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-
2
Q
What is the in submucosa layer of the esophagus
A
Areolar CT, blood vessels and mucous glands
3
Q
Where are the parotid glands located
A
Located inferior and anterior to the ears between the skin and the Masseter muscle
4
Q
What are the 9 essential amino acids
A
PVT TIM HaLL
Phenylalanine Valine Tryptophan Threonine Isoleucine Methionine Histidine Lysine Leucine
5
Q
What are the 5 major folds of the peritoneum
A
The greater and lesser omentum
Falciform ligament
The Mesentery
Mesocolon
6
Q
Micelles dump their contents into
A
enterocytes
7
Q
What are the 4 parts of the Colon
A
Ascending, Transverse, Descending, and sigmoid
8
Q
What happens to TAGs in the golgi
A
TAGs are packaged with cholesterol and lipoproteins
Forming a chylomicron
9
Q
How long does it take solid/ semi solid food to pass from the mouth to the stomach
A
4-8 seconds
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
11
Q
What are the two divisions of the peritoneum
A
The parietal and Visceral peritoneum
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)
13
Q
Everyday the pancreas produces _______ of pancreatic juice
A
1200-1500 ml
14
Q
What does the palate allow us to do while chewing food
A
Breathe
15
Q
What is the approx length and diameter of the S. Intestine
A
10 ft in length
And 1 in in diameter
16
Q
What are the two sphincters of the esophagus
A
Upper and lower esophageal sphincter
Upper is skeletal muscle
Lower is smooth muscle
17
Q
What are the functions of papillae
A
- taste buds
- receptors for touch
- helps to increase friction between food and tongue
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
19
Q
Lipids need to be broken down into
A
Fatty Acids or Monoglycerides
20
Q
What is the soluabilty of carbs and proteins
A
Water soluable
21
Q
Where is the appendix and what is its approx size
A
Attached to the cecum
3 inches long
22
Q
At what pressure does the interval sphincter relax
A
~55mmHg
23
Q
How much bile is made each day
A
600-1000 ml
24
Q
What’s the difference between internal and external hemorrhoids
A
Internal originate above the pectinate line
External originate below the pectinate line
25
What is another name for the hepatopancreatic ampulla
The ampulla of Vater
26
Describe the lesser omentum
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
27
The muscularis layer of the GI tract
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)
28
Where is bilirubin synthesized
In a two stage process in the Kupffer cells and in the reticuloenothlial cells (spleen)
29
What are the enzymes secreted by the brush border
```
Alpha-dextrinase
Maltase
Sucrase
Lactase
Aminopeptidase
Dippeptidase
Phopholipase B1
```
30
What is tonus
A state of sustained contraction exhibited by the GI tract
31
Submucosa layer of the GI tract
Areolar CT that binds the mucosa to the muscularis
Contains blood and lymph that receive the absorbed nutrients
Contains the plexus of Meissner
32
Where is midgut pain referred to
Peri-umbilical region via lesser splanchic nerves
| T10-T11
33
Where are sublingual glands
Beneath the tongue and just superior to the submandibular glands
34
What are the layers of the S. Intestine
Serosa
Muscularis - contains the plexus of Auerbach
Submucosa- Contain bunners glands and Meissner plexus
Mucosa- epithelium, lamina propia, and muscularis mucosae
35
What are the three phases of deglutition
Voluntary stage
Pharyngeal stage
Esophageal stage
36
What are the layers of the L. Intestine
Serosa- contains the Omental appendices
Muscularis- contains teh tenia coli and haustra
Submucosa- areolar CT
Mucosa
37
What is deglutition
Swallowing
38
Where does most of the pancreas lie
In the retro peritoneal space
| Tail is peritoneal
39
What is the function of the spleen
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)
40
What is the biliary tree of the liver
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*
41
What are crypts of Lieberkuhn
Deep crevices in the mucosal lining called intestinal glands
