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A&P II > Exam 3: GI > Flashcards

Exam 3: GI Flashcards

1
Q

what is mucus composed of

A

mainly water
electrolytes
glycoproteins

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2
Q

what are properties of mucus

A

adherent-sticks to food
body-coats well
low resistance-lubrication
self adherence-sticks together
resistant to digestion
buffering capacity

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3
Q

what shape must food be to swallow

A

bolus

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4
Q

why does mucus need to be resistant to digestion and have buffering capacity

A

can tolerate the HCl and low ph of stomach

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5
Q

what are the two types of saliva

A

serous
mucous

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6
Q

what is contained in serous saliva

A

watery secretion
contains a-amylase

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7
Q

what does amylase digest

A

carbs

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8
Q

what is contained in mucous saliva

A

mucin

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9
Q

can humans digest cellulose

A

no

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10
Q

how much saliva is secreted a day

A

800-1500 ml/day

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11
Q

what is the maximum rate of saliva secretion

A

4ml/min

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12
Q

what kind of saliva does the parotid gland secrete

A

serous

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13
Q

what kind of saliva does the submandibular gland secrete

A

mucous and serous

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14
Q

what kind of saliva does the sublingual gland secrete

A

mucous/serous

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15
Q

what kind of saliva does the buccal gland secrete

A

mucous

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16
Q

what two glands make up 90% of saliva secretion

A

parotid and submandibular

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17
Q

what is the cephalic phase of digestion

A

mouth watering in response to seeing or smelling food
(prepares)

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18
Q

what nerve controls the cephalic phase of digestion

A

vagus

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19
Q

what happens in the gastric phase of digestion

A

initiates digestion through stimulating:
pepcin
chief cells
parietal cells
mucous cells

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20
Q

what happens in the intestinal phase of digestion

A

absorption
nervous and hormonal mechanisms

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21
Q

what are the three phases of digestion

A

cephalic
gastric
intestinal

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22
Q

why doesnt the stomach digest itself

A

gastric mucosal barrier/mucous cells

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23
Q

what is the anatomical portion of the gastric mucosal barrier

A

cell membranes and tight junctions between cells

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24
Q

what is the physiological portion of the gastric mucosal barrier

A

diffused H ions are transported back to lumen

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25
Q

what is found in 95% of patients with duodenal ulcers

A

H pylori

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26
Q

what is found in 100% of gastric ulcers (when alcohol asa, NSAIDs are eliminated)

A

H pylori

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27
Q

what are propterties of H pylori

A

gram -
high urease activity
can withstand acid
NH4 damages epithelial cells in GU
increases acid secretion

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28
Q

what are risk factors for ulcers

A

NSAIDS
H. pylori
alcohol

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29
Q

how do NSIADS affect stomach

A

increased acid production
decreased mucous production

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30
Q

what must happen when chyme moves into small intestines

A

1-acid must be neutralizied
2-macromolecules (proteins, fats, starch) must be broken down for absorption

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31
Q

does pepcin digest protein?

A

no, it digests collagen which binds muscles together

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32
Q

what allows acidic chyme to be neurtalized

A

bicarb from pancreas

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33
Q

how does the pancreas help break down macromolecules

A

secretes digestive enzymes for all food types

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34
Q

what are the grape like structures in the pancreas that store and secrete digestive enzymes

A

acini

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35
Q

what secretes bicarb form the pancreas

A

ducts

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36
Q

what receives secretion from the acini in the pancreas

A

intercalated ducts

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37
Q

what receives the fluid from intercalated ducts in pancreas

A

intralobular ducts

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38
Q

what do islets of langerham do

A

release insulin and glucagon into the blood stream

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39
Q

what type of enzymes are prodouced in islets of langerham (end or exo)

