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Chemistry Module 4 > Gastric, Intestinal, and Pancreatic Function > Flashcards

Gastric, Intestinal, and Pancreatic Function Flashcards

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1
Q

Three functions of the stomach

A
  1. Movement of food to the duodenum
  2. Secretion of digestive enzymes, intrinsic factor, and hydrochloric acid
  3. Partial digestion of proteins
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2
Q

Anatomical location of the stomach and names of three distinct zones

A
  1. Fundus
  2. Body
  3. Antrum
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3
Q

Specific cell types in each zone of the stomach

A

Fundus: surface epithelial cells, mucus cells
Body: surface epithelial cells, mucus cells, parietal cells
Antrum: Mucous cells, G-cells, chief cells

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4
Q

Specific secretion(s) of surface cell epithelial

A

Produce mucus and shed and proliferate rapidly (every 3 days)

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5
Q

Specific secretion(s) of mucus cells

A

Secrete mucus

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6
Q

Specific secretion(s) of parietal cells

A

Hydrochloric acid and Intrinsic Factor

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7
Q

Specific secretion(s) of chief cells

A

Pepsinogen (that is converted in an acidic environment to pepsin)

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8
Q

Specific secretion(s) of G-cells

A

gastrin (gastrin stimulates the parietal cells to produce HCL)

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9
Q

Five functions of gastric hydrochloric acid

A
  1. Converts pepsinogen to pepsin
  2. Activates rennin (a milk curdling enzyme)
  3. Combines with food proteins to form acid metaproteins which are more easily digested by pepsin
  4. Prevent bacterial multiplication in the stomach
  5. Prevents precipitation of ingested calcium so that soluble calcium may be absorbed
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10
Q

Four stimuli for gastrin release

A
  1. When proteins, amino acids and calcium enter stomach
  2. Vagus nerve is activated and releases acetylocholine
  3. Catecholamines are circulating
  4. Antrum is distended
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11
Q

Three phases of gastric secretion

A
  1. Cephalic phases
  2. Gastric phase
  3. Intestinal phase
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12
Q

Cephalic phase stimuli and specific secretion produced in each phase

A

Vagus nerve, stimulated by site and smell, stimulates parietal cells to produce HCL and G-cells to produce gastrin

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13
Q

Gastric phase stimuli and specific secretion produced in each phase

A
  • In the stomach, gastrin release stimulates parietal cells to produce more HCL
  • Local antral distension stimulates further production of gastrin and therefore HCL
  • Chief cells respond to acidic environment; pepsinogen is produced that is rapidly converted to pepsin at pH 3
  • Chyme is produced (mucus-containing solution)
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14
Q

Intestinal phase stimuli and specific secretion produced in each phase

A
  • Ingested food helps neutralize HCL
  • Secretin is released, inhibiting gastrin-stimulated acid production and gastric motility
  • Gastric secretions cease
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15
Q

Three functions of gastric fluid

A
  1. Initiation of protein digestion
  2. Physical and chemical preparation of ingested food for absorption
  3. Secretion of intrinsic factor to promote Vit B12 absorption in the ileum
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16
Q

Four normal constituents of gastric secretions

A
  1. Hydrochloric acid
  2. Enzymes (pepsin (most important), salivary amylase, gastric lipase)
  3. Mucus
  4. Intrinsic factor
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17
Q

Three abnormal constituents of gastric fluid

A
  1. Blood
  2. Food
  3. Organic acids
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18
Q

Appearance of fresh blood in the stomach

A

red

19
Q

Appearance of blood that has remained in the stomach for a period of time

A

old blood is converted to hematin by the acidic pH and has a “coffee grounds” appearance

20
Q

Four indications for gastric analysis

A
  1. Aid in eval of patients with recurrent ulcer disease
  2. Aid in diagnosis of Zollinger-Ellison syndrome by demonstrating a hypersecretory state
  3. Determine if patient is able to secrete HCL at all (pernicious anemia)
  4. Determine the completeness of vagotomy after gastric surgery
21
Q

Specific diagnostic use of Basal Acid Output (BAO) for gastric function assessment

A

No stimulation after you fast and you measure if outputting acid; determine baseline pH

22
Q

Specific diagnostic use of Maximum Acid Output (MAO) for gastric function assessment

