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GI/Nutrition > First Aid Physiology > Flashcards

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
Q

Where would you find the largest number of goblet cells in the small intestine?

A

Ileum

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26
Q

The colon has crypts of Lieberkuhn, but no ______; and numerous ___________.

A

Villi

Goblet cells

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27
Q

The foregut is supplied by the ______ artery and recieves parasympathetic innervation from the ______.

A

Celiac

Vagus

Pharynx - proximal duodenum

Liver, GB, Pancreas, spleen (mesoderm)

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28
Q

The midgut is supplied by the ______ artery and recieves parasympathetic innervation from the ______.

A

SMA

Vagus

Distal duodenum - proximal 2/3 of transverse colon

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29
Q

The hindgut is supplied by the ______ artery and recieves parasympathetic innervation from the ______.

A

IMA

Pelvic

Distal 1/3 transverse colon - upper portion of rectum

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30
Q

What area of the colon is considered a watershed area between the SMA and IMA supplies?

A

Splenic Flexure

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31
Q

Where do the colateral branches of arterial circulation exist?

A

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

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32
Q

What veins are commonly invovled in portal HTN?

A

1. Esophageal veins (L. gastric)

2. Sm. epigastric veins of ant. abdominal wall (Paraumbilical veins)

3. Middle and Inferior Rectal (IMA/Sup. Rectal)

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33
Q

Pectinate (dentate) line

A

Where endoderm (hindgut) meets ectoderm

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34
Q

What things form above the pectinate line?

A

Inernal hemorrhoids

Adenocarcinoma

**not painful**

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35
Q

What things form below the pectinate line?

A

External hemorrhoids, Anal fissures, and Squamous cell Ca

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36
Q

What is the blood supply below the pectinate line?

A

Inf. rectal artery (internal pudendal)

Inf. rectal vein (internal iliac)

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37
Q

Anal Fissure

A

Tear in anal mucosa below pectinate line

Pain w/ pooping

Blood on Paper

Posterior (poorly perfused)

38
Q

Where is Zone 1 located? What is is commonly affected by?

A

Periportal Zone

1st by viral hepatitis

Ingested toxin (cocaine)

39
Q

Where is Zone 2 located? What is is commonly affected by?

A

Intermediate zone

40
Q

Where is Zone 3 located? What is is commonly affected by?

A

Pericentral vein (centrilobular) zone

1st affected by ischemia

Most sensitive to metabolic toxins

Site of alcoholic hepatitis

**Contains cytochrome P-450 system**

41
Q

What, besides gall stones can block the biliary strucutres?

A

Tumors in the head of the pancreas

42
Q

What is the organization of structures in the femoral triangle?

A

NAVEL (lateral - medial)

Nerve

Artery

Vein

Empty space

Lymphatics

43
Q

What is contained in the femoral sheath?

A

Femoral vein, artery, and canal (deep inguinal LN)

*3-4 cm below inguinal ligament*

44
Q

What is the most common diaphragmatic hernia?

A

Hiatal - sliding type

45
Q

Direct hernias are found _______ to the inferior epigastric artery while indirect hernias are found _______ to the inferior epigastric artery.

A

Medial (older men)

Lateral (infants)

46
Q

Femoral hernia protrudes below the _____________ thru femoral canal, below and alteral to the pubic tubercle.

A

Inguinal ligament

**females**

47
Q

What is the leading cause of bowel incarceration?

A

Femoral hernia

48
Q

What forms Hessleback trangle?

A
  1. Inferior epigastric vessels
  2. Lateral border of rectus abdominus
  3. Inguinal ligament

**site of direct inguinal hernia**

49
Q

Cholecystokinin is released by the I cells found in the _________ (2). It is upregualted by __________ and ___________.

A

Duodenum and Jejunum

Fatty acids and amino acids

50
Q

What are the main actions of CCK? (4)

A

↑ pancreatic secretion, GB contraction, Sphincter of Oddi relaxatation

↓ Gastric emptying

51
Q

Gastrin is released from the G-cells located in the _______________. It’s release is triggered by ______________(3), and inhibited by ____________.

A

Antrum

Stomach distention/alkalinization, AA, peptides, Vagal stim

Stomach pH < 1.5

52
Q

What are the functions of gastrin?

A
  1. Gastric H+ secretion
  2. Grwoth of gastric mucosa
  3. ↑ gastric motility
53
Q

Glucose-dependent Insulinotropic Peptide (GIP) is released from the K-cells and is found in ____________ (2). It is upregulated by ____________ (3).

A

Duodenum and Jejunum

FA, AA, oral glucose

54
Q

What are the functions of GIP?

A
  1. ↓ gastric H+ secretion
  2. ↑ insulin release
55
Q

Motilin is secreted in the ____________ and is increased in the __________ state.

