Feb19 M2-Intestinal Motor Function Flashcards

1
Q

SI motor activity

A
  • effective mixing

- slow propulsion

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2
Q

BER in SI charact (electrical control activity)

A
  • f fixed for certain region
  • origin is ICCs*****
  • DOESN’T CAUSE contractions
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3
Q

ERA charact

A
  • triggered by stretch or Ca
  • spikes freq on BER plateau. proportional to magnitude of stimuus
  • max freq is max freq of BER
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4
Q

how action potentials travel in SI (and stomach)

A

gap-junctions (ICCs and muscle fibers)

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5
Q

intrinsinc freq of BER in diff SI regions and colon

A

duod: 12 per min
jejunum: 10.5-12
ileum: 10.5
colon: 4-6 per min

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6
Q

proximal vs distal SI peristalsis

A
  • f of BER higher
  • SM more excitable
  • thicker SM
  • frequency and amplitude of contractions greater in proximal SI
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7
Q

(EXAM) 2 types of contractions in SI

A

segmentation and peristalsis

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8
Q

segmentation def + why exists

A

rings of circular contraction. to slow down and mix (bouncing back)

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9
Q

peristalsis def

A

1 propagating circulating ring.

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10
Q

segmentation charact

A
  • stimulus is DISTENSION (not automatic)
  • CIRCULAR only
  • ANS, hormones and ENS modul long distance
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11
Q

segmentation what exactly modulates it (what structure)

A

Auerbach’s plexus

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12
Q

consequence of issue in segmentation

A

diarrhea (bc segmentation offers resistance)

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13
Q

peristalsis charact (+ how differs from segmentation)

A
  • infrequent
  • irregular
  • SHORT DISTANCE
  • WEAK
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14
Q

trigger of peristalsis

A

stretching (like for segmentation): local reflexes against stretching + circ and longit interaction

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15
Q

muscles behind bolus in peristalsis

A

circ contracts

longit relaxes

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16
Q

muscles ahead of bolus in peristalsis

A

circ relaxes

longit contracts

17
Q

peristalsis and segmentation: what is necessary for them to work

A

integrity of ENS

18
Q

modulation of peristalsis

A

ANS, hormones (vagus, Ach, PSS)

19
Q

ileocecal sphincter charact

A

high P, normally closed. opens when ileum distended. closes harder when cecum distended

20
Q

roles of colon

A

mixing and abso of water

21
Q

rectum fct

22
Q

colon time to transit vs intestines

A
intestines = 6 hours
colon = 50-60 hours
23
Q

freq of BER in colon

A

5-12 in ascending
8-12 TC
6-8 descending
17 sigmoid

24
Q

segmentation and peristalsis in colon: trigger

A

always there, governed by irregular BER

25
3 reflexes for intestine and colon motility
1. gastrocolic reflex and 2. gastroileal (when stomach full) | 3. ileocolic: food in ileum = feel need to go to the bathroom
26
interdigestive period charact
cyclic myoelectric activity. intervals of 90 min from stomach to ileum
27
MMC (migrating myoelectric complex) phase 1 charact
60 min. no BER, no ERA.
28
MMC phase 2
20 minutes. irregular ERA and contractions
29
MMC phase 3
10 minutes regular spikes of contraction (ERA) ring moving down GI tract
30
what initiates MMC
ENS. (CNS? ANS? gut peptides? too)
31
what propagates MMC
ENS + MODULATION by ANS and gut peptides
32
what interrupts MMC
meal intake
33
MMC 2 fcts
1. housekeeping and prevent bacterial overgrowth | 2. non digestible particles clearance
34
constipation on bristol stool chart
1-2
35
IBS def
dx of exclusion: chronic abd pain and discomfort, high visceral sensitivity, constipation vs diarrhea dominant IBS
36
bleeding in IBS
none
37
3 possible causes of IBS
- ICC disorder - serotonin pathway problem - post infectious IBS (surgery of H pylori)
38
constipation IBS rx
anti cramps meds
39
diarrhea IBS rx
rule out bacterial overgrowth. anxiety and psychological interventions