A

endocrine portion

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40
Q

what kind of enzymes (endo or exo) are produced in the acini

A

exocrine

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41
Q

what lines the ducts in the pancreas

A

chloride channel, opens and allows sodium bicarb to escape

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42
Q

what do the chloride ducts in the pancreas transport

A

bicarb

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43
Q

what is produced in pancreas

A

insulin and glucagon
amylase, lipase
tripsonigen
chymotrypsin

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44
Q

what two pancreatic enzymes cleave proteins into polypeptides

A

trypsin
chymotrypsin

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45
Q

what kind of enzymes are trypsin, chymotripsin, carboxypeptidase

A

proteolytic enzymes

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46
Q

what three enzymes breakdown proteins

A

trypsin,
chymotripsin,
carboxypeptidase

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47
Q

what cleaves polypeptides into amino acids

A

carboxypeptidase

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48
Q

what keeps the proteolytic enzymes from eating pancrease

A

-trypsin inhibitors in cell
-they are all stored and secreted in inactive form

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49
Q

what is the precurser to trypsin

A

trypsinogen

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50
Q

what breaks down starches and glycogen into disaccharides

A

pancreatic amylase

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50
Q

what is the precurser to chymotripsin

A

chymotrypsinogen

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51
Q

what is the precurser to carboxypeptidase

A

procarboxypeptidase

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52
Q

what is the only luminal enzyme for carb digestion

A

amylase

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53
Q

all enzymes are secreted in ______ enzyme secretion must be decreased 10-15% of normal to cause problems

A

excess

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54
Q

what are all foods broken down into

A

proteins
carbs
fats

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55
Q

what breaks fats into fatty acids and monoglycerides

A

pancreatic lipase

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56
Q

what breaks phospholipids in fatty acids

A

phospholipase

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57
Q

when you break down fats they are too large to go into blood stream, so what absorbs them

A

lactiles, into lymph, into venous system

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58
Q

what breaks down cholesterol esters in fatty acids

A

cholesterol esterase

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59
Q

What converts trypsinogen to trypsin?

A

enterokinase

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60
Q

where is trypsin inhibitor made

A

inside the pancreas so trypsin in pancreas is still unable to cause harm

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61
Q

what happens when tripsin inhibitor in inhibited or neutralized

A

pancreatitis

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62
Q

where is enterokinase located

A

located in intestinal mucosa

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63
Q

where else is trypisin inhibitor located

A

in lungs

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64
Q

what ph does bicarb neutralize chyme to

A

7-8

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65
Q

what induces bicarb release from pancreas

A

secretin

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66
Q

where is secretin produced

A

S cells of duodenem

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67
Q

how does secretin affect liver

A

increase bile production in liver

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68
Q

how does secretin affect stomach

A

decreases HCl acid production by parietal cells

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69
Q

what produces HCl acid in stomach

A

parietal cells

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70
Q

what increases the rate of exchange between cl and bicarb in pancreas

A

secretin

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71
Q

what stimulates the secretion of fluid and HCO3 in the duodenum

A

the amount of acid entering the duodenum

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72
Q

what stimulates the sescretion of enzymes in the deuodenum

A

amount of fat and proteins entering the duodenum (not carbohydrates)

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73
Q

what stimulates the release of cholesystokinen

A

fat and aminio acids

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74
Q

at what pH is secretin released

A

<4.5

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75
Q

when is the max amount of secretin released

A

pH <3

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76
Q

during meals pH is rarely less than

A

3.5 or 4

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77
Q

what does Brunners glands secrete

A

alkaline mucus

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78
Q

what does the crypts of lieberkuhn do

A

secretes water like fluid (1800 ml day)

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79
Q

where are crypts of lieberkhun located

A

bottom of interstitial villi

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80
Q

why does interstitial villli regrow quickly

A

crypts of lieberkuhn contain lots of stem cells

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81
Q

are their crypts of lieberkuhn in large instestine?

A

yes, not there are no villi or enzyme, so mostly secrete alkaline mucous

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82
Q

what is present in all the digestive tract and alls movement through tract

A

alkaline mucous

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83
Q

what increases mucous production in Gi tract

A

parasympathetic stimulation

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84
Q

what is the major function of the colon

A

absorption of water, forms stool

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85
Q

what stimulates bile release

A

cholecystokinin responding to lipids

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86
Q

What does cholecystokinin do?

A

its a messenger,
does not do anything on its own,
tell the gall bladder to release bile

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87
Q

what is hydrolysis in digestion

A

adding water to nutrients so they can be absorbed in small intestines

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88
Q

what do carbohydrates break down into

A

monosaccharides

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89
Q

what are proteins broken down into

A

small peptides and amino acids

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90
Q

What are fats broken down into?