42
What are the 3 frenula
Labial frenula (mandibular and the maxillary)
Lingual frenula
43
What is the function of HCl
Deactivated salivary amylase
Activates lingual lipase
Activates pepsinogen
44
Where do the sympathetic nerves that supply the GI tissue arise from
The thoracic and upper lumbar regions of the spinal cord
45
What makes up the peritoneum
A layer of simple squamous epithelium (mesothelium) with an underlying layer of areolar CT
46
What are the three types of cells that make up the gastric pits of the stomach
```
Chief cells (exocrine)
Parietal Cells (exocrine)
Enteroendocrine Cells (endocrine)
```
47
Liver Function:
| Bile
Many endogenous waste products are deposited into bile
Promoted digestion of lipids in the S. Intestine
48
What is the largest peritoneal fold
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
49
What are the two plexuses of the enteric nervous system
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
50
During swelling the soft palate and uvula are drawn…
Superiorly
51
What is a sialogogues
Stimulates salivation
Lemon drops
Sour Candies
52
Describe chief cells
Stimulated by luminal peptides (proteins) And HCL
Secrete pepsinogen that becomes pepsin
**pepsin is the CHIEF digesting enzyme in the stomach**
53
What is the role of phopholipase
Phospholipid digestion
54
Where is bilirubin carried to… and by what?
Carried to the glomerulus to be excreted in the urine
Carried by albumin
55
In order to absorbed at the cellular level, lipids have to be…
Hydrolyzed
56
Approx how long is the Jejunum
3 feet long
57
The pyloric sphincter opens every..
15-20 seconds allowing about 3 ml of chyme to pass
58
What are the tonsils
Small masses of lymphatic tissue that produce antibodies to fight infections
59
What is the midgut
Supplied by the Superior Mesenteric artery
Middle and distal duodenum, jejunum, appendix, ascending colon, and proximal 2/3 transverse colon
60
What are the ducts of the sublingual glands called
The lesser sublingual ducts
| -open into the flood of the mouth in the oral cavity proper
61
Where is the majority of bilirubin produced
From the degradation of RBCs
62
What deactivates salivary amylase
Stomach acid
63
Are enzymes secreted into the colon
NO
64
What digests lipids in the S. Intestine
Pancreatic lipases
65
Liver functions:
| Protein synth.
```
Deamination of AA
Formation of urea
Synth of most plasma proteins
Synth of all non-essential AA
Synth most of the clotting factos
(Prothrombin)
```
66
What are the 4 layers of the GI tract
Serosa
MMuscularis
Submucosa
Mucosa
67
What are the layers of the stomach
```
Serosa
Muscularis
(3 layers of smooth muscle)
Submucosa
(Areolar CT)
Mucosa
(Lamina propia and muscularis mucosae)
```
68
Parotid glands secrete saliva to the oral cavity via
The parotid duct aka stenson duct
69
What CN supplies parasympathetic innervation to the GI
The Vagus
| CN X
70
What makes the soft palate of the mouth
Posterior portion of the roof of the mouth
Arch shaped muscular partition between the oropahrnyx and the nasopharynx lined with mucous membranes
71
At what pressure does the conscious desire to defecate happen
~18 mmHg
72
Where does most digestion and absorption of nutrients occur
In the small intestine
73
What makes a bile salt
When bile acids conjugate with taurine or glycine in the liver they are then known as bile salts
74
what is the color and pH of bile
Yellowish, brown, olive green liquid
PH: 7.6-8.6
75
What are the minor salivary glands
Labial
Buccal
Palatal
Lingual
76
What is the terminal 1 inch of the Rectum
The anal canal
77
What supplies motor nuerons to the secretly cells of the mucosa epithelium
The Submucosal (Meissner) plexus
78
What is responsible for the movement of food from the lower esophagus to the rectum
Peristalsis from smooth muscles
79
What system is the GI system closely related to
Cardiovascular
80
What is alcoholic cirrhosis
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
81
Ulcerative colitis can cause damage to the intestine where?
