Exam #5: Intro to GI Flashcards

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1
Q

What is the UES? What two anatomical structures does this sphincter separate?

A

UES= Upper Esophageal Sphincter

This is the sphincter that segregates the mouth from the esophagus

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2
Q

What is the LES? What two anatomical structures does this sphincter separate?

A

LES= Lower Esophageal Sphincter

This is the sphincter the segregates the esophagus from the stomach

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3
Q

What is the pyloric sphincter? What two anatomical structures does this sphincter separate?

A

The pyloric sphincter is the sphincter between the stomach & small intestine i.e. pylorus of stomach & duodenum

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4
Q

What is the ileocecal sphincter? What two anatomical structures does this sphincter separate?

A

This is the sphincter muscle also known as the “ileocecal valve” between the ileum & cecum (small & large intestine)

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5
Q

What is the IAS? What two anatomical structures does this sphincter separate?

A

IAS= Internal Anal Sphincter

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6
Q

What is the EAS? What two anatomical structures does this sphincter separate?

A

EAS= External Anal Sphincter

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7
Q

What are the four layers of the GI tract?

A

1) Serosa= outer, connective tissue & squamous epithelium
2) Muscularis= longituindal & circular smooth muscle
- Neurons that innervate regulate peristalsis
3) Subumucsa= large blood vessels, glands, and connective tissue
4) Mucusa= inner & can be divided into:
- Lamina propria= capillaries, neurons, and immune cells
- Lamina muscularis muscoa= smooth muscle to coordinate GI motility

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8
Q

What are the three modes of cell communication in the GI system?

A

1) Endocrine= utilizes blood
2) Paracrine= localized
3) Neurocrine= neurons innervating endocrine, vascular, or muscle cells

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9
Q

Define the relationship between the parasympathetic, sympathetic, and enteric branches nervous systems.

A

The SNS, PNS & enteric nervous system (ENS) are all parts of the autonomic nervous system:

  • ENS communicates with the SNS & PNS
  • Enteric= intrinsic
  • SNS & PNS= extrinsic

*****Note that the GI tract can function INDEPENDENTLY of the CNS b/c of ENS, but if works better with the SNS & PNS input

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10
Q

What is the function of PNS in GI tract?

A

Generally, think STIMULATION i.e. parasympathetic innervation:

  • Stimulates motility
  • Increases blood flow via vasodilation
  • Increases release of GI secretions
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11
Q

What is the function of the SNS in GI tract?

A

Generally, think INHIBITION i.e. sympathetic innervation:

  • Inhibits motility
  • Causes a reduction in blood flow via vasoconstriction
  • Inhibits release of GI secretion
  • **Note direct vs. indirect effects:
  • Indirect= ENS inputs
  • Direct= input directly on GI
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12
Q

What is the function of the enetric NS in GI tract?

A

Generally, the ENS is an independent nervous system entirely for the GI tract that is contained in the tissue layers of the GI tract; it is modulated by SNS & PNS input. Functions:

1) Motor neurons stimulate or inhibit smooth muscle contraction
2) Promotion of vasodilation & increased blood flow
3) Regulation of water, electrolyte, and hormone secretion
4) Sensory neurons relay stretch, pain, and chemical to extrinsic fibers

Associative= interneuron

Intestinofugal= regulate sympathetic ganglia

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13
Q

What is the function of associative neurons in the ENS?

A

These are interneurons that communicate between ENS neurons

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14
Q

What is the function of intestinogufal neurons in the ENS?

A

These neurons leave the GI tract and termination on sympathetic ganglia; they regulate sympathetic input to the GI tract

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15
Q

What the effect of ACh on GI function?

A

Generally excitatory

  • Vasodilation
  • Increase secretions
  • Smooth muscle contraction

*****This may be done indirectly via the ENS

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16
Q

What the effect of NE on GI function?

A

Generally inhibitory

  • Vasoconstrictive
  • Decrease secretion
  • Inhibit smooth muscle contraction
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17
Q

What the effect of DA on GI function?

A

Generally inhibitory

  • Vasoconstrictive
  • Decrease secretion
  • Inhibit smooth muscle contraction

*****Note that DA also inhibits ENS neuronal firing by interacting with pre-synaptic D2 receptors

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18
Q

What the effect of 5-HT on GI function?

A

Generally excitatory

  • Vasodilation
  • Increase secretion
  • Smooth muscle contraction

*****Generally, this is a NT that is used by the interneurons

19
Q

What the effect of NO on GI function?

A

Generally inhibitory

- Smooth muscle relaxation (vascular & GI)

20
Q

What the effect of VIP on GI function?