A

Important in determining if the patient has low acidity or anacidity

23
Q

Specific diagnostic use of Serum gastrin for gastric function assessment

A

Useful in diagnosis of the Zollinger-Ellison syndrome

24
Q

Specific diagnostic use of Schilling test for gastric function assessment

A

Useful in the diagnosis of pernicious anemia

25
Q

Specific diagnostic use of Hollander test for gastric function assessment

A

Useful in determining the completeness of vagotomy in peptic ulcer treatment; should not be increased in vagotomy

26
Q

Recognize five lab findings in stomach cancer

A
  1. Achlorhydria in gastric fluid
  2. Anacidity or hypoacidity of gastric fluid
  3. Blood (“coffee grounds” appearance) in gastric fluid
  4. Blood in feces
  5. Iron deficiency anemia due to blood loss
27
Q

Recognize causes for gastric and peptic ulcers

A
  1. Helicobacter pylori
  2. Smoking
  3. Caffeine
  4. Alcohol
  5. Stress
  6. Physical stress
  7. Acid and pepsin
  8. Nonsteroidal anti-inflammatory drugs (NSAIDs)
28
Q

List the specific cause for the Zollinger-Ellison

A

gastrinoma (a gastrin-secreting tumor of malignant cells in the duodenum or from a tumor in a non-beta islet cells of pancreas

29
Q

List the four typical lab findings for Zollinger-Ellison syndrome

A
  1. BAO > 10 mEq/hour
  2. MAO usually less than 25% higher than BAO, ie, both are high all the time
  3. Increased volume of secretion (160-800 mL/hour)
  4. Serum gastrin levels two to twenty thousand times normal!!!
30
Q

Cause of pernicious anemia

A

Gastric problems are caused by malfunctioning parietal cells, responsible for HCL production and secretion of intrinsic factor (IF)

31
Q

Six typical lab findings in pernicious anemia

A
  1. Anacidity
  2. Decreased gastric secretion volume
  3. Gastric atrophy
  4. Increased serum gastrin (>200 pg/mL)
  5. Macro-ovalocytes
  6. Hypersegmented neutrophils
32
Q

Functions of the duodenum

A

Has 6 major hormones to aid in digestion and protection of the intestinal lining; intraluminal hydrolysis of starch, proteins, and lipids

33
Q

Functions of the illeum

A
  • Absorption of Vitamin B12 and whatever products of digestion that were not absorbed by the jejunum
  • Diffuse neuroendocrine system cells secrete gastrin, secretion, and cholecystokinin into the bloodstream
34
Q

Functions of the large intestine

A
  1. Absorption of water from the remaining indigestible food matters
  2. Absorption of vitamins that are created by bacteria inhabiting the colon
  3. Fecal compaction until it can be eliminated
35
Q

Source of Cholecystokinin-pancreozymin (CCK-PZ)

A

Secreted by I cells of duodenum when digested proteins/fats enter duodenum and causes the:

36
Q

Stimulus for Cholecystokinin-pancreozymin (CCK-PZ)

A

Secreted by I cells when protein and fats enter the duodenum

37
Q

Three physiological effects Cholecystokinin-pancreozymin (CCK-PZ)

A
  1. Pancreas to produce enzymes
  2. Gall bladder to contract and empty contents
  3. Sphincter of Oddi to relax to allow gall bladder and pancreatic contents to ender duodenum
38
Q

Source of secretin

A

S cells both the duodenum and jejunum

39
Q

Stimulus of secretin

A

released when acidified contents of stomach reach duodenum (pH < 5)

40
Q

Two physiological effects of secretin

A
  1. Acts in synergy with CCK for release of pancreatic enzymes
  2. Simulates secretion of large amount of diluent pancreatic fluid rich in sodium bicarbonate
41
Q

Physiological effects of gastric inhibitory peptide

A

stimulates insulin release and is responsible for rapid metabolism of an oral glucose load

42
Q

Physiological effects of Vasoactive intestinal polypeptide

A

Causes relaxation of gut circular smooth muscle as well as smooth muscle in blood vessels, causing vasodilation. Also stimulates pancreatic secretion

43
Q

Physiological effects of motilin

A

Stimulates the contraction of the smooth muscles of the GI tract and contracts the lower esophageal sphincter

44
Q

Physiological effects of somatostatin

A
  • Most potent inhibitor of endocrine secretions;
  • inhibits release of GI and pancreatic hormones, as well as the release of GH and TSH;
  • Inhibits actions of all these hormones on their target tissues

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