At the microvili / absorptive cells
82
The open end of the cecum merges with ..
The colon
83
What are the readily absorbable forms of Carbs
Glucose, Frutcose, Galactose
84
Proteins are broken down into
Amino acids or small chains of amino acids (di/tripetides)
85
What is the role of elastase
Protein digestion
86
What is the duct of Wisung
The pancreatic duct
87
What is the function of the gall bladder
Stores and concentrates bile made by the liver
Reabsorbes water so that bile becomes 10x more concentrated
88
Describe filiform papillae
Pointed threadlike
Found on entire surface of tongue
Contain no tastebuds
Have tactile receptors
89
Explain obstructive jaundice
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**
90
What is the definition of diarrhea
Increase in the frequency, volume, or fluid content caused by increased motility and decrease absorption
Can be caused by lactose intolerance, stress, or microbes
91
The greater curvature of the stomach serosa continues as the
Greater omentum
92
What type of fluid do sublingual glands secrete
-mucous
93
What are the 4 types of papillae
Vallate
Fungiform
Foliate
Filiform
94
What is the primary duct in the pancreas
The duct of Wirsung aka the pancreatic duct
95
How early does the guy “differnetiate” in embryonic development
Week 3
| Foregut, midgut, hindgut
96
What is the pH of the intestinal juices
7.6 (alkaline)
97
What do the surface mucous/ goblet cells of the stomach mucosa secrete
Mucous rich bicarbonate to protect the stomach wall from HCL
98
What is the role of trypsin
Protein digestion
99
What is pepsin’s role
Is made from pepsinogen in chief cells
Most effective in acidic environment
Chemical digestion
100
What is the plexus of Meissner
An extensive network of enteric nuerons
101
Describe Vallate papillae
approx~ 12
Form an inverted V at the back of the tongue
-Contain 100-300 taste buds per papillae-
102
What pH do lingual and gastric lipases work at
Below 6.9
103
What is the role of enterochromaffin-like cells
Secrete histamine
| -activate parietal cells to produce more HCl
104
What are the 3 layers of the mucosa of the esophagus
Muscularis (smooth muscle)
Lamina propia (Areolar CT)
Nonkeratinized startified squamous epithelium,
105
What are the three parts of the pharnyx
The nasopharynx (respiration)
Oropharynx (digestion and RR)
Hypo/larnygopharynx (digestion and RR)
106
What is the only proteolytic enzyme of the stomach
Pepsin
107
Liver functions:
| Processes drugs and hormones
Detoxifies alcohol and excretes drugs such as penicillin into the bile
Chemically alters and deactivates T3T4
108
Where is foregut pain referred to
To the epigastrum via the greater splanchic nerves
| T5-T9
109
What isn’t the pathway for blood vessels entering the liver
The lesser omentum
110
What are Micelles
A transport vesicle made of Monoglycerols and Fatty acids mixed together with bile
111
Describe acute pancreatitis
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
```
112
What is the foregut
Supplied by branches of the celiac artery
Is salivary glands, esophagus, stomach, liver, gall bladder, pancreas, and proximal duodenum
113
Where is the plexus of Auerbach
In the muscularis layer of the GI
114
Describe the G- Cells of the stomach
Found only in the pyloric antrum
Secretes Gastrin
115
What is the Ligament of treitz
Aka Suspensory Ligament of the Duodenum
Is actually a suspensory MUSCLE covered by a fold of the peritoneum
116
What is the difference between micro and macro nutrients
Micro- can be readily absorbed
| Macro- Need to be broken down into smaller forms to be absorbed
117
What are plicae circulares
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
118
What is the uvula
- hangs from the free border of the soft palate
| - conical muscular process
119
What is the gastrocolic reflex
Signals from stomach activity cause movement of feces in the colon to move to the rectum
(LATE IN THE MEAL)
120
What allows the stomach to be distensible
Rugae
121
What effect does pancreatic amylase have of cellulose
None
122
What is the location of the pancreas
Lies posteriorly to the greater curvature of the stomach
123
Explain Jaundice
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
124
What is the pH of the stomach
4-6 when there is no food
| Down to 2 when there is food and HCl secretion
125
Chlyomicrons can make the blood appear
Turbid
126
What is the definition of constipation
Infrequent or difficult defecation caused by decreased motility of the intestines
127
What are the cells found in the crypts of lieberkuhn
```
S-cells
I- Cells
Absorptive cells
Goblet Cells
Paneth Cells
```
128
The pancreas and the tongue are considers
Accessory digestion organs
129
What is the role of bile
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
Explain hemorrhoids
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
What are the three layers of teh muscalaris of the esophagus
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
What gives feces its brown color
Urobilirbin being broken down into stercobilin
133
What is the gland responsible for pre vomit saliva
The parotid gland
134
What are the 6 basic processes of the digestive system
```
Ingestion
Secretion
Mixing and propulsion
Digestion
Absorption
Defecation
```
135
CARBS, FATS LIPDS.