A

monoglycerides and fatty acids

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91
Q

where does luminial/cavital digestion occur

A

in lumen of GI tract

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92
Q

what carries out luminal digestion

A

enzymes from salivary glands, stomach, pancreas

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93
Q

where does contact/membrane digestion occur

A

in the brush borders of GI tracts

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94
Q

what carries out contact digestion

A

enzymes on brush border of enterocytes

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95
Q

what enzymes are in the salivary glands

A

amyliase
lingual lipase

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96
Q

what enzymes are in the stomach

A

pepsin

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97
Q

what enzymes are in the pancrease

A

amylase
trypsin
chymotripsin
carboxypeptidase
elastase
lipase-colipase
phospholipase
cholesterol esterase

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98
Q

what enzymes are in the intestinal mucosa

A

enterokinase
sucrase, maltase, lactase, trehalase, extrinase
amino-oligopeptidase
dipeptidase

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99
Q

what enzymes are intracellular

A

dipeptidase
tripeptidase

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100
Q

what gets absorbed in the stomach

A

ethanol, NSAIDs, aspirin

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101
Q

what gets absorbed in the duodenum and jejjunum

A

nutrients,
vitamins,
various ions,
water,
electrolytes

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102
Q

what gets absrobed in the ileum

A

bile salts
vitamin B12

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103
Q

what gets absorbed in the colon

A

water and electrolytes

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104
Q

what gets absorbed in the rectum

A

drugs such as steroids and salicylates

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105
Q

what does B12 do

A

RBCs

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106
Q

how many layers do nutrients pass through to get to blood

A

8 layers

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107
Q

what are steps of carbohydrate digestion

A

1-alpha amylase in mouth (5% in mouth, 40 % in stomach)
2- small intestines pancreatic amylase
3- final at brush border

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108
Q

where does lactose (milk) and sucrose digestion occur

A

only brush border

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109
Q

what is lactose made up of

A

galactose and glucose

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110
Q

What is sucrose made of?

A

glucose and fructose

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111
Q

can you absorb lactose and sucrose? or maltose and glu-polymers?

A

NO

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112
Q

80% of all carbs are absorbed as

A

glucose
10-fructose
10-galactose

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113
Q

What is maltose/glu-polymers made of?

A

multiple glucose molecules

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114
Q

what are the steps of protein digestion

A

1- stomach- pepsin (digests collagen)

2-small intestines (trypsin, )

chymotrypsin, carboxypeptidase to amino acids)

3- brush border

4- cytoplasm cells (di and tri peptides)

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115
Q

Proteins are broken down into

A

peptides and amino acids

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116
Q

what are the steps of lipid digestion

A

1- emulsified by bile (enterokinin)
2-enzymatic digestion (lipase into fatty acid and glycerides)

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117
Q

most dietary lipid is

A

neutral fat or triglycerides

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118
Q

what is fat broken down into

A

fatty acids and glycerol

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119
Q

what are micells

A

a water-soluble transporter to transport fat for absorption into the lactile

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120
Q

what percentage of fat is broken down into triglycerides

A

90%

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121
Q

how much fluid enters the body a day from sources

A

diet -2
saliva- 1
stomach -2
bile -1
pancrease -1
SI -2

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122
Q

where is fluid absorbed

A

duodenum and jejunum- 4
ilium -3.5
colon -1.4

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123
Q

what is the movement of water inbody

A

diffusion/osmotic forces

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124
Q

hypotonic chyme results in water

A

absorption

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125
Q

hypertonic chyme results in water

A

entering intestines

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126
Q

chyme is usually what tonicity

A

isotonic

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127
Q

the endocrine system is made up of

A

anything that makes hormones

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128
Q

what two systems keep us in homogenous state

A

neuro system
endocrine system

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129
Q

what is the bodies quick reaction to homogenous state

A

neuro

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130
Q

what is the bodies slow and long lasting reaction to homogenous state

A

endocrine system

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131
Q

endocrine system uses the ________ system to have affect on body

A

venous

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132
Q

where does the paracrine system have affect

A

cell to cell through interstitial fluid

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133
Q

endocrine means it travels in the

A

blood

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134
Q

neuroendocrine means a _________ stimulates a hormone releases that travels in the _________

A

neuron
blood

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135
Q

where does autocrine system have effect

A

cells releases hormone to affect itself

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136
Q

what are the three classes or hormones

A

peptide/protein hormones
steroid hormones
amine hormones

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137
Q

a substance with <100 amino acids is a

A

peptide/polypeptide

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138
Q

a substance with >100 amino acids is a

A

protein

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139
Q

what glands and tissues create peptide/protien hormones

A

hypothalmus
anteiror pituitiary
posterior pituitary
thyroid
pancreas
liver
parathyroid
placenta
kidney
heart
GI tract
adipocyte

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140
Q

how do protein/peptide hormones work

A

there is a receptor on the surface of the target cell

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141
Q

what hormones work on a receptor of the target cell

A

peptide/proteins
amines

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142
Q

steroids are made up of

A

lipids

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143
Q

steroids have their affect by

A

entering the cell and working in cytoplasm

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144
Q

what organs/glands make steroid hormones

A

adrenal cortex
testes
ovaries
corpus luteum
placenta
kidney

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145
Q

What steroid hormones does the adrenal cortex secrete?

