Exam 4 - Digestive System Flashcards
What are the organs that make up the gastrointestinal tract
Mouth, pharynx, esophagus, stomach, small intestine, large intestine, rectum anus
What are the accessory organs of the digestive tract
pancreas, liver, gallbladder, salivary glands
What is another name for the digestive system
The alimentary system
What is each area of the digestive tract specialized for
Mouth/pharynx: digestion (mechanical and chemical), mastication, lubrication, and propulsion
Esophagus: conduit
Stomach: storage, digestion (churning, proteases, stomach acid)
Small intestine: Digestion and absorption
Large intestine: water and electrolyte balance
List and state the function of the sphincters in the body
Upper esophageal: swallowing
Lower esophageal: prevent gastric reflux into esophagus
Pyloric sphincter: partial regulation of gastric emptying, prevents duodenal-gastric reflux
ileocecal sphincter: separates large and small intestine
internal and external anal sphincters: control defication
Functions of accessory organs in relation to digestion
Liver: makes bile
Gallbladder: stores bile
Salivary glands: secretes mucous and amylase and saliva
Pancreas: secretes enzymes for digestion into lumen of small intestine
List and state function of cells of the mucousa
Surface cells: on villi of crypts of lieberkuhn, increase SA, minor digestive function
Goblet cells: secrete mucous
Stem/progeneter cells: at bottom, differentiate
Enteric endocrine cells: deepest part of crypt, secrete hormones into blood and secrete mucous
Undifferentiated cells: at bottom, turn into any cells
What must occur before food can be assimilated
Food must be digested into component molecules and absorbed into the blood/lymph
Carbohydrates: ingestion, digestion, and absorption
Ingested: 1/2 daily caloric intake as sugar or disaccharides
Digested: mouth - amylase small intestine - amylose (1,4): maltose and maltotriose amylopectin (1,6): alpha limited dextrins Villi - lactase: glucose and galactose Glucoamylase (1,4 gluc bonds) sucrase-isomaltase sucrase (1,4) isomalt (1,4 and 1,6)
Absorption:
lactose: Na+/gluco co-transporter
Fructose: GLUT5
GLUT2: basolat for gluc and galact
Proteins Ingestion, Digestion, and Absorption
Ingestion: 1/6 daily caloric intake as protein/large peptides
Digestion: stomach - pepsin small intestine trypsin and chymotripsin: oligosacch minimal carboxypeptidase: individual aa brush border: multiple peptidase to make individual aa
Absorption: apical (2nd active) aa: Na/aa co-trans di/tri: H+/peptide co-trans In cell all made aa Basolat (passive): aa channel down []
Lipids Ingestion, Digestion and Absorption
Ingestion: triglycerides
Digestion: small intestine only (no brush border)
lipase: breaks down on surface only
colipase: holds lipase to fat droplets until free fatty a and monoglyc
emulsification: churning and bile salts break down giant fat droplets into smaller so lipase works better
Absorption:
some: micelles in lumen
all eventually: passive diffusion thru membrane into cell and returned into triglyc
Absorptive process of Lipids
- Micelle to enterocyte
- reform triglyceride
- cholomicron
- exocytosed basolateral
- lacteals
- lymph vessels
- thoracic duct
- subclavian vein
Functions of the GI tract
Digestion
Excretion into the feces (via bile)
Water and electrolyte balance (no control)
Defense
Immunological - lymph nodes, mast cells, macrophages
Non-immunological: gastric acid, mucin, peristalsis
What is the source of fluid in the small intestine
Secretion by stomach and small intestine
Why is the immune system important to the GI tracct
it is all open to the external world which is a very large SA
Digestive Control and examples
Coordination of multiple secretory, enzymatic, and motor process (ex. acid in the stomach w/motor activity at the SAME TIME)
Neuronal, hormonal, and paracrine agents (thought of food, one hormone stim other)
Endocrine, neural and paracrine (ENS)
Where is the ENS located and what kinds of neurons does it have
The submucosal plexis is between the submucosa and mucosal layers
The myenteric plexis is between the outer longitudinal and next layer in
It is sensory, motor and interneurons
What are the functions of the Enteric Nervous System
controls vasoconstriction, secretion of secretory cells, and the mechano and chemoreceptors of the mucosa
Describe the brain-gut axis including descriptions of the innervations of the GI tract by the parasympathetic and sympathetic nervous systems
The brain gut axis is two way communication between the GI tract and the brain.
