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IPAP 21-2 Freshman Semester > GASTRO > Flashcards

GASTRO Flashcards

1
Q

Describe fungiform papillae

A

Mushroom shaped elevations that are scattered over the entire surface of the tongue

-contain 5 taste buds each-

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2
Q

What is the in submucosa layer of the esophagus

A

Areolar CT, blood vessels and mucous glands

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3
Q

Where are the parotid glands located

A

Located inferior and anterior to the ears between the skin and the Masseter muscle

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4
Q

What are the 9 essential amino acids

A

PVT TIM HaLL

Phenylalanine 
Valine 
Tryptophan 
Threonine 
Isoleucine 
Methionine 
Histidine 
Lysine 
Leucine
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5
Q

What are the 5 major folds of the peritoneum

A

The greater and lesser omentum
Falciform ligament
The Mesentery
Mesocolon

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6
Q

Micelles dump their contents into

A

enterocytes

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7
Q

What are the 4 parts of the Colon

A

Ascending, Transverse, Descending, and sigmoid

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8
Q

What happens to TAGs in the golgi

A

TAGs are packaged with cholesterol and lipoproteins

Forming a chylomicron

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9
Q

How long does it take solid/ semi solid food to pass from the mouth to the stomach

A

4-8 seconds

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10
Q

What is the most important cell in the stomach

A

Mucosal (goblet) cells

Without them HCl would eat a whole though your stomach

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11
Q

What are the two divisions of the peritoneum

A

The parietal and Visceral peritoneum

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12
Q

What does bilirubin become in the Large intestine>?

A

Urobilirubins that can become either urobilins (excreted in urine, yellow color) or sterecobilins (excreted in feces, brown color)

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13
Q

Everyday the pancreas produces _______ of pancreatic juice

A

1200-1500 ml

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14
Q

What does the palate allow us to do while chewing food

A

Breathe

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15
Q

What is the approx length and diameter of the S. Intestine

A

10 ft in length

And 1 in in diameter

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16
Q

What are the two sphincters of the esophagus

A

Upper and lower esophageal sphincter

Upper is skeletal muscle
Lower is smooth muscle

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17
Q

What are the functions of papillae

A
  • taste buds
  • receptors for touch
  • helps to increase friction between food and tongue
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18
Q

Describe the mesocolon

A

Two separate folds that bind portions of the large intestine to the posterior abdominal wall

  • first binds the transverse colon
  • second binds the sigmoid colon
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19
Q

Lipids need to be broken down into

A

Fatty Acids or Monoglycerides

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20
Q

What is the soluabilty of carbs and proteins

A

Water soluable

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21
Q

Where is the appendix and what is its approx size

A

Attached to the cecum

3 inches long

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22
Q

At what pressure does the interval sphincter relax

A

~55mmHg

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23
Q

How much bile is made each day

A

600-1000 ml

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24
Q

What’s the difference between internal and external hemorrhoids

A

Internal originate above the pectinate line

External originate below the pectinate line

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25
Q

What is another name for the hepatopancreatic ampulla

A

The ampulla of Vater

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26
Q

Describe the lesser omentum

A

Arises as anterior fold in the serosa of the stomach and distal duodenum connecting it to the liver

this is the pathway for blood vessels entering the liver

Contains the portal view, common hepatic artery, common bile duct, and lymph nodes

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27
Q

The muscularis layer of the GI tract

A

Skeletal muscle (voluntary)

In the mouth, pharynx, and superior esophagus, and anal sphincter

Smooth muscle (involuntary) 
*everywhere else*

Contains the myenteric plexus
(plexus of Auerbach)

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28
Q

Where is bilirubin synthesized

A

In a two stage process in the Kupffer cells and in the reticuloenothlial cells (spleen)

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29
Q

What are the enzymes secreted by the brush border

A 
Alpha-dextrinase 
Maltase 
Sucrase 
Lactase 
Aminopeptidase 
Dippeptidase 
Phopholipase B1
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30
Q

What is tonus

A

A state of sustained contraction exhibited by the GI tract

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31
Q

Submucosa layer of the GI tract

A

Areolar CT that binds the mucosa to the muscularis

Contains blood and lymph that receive the absorbed nutrients

Contains the plexus of Meissner

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32
Q

Where is midgut pain referred to

A

Peri-umbilical region via lesser splanchic nerves

T10-T11

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33
Q

Where are sublingual glands

A

Beneath the tongue and just superior to the submandibular glands

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34
Q

What are the layers of the S. Intestine

A

Serosa
Muscularis - contains the plexus of Auerbach
Submucosa- Contain bunners glands and Meissner plexus
Mucosa- epithelium, lamina propia, and muscularis mucosae

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35
Q

What are the three phases of deglutition

A

Voluntary stage
Pharyngeal stage
Esophageal stage

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36
Q

What are the layers of the L. Intestine

A

Serosa- contains the Omental appendices
Muscularis- contains teh tenia coli and haustra
Submucosa- areolar CT
Mucosa

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37
Q

What is deglutition

A

Swallowing

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38
Q

Where does most of the pancreas lie

A

In the retro peritoneal space

Tail is peritoneal

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39
Q

What is the function of the spleen

A

Blood passes through the sinusoids in the spleen, macrophages remove organisms and destroy them

FILTER

Also holds a Large reservoir of monocytes that get mobilized when tissue damage occurs (heart attack)