A

cortisol
aldosterone
androgens

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146
Q

what steroid hormones do the testes secrete

A

testosterone

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147
Q

what steroid hormones does the ovaries, corpus luteum, and placenta secrete

A

estrogens, progesterone

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148
Q

what steroid hormones does kidney secrete

A

1,25 dihydroxycholecalciferol

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149
Q

what glands/organs secrete amine hormones

A

hypothalamus
thyroid
adrenal medulla

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150
Q

what amine hormone does the hypothaomus secrete

A

dopamine

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151
Q

what does dopamine do

A

neurotransmitter
movement of spinae eretae
motivation
emotion/feel good

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152
Q

what amine hormones does the thyroid secrete

A

T3 T4

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153
Q

what amine hormone does the adrenal medulla secrete

A

NE
EPI

154
Q

where do all amine hormones come from

A

tyrosine

155
Q

what is an example of a transport protein

A

albumin

156
Q

what creates a positive feedback

A

levels too low, tell you to secrete hormone

157
Q

what creates a negative feedback

A

levels too low, tell you to stop secreting hormone

158
Q

Where does the pituitary gland sit?

A

sella tursica

159
Q

which part of the pituitary is vascular driven

A

anterior

160
Q

which part of the pituitary is neurologically driven

A

posterior

161
Q

adeno means

A

glandular

162
Q

antidiuretic hormone (ADH) is also called

A

vasopressin

163
Q

what is released when the posterior pituitary is stimulated

A

oxytocin and vasopressin (ADH)

164
Q

what is secreted from the anterior pituitary

A

growth hormone
adrenocorticotrophic hormone
TSH
FSH, LH
melanocyte stimulating hormone
prolactin

165
Q

what does oxytocin do

A

Milk letdown and uterine contractions

166
Q

What does ADH do?

A

increases NaCl and H20 resorption in kidney increased intravascular volume
vasoconstriction

167
Q

what connects the hypothalamus to the pituitary gland

A

portal system

168
Q

what must be present to cause a release a hormone from anterior pituitary

A

release hormone in hypothalamus, goes through portal system to anterior pituitary

169
Q

what does GHRH release

A

GH

170
Q

what does GnRH release

A

LH
FSH

171
Q

What does PRH stimulate?

A

prolactin

172
Q

What does CRH stimulate?

A

ACTH

173
Q

What does TRH stimulate?

A

TSH

174
Q

what does growth hormone do to liver

A

IGFs

175
Q

what does FSH and LH do to testes/ovaries

A

testoserone/estradiol/progesterone production

176
Q

what does prolactin do to mammary gland

A

produce milk

177
Q

what does ACTH do yo adrenal gland

A

cortisol

178
Q

what does TSH do to thyroid

A

release T3 T4

179
Q

what three things is food broken down into

A

fats
carbs
proteins

180
Q

fats are broken down into

A

fatty acids and glycerol

181
Q

proteins are broken down into

A

amino acids

182
Q

Carbs are broken down into

A

monosaccharides

183
Q

what are the segments of the GI tract

A

mouth
pharynx
esophagus
stomach
small intestine
large intestine
sphincters

184
Q

what does the liver produce for digestion

A

produces bile

185
Q

what does bile do

A

emulsifies fat

186
Q

what does the gall bladder do for digestion

A

stores bile

187
Q

what tells gall bladder to release bile

A

cholecystokinins

188
Q

What are the endocrine functions of the pancreas?

A

insulin
glucagon

189
Q

what does an exocrine gland do

A

Secrete products into ducts, tears and sweat

190
Q

what does a paracrin gland do

A

releases hormones to affect neighboring cells

191
Q

what does an endocrine gland do

A

releases hormone to bloodstream

192
Q

What are the exocrine functions of the pancreas?

A

amylase (carbs)
lipase (fats)
tripsan (proteins)

193
Q

what does the pancreas release to neutralize the gastric pH

A

bicarb

194
Q

why does pancreatits lead to duodenal ulcers

A

pancreas doesnt creat bicarb

195
Q

what do parotid and salivary glands secrete for digestion (and submandibular?)

