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GI week 2 > gastric motility > Flashcards

gastric motility Flashcards

1
Q

What kind of accommodation does the stomach exhibit when food enters?

A

receptive relaxation due to the swallowing refulx and response to gastric mechanorecrpots

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2
Q

What NT are released during receptive relaxation?

A

ACH-VIP/NO, maybe something else?

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3
Q

What effect does the dorsal vagal complex have in response have during a meal?

A

a minor one

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4
Q

What is the Gastrocolic reflex

A

induces the need to defecate after ingesting a meal

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5
Q

What is the Gastroileal reflex

A

causes ileoceccal valve to relax transfer contents from small to large bowel

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6
Q

What is the optimal pH for gastric lipase? What does it do?

A

pH 3-6, produces free fatty acids

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7
Q

Is there active transport in the stomach?

A

no, only absorbed by diffusion-alcohol and aspirin

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8
Q

The emptying of liquids in the stomach uses?

A

the proximal stomach using tonic contractions and the pyloris opens partially in response to feedback from the duodenum

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9
Q

the empyting of solids in the stomach uses?

A

antral stomach pump uses phasic contractions driven by basal electrical rhythm to grind the meal

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10
Q

How big must the food be to passs through the pyrolus?

A

<2mm

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11
Q

What does the peristalsis occur at?

A

basic electrical rhythm- 3-5 min

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12
Q

How can amplitude of the BER be changed?

A

neural (aCH causes Ca influx) and hormonal (gastrin)

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13
Q

What determines the magnitude of contraction in the stomach?

A

number of AP on the crests of the slow waves determines the magnitude of contraction

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14
Q

What happens to the contractions are they get closer to the pyloric sphincter?

A

they speed up and strengthen

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15
Q

Does sugar or a solid meal empty the stomach faster>

A

sugar!

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16
Q

What inhibits gastric contractions adn emptying>

A

acid in the duodenum(enteric/vagal or hormonal secretin ad somatostatin), fat in the duodenum via CCK, osmolality of duodenal contents via enteric neural mechanisms (maybe hormones)

17
Q

What does konjac flour do?

A

delays gastric empyting, keeps you fuller longer

18
Q

What are the feedback mechanisms from the SI to the stomach?

A

nutrients- postive feedback to the fundus to relax, pylorus to contract, neg feedback to the antrum which grinds the food

19
Q

When does the MMC work?

A

during fasting

20
Q

What is phase 1 of the MMC>

A

Phase I: Quiescence

20-60 minutes

21
Q

What is phase 2 of the MMC>

A

Phase II: Irregular,
Peristaltic Contractions
10-30 minutes
Increase in gastric, pancreatic juices

22
Q

What is phase 3 of the MMC

A 
Phase III: FASTING! 
Intense Contractions
5-10 minutes
Pylorus opens fully
Stimulated by some
	prokinetic drugs
Benzoar hairball?
23
Q

What is pyloric stensos

A

congenital condition where pylorus fails to relax after a meal leading to malnutrition and dehydration. Treated with surgical myotomy.

24
Q

What is Gastroparesis? what is it due to?

A

delayed gastric empyting due to DM neuropathy (and surgery,drugs, cancer), the vagus and enteric nerves fail to generate enough force to empty the stomach

25
Q

what do you treat Gastroparesis with?

A

prokinetic drugs- cisapirzide or metocloproamie

26
Q

what is Dumping Syndrome

A

rapid gastric emptying usually due to gastric by pass, high sugar meals.

27
Q

How does the body deal with dumping syndrome?

A

water moves into the lumen resulting in hypovolemia and reduced blood pressure. Results in nausea, weakness, dizziness, sweating, shakiness, diarrhea, heart palpitations

28
Q

how does Peptic ulcer disease lead to abnormal motility

A

scarring and ulcers near the pylorus can delay emptying or in duodenal ulcers can lead to rapid gastric emptying due to loss of duodenal negative
feedback mechanisms.

29
Q

What are some causes of vomiting

A

gastritis, poisoning, brain tumors, increased intracranial pressure, migraine, vestibular problems, bowel obstruction

30
Q

What is regurgitation?

A

the return of undigested food (that has not yet reached the stomach) back up the esophagus to the mouth.

31
Q

What are sensors for vommiting?

A

phaynx, higher centers, vestibular info, irritants of blockage of GI tract, blood born elements

32
Q

What does the parasympathetics due in response to vommiting?

A

increase salivation (bicarb) to protect teeth

33
Q

Where does retro-peristalsis start?

A

middle of small intestine

34
Q

What can happen before vomiting>

A

retching- inspiration against a closed glottis

35
Q

What is the mecahnism of vomiting?

A

glottis closes, hyoid moves up and forward opening the UES, diaphragm and ab muscle contracts moving food into esophagus as LES relaxes

36
Q

Does the stomach contract during vomiting?

A

NO, just the annular notch

37
Q

Does the esophagus retroperistalsis during vomiting>

A

no, all control is mediated by extrinsic nerves

38
Q

What are NT that are inhibited to control vomiting?

A

dopa, histamine, and serotonin

GI week 2 (8 decks)

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