Exam 2 (Neuroendocrine + Oral Digestion) Flashcards
Two types of clinically relevant enteric interneurons
serotonergic
enkephalinergic
What do serotonergic interneurons facilitate?
effector neuron action
Serotonergic NT
serotonin
What 2 responses occur with serotonergic interneurons?
- increase peristalsis
- increase net fluid secretion
What diseases can occur involving serotonergic interneurons?
- carcinoid syndrome
- inflammatory diarrhea (salmonella)
Carcinoid syndrome is a ______ tumor that secretes _____.
neuroendocrine
serotonin
Salmonella is an inflammatory diarrheal disease that increases _____ secretion.
serotonin
Enkephalinergic interneurons overall function
establish “segmentation” pattern
What is the lay term equivalent to enkephalinergic neurons?
“gut endorphins”
What 2 responses occur from Enkephalingeric neurons?
-inhibit effector neurons of alternating segments (= promote mixing contents)
-decrease secretion & increase absorption
What are the overall 3 functions of enkephalingeric interneurons?
- slow aboral transit
- enable mixing
- increase net fluid absorption
What is Loperamide? What’s another name for it?
synthetic opiate (type of enkephalinergic interneuron)
imodium
Functions of Loperamide
mimics enkephalin
anti-diarrheal
____ NS is local while ____ is outside gut wall.
enteric
extrinsic
Which type of innervation has the dominant tone of the alimentary tract?
PSNS
Main function of PSNS innervation of extrinsic NS
promote digestion
coordinate enteric NS
3 responses to PSNS activity in extrinsic NS
- motility patterns (peristalsis)
- net fluid secretion
- vasodilation splanchnic vasculature (up blood flow to GI)
PSNS innervation = same as ______ of Enteric NS because ENS plexis = ______ neurons of PSNS
effector neurons
postganglionic
When does the SNS of the Extrinsic NS have dominant tone on alimentary tract?
fight or flight
or
in long reflex
Main function of SNS innervation of Extrinsic NS
inhibit digestion
recover fluid volume
What 3 responses occur due to the SNS of the Extrinsic NS?
- decreased motility (conserve E)
- increase net fluid absorption
- vasoconstriction of splanchnic vasc.
(SNS/PSNS) increases blood flow to GI tract while (SNS/PSNS) increases circulating blood volume.
PSNS
SNS
Cholinergic innervation of striated muscle occurs what two locations?
esophagus
external anal sphincter
PSNS is made up of what 2 neuron types?
PSNS preganglionic neurons
PSNS postganglionic neurons (interneurons + effector of enteric NS)
SNS makes up what neuron types/pathway?
CNS –> preganglionic neurons –> external ganglia –> postganglionic neurons –> gut
If the gut wall was cut off from the CNS, what NS would be intact? Which would be lost?
enteric NS intact
SNS lost
What responses would be seen if CNS cut off from gut wall?
up peristalsis
up secretion
up vasodilation
dominant PSNS control, no SNS
Long reflexes are part of the ____ nervous system.
extrinsic
What is the function of long reflexes?
regulate digesta over long intestine distances
What are the two main types of long reflexes?
stimulatory
inhibitory
What is one type of stimulatory long reflex? What organ is acted on?
gastrocolic (stomach –> colon)
What are the 4 types of inhibitory long reflexes? What organs are acted on?
- enterogastric (SI –> stomach)
- enteroenteric (SI –> SI)
- coloileal (colon –> terminal part SI)
- ileogastric (ileum –> stomach)
Stimulus of Gastrocolic Reflex
full stomach (stretch)
Response of Gastrocolic Reflex
increase colon motility = move content to rectum
What neuron type is present in all long reflexes?