A

alpha-amylase to digest carbs

196
Q

anatomy review

A
197
Q

what is the outside layer of the GI tract

A

serosa

198
Q

Gi tract muscle shortens the tube (peristalsis)

A

longitudinal

199
Q

what Gi tract muscle creates intestinal tone

A

circular muscle

200
Q

what is the inside layer of the Gi tract

A

mucosa

201
Q

gut wall layers

A
202
Q

what is the enteric nervous system of the GI tract

A

myenteric plexus

203
Q

what are the two nervous systems of the GI tract

A

enteric
autonomic

204
Q

what is the role of the enteric nervous system of the GI tract

A

create intestinal tone

205
Q

what is the role of the mesentery

A

Attaches to abd wall
conduit for blood supply

206
Q

which GI nerve plexus is in between longitudinal and circular muscle

A

myenteric nerve plexus

207
Q

what three things regulate the Gi tract

A

GI peptides
nerves
smooth muscle

208
Q

all Gi hormones are ________

A

peptides

209
Q

what is a VIP

A

vasoactive intestinal peptide (nitrous oxide)

210
Q

can the ENS function without the ANS

A

yes

211
Q

what NS in the Gi tract creates visceral tone

A

ENS (enteric nervous system)

212
Q

what is the effect of exciting a sphincter

A

closes

213
Q

what stimulates the release of gastrin

A

protein
distention
nervous system

214
Q

What inhibits release of gastrin?

A

acid

215
Q

Where is gastrin secreted?

A

G cells in the antrum of the stomach, duodenum, and jejunum

216
Q

what is the action of gastrin

A

stimulates gastric acid secretion and mucosal growth

217
Q

what stimulates the release of cholecystokinin

A

proteins
fats
acids

218
Q

where is cholecystokinin released

A

I cells of the duodenum, jejunum, and ileum

219
Q

what is the action of cholecystokinin

A

stimulates:
pancreatic enzyme secretion
pancreatic bicarb secretion
gallbladder contraction
growth of the exocrine pancreas

inhibits:
gastric emptying

220
Q

what stimulates secretin release

A

acid
fat

221
Q

what is the site of aciton of secretin

A

S cells of duodenum, jejunum and ileum

222
Q

what are the actions of secretin

A

stimulates:
- pepsin secretion
- pancreatic bicarbonate secretion
- biliary bicarbonate secretion
- growth of exocrine pancreas

inhibits:
- gastric acid secretion

223
Q

what stimulates the release of gastric inhibitory peptide

A

proteins
fats
carbs

224
Q

what is the site of secretion of Gastric inhibitory peptide

A

K cells of duodenum and jejunum

225
Q

what are the actions of gastric inhibitory peptide

A

stimulates insulin release,
inhibits gastric acid secretion

226
Q

what stimulates the secretion of motilin

A

Fat, acid, nerve

227
Q

what is the site of secretion of motilin

A

M cells of duodenum and jejunum

228
Q

what is the action of Motilin

A

stimulates gastric motility and intestinal motility

229
Q

T/F most ulcers are caused by excess HCl

A

F, its from decreased mucous

230
Q

what breaks down protein

A

pepsin

231
Q

what stimulates the secretion of pepsin

A

protein ingestion/secretin

232
Q

what breaks down fats

A

lipase and bile

233
Q

what is the location of the enteric NS

A

gut wall from esophagus to anus

234
Q

if sphincter is inhibited it then _______

A

opens

235
Q

what nervous systems exhibit extrinsic control of the GI tract

A

parasympathetic
sympathetic

236
Q

what are the two parts of the enteric nervous system

A

myenteric plexus
submucosal plexus

237
Q

what is the function of the myenteric plexus

A

controls GI motility

238
Q

what are the stimulatory influences of the myenteric plexus

A

tone
contraction frequency/intensitry (peristalsis)

239
Q

sympathetic nerves in the bowel are _______ ganglionic

A

post

240
Q

what are the inhibitory influences of the myenteric plexus

A

decreased sphincter tone (pyloric, ileocecal, LES)

241
Q

where is the submucosal plexus located

A

mucosal layer from esophagus to anus

242
Q

what is the function of the submucosal plexus

A

Secretion
Absorption
Contraction of muscularis mucosa

243
Q

what is the parasympathetic innervation for the first half of the gut

A

vagus nerve

244
Q

what is the parasympathetic innervation for the second half of the gut

A

pelvic nerve

245
Q

Where do parasympathetic nerves originate?

A

pons and sacrum

246
Q

parasympathetic have a _________ postganglionic

A

short

247
Q

where do the sympathetic nerves for the GI tract come from

A

T5-L2

248
Q

how does exciting parasympathetic affect GI

A

increased digestion

249
Q

what kind of influence does the sympathetic have on GI

A

inhibitory

250
Q

What are excitatory neurotransmitters of the Gi tract

A

acetylcholine,
substance P,
serotonin

251
Q

what are the inhibitory neurotransmitters of the GI tract

A

VIP
NO

252
Q

what stimulates sensory afferent neurons in the GI

A

distension of Gut wall
irritation of gut mucosa
specific chemical stimuli

253
Q

what is function of gap junctions in Gi smooth muscle

A

helps cells move as one for peristalsis

254
Q

what is a syncytium

A

When cells are connected together, as by gap junctions, and act as one large cell.