Participates in hematopoiesis

RBC and Platelet destruction
(Salvages the iron and glob in to be reused)

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40
Q

What is the biliary tree of the liver

A

Bile ducts inside the liver, the common hepatic duct outside the liver, the gallbladder and its cystic duct, the common bile duct, and the duct of the pancreas

not the portal vein

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41
Q

What are crypts of Lieberkuhn

A

Deep crevices in the mucosal lining called intestinal glands

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42
Q

What are the 3 frenula

A

Labial frenula (mandibular and the maxillary)

Lingual frenula

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43
Q

What is the function of HCl

A

Deactivated salivary amylase
Activates lingual lipase
Activates pepsinogen

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44
Q

Where do the sympathetic nerves that supply the GI tissue arise from

A

The thoracic and upper lumbar regions of the spinal cord

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45
Q

What makes up the peritoneum

A

A layer of simple squamous epithelium (mesothelium) with an underlying layer of areolar CT

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46
Q

What are the three types of cells that make up the gastric pits of the stomach

A 
Chief cells (exocrine) 
Parietal Cells (exocrine) 
Enteroendocrine Cells (endocrine)
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47
Q

Liver Function:

Bile

A

Many endogenous waste products are deposited into bile

Promoted digestion of lipids in the S. Intestine

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48
Q

What is the largest peritoneal fold

A

The greater omentum

  • drapes of the the transerve colon and the small intestine
  • attaches to portions of the stomach and duodenum, folds upwards to attach to the transverse colon
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49
Q

What are the two plexuses of the enteric nervous system

A

The Myenteric (Auerbach)plexus between the longitudinal and circular smooth muscle layer of the muscularis

The Submucosal Plexus (Meissner)
Between the submucosal layer and the muscularis mucosae of the mucosal layer

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50
Q

During swelling the soft palate and uvula are drawn…

A

Superiorly

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51
Q

What is a sialogogues

A

Stimulates salivation

Lemon drops
Sour Candies

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52
Q

Describe chief cells

A

Stimulated by luminal peptides (proteins) And HCL

Secrete pepsinogen that becomes pepsin
pepsin is the CHIEF digesting enzyme in the stomach

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53
Q

What is the role of phopholipase

A

Phospholipid digestion

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54
Q

Where is bilirubin carried to… and by what?

A

Carried to the glomerulus to be excreted in the urine

Carried by albumin

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55
Q

In order to absorbed at the cellular level, lipids have to be…

A

Hydrolyzed

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56
Q

Approx how long is the Jejunum

A

3 feet long

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57
Q

The pyloric sphincter opens every..

A

15-20 seconds allowing about 3 ml of chyme to pass

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58
Q

What are the tonsils

A

Small masses of lymphatic tissue that produce antibodies to fight infections

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59
Q

What is the midgut

A

Supplied by the Superior Mesenteric artery

Middle and distal duodenum, jejunum, appendix, ascending colon, and proximal 2/3 transverse colon

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60
Q

What are the ducts of the sublingual glands called

A

The lesser sublingual ducts

-open into the flood of the mouth in the oral cavity proper

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61
Q

Where is the majority of bilirubin produced

A

From the degradation of RBCs

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62
Q

What deactivates salivary amylase

A

Stomach acid

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63
Q

Are enzymes secreted into the colon

A

NO

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64
Q

What digests lipids in the S. Intestine

A

Pancreatic lipases

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65
Q

Liver functions:

Protein synth.

A 
Deamination of AA 
Formation of urea 
Synth of most plasma proteins 
Synth of all non-essential AA 
Synth most of the clotting factos 
(Prothrombin)
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66
Q

What are the 4 layers of the GI tract

A

Serosa
MMuscularis
Submucosa
Mucosa

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67
Q

What are the layers of the stomach

A 
Serosa 
Muscularis 
(3 layers of smooth muscle) 
Submucosa 
(Areolar CT) 
Mucosa
(Lamina propia and muscularis mucosae)
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68
Q

Parotid glands secrete saliva to the oral cavity via

A

The parotid duct aka stenson duct

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69
Q

What CN supplies parasympathetic innervation to the GI

A

The Vagus

CN X

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70
Q

What makes the soft palate of the mouth

A

Posterior portion of the roof of the mouth

Arch shaped muscular partition between the oropahrnyx and the nasopharynx lined with mucous membranes

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71
Q

At what pressure does the conscious desire to defecate happen

A

~18 mmHg

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72
Q

Where does most digestion and absorption of nutrients occur

A

In the small intestine

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73
Q

What makes a bile salt

A

When bile acids conjugate with taurine or glycine in the liver they are then known as bile salts

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74
Q

what is the color and pH of bile

A

Yellowish, brown, olive green liquid

PH: 7.6-8.6

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75
Q

What are the minor salivary glands

A

Labial
Buccal
Palatal
Lingual

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76
Q

What is the terminal 1 inch of the Rectum

A

The anal canal

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77
Q

What supplies motor nuerons to the secretly cells of the mucosa epithelium

A

The Submucosal (Meissner) plexus

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78
Q

What is responsible for the movement of food from the lower esophagus to the rectum

A

Peristalsis from smooth muscles

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79
Q

What system is the GI system closely related to

A

Cardiovascular

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80
Q

What is alcoholic cirrhosis

A

The majority of ingested ethanol is metabolized in the liver

A byproduct of acetyl aldehyde creates oxidataive stress and trigger adverse immune reactions leading to cell death

  • starts as fatty liver disease
  • can progress to fibrosis, then cirrhosis
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81
Q

Ulcerative colitis can cause damage to the intestine where?