A

Generally inhibitory

- Smooth muscle relaxation (vascular & GI)

21
Q

What is the source, target, and action of cholecystokinin (CCK) in GI function?

A

Source= duodenum

Target

  • Pancreas
  • Gallbladder
  • Stomach
  • Sphincter of Oddi

Action

  • Increase enzyme secretion
  • Increase contraction
  • Decrease emptying
  • Increase relaxation
22
Q

What is the source, target, and action of Gastrin in GI function?

A

Source= G-cells of stomach

Target=

  • Parietal cells
  • ECL
  • D-cells

Action= promote gastric acid secretion

23
Q

What is the source, target, and action of Motilin in GI function?

A

Source= upper GI

Target

  • Stomach
  • Duodenum

Action= increase smooth muscle contraction

24
Q

What is the source, target, and action of Peptide YY in GI function?

A

Source= ileum & colon

Target= pancreas

Action= decrease enzyme & fluid secretion

25
Q

What is the source, target, and action of Secretin in GI function?

A

Source= duodenum

Target=

  • pancreas
  • stomach

Action

  • Increase bicarbonate secretion
  • Decrease acid secretion
  • Delay gastric emptying
26
Q

What is the effect of Somatostatin on GI function?

A

Source=

  • stomach
  • duodenum
  • pancreatic cells

Target=

  • stomach
  • intestine
  • pancreas
  • liver

Action=

  • decrease acid secretion
  • increase fluid absorption
  • decrease smooth muscle contraction
  • decrease secretions
  • decrease bile flow
27
Q

What is the effect of prostaglandins on GI function?

A

Source=

  • stomach
  • intestine/ immune cells

Target

  • stomach
  • intestines

Action=

  • increase blood flow
  • decrease acid secretion
  • increase mucus/ bicarbonate secretion
  • increase motility
  • increase fluid secretion
28
Q

What is the effect of histamine on GI function?

A

Source=

  • stomach
  • intestine/ immune cells

Target=

  • stomach
  • intestine

Action=

  • increase acid secretion
  • increase fluid secretion
29
Q

Describe the blood supply to the stomach.

A

The blood flow to & from the stomach is known as the “splanchnic circulation”

  • Blood from GI organs is carried to the portal vein
  • Portal vein empties into the liver
  • Liver returns blood to the body via the hepatic vein

GI–>portal vein–>liver–>hepatic vein–>body

30
Q

How does ACh influence blood flow to the GI tissues?

A

Vasodilation & increase blood flow

31
Q

How does CO2 influence blood flow to the GI tissues?

A

Vasodilation & increase blood flow

32
Q

How does VIP influence blood flow to the GI tissues?

A

Vasodilation & increase blood flow

33
Q

How does NE influence blood flow to the GI tissues?

A

Vasoconstriction & decreased blood flow

34
Q

Describe the GI smooth muscle membrane potential.

A

Remember that GI smooth muscle has a “resting slow wave” potential i.e. continuous depolarization & repolarization that DOES NOT result in contraction

35
Q

How are contractions initiated in GI smooth muscle?

A

“Spike potentials” i.e. a stimulus triggers a rapid depolarization on the up-slope of a slow wave potential–>contraction

36
Q

What are the four types of contraction seen in GI smooth muscle? What is the general function of these different types of contraction?

A

1) Segmental= mixing
2) Peristaltic= moving
3) Reverse peristaltic= storing
4) Migrating Motor Complex= fasting state contractions to keep things clear

37
Q

What are the three phases of the MMC?

A

Phase 1= quiescent period
Phase 2= increase in irregular action potentials
Phase 3= regular spike potentials–peak contraction

38
Q

What regulates the MMC?

A
  • Motilin plays a major role
  • ENS
  • Vagus nerve
39
Q

What are the key stimuli that initiate GI contractions?

A
  • Mechanical stretch

- ACh from PNS/ ENS

40
Q

What are the key stimuli that inhibit GI contractions?

A
  • NO
  • VIP
  • NE
41
Q

What are the two sites in the GI tract that are under voluntary control?

A

1) Upper esophageal sphincter

2) External anal sphincter

42
Q

What are sphincters?

A

Circular muscle that control anterograde & retrograde movements

43
Q

What are the key NTs that relax sphincter muscle?

A

NO

VIP

44
Q

What is counter-current blood flow? What are the pathologic implications of counter-current blood flow?

A

Mucosal surface of the GI/ villi:
- Blood supply is “counter current” i.e. arterial & venous blood pass each other, which facilitates diffusion of oxygen & nutrients

**Compromised blood flow= compromised health of villi–>shrink