Which spends the most time in the stomach, which spend the least
Carbs spend the least
| Fats remain the longest
136
Describe parietal cells of the stomach
Stimulated by luminal peptides (proteins) and gastrin-releasing peptide
(Neurotransmitter from the vagus nerve)
Secretes HCL And Intrinsic factor and Bicrarb
137
How is peristalsis triggered
As food pushes on the lumen, reflex is triggered to contract which pushes the bolus forward
138
What do absorption cells, Goblet cells and Paneth cells do
Absorptive cell- absorb contents from the lumen
Goblet cells- produce and secrete mucous
Paneth cells- secrete lysozyme and participate in phagocytosis
139
What is the only intestinal organ attached to the abdominal wall
The liver via the falciform ligament
140
Are the circular folds (plicae) in the L. Intestine
NO
141
The adventita of the GI
Single layer of connective tissue for the esophagus and proximal duodenum
142
What hormones is protein involved in the synthesis of
Serotonin, Epi, melatonin, histamine
143
How does acetylcholine effect the GI
Stimulated gastro activity
144
What are the steps of Heme breakdown to Bilirubin
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
What are portal triads
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
What hormones control gastric emptying
```
GDIP (glucose dependent insulinotropic polypeptide)
Aka GIP (gastric Inhibitory Polypeptide)
```
Has a inhibitory effect on gastric muscle, slowing peristalsis
147
What nervous reflex control gastric emptying
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
What is the role of gastrin
Stimulated HCl production in parietal cells
Stimulated epithelium repair
Stimulates histamine release in enterochromaffin like cells
149
What gives the mucosal lining its velvety appearance
Villi
| -vastly increases the surface area of the S. Intestine
150
What part of the GI tract never comes in contact with food
Salivary Glands, Liver, Gallbladder, pancreas
151
Where does the S. Intestine end?