GVA (general visceral afferent) –> send info to CNS
Outcome of Gastrocolic Reflex (PSNS/SNS)
up PSNS
down SNS to colon
Stimulatory Long Reflexes overall function
speed transmit of GI contents
Inhibitory Long Reflexes overall function
slow transit of Gi contents to avoid overfilling of a segment
Enterogastric reflex stimulus
digesta in upper SI
Enterogastric reflex response
inhibit gastric emptying (decrease GI motility)
Output of Enterogastric Reflex (PSNS/SNS)
down PSNS | up SNS
Stimulus of Enteroenteric Reflex
digesta in SI (distal)
Enteroenteric Reflex response
inhibit peristalsis of intestine (distal SI inhibits site oral to it to prevent overfilling)
Enteroenteric Reflex response (PSNS/SNS)
down PSNS
up SNS @ oral site
Coloileal reflex stimulus
full colon (stretch)
Coloileal reflex response
inhibit ileal emptying (decrease motility)
Coloileal reflex Output (PSNS/SNS)
down PSNS
up SNS @ ileum
Ileogastric Reflex Stimulus
full ileum (stretch)
Ileogastric reflex response
inhibit gastric emptying
Ileogastric reflex (PSNS/SNS)
down PSNS
up SNS @ stomach
What are the 4 different modes of action of GI hormones?
- endocrine
- paracrine
- neurocrine
- exocrine
Which mode of action for GI hormones are hormones secreted by nerve cell –> target cell (similar to NTs)?
neurocrine
Which mode of action for GI hormones use local diffusion –> target?
paracrine
Which mode of action for GI hormones enters the bloodstream directly –> target?
endocrine
Which mode of action for GI hormones enter the lumen –> target?
exocrine
What are the 3 main hormone families (GI peptide hormones for GI function)? By what similarities are they grouped?
- Gastrin/Cholecystokinin (CCK)
- Secretin
- Other
Grouped by amino acid composition
What are the 2 neural stimuli for gastrin?
- acetylcholine (vagus N)
- GRP (gastrin-releasing peptide)
What are the 2 luminal stimuli for gastrin?
amino acids (in gastric lumen)
gastric pH > 4
Location of Gastrin
antrum
Cell type that releases Gastrin
G cells
Mode of Action (Gastrin)
endocrine
Target organ for Gastrin
glandular stomach
Response to Gastrin
parietal cells: HCl secretion
chief cells: pepsinogen release
up GI motility
Another name for CCK
pancreozymin
Luminal stimuli for CCK
amino acids (upper SI)
fats (upper SI)
CCK Location
upper SI
Cell type than releases CCK
I cells
Mode of action for CCK
endocrine
Target organs & their responses to CCK (3)
- pancreatic acini –> secrete pancreatic proenzymes
- gallbladder –> contracts GB
- sphincter of oddi –> relaxation (bile release)
Secretin stimulus for release
H+ ions (upper SI)
Secretin Location
upper SI
What cell type releases Secretin?
S cells
Mode of Action for Secretin
endocrine
Target for Secretin
pancreatic duct
Response to Secretin
stimulate HCO3-rich + watery secretion (hydrolatic)
What is the name for the secretion subgroup that contains 3 different GI peptide hormones?
incretin
What 3 peptide hormones are within the incretin subgroup?
- GLP-1 / GLP-2 (glucagon-like peptides)
- GIP (glucose-dependent insulinotropic peptide)
- VIP (vasoactive intestinal peptide)
GLP-1 / GLP-2 Stimuli
carbohydrates (in SI)
hyperosmolar solution (SI)
Location of GLP-1/2
small intestine
Cell type that releases GLP
L cells
Mode of Action of GLP-1/2
endocrine
Targets/Responses (3) of GLP-1/2
pancreatic B cells –> up insulin secretion
stomach –> inhibit GI motility
intestine –> mucosal growth
Which response of GLP-1/2 is via the CNS and therefore neuroendocrine?
inhibition of GI motility in the stomach
GIP stimulus
carbohydrates (in SI)
Location of GIP
small intestine
What cell type release GIP?
K cells
Mode of Action for GIP
endocrine
Target/Response of GIP
pancreatic B cells –> up insulin secretion
What GI peptide is part of the secretin family and is a neurotransmitter similar to secretin (neurocrine)?
VIP (vasoactive intestinal peptide)
Secretin release is coupled with ____ release which stimulates what?
CCK
release of pancreatic proenzymes
= complimentary actions of hormones
What 4 GI peptides are in the “other” family?