A

At the microvili / absorptive cells

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82
Q

The open end of the cecum merges with ..

A

The colon

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83
Q

What are the readily absorbable forms of Carbs

A

Glucose, Frutcose, Galactose

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84
Q

Proteins are broken down into

A

Amino acids or small chains of amino acids (di/tripetides)

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85
Q

What is the role of elastase

A

Protein digestion

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86
Q

What is the duct of Wisung

A

The pancreatic duct

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87
Q

What is the function of the gall bladder

A

Stores and concentrates bile made by the liver

Reabsorbes water so that bile becomes 10x more concentrated

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88
Q

Describe filiform papillae

A

Pointed threadlike
Found on entire surface of tongue
Contain no tastebuds
Have tactile receptors

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89
Q

Explain obstructive jaundice

A

Obstruction of the bile ducts by either a stone or mass

Causes damage to hepatic cells (hepatitis)

Rate of bilirubin production is normal, but excess bilirubin accumulates in the liver

Can not leave liver due to damaged hepatocytes

Often leaves the liver by rupturing the congested bile canalculi

Causes direct emptying of bile into the lymph system

Stool may become gray or clay colored do to lack of Stercobilin

Low or no urobilirubin made or secreted in urine

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90
Q

What is the definition of diarrhea

A

Increase in the frequency, volume, or fluid content caused by increased motility and decrease absorption

Can be caused by lactose intolerance, stress, or microbes

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91
Q

The greater curvature of the stomach serosa continues as the

A

Greater omentum

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92
Q

What type of fluid do sublingual glands secrete

A

-mucous

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93
Q

What are the 4 types of papillae

A

Vallate
Fungiform
Foliate
Filiform

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94
Q

What is the primary duct in the pancreas

A

The duct of Wirsung aka the pancreatic duct

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95
Q

How early does the guy “differnetiate” in embryonic development

A

Week 3

Foregut, midgut, hindgut

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96
Q

What is the pH of the intestinal juices

A

7.6 (alkaline)

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97
Q

What do the surface mucous/ goblet cells of the stomach mucosa secrete

A

Mucous rich bicarbonate to protect the stomach wall from HCL

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98
Q

What is the role of trypsin

A

Protein digestion

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99
Q

What is pepsin’s role

A

Is made from pepsinogen in chief cells

Most effective in acidic environment
Chemical digestion

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100
Q

What is the plexus of Meissner

A

An extensive network of enteric nuerons

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101
Q

Describe Vallate papillae

A

approx~ 12
Form an inverted V at the back of the tongue

-Contain 100-300 taste buds per papillae-

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102
Q

What pH do lingual and gastric lipases work at

A

Below 6.9

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103
Q

What is the role of enterochromaffin-like cells

A

Secrete histamine

-activate parietal cells to produce more HCl

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104
Q

What are the 3 layers of the mucosa of the esophagus

A

Muscularis (smooth muscle)
Lamina propia (Areolar CT)
Nonkeratinized startified squamous epithelium,

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105
Q

What are the three parts of the pharnyx

A

The nasopharynx (respiration)
Oropharynx (digestion and RR)
Hypo/larnygopharynx (digestion and RR)

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106
Q

What is the only proteolytic enzyme of the stomach

A

Pepsin

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107
Q

Liver functions:

Processes drugs and hormones

A

Detoxifies alcohol and excretes drugs such as penicillin into the bile

Chemically alters and deactivates T3T4

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108
Q

Where is foregut pain referred to

A

To the epigastrum via the greater splanchic nerves

T5-T9

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109
Q

What isn’t the pathway for blood vessels entering the liver

A

The lesser omentum

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110
Q

What are Micelles

A

A transport vesicle made of Monoglycerols and Fatty acids mixed together with bile

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111
Q

Describe acute pancreatitis

A

Sever condition
Where the pancreas releases trypsin instead of trypsinogen

Which degraded and digestes the pancreas. (Auto digestion)

Causes: 
Alcoholism 
C. Fibrosis 
Hypercalcemia 
Hyperlipidemia 
Drugs 
Autoimmune
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112
Q

What is the foregut

A

Supplied by branches of the celiac artery

Is salivary glands, esophagus, stomach, liver, gall bladder, pancreas, and proximal duodenum

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113
Q

Where is the plexus of Auerbach

A

In the muscularis layer of the GI

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114
Q

Describe the G- Cells of the stomach

A

Found only in the pyloric antrum

Secretes Gastrin

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115
Q

What is the Ligament of treitz

A

Aka Suspensory Ligament of the Duodenum

Is actually a suspensory MUSCLE covered by a fold of the peritoneum

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116
Q

What is the difference between micro and macro nutrients

A

Micro- can be readily absorbed

Macro- Need to be broken down into smaller forms to be absorbed

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117
Q

What are plicae circulares

A

Circular folds in the S. Intestine
Permanent ridges that begin near proximal portion of the duodenum, and end near the mid portion of the ileum

Act to Increase the surface area for absorption

Causes chyme to spiral allowing for more dissolution

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118
Q

What is the uvula

A
  • hangs from the free border of the soft palate

- conical muscular process

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119
Q

What is the gastrocolic reflex

A

Signals from stomach activity cause movement of feces in the colon to move to the rectum