At the ileocecal sphincter
152
What nervous system regúlales the enteric nervous system
The autonomic
153
What is the role of chymotrypsin
Protein digestion
154
Describe the Mesentery
Fan shaped fold,
| Binds the jejunum of the S. Intestine and the Posterior peritoneal wall
155
What is ankyloglossia
When the lingual frenulum is abnormally short, rigid, or anteriorly displaced
156
How often do the cells of the S. Intestine slough off
Every 5-7 days
157
What are the major salivary glands
Parotids
Submandibular
Sublingual
158
What does most of the emulsification work of lipids and where does this occur and at what pH
Bile in the small intestine
| Works best in alkaline pH of 7.2-8
159
Where does the Ligament of Treitz begin and connect
Begins at the diaphragm, connects to the duodenojejunum flexure Suspending it upwards
160
Describe the pharynx
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
What is the largest serous membrane in the body
The peritoneum
162
What process of bilirubin synthesis is slow to start at birth
The conjugation of bilirubin with glucouronic acid in the liver
163
Liver Function:
| Excretion of bilirubin
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
What CN control salivation
CN VII- all three glands
CN IX- Parotid Gland
CN V - Buccal branch- parotid
Lingual branch- sublingual, submandibular
165
What type of substances have be digested in the stomach
Water, ions, and short chain fatty acids and some drugs
| asprin, alcohol
166
What surround the amopulla of Vater
The sphincter of Oddi
167
What is the function of the biliary tree
Make, stores, and secretes bile
- rids the liver and body of certain wastes
- aids in the digestion of food in the small intestine
168
What is the terminal portion of the GI
Large intestine
169
What type of cell is in papillae
Stratified squamous epithelium
170
What is the pH of pancreatic juice
7.1-8.2
Because of sodium bicarbonate
- buffers the acidic gastric juices of chyme
- stops the action of pepsin
171
What do I-Cells do
Secrets cholecystokinin (CKK)
Found in the duodenum
Slows gastric emptying and H+ secretion
Stimulates pancreatic juice secretion
STIMULATES GALLBLADDER CONTRACTION
Promotes the satiety
172
What is the pH of saliva
6. 35-6.85 (acidic)
| * buffered by phosphate and bicarb*
173
What reflex opens the lower esophageal sphincter
Vago-vagal reflex
| Afferent and efferent fibers of teh vagus nerve
174
What is the process of moving lipids out of the digestive lumen into the enterocytes
Emulsification
175
Where does chyme become feces?
In the L. Intestine as it hardens
176
What is another name for the duct of Santorini
Accessory duct of the pancreas
177
Describe the rectum
The last 8 inches of the GI tract
lies anterior to the sacrum and coccyx
178
What enzyme digests carbs
Amylases
179
After mastication, food is swallowed as a…
Bolus
180
What type of fluid do submandibular glands secrete
Seromucous fluid
- contains alpha-amylase
- contains some mucous cells
181
Describe hepatic sinusoids
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
What are the three forms of Carbohydrates
Mono, Di, and Polysaccharides
183
Where are TAGS stored in the body
Adipocytes and Hepatocytes
184
HDLs
Reverse the transport of cholesterol
Returns excess cholesterol to the liver for recycling
Is made in the liver and S. Intestine
185
Where are submandibular glands
In the floor of the mouth, medial and inferior to the body of the mandible bone
186
Explain appendicitis
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
What is TOXIC MEGACOLON
When the large intestines dilate to 4-8 inches
Can be a complication of inflammatory bowel disease or C. Diff or colitis
188
What kind of muscle is the tongue
Skeletal
189
Where is the tongue attached to
Inferiorly to the hyoid bone, styloid process of the temporal bone and the mandible
190
What is the hindgut
Supplied by the inf. Mesenteric artery
Distal 1/3 of the transverse colon, descending, sigmoid colon, rectum and proximal anal canal
191
What is the physiology of the esophagus
```
Secretes mucous
(protective function)
```
Transports food to the stomach
Does NOT secrete digestive enzymes or participate in absorption
192
Where is the cecum and what is it’.?
Inferior to the ileocecal valve
Small pouch 2.4 inches long
193
What enzyme breaks down protiens
Proteases
194
For proteins: anything larger than ____ amino acids linked together is too large for absorption
3
195
Most lipids are not broken down till they reach the….
