has around 500 functions that link to metabolism. Functional cells are hepatocytes.
• Carbohydrate conversion and storage (Glucose/glycogen homeostasis)
• Deamination of amino acids produced ammonia =urea
• Detoxification of substances; lactate, alcohol and hormones and medicines

37
Q

The structure of the ilium

A

The four layers of the ilium are:
Serosa – outer layer of connective tissue
Muscle layer – longitudinal and circular muscles
Sub mucosa – the inner layer containing blood, lymph vessels, nerves
Mucosa – the lining of the small intestine with the epithelial cells on the inside that absorb the nutrients on
the inner surface.

The microvilli that line the epithelial cells of the ilium create a ‘brush border’ that acts to increase the surface
area for absorption.

38
Q

The five steps of carbohydrate digestion and absorption

A
  1. In the mouth salivary amylase hydrolyses the glyosidic bonds between the starch molecule to produce maltose (disaccharide). Salivary amylase in the mouth also contains mineral salts to maintain PH.
    2.Salivary amylase is denatured in the stomach and stomach acid breakdown takes over.
    3.As the chyme is moved from the stomach into the small intestine Pancreatic amylase is then added along with bile to maintain PH.
    4.Epithelial cells lining the ilium contain the enzyme Maltase, a disaccharidase in their
    membranes
    5.The maltose hydrolyses the disaccharide into alpha glucose which is then drawn into the cell through co-transport
39
Q

Other membrane bound disaccharidases

A

• Sucrase hydrolyses the glycosidic bonds in the sucrose molecule which produce the two monosaccharides glucose and fructose.
• Lactase hydrolyses the glycosidic bonds in the lactose molecule which produce the two monosaccharides lactose and galactose.
• These monosaccharides are absorbed through the ilium but in different ways. Galactose is co-transported but fructose is absorbed through facilitated diffusion only

40
Q

Summary of carbohydrate monomer absorption

A

• Glucose – cotransport
• Fructose – facilitated diffusion
• Galactose - cotransport

41
Q

4 Stage of lipid digestion and absorption

A

1.Physical and chemical breakdown in the mouth and stomach acid
2.Chyme passes to the small intestine and bile salts bind and emulsify lipids into small droplets (micelles) and lipase hydrolyses the ester bonds to release fatty acid chains and glycerol in the lumen.
3.As the micelles contact the cell membranes of the microvilli and breakdown releasing the non polar monoglycerides and fatty acids that can diffuse across the cell membranes
4.reformed triglycerides are then moved away by lacteals (lymphatic system)

42
Q

Stages of protein digestion and absorption

A

1.Physical digestion in the mouth from teeth increases surface area
2.The enzyme pepsin, secreted from the cells lining the stomach, create smaller sizes protein polypeptides helped by stomach acid
3.Chyme passes from the stomach into the small intestine and pancreatic juices added which contain other enzymes that break down proteins into dipeptides in the lumen of the ileum.
4.Epithelial cells lining the lumen of the small intestine contain dipeptides enzymes. These enzymes hydrolyse dipeptides into amino acids which are released into the cytoplasm of the cell through co-transport

43
Q

The large intestine:

A

•The body cannot afford to loose this water, so the large intestines job is to slow down the passage of waste so that the water and electrolytes can be reabsorbed, formation and transport of faeces and further chemical digestion by gut microbes.
•The structure of the layers is similar but there are no villi present.
•Faeces is stored in the rectum until it is expelled through the anus

44
Q

Crohn’s disease

A

• Crohn’s is an Inflammatory Bowel Disease (IBD).
• The body starts attacking itself, causing painful ulcers and inflammation in the gut. Although Crohn’s is called an Inflammatory Bowel Disease, any part of the gut can be affected, from your mouth to your anus. It can also affect other parts of your body
• Crohn’s can be diagnosed at any age, most commonly before the age of 30
• At least 1 in every 323 people in the UK are living with Crohn’s Disease.
• Crohn’s is a lifelong condition. You may have periods of good health known as remission, as well as times when symptoms are more active, known as flare-ups or relapses. There is no cure