(LATE IN THE MEAL)

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120
Q

What allows the stomach to be distensible

A

Rugae

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121
Q

What effect does pancreatic amylase have of cellulose

A

None

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122
Q

What is the location of the pancreas

A

Lies posteriorly to the greater curvature of the stomach

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123
Q

Explain Jaundice

A

Yellowish coloration of the skin, mucous embraces, and sometimes the sclerae of the eyes (icterus)

Is due to a build up of unconjugated bilirubin in extra cellular spaces

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124
Q

What is the pH of the stomach

A

4-6 when there is no food

Down to 2 when there is food and HCl secretion

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125
Q

Chlyomicrons can make the blood appear

A

Turbid

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126
Q

What is the definition of constipation

A

Infrequent or difficult defecation caused by decreased motility of the intestines

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127
Q

What are the cells found in the crypts of lieberkuhn

A 
S-cells 
I- Cells 
Absorptive cells 
Goblet Cells 
Paneth Cells
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128
Q

The pancreas and the tongue are considers

A

Accessory digestion organs

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129
Q

What is the role of bile

A

Important role in fat digestion and absorption

Also serves as a means for excretion of waste products from the blood
Bilirubin, hormones, and meds

130
Q

Explain hemorrhoids

A

Caused by increase pressure on the anal veins

  • Pregancy
  • hard stools
  • pushing too hard to poop

Blood in veins pool and dilate the surrounding tissue

Can either be internal or external

Can contain blood clots

131
Q

What are the three layers of teh muscalaris of the esophagus

A

Superior 1/3 is skeletal muscle
Middle 1/3 is skeletal muscle to smooth muscle
Inf. 1/3 is smooth muscle (where peristalsis occurs)

132
Q

What gives feces its brown color

A

Urobilirbin being broken down into stercobilin

133
Q

What is the gland responsible for pre vomit saliva

A

The parotid gland

134
Q

What are the 6 basic processes of the digestive system

A 
Ingestion 
Secretion 
Mixing and propulsion 
Digestion 
Absorption 
Defecation
135
Q

CARBS, FATS LIPDS.

Which spends the most time in the stomach, which spend the least

A

Carbs spend the least

Fats remain the longest

136
Q

Describe parietal cells of the stomach

A

Stimulated by luminal peptides (proteins) and gastrin-releasing peptide
(Neurotransmitter from the vagus nerve)

Secretes HCL And Intrinsic factor and Bicrarb

137
Q

How is peristalsis triggered

A

As food pushes on the lumen, reflex is triggered to contract which pushes the bolus forward

138
Q

What do absorption cells, Goblet cells and Paneth cells do

A

Absorptive cell- absorb contents from the lumen

Goblet cells- produce and secrete mucous

Paneth cells- secrete lysozyme and participate in phagocytosis

139
Q

What is the only intestinal organ attached to the abdominal wall

A

The liver via the falciform ligament

140
Q

Are the circular folds (plicae) in the L. Intestine

141
Q

The adventita of the GI

A

Single layer of connective tissue for the esophagus and proximal duodenum

142
Q

What hormones is protein involved in the synthesis of

A

Serotonin, Epi, melatonin, histamine

143
Q

How does acetylcholine effect the GI

A

Stimulated gastro activity

144
Q

What are the steps of Heme breakdown to Bilirubin

A
  1. Heme oxygenate liberates iron from the heme molecule producing BILIVERDIN
  2. BILIVERDIN gets reduces to a yellowish free-bilirubin aka unconjugated bilirubin
  3. BILIRUBIN attaches to albumin which will transport it to the liver
  4. In the liver bilirubin is conjugated with glucouronic acid
  5. The conjugated BILIRUBIN is then released into the bile
145
Q

What are portal triads

A

Found at the corners of the hepatic lobules

  • a bile duct (flows away from the central vein)
  • Branch of the hepatic artery ( flows toward the central vein)
  • Branch of the portal vein (flows toward the central vein)
146
Q

What hormones control gastric emptying

A 
GDIP (glucose dependent insulinotropic polypeptide) 
Aka GIP (gastric Inhibitory Polypeptide)

Has a inhibitory effect on gastric muscle, slowing peristalsis

147
Q

What nervous reflex control gastric emptying

A

Enterogastic reflex

Chemoreceptors and baro receptors stimulated in the duodenal mucosa cause a reflex that inhibit gastric peristalsis

Also signals from the Small and Large intestine distention inhibit stomach motility

148
Q

What is the role of gastrin

A

Stimulated HCl production in parietal cells
Stimulated epithelium repair
Stimulates histamine release in enterochromaffin like cells

149
Q

What gives the mucosal lining its velvety appearance

A

Villi

-vastly increases the surface area of the S. Intestine

150
Q

What part of the GI tract never comes in contact with food

A

Salivary Glands, Liver, Gallbladder, pancreas

151
Q

Where does the S. Intestine end?