- somatostatin
- histamine
- motilin
- guanylin
What is the stimulus for Somatostatin release?
H+ ions (stomach pH < 4)
Location of Somatostatin
stomach
Cell type that produces somatostatin
D cells
Mode of action for Somatostatin
paracrine
Target for Somatostatin
stomach
What two cells produce responses from Somatostatin? What is their response?
parietal cells + chief cells
inhibit gastric acid & pepsin secretion
What other two responses (other than from parietal & chief cells) occur from Somatostatin?
release gastrin (at G cells)
release histamine (ECL)
Overall, what is the response to Somatostatin?
stop gastric secretions
Histamine neural stimulus
acetylcholine
Histamine hormonal stimulus
gastrin
What two things release histamine?
ECL cells
Histaminergic nerves
Where are enteroendrocrine cells that release histamine located?
stomach
Mode of action of Histamine
paracrine (local)
Target organ for histamine
stomach
Response to histamine
HCl secretion (up gastric acid)
Motilin neural stimulus
acetylcholine
What cell type releases motilin?
M cells
Where are enterendocrine cells that release motilin located?
upper SI
Mode of action of motilin
neurocrine (neural cells)
What 2 targets does motilin act on?
stomach + SI
Motilin response
hormonal component to phase 3 migrating motor complexes (peristaltic contractions)
Guanylin stimulus
salt ingestion
What cell type releases guanylin?
goblet cells
Where are enteroendocrine cells that release guanylin located?
large intestine
Mode of action of guanylin
exocrine (into GI lumen)
Target organ of guanylin
large intestine
Response to Guanylin
stim. intestinal secretion
Which two “other” family peptides work together to stimulate clearing of digesta?
guanylin + motilin
What disease causes secretory diarrhea by E. coli toxin binding to guanylin receptor?
colibacillosis (traveler’s diarrhea)
Colibacillosis is caused by E. coli toxin binding to _____ receptor = diarrhea
guanylin
Agonist-receptor interactions are similar to what?
many drugs
Agonist properties are based on ____ and ____.
affinity
efficacy
Affinity
ability of hormone to bind to receptor
Efficiacy
ability of hormone to activate receptor
Match affinity + efficacy of categories of hormone agonists:
(high/low/partial/none)
Full agonist
Partial agonist
Full antagonist
Full agonist: high affinity | high efficacy
Partial agonist: high affinity | partial efficacy
Full antagonist: high affinity | no efficacy
Example of two hormones that increase in concentration at different times of digestion and can act on each other’s receptors.
Gastrin + CCK
Increased ____ concentration occurs when the stomach fills, and as food enters SI, the _____ concentration increases, decreasing the efficacy of _____ at its receptor ____.
gastrin
CCK
gastrin
CCKB
What is the overall result of the varying concentrations of gastrin + CCK able to act on each other’s receptors?
entry of digesta in duodenum slows outflow from stomach
Example of stimulus-response coupling
crypt fluid secretion
The response to an agonist is usually dependent on ________.
2nd messengers
2 main categories of intracellular messengers
- cyclic nucleotides (cAMP/cGMP)
- intracellular Ca2+ mobilization
Process of cyclic nucleotide messengers when an agonist binds
- receptor stim. ATP/GTP
- converted to cAMP/cGMP
- protein kinase A/G activated
= secretion of Cl- + HCO3-
How long do the effects of cyclic nucleotide messengers last?
minutes to hours
Example of cyclic nucleotide messenger
VIP neurotransmitter (stim. intestinal secretion)
Clinical relevance: ______ are the main intracellular messengers in intestinal epithelia stimulated by _______ from pathogenic bacteria.
cyclic nucleotides
enterotoxins
Pathological: in excess, cyclic nucleotides cause what?
secretory diarrhea
Intracellular Ca2+ mobilization (2nd messenger) is (shorter/longer) acting than cyclic nucleotides.
shorter
Intracellular Ca2+ mobilization process when an agonist binds
Receptor increases intracell. Ca2+ (direct via protein kinase C or calmodulin
= epithelial fluid secretion
How long do the effects of intracellular Ca2+ mobilizations last?
seconds to minutes
Example of intracellular Ca2+ mobilization
cholinergic neural stim. of intestinal secretions
(Cyclic nucleotide / intracellular Ca2+ mobilization) second messenger method is not used by many pathogens.
intracellular Ca2+ mobilization
Systemic hormones don’t originate from ____.