Small Intestine
196
What is the defecation reflex
Distention is the rectum triggers baroreceptors that signal the colon and the anal canal to contract
197
What enzyme breaks down lipids
Lipases
198
What is choedocholithiasis
Stones in the common bile duct
199
What is the epithelium layer of the mucosa
Nonkeratinized stratified squamous in the mouth, pharynx, and anal canal
(Protective function)
Simple Columnar in the stomach and intestines
(Secretion and absorption)
200
What is considered to be the brain of the gut
The enteric nervous system
201
What is hemolytic jaundice
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
What is ascites
When excess fluid accumulates in the mesocolon/peritoneum
203
How long does it take to empty the stomach
2-6 hours
204
LDLs
Delivers cholesterol to cells throughout the body
Leftover remains of VLDLs
Remolded in the LIVER
*Smaller than VLDL*
205
Gastric pacemakers cells located along the ____________ begin propulsion waves every _________ seconds
Greater curvature
15-20 seconds
206
What are Von Ebners Gglands
Lingual glands in the lamina propia
- secrete watery serous fluid
- contains lingual lipase
207
Which tonsils if inflamed can close off sinus drainage and cause difficulty breathing
The pharyngeal tonsils
208
What is the end product of cholesterol metabolism and where does it occur
Bile acids
In the hepatocytes
209
What starts the breakdown of carbohydrates
Salivary alpha amylase
| **chloride activates this**
210
Sometimes the only complain of GERDS is
A cough that doesn’t go away
211
What is the role of Intrinsic Factor
AIDS in the absorption of B12 (cyanocobalamin) in the S. Intestine
212
What muscle does stenson duct penetrate
| Near what tooth
The buccinator
The second maxillary molar
213
How does Norepi effect the GI
Inhibits gastro activity
214
Where is hindgut pain referred to
Suprapubic region via the least splanchic nerve
T12
215
The merging of the common bile duct and the duct of wirsung creates..
The hepatopancreatic ampulla
216
What are the three types of tonsils
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
Describe hepatocytes
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
What is it called when digestive reflexes cause a forward and backwards movement within a single segment
Segmentation
219
What does the term Viscera-Somatic Convergence mean
Abdominal organs lack dedicated sensory pathways,
| Pain is often referred to skin or muscle
220
VLDL
Very low density lipid
Synth. In the liver from excess fat and cholesterol
*smaller than a chylomicron*
221
What are the four main regions of teh stomach
The cardia
The fundus
The body
The pyloric part
222
What is another name for the serosa of the GI tract
Visceral peritoneum
223
What are the three groups of Macro nutrients
Carbs, proteins, lipids
224
Describe the gall bladder and its location
Pear shaped sac
| Located in a depression of teh posterior inferior aspect of the liver
225
What do Interneurons do
Connest the myenteric and submucosal plexuses
226
Where is the plexus of Meissner
In the submucosa layer of the GI tract
Between the submucosa layer and the muscularis mucosae
227
What is the role of enteroendocrine cells of the stomach
D-Cells (somatostatin, aka GHIH)
| Secretes hormone into the interstitium with inhibits gastrin release
228
Explain hyperlipidemia and its mediation
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
What two functions does water serve in saliva
Allows for tasing by gustatory receptors
Allows for digestive reactions to begin
230
Where is lingual lipase secreted
Where is it activated
Secreted in the mouth
Activates in the stomach
231
What is it called when part of the stomach herniates through the esophageal hiatus
Hiatal hernia
232
Liver Function:
| Phagocytosis
Kupffer cells phagocytose aged RBCs and WBCs
233
What are the layers of the esophagus
Adventitia
Muscularis
Submucosa
Mucosa
234
What makes the Oral Cavity Proper
Space that extends from the lingual side of the teeth back to the fauces
235
What are the 4 main regions of the L. Intestine
Cecum
Colon
Rectum
Anal Canal
236
What do S-cells do
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
Where is bile made…. Where is it strored
Made in the liver
| Stored in the gallbladder
238
What is the heaviest gland in the body
Liver, also the largest internal organ
239
What are the forms of Carbs that require digestion
Disaccharides- broken down into sucrose, lactose and maltose
Polysaccharides- broken down in to starches and glycogen
240
What is Sjogren syndrome
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
Approx how long is the esophagus
10 inches
242
At what pressure may the external sphincter fail
~80 mmHg
243
Carbs are broken down into….