A

At the ileocecal sphincter

152
Q

What nervous system regúlales the enteric nervous system

A

The autonomic

153
Q

What is the role of chymotrypsin

A

Protein digestion

154
Q

Describe the Mesentery

A

Fan shaped fold,

Binds the jejunum of the S. Intestine and the Posterior peritoneal wall

155
Q

What is ankyloglossia

A

When the lingual frenulum is abnormally short, rigid, or anteriorly displaced

156
Q

How often do the cells of the S. Intestine slough off

A

Every 5-7 days

157
Q

What are the major salivary glands

A

Parotids
Submandibular
Sublingual

158
Q

What does most of the emulsification work of lipids and where does this occur and at what pH

A

Bile in the small intestine

Works best in alkaline pH of 7.2-8

159
Q

Where does the Ligament of Treitz begin and connect

A

Begins at the diaphragm, connects to the duodenojejunum flexure Suspending it upwards

160
Q

Describe the pharynx

A

Funnel shaped tube that extends from the internal nares to the esophagus posteriorly and the the larynx anteriorly

-composed of skeletal muscle and lined with mucous

161
Q

What is the largest serous membrane in the body

A

The peritoneum

162
Q

What process of bilirubin synthesis is slow to start at birth

A

The conjugation of bilirubin with glucouronic acid in the liver

163
Q

Liver Function:

Excretion of bilirubin

A

Bilirubin is reabsorbed from old RBCs and excreted into the bile where it is metabolized in the S. Intestine and eliminated in the feces

164
Q

What CN control salivation

A

CN VII- all three glands
CN IX- Parotid Gland
CN V - Buccal branch- parotid
Lingual branch- sublingual, submandibular

165
Q

What type of substances have be digested in the stomach

A

Water, ions, and short chain fatty acids and some drugs

asprin, alcohol

166
Q

What surround the amopulla of Vater

A

The sphincter of Oddi

167
Q

What is the function of the biliary tree

A

Make, stores, and secretes bile

  • rids the liver and body of certain wastes
  • aids in the digestion of food in the small intestine
168
Q

What is the terminal portion of the GI

A

Large intestine

169
Q

What type of cell is in papillae

A

Stratified squamous epithelium

170
Q

What is the pH of pancreatic juice

A

7.1-8.2

Because of sodium bicarbonate

  • buffers the acidic gastric juices of chyme
  • stops the action of pepsin
171
Q

What do I-Cells do

A

Secrets cholecystokinin (CKK)

Found in the duodenum

Slows gastric emptying and H+ secretion

Stimulates pancreatic juice secretion

STIMULATES GALLBLADDER CONTRACTION

Promotes the satiety

172
Q

What is the pH of saliva

A
  1. 35-6.85 (acidic)

* buffered by phosphate and bicarb*

173
Q

What reflex opens the lower esophageal sphincter

A

Vago-vagal reflex

Afferent and efferent fibers of teh vagus nerve

174
Q

What is the process of moving lipids out of the digestive lumen into the enterocytes

A

Emulsification

175
Q

Where does chyme become feces?

A

In the L. Intestine as it hardens

176
Q

What is another name for the duct of Santorini

A

Accessory duct of the pancreas

177
Q

Describe the rectum

A

The last 8 inches of the GI tract

lies anterior to the sacrum and coccyx

178
Q

What enzyme digests carbs

179
Q

After mastication, food is swallowed as a…

180
Q

What type of fluid do submandibular glands secrete

A

Seromucous fluid

  • contains alpha-amylase
  • contains some mucous cells
181
Q

Describe hepatic sinusoids

A

Highly permeable capillaries between rows of hepatocytes

  • receives O2 blood from branches of the hepatic artery
  • receives nutrient rich blood from the portal vein
182
Q

What are the three forms of Carbohydrates

A

Mono, Di, and Polysaccharides

183
Q

Where are TAGS stored in the body

A

Adipocytes and Hepatocytes

184
Q

HDLs

A

Reverse the transport of cholesterol

Returns excess cholesterol to the liver for recycling
Is made in the liver and S. Intestine

185
Q

Where are submandibular glands

A

In the floor of the mouth, medial and inferior to the body of the mandible bone

186
Q

Explain appendicitis

A

Inflammation of the appendix
(Obstruction by chyme, fecolith, foreign body, carcinoma, stenosis, or kinking)

High fever, elevated WBC, neutrophils count greater than 75%

Can lead to ischemia, gangrene, or perforation within 24 hrs

S/s generalized pain in the umbilical region, localized to RLQ

187
Q

What is TOXIC MEGACOLON

A

When the large intestines dilate to 4-8 inches

Can be a complication of inflammatory bowel disease or C. Diff or colitis

188
Q

What kind of muscle is the tongue

189
Q

Where is the tongue attached to

A

Inferiorly to the hyoid bone, styloid process of the temporal bone and the mandible

190
Q

What is the hindgut

A

Supplied by the inf. Mesenteric artery

Distal 1/3 of the transverse colon, descending, sigmoid colon, rectum and proximal anal canal

191
Q

What is the physiology of the esophagus

A 
Secretes mucous 
(protective function)

Transports food to the stomach

Does NOT secrete digestive enzymes or participate in absorption

192
Q

Where is the cecum and what is it’.?

A

Inferior to the ileocecal valve

Small pouch 2.4 inches long

193
Q

What enzyme breaks down protiens

194
Q

For proteins: anything larger than ____ amino acids linked together is too large for absorption

195
Q

Most lipids are not broken down till they reach the….