Parasymp is mainly responsible
Vagus nerve to majority acting as th epostgang of parasymp so releases ACh on M2 and M3 receptors
Pelvic Nerve to descending colon and beyond
Symp - no evidence
Describe the types of GI motor activity
Churning - mixing
Peristalsis - movement/propulsion forward
Reservior action - prevents anything from entering the small intestine while maintaining low P
Describe how sphincters regulate flow and their interactions with surrounding smooth muscle
Proximal stimulation = relaxation
Distal stimulation = contraction
Describe the stages of deglutition
Voluntary phase - tongue bushes the bolus towards oropharynx
Pharyngeal phase - soft palate closes off nasopharyns, pharyns and larynx are elevated
succesibe constriction of pharyngeal constrictors: pushes bolus through pharynx to esophagus and pushes epiglottis over larynx
Inferior pharyngeal constrictor contracts and upper esophageal relaxes - bolus enters
Esophageal phase - bolus moved by peristalsis; lower espoh sphincter opens when puper closes
Identify the functional separation for the stomach and duodenum
Allows for neutralization of stomach acid and proper functioning of the small intestine
Describe the actions of the internal and external anal sphincters when defecation is desired
P in rectum over time-
When fecal enters, increase P due to increase V
triggers reflex to cause rectal relaxation and increased cl (active contraction of rectal smooth, relax of smooth internal anal sphincter)
Skeletal muscles of external anal sphincter contracts due to proximal P on sphincter - involuntary reflex different than other sphincters
Describe the actions of the internal and external anal sphincters when defecation is not desired
P in rectum over time-
When fecal enters, increase P due to increase V
triggers reflex to cause rectal relaxation and increased cl (active contraction of rectal smooth, relax of smooth internal anal sphincter)
To defecate, must be voluntary conscious relaxation of external sphincter
Identify the steps necessary for defecation
1) relax of external anal sphincter
2) flexion of the hips
3) contraction of abdominal muscles
4) relaxation of the pelvic floor
List the main three functions of the stomach
Secretory
Motor
Hormonal
List the secretory products of the stomach (6)
Acid, mucous, pepsinogen, bicarbonate, water, intrinsic factor
List the 2 main hormones producted by the stomach
gastrin and somatostatin
What are the motor functions and stages of the stomach
Functions: secretory, motor, hormonal
1) receiving and providing temporary storage of dietary foods and liquids
2) mixing of food and water with gastric secretory products
3) grinding food so that it is smaller
4) regulating exit of retained material from the stomach into the duodenum
Histology of the stomach (cells)
Surface and neck mucus cells
Gastric pit - increase SA of stomach
Gastric Glands - chief cells (pepsinogen secretion), parietal cells (secrete HCl and Intrinsic factor), and enteroendocrine cells ( secrete things into blood)
Steps of acid secretion by parietal cells
Use CO2 to make H+
CA to make carbonic acid
then bicarb and H+ ions
Shift where Cl- enters cell w/H+
List the purposes for gastric acid
Kill pathogens, denature proteins, activate pepsinogen
Describe how acid secretion is regulated including the chemical messengers involved, the source of the secretogues, their pathways of activation, their mechanisms of action, and the stimuli for release of the secretogues
Direct control:
1) stimulated by ACh from para
1a) feed-forward to secrete before enters thru Vagus Nerve releasing ACh on M3 (Gq) of parietal cells and ECL
1b) negative feedbacck once in stomach - gastric distention activates vagus to brain and back
2) Gastrin from antrum G cells onto CCKB receptor on body of stomach
2a) stim by vagus nerve stim enteric nervous system releasing GRP
2b) stim by aa/peptide products on apical side to release gastrin and more acid
3) histamine from body endocrine cells (H2 receptor of parietal cell)
Indirect: ACh or Gastrin caused histamine release
Describe the inhibitors of acid secretion including their location of production, their pathways and mechanism for inhibition, and the stimuli for and/or inhibitors of their release (as much as stated in the lecture notes)
Somatostatin secreted from D cells by luminal acid or gastrin which then inhibits acid secretion by…
1) Parietal cell Gi receptor to decrease phosphorylation
2) Antagonizes intracellular effects of histamine
3) Indirectly inhibits gastrin and histamine secretion
- -Inhibited by ACh from ENS or Vagus
Prostaglandin inhibits acid secretion by….
1) acts on Gi receptors of parietal cell to directly reduce secretion
2) Indirectly reduce gastrin and histamine secretion
Describe acid secretion during the basal state and during the 3 phases in response to a meal (include all the steps found in each phase and rough percent of total acid secretion thatoccurs in each phase)
Basal state: interdigestive - highest at night (pH 3) and lowest in morning (pH 7)
Cephalic: first response to meal, 30% total secretion - feed-forward
activates Vagus nerve to release ACh to stomach
Gastric: second response 50-60% total secretion - distention stom activates local reflexes and the vago-vagal to release ACh on G, ECL, and parietal cells and GRP on G cells. Also digestion of protein
Intestinal- minor phase, 5-10% secretion- protein digestive products stim parietal to release gastric acid
Describe pepsinogens/pepsins where each are made, the stimuli for production of each and the mechanisms of action for the secretogue ,
including their function,
Released by chief cells when stimulated by ACh during the cephalic phase and by the vago-vagal reflex due to stom distention and ACh onto cells to release pepsinogen
Pepsinogen will become pepsin only if pH <5 & only active <3.5. Even more active <3
Function: cleaves proteins in middle and not at ends
Role of stomach in carbo and fat digestion
None
Describe the components, functions and mechanisms of the gastric diffusion barrier
Concentration gradient of H+ so that higher in lumen than cell and interstitial. pH mucous close to 7
All parts: apical mem cells impermeable to H+ and apical w/very tight junctions
All minus gastric glands:
[HCO3-] increase in mucous to protect surface of cells
Mucous gell layer = layer b/t lumen and cells
released by…
1) ACH by enteric mucous cells to secrete
2) Phys or Chem (acid, pepsins, and ethanol) irritation
3) Prostaglandins - cell irritated, releases prost, trigger mucous secretion
Describe the protection against acid mechanisms in the duodenum (2)
S cells sensitive to acid, secrete secretin to act in pancrease to stim release of bicarb.
Brunner’s glands of submucosa secrete bicarb if cells irritated
Describe the glands of pancreas and salivary glands
Exocrine pancreas: acinar cells that secrete into lumen of acinus to flow thru ducts
Salivary glands have same organization but w/alveolar cells, not acinar cells