A

Small Intestine

Fasting

56
Q

What is the function of Motilin?

A

Produces the migrating motor complexes (MMC)

57
Q

Secretin is released from the S-cells in the ___________. It is increased by ________(2).

A

Duodenum

Acid and fatty acid in the lumen of the duodenum

58
Q

What is the function of Secretin? (3)

A
  1. ↑ HCO3 secretion pancreas
  2. ↑ bile secretion
  3. ↓ gastric acid secretion
59
Q

Somatostatin is released from the D cells in the __________. (2) Its release is increased in response to ______ and decreased in response to _____________.

A

Pancreatic islets & GI mucosa

Acid

Vagal stimulation

60
Q

What is the function of SST? (4)

A
  1. ↓ Gastric Acid & Pepsinogen secretion
  2. ↓ Pancreatic and small intestine fluid secretion
  3. ↓ GB contraction
  4. ↓ Insulin and Glucagon release
61
Q

What is the function of NO in the GI system?

A

↑ smooth muscle relaxation - LES

62
Q

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 _____________.

A

Sphincters, GB, and Sm. Intestine

Distention & Vagal Stim

Adrenergic Input

63
Q

What is the function of VIP?

A

↑ Intestinal water and electrolyte secretion

↑ relaxation of intestinal SM and sphincters

64
Q

VIPoma

A

Islet cell pancreatic tumor

Copious Watery Diarrhea, Hypokalemia, Achlorhydria

65
Q

Intrinsic factor is released by the ___________ and is required for ____ absorption in the terminal ileum.

A

Parietal cells (body)

B12

66
Q

Gastric acid (HCl) is secreted from the __________. It is increased in response to ___________(3) and decreased in response to __________ (3).

A

Parietal cells

Histamine, ACh, Gastrin

SST, GIP, PG

67
Q

Pepsin is secreted from the ________. It is increased by ___________(2). And functions to aid in ____________.

A

Chielf cells

Vagal Stim and Local Acid

Protein digestion

68
Q

Pepsinogen is inactive and must be converted to the active __________ by what molecule?

A

Pepsin

H+

69
Q

HCO3- is released from mucosal cells in the what 3 structures? And from the Brunner glands in the ___________. What increases HCO3- release?

A

Stomach, duodenum, and salivary glands

Duodenum

Pancreatic and biliary secretion w/ secretin

70
Q

Gastrin ↑ acid secretion primarily through its effects on what cell?

A

ECL cells → Histamine release → Parietal cells

71
Q

When might you see hypertrophy of Brunner’s glands?

A

Peptic Ulcer Disease

**secrete alkaline mucus**

72
Q

What 4 things are secreted by the pancreas?

A

α-amylase

Lipase, phospholipase A, colipase

Proteases

Trypsinogen

73
Q

The proteases trypsin, chymotrypsin, elastas, and carboxypeptidase are secreted as ___________. What activates them?

A

Zymogens - must be activated by trypsin

74
Q

What activates trypsinogen?

A

Enterokinase/enteropeptidase - brush border ezymes on the duodenal/jejunal mucosa

75
Q

Only ___________ are absorbed by the enterocytes.

A

Monosaccharides

76
Q

What are the monosaccharides?

A

Glucose, galactose, fructose

77
Q

Glucose and Galactose are taken up by what transporter?

A

SGLT1 - Na dependent

78
Q

Fructose is taken up by the enterocytes by what transporter?

A

Facilitated diffusion by GLUT-5

79
Q

All of the monosaccharides—glucose, galactose, and fructose—are transported to the blood by what enzyme?

A

GLUT-2

80
Q

How is iron absorbed?

A

Fe2+ in the duodenum

81
Q

How is folate absorbed?

A

Jejunum and Ileum

82
Q

How is B12 absorbed?

A

Terminal ileum along w/ bile acids - require IF

83
Q

What cell in the Peyer’s patch sample and present antigens to immune cells?

A

M cells

84
Q

Where are the Peyer’s patches located?

A

Lamina Propria and Submucosa of Ileum

85
Q

What is bile composed of??

A

Bile salts (bile acid + glycine or taurine)

Phospholipids

Cholesterol

BIlirubin

Water

Ions

86
Q

What catalyzes the rate limiting step of bile synthesis?

A

Cholesterol 7α-hydroxylase

87
Q

What are the functions of bile?

A
  1. Digestion/absorption of lipids/fat soluble vitamins
  2. Cholesterol excretion - only method
  3. Antimicrobial activity
88
Q

Bilirubin is a product of ______ metabolism.

A

Heme

89
Q

Unconjugated bilirubin is water __________

Conjugated bilirubin is water ________

A

Insoluble - albumin

Soluble - conjugated w/ glucuronic acid

90
Q
A

GI/Nutrition (6 decks)

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