A

Small Intestine

196
Q

What is the defecation reflex

A

Distention is the rectum triggers baroreceptors that signal the colon and the anal canal to contract

197
Q

What enzyme breaks down lipids

198
Q

What is choedocholithiasis

A

Stones in the common bile duct

199
Q

What is the epithelium layer of the mucosa

A

Nonkeratinized stratified squamous in the mouth, pharynx, and anal canal
(Protective function)

Simple Columnar in the stomach and intestines
(Secretion and absorption)

200
Q

What is considered to be the brain of the gut

A

The enteric nervous system

201
Q

What is hemolytic jaundice

A

RBCs are hemolysed as much higher rate than normal, causin the liver to be unable to keep up with bilirubin excretion

  • A high build up of unconjugated bilirubin in plasma levels
  • Increased urbobilirubin levels which mainly gets excretes at high amounts in the urine
202
Q

What is ascites

A

When excess fluid accumulates in the mesocolon/peritoneum

203
Q

How long does it take to empty the stomach

204
Q

LDLs

A

Delivers cholesterol to cells throughout the body

Leftover remains of VLDLs
Remolded in the LIVER

Smaller than VLDL

205
Q

Gastric pacemakers cells located along the ____________ begin propulsion waves every _________ seconds

A

Greater curvature

15-20 seconds

206
Q

What are Von Ebners Gglands

A

Lingual glands in the lamina propia

  • secrete watery serous fluid
  • contains lingual lipase
207
Q

Which tonsils if inflamed can close off sinus drainage and cause difficulty breathing

A

The pharyngeal tonsils

208
Q

What is the end product of cholesterol metabolism and where does it occur

A

Bile acids

In the hepatocytes

209
Q

What starts the breakdown of carbohydrates

A

Salivary alpha amylase

chloride activates this

210
Q

Sometimes the only complain of GERDS is

A

A cough that doesn’t go away

211
Q

What is the role of Intrinsic Factor

A

AIDS in the absorption of B12 (cyanocobalamin) in the S. Intestine

212
Q

What muscle does stenson duct penetrate

Near what tooth

A

The buccinator

The second maxillary molar

213
Q

How does Norepi effect the GI

A

Inhibits gastro activity

214
Q

Where is hindgut pain referred to

A

Suprapubic region via the least splanchic nerve

T12

215
Q

The merging of the common bile duct and the duct of wirsung creates..

A

The hepatopancreatic ampulla

216
Q

What are the three types of tonsils

A

Palatine tonsils- situated between the arches of the mouth
(commonly infected)

Lingual tonsils- located at the base of the tongue (only one)

Pharyngeal Tonsils- aka adenoids
Located on the superior portion of the nasopharynx
(Usually removed with the palatine tonsils)

217
Q

Describe hepatocytes

A

Specialized epithelial cells interspersed thought out the liver
(make up 80 % of the mass of the liver)

Forms a cell layer that separates sinuosidad blood from the canalicular bile

cells that synth.

  • Albumin
  • clotting fxs
  • cholesterol
  • bile
218
Q

What is it called when digestive reflexes cause a forward and backwards movement within a single segment

A

Segmentation

219
Q

What does the term Viscera-Somatic Convergence mean

A

Abdominal organs lack dedicated sensory pathways,

Pain is often referred to skin or muscle

220
Q

VLDL

A

Very low density lipid

Synth. In the liver from excess fat and cholesterol
smaller than a chylomicron

221
Q

What are the four main regions of teh stomach

A

The cardia
The fundus
The body
The pyloric part

222
Q

What is another name for the serosa of the GI tract

A

Visceral peritoneum

223
Q

What are the three groups of Macro nutrients

A

Carbs, proteins, lipids

224
Q

Describe the gall bladder and its location

A

Pear shaped sac

Located in a depression of teh posterior inferior aspect of the liver

225
Q

What do Interneurons do

A

Connest the myenteric and submucosal plexuses

226
Q

Where is the plexus of Meissner

A

In the submucosa layer of the GI tract

Between the submucosa layer and the muscularis mucosae

227
Q

What is the role of enteroendocrine cells of the stomach

A

D-Cells (somatostatin, aka GHIH)

Secretes hormone into the interstitium with inhibits gastrin release

228
Q

Explain hyperlipidemia and its mediation

A

Excess build up of lipids

Medications- Bile acid sequestrants
(Colestipol, cholestyramine, colesevelam)

Work to sequester bile acids before they can be used to emulsify lipids

Lipids are not broken down and are excreted in the feces

thought to lower the cholesterol level and LDL level

(Does not have strong effect of TAGs)

229
Q

What two functions does water serve in saliva

A

Allows for tasing by gustatory receptors

Allows for digestive reactions to begin

230
Q

Where is lingual lipase secreted

Where is it activated

A

Secreted in the mouth

Activates in the stomach

231
Q

What is it called when part of the stomach herniates through the esophageal hiatus

A

Hiatal hernia

232
Q

Liver Function:

Phagocytosis

A

Kupffer cells phagocytose aged RBCs and WBCs

233
Q

What are the layers of the esophagus

A

Adventitia
Muscularis
Submucosa
Mucosa

234
Q

What makes the Oral Cavity Proper

A

Space that extends from the lingual side of the teeth back to the fauces

235
Q

What are the 4 main regions of the L. Intestine

A

Cecum
Colon
Rectum
Anal Canal

236
Q

What do S-cells do

A

Secrete secretin

Found in the duodenum

Sense when the pH is below 4.5 and secrete secretin

increases pancreatic bicarbonate in the lumen to help buffer HCl from the stomach

decreases HCl production

237
Q

Where is bile made…. Where is it strored

A

Made in the liver

Stored in the gallbladder

238
Q

What is the heaviest gland in the body

A

Liver, also the largest internal organ

239
Q

What are the forms of Carbs that require digestion

A

Disaccharides- broken down into sucrose, lactose and maltose

Polysaccharides- broken down in to starches and glycogen

240
Q

What is Sjogren syndrome

A

Auto immune disease

Attached the salivary and lacrimal glands

S/s
Xerostomia- dry mouth
Keratoconjuctivitis sicca- dry este
Very Dry Joints

Constant eye pain
Altered Taste and Eating

241
Q

Approx how long is the esophagus

242
Q

At what pressure may the external sphincter fail

243
Q

Carbs are broken down into….