255
Q

what are slow waves

A

-rhythmical changes in membrane potential caused by variations in sodium conductance
-increased membrane potentials, but not to threshold

256
Q

What is a spike potential/wave

A

-occurs when slow waves reach threshold
-cause SM to contract
-Ca enters to cause contraction

257
Q

slow waves are controlled by what ion

A

Na

258
Q

spike waves are controlled by what ion

A

Ca

259
Q

what is the propulsive movement of the GI tract

A

peristalsis

260
Q

orad is towards

A

mouth

261
Q

caudad is to

A

tail

262
Q

what muscle do peristalsis

A

circular and longitudinal muscles

263
Q

what stimuli increase peristalsis

A

1-distension (orad contraction with downstream receptive relaxation)
2-irritation of gut epithelium
3- parasympathetic nervous system

264
Q

how does atropine affect peristalsis

A

decreases, blocks Ach receptors

265
Q

what is another name for portal circulation

A

Hepatic

266
Q

where does blood from stomach, intestines go first

A

liver (portal vein)

267
Q

portal circulation

A
268
Q

what three branches of the aorta supply the Gi

A

celiac trunk
superior mesenteric
inferior mesenteric

269
Q

how does a meal affect GI blood flow

A

increases

270
Q

in villi _______% of oxygen is shunted from artery to vein
what is this called

A

80%
countercurrent oxygen loss

271
Q

what happens to villi when there is circulatory shock, decreased CO, hypotension, mechanical obstruction

A

avascular necrosis to tip of villi, sloughs off

272
Q

what absorbs fats into the lymph system

A

central lacteal in villi

273
Q

how does fat get into blood stream from Gi tract

A

lymph system

274
Q

what is purpose of chewing

A
  • Breaks cells - breaks apart indigestible cellulose
  • Increases surface area
  • Mixes food with saliva
  • Begins digestion of starches (a-amylase, lingual lipase)
  • Lubricates food for swallowing
275
Q

which nerve controls chewing

A

cranial nerve 5, trigeminal (maxillary and mandibular branches)

276
Q

what stimulates the swallow reflex

A

bolus in back of mouth

277
Q

what are the three stages of swallowing

A

voluntary stage,
pharyngeal stage,
esophageal stage

278
Q

what are the 5 processes for swallwoing

A

1) tongue pushes bolus to soft pallate, soft pallate elevates blocking off nasal passage
2) pharyngeal folds keep large food particles out
3) thyroid cartilage moves up and out, epiglottis folds down to block off trachea
4) upper esophageal sphincter dilates/relaxes
5) esophageal peristalsis

279
Q

where does swallowing reflex come from

A

pons

280
Q

what is the continuation of pharyngeal peristalsis in the esophagus

A

primary peristalsis

281
Q

what happens in esophagus after primary peristalsis

A

secondary peristalsis

282
Q

what induces secondary peristalsis

A

distension

283
Q

the upper 1/3 of esophagus is _________- muscle

A

striated

284
Q

the lower 2/3 of esophagus is _______ muscle

A

smooth

285
Q

how does surgery affect elasticity of esophagus

A

decreases

286
Q

what keeps air from entering esophagus

A

upper esophageal sphincter

287
Q

what keeps acid from refluxing into esophagus

A

lower esophageal sphincter

288
Q

what are the layers of the stomach muscles

A

longitudinal
circular
oblique

289
Q

what are the functions of gastric smooth muscle

A
  • Relaxes to accommodate food - orad area (receptive relaxation)
  • Mixes food with gastric juice - caudad area (retropulsion)
  • Propels chyme into duodenum - caudad area (antral pump)
290
Q

what ph does chyme have to be for enzyme function

A

7

291
Q

what 4 factors increase gastric emptying

A

1- increased tone of orad stomach
2- forceful peristalsis contraction
3- decreased tone of pyloris
4- absence of segmental contraction in intestine

292
Q

what 4 factors decrease gastric emptying

A

1- relaxation of orad stomach
2- decreased force of peristaltic contractions
3- increased tone of pyloric sphincter
4- segmentation contraction in intestine

