Gastric secretions Flashcards

1
Q

Major components of gastric juice

A

water
organic compounds: intrinsic factor, pepsinogen, lipase, mucus
Ions: Na, H, K, Cl, HCO3

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2
Q

Oxyntic/gastric glands

A

Parietal
Chief (Peptic)
Mucous Neck
Paracrine

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3
Q

Products of parietal glands

A

HCl IF

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4
Q

Products of chief/peptic glands

A

pepsinogen, lipase

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5
Q

Products of mucous neck glands

A

mucin

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6
Q

Products of paracrine glands

A

histamine (ECL), somatostatin (D)

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7
Q

Pyloric glands

A

Mucous
Endocrine
Paracrine

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8
Q

Products of mucous glands

A

mucous/HCO3-

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9
Q

Products of endocrine glands (pyloric)

A

gastrin (G)

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10
Q

Products of paracrine glands (pyloric)

A

somatostatin (D)

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11
Q

Major functions of stomach acid

A

bacteriostatic agent
activate pepsinogen
denature protein
facilitate absorption of vitamin B12, calcium

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12
Q

Mechanism of acid secretion by the parietal cell

A
  1. K+ dependent H+ ATPase transports H+ out of the cell in exchange for K+ at the secretory membrane
  2. OH- remaining in cytoplasm is converted to HCO3- by carbonic anhydrase
  3. HCO3- exchanged for Cl- at basolateral membrane surface, passes into bloodstream. HCO3- makes blood slightly alkaline
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13
Q

Tubulovascular system

A

contain H/K ATPase and glycoprotein intrinsic factor
large amounts of tubulovesicles close to the cell membrane in parietal cells
Stimuli –> vesicles fuse with canaliculus, increase surface area for pumping out acid

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14
Q

Conversion of pepsinogen –> pepsin

A

Pepsinogen secreted by chief cells into gastric lumen
Pepsinogen activated by acid –> pepsin
Pepsin can activate pepsinogen (autocatalysis)

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15
Q

Components of the gastric mucosal barrier

A

mucus

surface active phospholipids

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16
Q

Function of the gastric mucosal barrier

A

mucus: lubricant, acid neutralization, trapping alkaline epithelial cell secretions, prevents back diffusion of H+ across the mucosa

Surface active phospholipids: binds to mucus and repels protons

PGs: inhibits acid secretion, prevents surface epithelial cell exfoliation, increases mucosal blood flow, stimulates mucus and bicarbonate secretion, enhances synthesis of surface-active phospholipids that line the gastric mucosa

17
Q

Gastrin

A

originates in G cells (pyloric gland)
receptor on parietal cell, stimulate acid secretion
stimulate histamine release

18
Q

Histamine (gastric)

A

origin: ECL cells, (oxyntic gland), mast cells, neurons

H2 receptor on parietal cells –> acid secretion

19
Q

ACh (gastric)

A

origin: intrinsic neurons
M3 receptors on parietal cells –> acid secretion
stimulates histamine release

20
Q

Characteristics of H. pylori

A
High mutation rate
motility
ability to attach to epithelial cells
virulence factors
urease
evasion of immune response
21
Q

Stimulatory phases of gastric secretion

A
  1. Cephalic
  2. Gastric
  3. Intestinal
22
Q

Cephalic phase - stimulatory

A

Prior to food being swallowed
Conscious thoughts/stimulation of olfactory, gustatory and mechanoreceptors

  1. Sensory input stimulates hypothalamus
  2. Parasympathetic motor output via vagus nerve –> stimulates parietal and chief cells (via ACh) and G cells (GRP) due to neurotransmitter release from enteric neuron
23
Q

Gastric phase - stimulatory

A
  1. Food enters the stomach and activates stretch/mechanoreceptor-based reflex, both local and via the vago-vagal loop that stimulates secretion (neuronal component)
  2. Food buffers gastric juice –> feeds back to activate parietal cells and the products of protein breakdown (peptones) directly stimulate G cells to produce gastrin (non-neuronal component)
24
Q

Intestinal phase - stimulatory

A
  1. Food reaches proximal part of the small intestine
  2. Peptone in the chyme stimulates G cells located in duodenal mucosa to produce more gastrin –> acts on parietal & chief cells in the gastric glands (via gastrin)
25
Q

Cephalic phase - inhibitory

A

stomach filling (reflex) and feeling of satiety (higher centres)

26
Q

Gastric phase - inhibitory

A

pH drops in the antrum (food is being ground down into smaller chyme), stimulates “D” cells in the pyloric glands to release somatostatin: acts locally/paracrine to inhibit G cell production of gastrin

27
Q

Intestinal phase - inhibitory

A
  1. Passage of chyme into duodenum stimulates a short neuronal “enterogastric reflex arc” through the sym celiac ganglion
  2. Stimulate production of enterogastrones - hormones that feedback to inhibit G cell, parietal and chief cell activity and smooth muscle contraction

Enterogastrones: secretin (stimulated by acid), cholecystokinin/CCK (stimulated by amino acids and fat), GIP and GLP-1 peptides (stimulated by fat and glucose)

28
Q

Prostaglandin function in secretion

A

Inhibits acid secretion
Prevents surface epithelial cell exfoliation
increases mucosal blood flow
Stimulates mucus and bicarb secretion
Enhances synthesis of surface-active phospholipids