A

Glucose
Fructose
Galactose

244
Q

What Nervous system controls salivation

A

ANS (Paramsympathetic)

245
Q

Ones fatty acids and momglycerols enter the enterocytes they…

A

Combine back together to form TAGs, in the endoplasmic reticulum then sent to the golgi

246
Q

Describe physiologic jaundice

A

Occurs in newborns

Blue light is used to convert bilirubin into substances the kidneys can secrete

247
Q

What is the shortest region of the S. Intestine and where is it

A

The duodenum

Located retro peritoneal

Starts after the pyloric sphincter and merges with the jejunum

248
Q

What is the mucosa of the L. Intestine made of

A

Simple columnar epithelium
(Most absorptive and goblet cells)
Lamina propia- solitary lymphatic nodules found in this layer extend to the submucosa
Muscularis mucosa- smooth muscle

249
Q

What is the lingual frenulum

A

IS a fold in the midline of the ventral aspect (under surface of the tongue)

250
Q

What are the three divisions of the pyloric part of the stomach

A

The antrum
Canal
Pylorus

251
Q

How much is water is excreted in feces

A

Approx 100 ml

252
Q

What is responsible for feces odor

A

Bacteria releasing índole, skatole, and hydrogen sulfate

253
Q

What makes up the oral vestibule

A

Oral space complete bound by checks, lips, gums, and bucal side of teeth

254
Q

What makes the hard palate

A

Anterior portion fo the roof of the mouth

Formed by the palatine bones and the maxillae bones

covered by mucous membranes

255
Q

How does chemical digestion occur in the colon

A

By bacteria causing gas and Odor

256
Q

What components of pancreatic juices break down proteins in the S. Intestine

A

Trypsin, chymotripsin, carboxypeptidase, and elastase

257
Q

How many micro nutrients are considered essential

A

28

Slide 12

258
Q

What is the palate of the mouth

A
  • forms the roof of the mouth
    -Separates the oral cavity from the nasal cavity
    Is made of the hard and soft palate
259
Q

What are the three layers of the mucosal layer of the stomach

A

Muscularis mucosae
Lamina propia
Mucosa

260
Q

Liver function:

Carbohydrate (starch) metabolism

A

Glycogenesis and Glycogenolysis

261
Q

What are the S/s of Alcoholic cirrhosis

A 
Jaundice 
Nausea 
Malaise
Ascites 
Hepatic Encephalopathy 
Renal failure 
Death
262
Q

Where are chlyomicrons sent…

A

Dumped into the lacteal duct that converges with the thoracic duct (at the subclavian vein)

263
Q

The serosa of the GI tract

A

Serous membrane composed of areolar connective tissue and simple squamous epithelium (mesothelium)

264
Q

Where does the duct of Wirsung open into

A

The duodenum

265
Q

In what cell does the break down of heme to bilirubin occur…

A

In macrophages of reticuloendothelial cells (spleen, liver)

266
Q

Where are papillae found

A

On the dorsal (upper surface) and lateral surface of the tongue

267
Q

What can happen if bilirubin accumulates

A

Can cross the BBB and be toxic

Also Jaundice

268
Q

What is the “brush border” of the S. Intestine and what is it made of and do ?

A

Is microvili, where are small projections of absorptive cels

269
Q

Liver Function: lipid metabolism

A

Sythizes and stores some triglycerides, most lipoproteins, and large quantities of cholesterol

270
Q

What is a food bolus called after entering the stomach

271
Q

What is the duct of santorini

A

Smaller duct branching off of the pancreatic duct

Drains in the duodenum just proximal to the ampulla of Vater

272
Q

What type of fluid do paratid glands secrete

A

Serous (watery) fluid

-contains alpha-amylase

273
Q

What are the two sources of blood for the liver

A 
The hepatic artery (25%) 
Portal Vein (75%)
274
Q

What are the 4 non essential amino acids

A

Alanine
Aspartate
Cysteine
Glutamate

275
Q

Where does the S. Intestine begin

A

Immediately after the pyloric sphincter

276
Q

How many amino acids are there…
How many are essential,
How many are conditionally essential
How many are non essential

A

20
9 essential
7 conditional
4 non

277
Q

Kupffer cells aka

A

Stella te reticuloendothelial cells

278
Q

Exocrine cells vs enteroendocrine cells

A

Exocrine- secrete mucous/fluid/enzymes into lumen

Entero- secrete hormones into the blood stream

279
Q

What two lipases start the emulsification process

A

Lingual and gastric lipases

280
Q

What is the gastroileal reflex

A

Secretory and motor activity of the stomach send signals to the terminal portion of the ileum causing acceleration of mover you through the ileocecal sphincter

(EARLY IN THE MEAL)

281
Q

What does the mucosa of the stomach contain

A

Gastric glands
Exocrine glands
Enteroendocrine cells

282
Q

Describe Foliate papillae

A

Located in the small trenches on the lateral margins on the tongue

-most of the tastebuds degenerate in child hood-
(Sour taste)

283
Q

What exogenous things can relax the lower esophageal sphincter

A 
alcohol
Dopamine 
NO 
prostaglandins 
Chocolate 
Acid gastric Juice 
Fat 
Smoking
284
Q

What hormones causes dry mouth in dehydration

285
Q

When the kidneys aren’t functioning properly, what can provide some waste filtering…
What does this lead to…

A

The peritoneum

Peritonitis

286
Q

At what pH is pepsinogen rapidly activated?