Glucose
Fructose
Galactose
244
What Nervous system controls salivation
ANS (Paramsympathetic)
245
Ones fatty acids and momglycerols enter the enterocytes they…
Combine back together to form TAGs, in the endoplasmic reticulum then sent to the golgi
246
Describe physiologic jaundice
Occurs in newborns
Blue light is used to convert bilirubin into substances the kidneys can secrete
247
What is the shortest region of the S. Intestine and where is it
The duodenum
Located retro peritoneal
Starts after the pyloric sphincter and merges with the jejunum
248
What is the mucosa of the L. Intestine made of
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
What is the lingual frenulum
IS a fold in the midline of the ventral aspect (under surface of the tongue)
250
What are the three divisions of the pyloric part of the stomach
The antrum
Canal
Pylorus
251
How much is water is excreted in feces
Approx 100 ml
252
What is responsible for feces odor
Bacteria releasing índole, skatole, and hydrogen sulfate
253
What makes up the oral vestibule
Oral space complete bound by checks, lips, gums, and bucal side of teeth
254
What makes the hard palate
Anterior portion fo the roof of the mouth
Formed by the palatine bones and the maxillae bones
**covered by mucous membranes**
255
How does chemical digestion occur in the colon
By bacteria causing gas and Odor
256
What components of pancreatic juices break down proteins in the S. Intestine
Trypsin, chymotripsin, carboxypeptidase, and elastase
257
How many micro nutrients are considered essential
28
Slide 12
258
What is the palate of the mouth
- forms the roof of the mouth
-Separates the oral cavity from the nasal cavity
Is made of the hard and soft palate
259
What are the three layers of the mucosal layer of the stomach
Muscularis mucosae
Lamina propia
Mucosa
260
Liver function:
| Carbohydrate (starch) metabolism
Glycogenesis and Glycogenolysis
261
What are the S/s of Alcoholic cirrhosis
```
Jaundice
Nausea
Malaise
Ascites
Hepatic Encephalopathy
Renal failure
Death
```
262
Where are chlyomicrons sent…
Dumped into the lacteal duct that converges with the thoracic duct (at the subclavian vein)
263
The serosa of the GI tract
Serous membrane composed of areolar connective tissue and simple squamous epithelium (mesothelium)
264
Where does the duct of Wirsung open into
The duodenum
265
In what cell does the break down of heme to bilirubin occur…
In macrophages of reticuloendothelial cells (spleen, liver)
266
Where are papillae found
On the dorsal (upper surface) and lateral surface of the tongue
267
What can happen if bilirubin accumulates
Can cross the BBB and be toxic
Also Jaundice
268
What is the “brush border” of the S. Intestine and what is it made of and do ?
Is microvili, where are small projections of absorptive cels
269
Liver Function: lipid metabolism
Sythizes and stores some triglycerides, most lipoproteins, and large quantities of cholesterol
270
What is a food bolus called after entering the stomach
Chyme
271
What is the duct of santorini
Smaller duct branching off of the pancreatic duct
Drains in the duodenum just proximal to the ampulla of Vater
272
What type of fluid do paratid glands secrete
Serous (watery) fluid
| -contains alpha-amylase
273
What are the two sources of blood for the liver
```
The hepatic artery (25%)
Portal Vein (75%)
```
274
What are the 4 non essential amino acids
Alanine
Aspartate
Cysteine
Glutamate
275
Where does the S. Intestine begin
Immediately after the pyloric sphincter
276
How many amino acids are there…
How many are essential,
How many are conditionally essential
How many are non essential
20
9 essential
7 conditional
4 non
277
Kupffer cells aka
Stella te reticuloendothelial cells
278
Exocrine cells vs enteroendocrine cells
Exocrine- secrete mucous/fluid/enzymes into lumen
Entero- secrete hormones into the blood stream
279
What two lipases start the emulsification process
Lingual and gastric lipases
280
What is the gastroileal reflex
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
What does the mucosa of the stomach contain
Gastric glands
Exocrine glands
Enteroendocrine cells
282
Describe Foliate papillae
Located in the small trenches on the lateral margins on the tongue
-most of the tastebuds degenerate in child hood-
(Sour taste)
283
What exogenous things can relax the lower esophageal sphincter
```
alcohol
Dopamine
NO
prostaglandins
Chocolate
Acid gastric Juice
Fat
Smoking
```
284
What hormones causes dry mouth in dehydration
ADH
285
When the kidneys aren’t functioning properly, what can provide some waste filtering…
What does this lead to…
The peritoneum
Peritonitis
286
At what pH is pepsinogen rapidly activated?
