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First Aid Physiology Flashcards

1
Q

Rostral fold closure results in ______________.

Lateral fold closure results in ______________.

Caudal fold closure results in ______________.

A

Sternal defects

Omphalocele, gastroschisis

Bladder extrophy

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2
Q

What week does the midgut herniate thru the umbilical ring? What week does it return and rotate around the SMA?

A

6th week

10th week

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3
Q

What causes duodenal atresia? What is it associated with?

A

Failure to recanalize

Trisomy 21

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4
Q

What is the most common type of tracheoesophageal anomaly? How does it present

A

Esophageal atresia + distal TEF

Drooling, choking, vomiting w/ 1st feeding

Failure to pass NG tube

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5
Q

A 3 week old male infant preseents with non-bileous projectile vomiting and a palpable olive mass in the epigastric region. What is the most likely diagnosis?

A

Pyloric Stenosis

Treat w/ surgical incision

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6
Q

The ventral pancreatic bud contributes to the _____, main pancreatic duct, and the uncinate process. Every thing else is formed from the ______________.

A

Head

Dorsal pancreatic bud

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7
Q

What complication can annular pancreas cause?

A

Dudodenal obstruction

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8
Q

When does the defect that results in pancreas divisum occur?

A

8 weeks - failure of ventral and dorsal parts to fuse

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9
Q

The spleen arises in the __________ of the stomach but is supplied by ____________.

A

Mesentary

Celiac artery/foregut

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10
Q

What are the retroperitoneal structures?

A

SAD PUCKER

Suprarenal glands

Aorta/IVC

Duodenum 2nd-4th

Pancreas except tail

Ureters

Colon

Kidneys

Esopahgus lower 2/3

Rectum

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11
Q

What turns into the falciform ligament?

A

Fetal Umbilical Vein

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12
Q

What is contained in the hepatoduodenal ligament?

A

Portal triad: Proper hepatic, portal vein, common bile duct

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13
Q

What is contained in the gastrohepatic ligament?

A

Gastric Arteries

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14
Q

What ligament is sometimes cut during surgery to access the lesser sac?

A

Gastroheptatic

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15
Q

What ligament separates the greater and lesser sacs on teh left?

A

Gastrosplenic

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16
Q

What does the gastrosplenic ligament contain?

A

Short gastrics

L gastro-omental vessels

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17
Q

What does the splenorenal ligament contain?

A

Splenic artery and vein

Tail of the pancreas

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18
Q

Where is Auerbach’s Myenteric Plexus located? What does it do?

A

Between the Inner Circular and Outer Longitudinal layers of the musuclaris propria

Motility and Relaxation

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19
Q

Where is Meissner’s Submucosal Plexus located? What does it control

A

In the submucosa.

Blood flow, secretions, & absorption

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20
Q

How far do ulcers extend? How far do erosions extend?

A

Into the submucosa, inner or outer muscular layer

Mucosa only

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21
Q

What are Brunner glands characteristic of?

A

Duodenum (submucosa)

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22
Q

Where do you find plicae circulares?

A

Jejunum & proximal Ileum

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23
Q

Where do you find peyer patches + plicae circulares?

A

Ileum

Plicae ciruclares in proximal ileum

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24
Q

Where do you find Crypts of Lieberkuhn?