293
Q

activation of intestinal receptors __________ gastric emptying

A

decreases

294
Q

what stimulates intestinal mucosa receptors

A

high or low osmolarity
acids
fats
proteins

295
Q

what do fats and proteins trigger for gastric emptying

A

CCK (cholecystokinin) release increases gastric distensibility which decreases gastric emptying

296
Q

what do acids trigger for gastric emptying

A

decreases via intrinsic neural reflex

297
Q

what are the two types of movement in the small intestines

A

peristalsis
segmentation

298
Q

what movement is a propulsive movement

A

peristalsis

299
Q

what movement is a mixing movement

A

segmentation

300
Q

what sweeps undigested residue toward colon to maintain low bacteria counts in upper intestine

A

migrating motility complexes

301
Q

what is the most coordinated, rapid peristalsis

A

migrating motility complexes

302
Q

what type of intestinal movement happens between meals

A

migrating motility complexes

303
Q

what mediates migrating motility complexes

A

motlin
ENS

304
Q

what mediates the peristaltic reflex

A

ENS

305
Q

what mediates the intestino-intestinal reflex

A

extrinsic nerves

306
Q

what stimulates gastroileal reflex

A

meal
ileocecal sphincter relaxes
ileal peristalsis increases

307
Q

spike potentials and thus contractions depends of what two types of input

A

neural and hormonal

308
Q

What does motilin do?

A

mediates migratory motor complexes

309
Q

what do serotonin and prostaglandins do

A

stimulate motility (large quantities in small intestines)

310
Q

what two structures are in the ileocecal junction

A

valve-prevent backflow
sphincter-regulates movement from ileum to cecum

311
Q

what are the functions of the large intestines

A

-mixes chyme-enhanvces fluid and electrolyte absorption (haustra)
-propels fecal material (mass movement)

312
Q

(more/less) water is reabsorbed in small intestines than in the colon

A

more

313
Q

what muscles are in the large intestines

A

-longitudinal smooth muscle
-circular smooth muscle
-internal anal sphincter
-external anal sphincter
-hausta

314
Q

what is the internal anal sphincter made of

A

circular muscle

315
Q

what is the external anal sphincter made of

A

striated muscle

316
Q

where is myenteric plexus concentrated in large intestines

A

teneae coli

317
Q

where does large intestines receive parasympathetic innervatgion

A

vagus in proximal colon
pelvic nerves S2-s4 in distal colon, rectum/anus

318
Q

what innervates in external anal sphincter

A

pudendal nerve

319
Q

what is the purpose of haustral contractions

A

mixing movements facilitate fluid and electrolyte absorption

320
Q

what is the propulsive movement of the large intestines

A

mass movement

321
Q

when do mass movements occur

A

after meals
reflexes like gastrocolic reflex and duodenocolic reflex

322
Q

what are the three levels of control of defecation

A

intrinsic reflex
spinal cord reflex
involvement of higher centers

323
Q

what are steps intrinsic defecation reflection

A

1-mass movement goes into rectum
2-rectal distention sends afferent signals through myenteric plexus
3- internal anal sphincter relaxes and IF external anal sphincter is VOLUNTARILY relaxed then defecation

324
Q

what are the steps of spinal cord defecation reflex

A

1-rectal distension initiates cord reflex afferent signals go to sacral cord and then back to descending and sigmoid colons and rectum
2s2-s4 neurons provide sensory and motor fibers for defecation reflex

325
Q

what is the higher centers defecation reflex

A

valsava maneuver

326
Q

what sphincters are in intestinal tract

A

upper esophageal (keeps air from going down)
lower esophageal (keeps acid from going up)
pyloric sphincter (holds food in stomach
ileocecal (small to large, ileum to cecum)
internal anal (myenteric)
external (voluntary)

327
Q

what does the peristaltic reflex do

A

bowel stretch
proximal contraction
distal relaxation

328
Q

what does the enterogastric reflex do

A

from duodenum to regulate gastric emtpying

329
Q

what does the gastroileal reflex do

A

gastric distension relaxes ileocecal sphincter

330
Q

what does the intestino-intestinal reflex do

A

over distension or injury of bowel segment causes bowel to relax

331
Q

what does gastro and duodenocolic reflexes do

A

distention of stomach/duodenum initiates mass movement

332
Q

what initiates the defecation reflex

A

rectal distension initiates defecation

333
Q

Where does bilirubin come from?

A

It comes from the breakdown of heme, a part of the hemoglobin.

334
Q

What is erythropoiesis?