Ph less than 3
287
What is in the the lamina propria layer of the mucosa
Areolar CT with blood and Lymph vessels
| Contains MALT
Tonsils, S. Intestine, appendix, and L. Intestine
288
What divides the tongue into lateral halves
The median septum
289
What gets converted by the liver to bile acids
Cholesterol
290
What is the pectinate line in the Anal canal
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
What fold in the peritoneum is classically called the beer belly
The greater omentum
292
What are the three regions of the S. Intestine
Duodenum
Jejunum
Ileum
293
What is the role of caboxypeptidase
Protein digestion
294
What duct do submandibular glands secrete saliva through
Wharton’s Ducts
Open on either side of the lingual frenulum
295
What is salivary alpha-amylase
A digestive enzyme found in the saliva
296
What is the valve that connects the S. Intestine to the L. Intestine
The ileocecal valve
297
What does the pancreatic duct merge with
The common bile duct
298
What is the longest region of the S. Intestine
The ilium
| Approx 6 ft
299
GI tract, aka
Alimentary tract
300
What digests carbohydrates in the S. Intestine
Pancreatic amylase
301
What is the advantage of bile salts
They are more water soluable making them more efficient in the intestinal lumen
302
Liver Functions:
| Storage
Stores fat soluble vitamins ADEK
As well as B12
Stores Iron and Copper
303
Lipases break fatty droplets down into…
+3 Fatty Acids
304
What supplies motor impulses to the longitudinal and circular layers of teh muscularis
The Myenteric Plexus (Auerbach)
305
Describe the sigmoid colon
Located retro peritoneal
Begins at the left iliac crest and projects medially to midline
Terminates at the rectum
(3rd sacral vertebrae)
306
How long does chyme remain in the L. Intestine
3-10 hours
307
Approx how long is the L. Intestine
5 ft long
| 2.5 in diameter
308
What are the three layers of the mucosa of the GI tract
Muscularis mucosae
Lamine Propria
Epithelium
309
What is cholelithiasis
Stones in the gallbladder
Can cause minimal, intermittent, or complete obstruction of bile flow out of the gallbladder
310
Describe GERD
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
What is the falciform ligament
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
What attaches the large intestine to the the posterior wall?
The mesocolon (peritoneal fold)
313
What are the functions of the pancreas
Exocrine- cluster of glandular cells that produce digestive enzymes
Endocrine- produce the hormones insulin/ glucagon
314
What is the important landmark that seperates the Upper and lower GI
The ligament of Trietz
315
The muscularis mucosae of the mucosa layer contains
Thin layer of smooth muscle fibers
This layer is what giver the mucus membrane of the S. Intestine a folded appearance
316
What are the two muscular folds that run down the lateral sides of the soft palate
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
Where does the esophagus pass through the diaphragm
The esophageal hiatus
318
What are the overal functions of the Large intestine
Absorption
Produces vitamins (K and biotin)
Forms feces
319
What is cholangitis
Biliary tree inflammation or infection
320
What is the major functional unit of the liver
Hepatic lobules
- hexagonal shape
- made of rows of hepatocytes
321
What is the volume of water that enters the S. Intestine
| How much water is absorbed in the S. Intestine and Large intestine
9. 3 L per day
2. 3 liters from food and liquids
7. 0 from gastric secretions
S. Intestine: 8.3 L of fluid
L. Intestine: 0.9 L of Fluid
322
What is the most distensible part of the GI tract
The stomach
