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Physio U4 > Gastric and Small intestine Motility > Flashcards

Gastric and Small intestine Motility Flashcards

1
Q

2 functional areas of the stomach

A

Orad and Caudad

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2
Q

Orad

A

fundus and upper portion; receptive relaxation to receive bolus, Adaptive relaxation to store chyme

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3
Q

Caudad

A

lower portion and antrum; regulates gastric emptying at a rate appropriate for digestion and absorption

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4
Q

Receptive relaxation (long neural reflex)

A

the orad stomach is highly compliant and can receive large volumes of food without increasing gastric pressure

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5
Q

Adaptive relaxation (short and long neural pathway)

A

the orad stomach relaxes when the caudad stomach is distended by gastric contents

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6
Q

adaptive relaxation promotes retropulsion by

A

providing a pressure gradient

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7
Q

Peristaltic contractions of the caudad stomach function to

A

mix chyme, emulsify fats, reduce food particle size, amd propel contents toward pylorus, delivery to small intestine at appropriate rate

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8
Q

Sieving (emptying the stomach)

A

pylorus opens and SMALL (<2mm) particles enter duodenum

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9
Q

Retropulsion

A

trailing contraction forces larger particles near pylorus through a small opening to forcefully break them up

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10
Q

Leading contraction

A

closes pylorus

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11
Q

trailing contraction

A

forces contents through small space with great pressure

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12
Q

Retropulsion function

A

mix gastric contents, reduce particle size, and emulsify fats

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13
Q

Factors that determine gastric emptying

A

motilities of stomach and duodenum, diameter of pylorus, composition of particles in the lumen of stomach and small intestine

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14
Q

Factors that increase gastric emptying

A

increased orad distention, increased caudad contractions, large pylorus diameter, increased PNS, decreases SNS

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15
Q

Factors that decrease gastric emptying

A

increased SNS, decreased PNS, duodenal distention

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16
Q

Particles in stomach - liquids

A

empty immediately

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17
Q

Particles in stomach - smaller particles <2 mm

A

empty faster than larger particles

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18
Q

Particles in stomach - peptides

A

increased gastrin = increased gastric emptying

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19
Q

Particles in duodenum

A

decrease gastric emptying via feedback inhibition

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20
Q

Particles in duodenum - Acidic chyme

A

H+ by secretin

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21
Q

Particles in duodenum - Fat

A

slows for digestion by CCK

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22
Q

Particles in duodenum - hypertonic chyme

A

long and short reflexes slow for reabsorption

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23
Q

How do particles in the ileum affect gastric emptying?

A

decreases it via long reflexes and GI hormones

24
Q

Gastroparesis

A

impaired or delayed gastric emptying w/o obstruction

25
Q

Causes of gastroparesis

A

Autonomic Neuropathy, vagotomy, and medications

26
Q

Treatments for gastroparesis

A

small meals, viscous foods, low fat diet, protokinetic meds (erythromycin)

27
Q

Diabetic with gastroparesis

A

erythromycin treatment

28
Q

Type I diabetic eats meal high in fat, his insulin delivery should be

A

20% at beginning of meal, 80% afterwards

29
Q

Function of phasic contractions in small intestine

A

mix chyme, expose chyme to enterocyte brush border for digestion-secretion, move chyme towards colon

30
Q

2 types of phasic contractions in the small intestine during digestive period

A

segmentation and peristalsis

31
Q

Long neural reflexes in small intestine

A

cause phasic contractions before chyme enters small intestine

32
Q

Short neural reflexes ins mall intestine

A

due to chemosensitive and mechanosensitive IPANs that determine the rate of phasic contractions to optimize digestion and absorption

33
Q

Segmentation phasic contraction functions to

A

mix contents of small intestine and to expose contents to mucosa for digestion and reabsorption (NON-PROPULSIVE)

34
Q

Peristalsis phasic contraction functions to

A

propel chyme through the small intestine; ahead of chyme, longitudinal muscle contracts while circular relaxes, and behind the chyme, longitudinal relaxes and circular contracts (PROPULSIVE)

35
Q

Phasic contraction frequency is limited by

A

slow waves

36
Q

Slow waves control maximal frequency of phasic contractions during

A

digestive phase and fasting

37
Q

Location of Migrating Motility Complex

A

gastric antrum and small intestine (not colon)

38
Q

Function of Migrating Motility Complex

A

Sweep undigested and unabsorbed contents into the large intestine

39
Q

MMC sweeps

A

undigested particles from stomach to ileum (80-120 min) and recurs every 75-90 min

40
Q

3 phases on MMC during fasting

A
  1. no phasic contractions
  2. random, irregular phasic contractions
  3. 3-6 min of intense phasic contractions
41
Q

Activity front

A

phase 3 of MMC

42
Q

Phase 1

A

no slow waves produce AP, no phasic contractions, low motilin

43
Q

Phase 2

A

50% of slow waves are accompanied by AP and phasic contractions, medium motilin

44
Q

Phase 3

A

100% of slow waves produce AP with phasic contractions, high motilin

45
Q

Motilin follows pattern of phases

A

low concentration during phase 1, medium during phase 2, and high during phase 3

46
Q

Emesis (vomiting)

A

reflex controlled by brainstem; accompanied by nausea and salivation, nausea only if sub threshold, to remove noxious substances, can lead to hypokalemia and metabolic alkalosis

47
Q

Causes of vomiting

A

overdistention (stomach or duodenum), emetic chemicals, activation of chemoreceptor trigger zone, tactile receptos in pharynx, vestibular system, higher brain centers (trauma, anxiety)

48
Q

Serotonin

A

released by endocrine cell of upper small intestine, activates afferent vagal nerves

49
Q

Emetic chemicals

A

activate chemoreceptors in stomach and duodenum

50
Q

Chemoreceptor Trigger zone (area postrema)

A

stimulated by chemicals triggers vomiting

51
Q

Vomiting reflex

A

reverse peristalsis, relaxation of pylorus and contraction of duodenum, contents flow backwards, LES and UES open, increased intra-abdominal pressure and decreased intra-thoracic pressure

52
Q

What determines the rate of phasic contractions once food enters small intestines?

A

IPANs and short neural reflexes

53
Q

Purpose of MMC

A

during fasting (interdigestive period) sweep unabsorbed contents into colon to prevent bacteria overgrowth

54
Q

Plasma concentration of motilin is directly related to ___________ during MMC

A

frequency of phasic contractions, phase of MMC during fasting

55
Q

During MMC, the slow wave frequency

A

does NOT change

56
Q

Erythromycin

A

motilin agonist, causes gastric emptying, diarrhea

Physio U4 (9 decks)

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