A

production of red blood cells in marrow

335
Q

how long to rbcs live

A

120 days

336
Q

what three areas dispose of RBCs

A

spleen
liver
marrow

337
Q

what breaks down RBC

A

macrophages

338
Q

what are RBCs broken down into

A

heme and globin

339
Q

What is heme broken down into?

A

iron and bilirubin

340
Q

bilirubin is___________ soluble

A

lipid

341
Q

unconjugated bilirubin binds with ___________ to go through blood stream and make it non-toxic

A

albumin

342
Q

bilirubin enters the liver as

A

unconjugated

343
Q

what cells in the liver break down RBCs

A

kupffer cells, also form unconjugated bilirubin

344
Q

what substance in the liver changes bilirubin to conjugated form

A

glucaronic acid

345
Q

conjugated bilirubin is ___________ soluble

A

water

346
Q

what happens when bacteria in gut attacks bilirubin

A

changes it back to unconjugated bilirubin (10%)

347
Q

what happens to the bilirubin that is unconjugated by bacteria in bowel

A

5% (half) excreted in urine (gives yellow color)
5% (half) goes back to liver

348
Q

what gives stool its brown color

A

conjugated bilirubin

349
Q

what is another name for parietal cells

A

oxytonic

350
Q

what produces mucus in stomach

A

mucus cells

351
Q

what produces gastrin in stomach

A

G cells

352
Q

what produces somatostatin in stomach

A

D cells

353
Q

what creates HCl in stomach

A

parietal cells

354
Q

what produces pepsinogen in stomach

A

chief cells

355
Q

What converts pepsinogen to pepsin?

A

HCl

356
Q

what does pepsin do

A

digests proteins

357
Q

where are proton pumps located in stomach

A

parietal cells

358
Q

what is echanged for for H in parietal cells proton pump

A

K

359
Q

what do endochromattin cells produce

A

histamine, then attaches to H2 receptor on parietal cell, stimulates HCl production

360
Q

what does gastrin do

A

goes to blood stream, attaches to G receptor on parietal cell to stimulate HCL
also attaches to endochromattin cell G receptor which stimulates histamine and thus HCL

361
Q

what nuerotransmitter from vagus nerve stimulates endochromattin cell

A

Ach

362
Q

what are the two areas of affect of Vagus nerve in stomach

A

endochromattin cell
muscarinic receptor on parietal cell

363
Q

what are sources of HCl production/stimulation
positive feedback

A

vagus nerve histamine
proton pump in parietal cell
endochromattin cell histamin
G cell gastrin release

364
Q

what are sources of inhibiting HCl

A

-D cells-somatostatin
-arachidonic acid producing prostaglandins

365
Q

where does somastain from D cells have affects

A

ties up gastrin in blood stream
ties up G receptors on parietal cells
negative impact on parietal cells

366
Q

what do prostaglandins do to parietal cell

A

decrease HCl

367
Q

what do prostaglandins do to mucus cells

A

increased mucus and bicarb production

368
Q

how do antacids work

A

neutralize stomach acid, limited affect

369
Q

How do H2 receptor antagonists work? (somatadin)

A

-Decreases gastric acid secretion by blocking H2 receptors on parietal cells of stomach
-not long lasting

370
Q

How do PPIs work? (prilosec)

A

inhibit the H+/K+ proton pump stomach parietal cells.

371
Q

how do nsaids affect stomach acid

A

inhibit cos from arachadonic acid, so no prostaglandin, so no prostaglandins to stoc HCl, produce bicarb, and increase mucous

372
Q

what peptide/protein hormones does thyroid produce

A

calcitonin

373
Q

what peptide/protein hormones does pancreas produce

A

insulin, glucagon, somatostatin

374
Q

what peptide/protein hormones does liver produce

A

somatomedin (IGF-1)

375
Q

what peptide/protein hormones does parathyroid produce

A

PTH

376
Q

what peptide/protein hormones does placenta produce

A

HCGs
HCS
HPL

377
Q

what peptide/protein hormones does kidney. produce

A

renin

378
Q

what peptide/protein hormones does heart produce

A

ANP

379
Q

what peptide/protein hormones does GI tract produce

A

gastrin
CCK
secretin
GIP
somatostatin
GLP-1

380
Q

what peptide/protein hormones does adipocytes produce

A

leptin

381
Q

what peptide/protein hormones does anterior pituitary produce

A

ACTH,
TSH,
FSH,
LH,
PRL,
GH

382
Q

what peptide/protein hormones does does hypothalamus produce

A

TRH,
GnRH,
CRH,
GHRH,
somatostatin

383
Q

what peptide/protein hormones does posterior pituitary produce

A

oxytocin
ADH

A&P II (3 decks)

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