A

Small & large intestine

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25
Where would you find the largest number of **goblet cells** in the small intestine?
Ileum
26
The **colon** has crypts of Lieberkuhn, but no \_\_\_\_\_\_; and numerous \_\_\_\_\_\_\_\_\_\_\_.
Villi Goblet cells
27
The **foregut** is supplied by the ______ artery and recieves parasympathetic innervation from the \_\_\_\_\_\_.
**Celiac** **Vagus** Pharynx - proximal duodenum Liver, GB, Pancreas, spleen (mesoderm)
28
The **midgut** is supplied by the ______ artery and recieves parasympathetic innervation from the \_\_\_\_\_\_.
SMA Vagus Distal duodenum - proximal 2/3 of transverse colon
29
The **hindgut** is supplied by the ______ artery and recieves parasympathetic innervation from the \_\_\_\_\_\_.
IMA Pelvic Distal 1/3 transverse colon - upper portion of rectum
30
What area of the colon is considered a watershed area between the SMA and IMA supplies?
Splenic Flexure
31
Where do the colateral branches of arterial circulation exist?
Superior **epigastric** (internal thoracic/mammary) ↔︎ Inf. **epigastric** (external iliac) Sup. **pancreaticoduodenal** ↔︎ Inf. **pancreaticoduodenal** - Celiac and SMA Middle **colic** ↔︎ Left **Colic** - SMA and IMA Sup. **rectal** ↔︎ Middle & Inf. **Rectal** - IMA and internal iliac
32
What veins are commonly invovled in portal HTN?
**1. Esophageal veins** (L. gastric) **2. Sm. epigastric veins of ant. abdominal wall** (Paraumbilical veins) **3. Middle and Inferior Rectal** (IMA/Sup. Rectal)
33
Pectinate (dentate) line
Where endoderm (hindgut) meets ectoderm
34
What things form **above the pectinate line?**
Inernal hemorrhoids Adenocarcinoma \*\*not painful\*\*
35
What things form **below the pectinate line?**
External hemorrhoids, Anal fissures, and Squamous cell Ca
36
What is the blood supply below the pectinate line?
Inf. rectal artery (internal pudendal) Inf. rectal vein (internal iliac)
37
Anal Fissure
Tear in anal mucosa below pectinate line **P**ain w/ **p**ooping Blood on **P**aper **P**osterior (**p**oorly **p**erfused)
38
Where is **Zone 1** located? What is is commonly affected by?
**Periportal Zone** 1st by **viral** **hepatitis** Ingested toxin (**cocaine**)
39
Where is **Zone 2** located? What is is commonly affected by?
Intermediate zone
40
Where is **Zone 3** located? What is is commonly affected by?
**Pericentral vein** (centrilobular) **zone** 1st affected by **i****schemia** Most sensitive to **m****etabolic toxins** Site of **alcoholic hepatitis** \*\*Contains cytochrome P-450 system\*\*
41
What, besides gall stones can block the biliary strucutres?
Tumors in the head of the pancreas
42
What is the organization of structures in the **femoral triangle?**
NAVEL (lateral - medial) **N**erve **A**rtery **V**ein **E**mpty space **L**ymphatics
43
What is contained in the femoral sheath?
Femoral vein, artery, and canal (deep inguinal LN) \*3-4 cm below inguinal ligament\*
44
What is the most common diaphragmatic hernia?
Hiatal - sliding type
45
**Direct hernias** are found _______ to the inferior epigastric artery while indirect hernias are found _______ to the inferior epigastric artery.
Medial (older men) Lateral (infants)
46
**Femoral hernia** protrudes below the _____________ thru femoral canal, below and alteral to the pubic tubercle.
Inguinal ligament \*\*females\*\*
47
What is the leading cause of bowel incarceration?
Femoral hernia
48
What forms Hessleback trangle?
1. Inferior epigastric vessels 2. Lateral border of rectus abdominus 3. Inguinal ligament \*\*site of direct inguinal hernia\*\*
49
**Cholecystokinin** is released by the **I cells** found in the _________ (2). It is upregualted by __________ and \_\_\_\_\_\_\_\_\_\_\_.
Duodenum and Jejunum Fatty acids and amino acids
50
What are the main actions of CCK? (4)
↑ pancreatic secretion, GB contraction, Sphincter of Oddi relaxatation ↓ Gastric emptying
51
**Gastrin** is released from the **G-cells** located in the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. It's release is triggered by \_\_\_\_\_\_\_\_\_\_\_\_\_\_(3), and inhibited by \_\_\_\_\_\_\_\_\_\_\_\_.
Antrum Stomach distention/alkalinization, AA, peptides, Vagal stim Stomach pH \< 1.5
52
What are the functions of **gastrin?**
1. Gastric H+ secretion 2. Grwoth of gastric mucosa 3. ↑ gastric motility
53
**Glucose-dependent Insulinotropic Peptide (GIP)** is released from the K-cells and is found in ____________ (2). It is upregulated by ____________ (3).
Duodenum and Jejunum FA, AA, oral glucose
54
What are the functions of **GIP**?
1. ↓ gastric H+ secretion 2. ↑ insulin release