GI tract
_____ hormones are systemic hormones.
adrenal
Two types of adrenal hormones (systemic)
epinephrine
adrenocorticosteroids
Two sub-types of adrenocorticosteroids
aldosterone
glucocorticoids
Epinephrine uses (PSNS/SNS) action via adrenergic receptors.
SNS
3 responses to epinephrine
- down motility
- up absorption
- down GI blood flow
Aldosterone increases ____ absorption in the colon / salivary duct.
Na+
What 2 things increase due to aldosterone production?
- Na+ channels (ENAC)
- Na+ pump
Aldosterone has the same effect in _____ as in the colon/salivary duct.
distal tubule of kidney
What 3 responses occur from glucocorticoid secretion?
- up Na/K ATPase
- down prostaglandin tone
- suppress immune system
Submucosal control is (systemic/local).
local (paracrine)
In a non-pathological state, prostaglandins promote what 3 things?
- motility
- secretion
- vasodilation (up flow)
In a pathological state, submucosal control causes increase in _____ & ____, leading to what 2 responses?
WBCs & prostaglandins
diarrhea & intestinal muscle spasms
What are the 4 cell types under submucosal control?
- fibroblasts
- macrophages
- PMNs + eosinophils
- mast cells
What cell type is the major source of prostaglandins in the physiological state under submucosal control?
fibroblasts
Fibroblasts produce prostaglandins when there is ____ damage for what purpose?
mucosal
protective: up flow + secretion = flush & repair
What cell type produces just prostaglandins under submucosal control?
macrophages
What two substances do PMN’s & eosinophils produce under submucosal control?
prostaglandins
serotonin
What cell type is aligned with effector neurons in intestine and release histamine?
mast cells
Which cell type under submucosal control has a role in allergic states?
mast cells
Histamine release from mast cells causes what?
increased fluid secretion = “wash away” antigens
Why do food allergies occur?
up food sensitivity to food antigen = diarrhea
Term for “seizing & conveying of food into the mouth”
Prehension
Cattle prehension organ
tongue (grasp grass + scoop grain)
Sheep prehension organs
tongue + cleft upper lip
graze closer to ground
Horse prehension organ
mobile upper lip (fine motor movements)
Pig prehension organ
pointed lower jaw (root/shovel)
How do herbivores & omnivores drink?
via suction
How to carnivore undergo prehension?
tearing movements (teeth, jaws, head)
How to carnivores drink?
lapping
4 functions of mastication
- reduces food size
- up surface area
- break cellulose (more starch available)
- mixes food w/ saliva
What 3 things does mixing food with saliva add to it for mastication?
buffers
enzymes
mucous
What is the first step of mastication?
biting smaller bits (reduce size) to increase surface area
Herbivores masticate by ________ to increase surface area.
grinding of plant matter
Ruminants grind plant matter during initial intake and ______.
rumination
Cheek teeth of herbivores are (hypsodont/brachydont) meaning _____.
hypsodont
continuously growing
What kind of teeth have rough table surface & lateral + vertical movements of the jaw?
cheek teeth
Carnivores masticate only to ______.
reduce food to swallowing size
Omnivores masticate on _____ diet while gulping on _____ diet.
plant
carnivorous
What condition do lateral + circular movements cause on horses?
“points” on outer upper arcade & inner lower arcade
What is the main sign of “points” on teeth? How is it treated?
dropping food
float teeth
What tools are used to float horse teeth?
long handled rasps to grind down teeth
2 signs of malocclusion
weight loss
drop food
Malocclusion occurs when maxillary arcade (overgrows/stops growing) and mandibular arcade (overgrows/stops growing).
overgrow
stops growing
How do you treat malocclusion horses?
soak pelleted horse feed in water = “gruel” so they can eat