45
Q

Symptoms of Crohn’s disease

A

• Severe pain in the tummy area (abdominal pain). Location can vary
• Diarrhoea. In Crohn’s, the faeces may sometimes be mixed with mucus, pus or blood.
• Extreme tiredness
• Generally feeling unwell.
• Loss of appetite and weight loss.
• Anaemia

46
Q

Symptoms and impacts of Crohn’s disease

A

• Severe pain in the tummy area (abdominal pain). Sleeplessness, irritability, overuse of painkillers, chronic pain – impact on mental health
• Diarrhoea. Reaching a toilet, restriction on activities, continence concerns, leaking, soreness, dehydration,
• Extreme tiredness – from lack of nutrients, pain, waking for toilet
• Generally feeling unwell. Swelling, pain, fever, inflammation, temperature
• Loss of appetite and weight loss. Lack of absorption of digestive products
• Anaemia. Lack of iron, fewer red blood cells, lower PO2, fatigue, tiredness, impact on lifestyle

47
Q

Causes of Crohn’s

A

• There is no single cause for developing Crohn’s.
• It is thought that a mixture of genetics, the environment, the immune system and microorganisms in the digestive system create the conditions.
• There is some evidence that variation in genes linked to the immune system may be involved

48
Q

Types of Crohn’s disease

A

Depending on the area of inflammation in the gut there are number of different types that can be identified:
. End of small bowl=Terminal ileal and ileocaecal
. Colon= Crohn’s colitis
. Small bowl=ileitis or jejunoileitis
. Upper part of the gut= gasrtroduodenal
. Area around anus= perianal

49
Q

Severity – could be a mixture of two groups

A

• Mild – Need to excrete often, with or without tummy pain, but you can eat normally. There are no signs of dehydration, tenderness in the tummy area or weight loss.
• Moderate– Need to excrete often, have tummy pain or tenderness in this area with fever and possible weight loss.
• Severe or severely active – Very poor general health and one or more symptoms such as weight loss, fever, severe pain in the tummy area and usually 3 to 4 or more loose faeces (diarrhoea) a day

50
Q

Complications in the gut

A

• Fistula– passage from the lumen of the intestine to another area of the body or organ – even the skin.
• Stricture– narrowing of the intestine caused by scar tissue formed from ulcers or inflammation– could cause a blockage
• Perforation of the intestine – creates a hole in the wall which is spill contents into the body (including bacteria)

51
Q

Complications outside the intestines

A

• Around 1 in 2 people develop problems in other parts of the body.
• Most affected are joints, eyes, or skin.
• These are also known as extra-intestinal manifestations or EIMs because they’re outside the gut.
• They often occur when during flare-up but can develop before any signs of bowel problems and even when no symptoms

52
Q

Medications

A

• Anti-diarrhoeal drugs – prevent accidents
• Laxatives and Bulking agents – make faeces easier to pass
• Painkillers and antispasmodics – control pain and reduce cramping
• Liquid only diet for 6-8 weeks during flareups/childhood - relief from food
• Steroids– reduce inflammation
• Immunosuppressants– reduce immune activity to reduce inflammation

53
Q

Surgical treatments

A

The most common operations are to:

• Remove the damaged part of the gut – this is a resection. If a large part is removed then a stoma may be necessary
• Widen a narrowed part of the gut known as a stricture – this is a strictureplasty
• All surgery comes with risks and associated recovery times and impact on the body

54
Q

Biological medicines

A

• Biologics and other targeted medicines are treatments that block particular proteins or chemical pathways involved in inflammation. They are more precise than immunosuppressant medicines.

55
Q

Managing Crohn’s

A

A multidisciplinary team will by led by led by a consultant adult or paediatric gastroenterologist. Teams are different but are likely to include an IBD nurse specialist, specialist gastroenterology dietitian, surgeon, psychologist and expert pharmacist in IBD. They will also refer you to any other health professionals you might need to see

Toni Science (9 decks)

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