A

Ph less than 3

287
Q

What is in the the lamina propria layer of the mucosa

A

Areolar CT with blood and Lymph vessels

Contains MALT
Tonsils, S. Intestine, appendix, and L. Intestine

288
Q

What divides the tongue into lateral halves

A

The median septum

289
Q

What gets converted by the liver to bile acids

A

Cholesterol

290
Q

What is the pectinate line in the Anal canal

A

Aka denate line

Lies at the inferior most portion of the anal columns

Above the line is only sensitive to stretch
(Upper 2/3)

Below the line is sensitive to pain, temperature, and touch
(Lower 1/3)

291
Q

What fold in the peritoneum is classically called the beer belly

A

The greater omentum

292
Q

What are the three regions of the S. Intestine

A

Duodenum
Jejunum
Ileum

293
Q

What is the role of caboxypeptidase

A

Protein digestion

294
Q

What duct do submandibular glands secrete saliva through

A

Wharton’s Ducts

Open on either side of the lingual frenulum

295
Q

What is salivary alpha-amylase

A

A digestive enzyme found in the saliva

296
Q

What is the valve that connects the S. Intestine to the L. Intestine

A

The ileocecal valve

297
Q

What does the pancreatic duct merge with

A

The common bile duct

298
Q

What is the longest region of the S. Intestine

A

The ilium

Approx 6 ft

299
Q

GI tract, aka

A

Alimentary tract

300
Q

What digests carbohydrates in the S. Intestine

A

Pancreatic amylase

301
Q

What is the advantage of bile salts

A

They are more water soluable making them more efficient in the intestinal lumen

302
Q

Liver Functions:

Storage

A

Stores fat soluble vitamins ADEK
As well as B12
Stores Iron and Copper

303
Q

Lipases break fatty droplets down into…

A

+3 Fatty Acids

304
Q

What supplies motor impulses to the longitudinal and circular layers of teh muscularis

A

The Myenteric Plexus (Auerbach)

305
Q

Describe the sigmoid colon

A

Located retro peritoneal

Begins at the left iliac crest and projects medially to midline

Terminates at the rectum
(3rd sacral vertebrae)

306
Q

How long does chyme remain in the L. Intestine

A

3-10 hours

307
Q

Approx how long is the L. Intestine

A

5 ft long

2.5 in diameter

308
Q

What are the three layers of the mucosa of the GI tract

A

Muscularis mucosae
Lamine Propria
Epithelium

309
Q

What is cholelithiasis

A

Stones in the gallbladder

Can cause minimal, intermittent, or complete obstruction of bile flow out of the gallbladder

310
Q

Describe GERD

A

When the lower esophageal sphincter fails to close properly, gastric juices can erode the lower esophagus lining

-may lead to cancer
(Esophageal metaplasia)
Aka Barnett’s esophagus

311
Q

What is the falciform ligament

A

Fold that attaches the liver to the ventral surface of the abdominal wall

-free border of this ligament contains the ligamentum there’s (remnant of the umbilical vein)
Aka the round ligament

312
Q

What attaches the large intestine to the the posterior wall?

A

The mesocolon (peritoneal fold)

313
Q

What are the functions of the pancreas

A

Exocrine- cluster of glandular cells that produce digestive enzymes

Endocrine- produce the hormones insulin/ glucagon

314
Q

What is the important landmark that seperates the Upper and lower GI

A

The ligament of Trietz

315
Q

The muscularis mucosae of the mucosa layer contains

A

Thin layer of smooth muscle fibers

This layer is what giver the mucus membrane of the S. Intestine a folded appearance

316
Q

What are the two muscular folds that run down the lateral sides of the soft palate

A

The palotoglossal arch - anterior fold that extend tot the side of the base of the tongue
The palaopharyngeal arch - posterior fold that extends to the the side of the pharynx

317
Q

Where does the esophagus pass through the diaphragm

A

The esophageal hiatus

318
Q

What are the overal functions of the Large intestine

A

Absorption
Produces vitamins (K and biotin)
Forms feces

319
Q

What is cholangitis

A

Biliary tree inflammation or infection

320
Q

What is the major functional unit of the liver

A

Hepatic lobules

  • hexagonal shape
  • made of rows of hepatocytes
321
Q

What is the volume of water that enters the S. Intestine

How much water is absorbed in the S. Intestine and Large intestine

A
  1. 3 L per day
  2. 3 liters from food and liquids
  3. 0 from gastric secretions

S. Intestine: 8.3 L of fluid
L. Intestine: 0.9 L of Fluid

322
Q

What is the most distensible part of the GI tract

A

The stomach

IPAP 21-2 Freshman Semester (22 decks)

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