55
**Motilin** is secreted in the ____________ and is _increased_ in the __________ state.
Small Intestine Fasting
56
What is the function of Motilin?
Produces the migrating motor complexes (MMC)
57
**Secretin** is released from the **S-cells** in the \_\_\_\_\_\_\_\_\_\_\_. It is _increased_ by \_\_\_\_\_\_\_\_(2).
**Duodenum** **Acid** and **fatty acid** in the lumen of the duodenum
58
What is the function of Secretin? (3)
1. **↑ HCO3** secretion *pancreas* 2. **↑ bile** secretion 3. **↓ gastric acid** secretion
59
**Somatostatin** is released from the **D cells** in the \_\_\_\_\_\_\_\_\_\_. (2) Its release is _increased_ in response to ______ and _decreased_ in response to \_\_\_\_\_\_\_\_\_\_\_\_\_.
Pancreatic islets & GI mucosa Acid Vagal stimulation
60
What is the function of SST? (4)
1. ↓ Gastric Acid & Pepsinogen secretion 2. ↓ Pancreatic and small intestine fluid secretion 3. ↓ GB contraction 4. ↓ Insulin and Glucagon release
61
What is the function of **NO** in the GI system?
**↑ smooth muscle relaxation** - LES
62
**Vasoactive Intestinal Polypeptide (VIP)** is released from **PS ganglia** in what 3 structures? It is _increased_ in response to \_\_\_\_\_\_\_\_\_\_\_\_\_(2), and _decreased_ in response to \_\_\_\_\_\_\_\_\_\_\_\_\_.
Sphincters, GB, and Sm. Intestine Distention & Vagal Stim Adrenergic Input
63
What is the function of **VIP**?
↑ Intestinal water and electrolyte secretion ↑ relaxation of intestinal SM and sphincters
64
VIPoma
Islet cell pancreatic tumor Copious Watery Diarrhea, Hypokalemia, Achlorhydria
65
**Intrinsic factor** is released by the ___________ and is required for ____ absorption in the _terminal ileum_.
Parietal cells (body) B12
66
**Gastric acid (HCl)** is secreted from the \_\_\_\_\_\_\_\_\_\_. It is _increased_ in response to \_\_\_\_\_\_\_\_\_\_\_(3) and _decreased_ in response to __________ (3).
Parietal cells Histamine, ACh, Gastrin SST, GIP, PG
67
Pepsin is secreted from the \_\_\_\_\_\_\_\_. It is increased by \_\_\_\_\_\_\_\_\_\_\_(2). And functions to aid in \_\_\_\_\_\_\_\_\_\_\_\_.
Chielf cells Vagal Stim and Local Acid Protein digestion
68
Pepsinogen is inactive and must be converted to the active __________ by what molecule?
Pepsin H+
69
**HCO3-** is released from **mucosal** **cells** in the what 3 structures? And from the **Brunner glands** in the \_\_\_\_\_\_\_\_\_\_\_. What _increases_ HCO3- release?
Stomach, duodenum, and salivary glands Duodenum Pancreatic and biliary secretion w/ secretin
70
Gastrin ↑ acid secretion primarily through its effects on what cell?
ECL cells → Histamine release → Parietal cells
71
When might you see hypertrophy of Brunner's glands?
Peptic Ulcer Disease \*\*secrete alkaline mucus\*\*
72
What 4 things are secreted by the pancreas?
**α-amylase** **Lipase**, phospholipase A, colipase **Proteases** **Trypsinogen**
73
The proteases trypsin, chymotrypsin, elastas, and carboxypeptidase are secreted as \_\_\_\_\_\_\_\_\_\_\_. What activates them?
Zymogens - must be activated by **trypsin**
74
What activates **trypsinogen**?
**Enterokinase/enteropeptidase** - brush border ezymes on the duodenal/jejunal mucosa
75
Only ___________ are absorbed by the enterocytes.
Monosaccharides
76
What are the monosaccharides?
Glucose, galactose, fructose
77
**Glucose** and **Galactose** are taken up by what transporter?
**SGLT1** - *Na dependent*
78
Fructose is taken up by the enterocytes by what transporter?
Facilitated diffusion by **GLUT-5**
79
All of the **monosaccharides**—glucose, galactose, and fructose—are transported to the _blood_ by what enzyme?
**GLUT-2**
80
How is iron absorbed?
Fe2+ in the duodenum
81
How is folate absorbed?
Jejunum and Ileum
82
How is B12 absorbed?
Terminal ileum along w/ bile acids - require IF
83
What cell in the Peyer's patch sample and present antigens to immune cells?
M cells
84
Where are the Peyer's patches located?
Lamina Propria and Submucosa of Ileum
85
What is bile composed of??
Bile salts (bile acid + glycine or taurine) Phospholipids Cholesterol BIlirubin Water Ions
86
What catalyzes the rate limiting step of bile synthesis?
Cholesterol 7α-hydroxylase
87
What are the functions of bile?
1. Digestion/absorption of lipids/fat soluble vitamins 2. Cholesterol excretion - only method 3. Antimicrobial activity
88
Bilirubin is a product of ______ metabolism.
Heme
89
Unconjugated bilirubin is water \_\_\_\_\_\_\_\_\_\_ Conjugated bilirubin is water \_\_\_\_\_\_\_\_
Insoluble - albumin Soluble - conjugated w/ glucuronic acid
90

GI/Nutrition (6 decks)

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