GASTRO Flashcards
Describe fungiform papillae
Mushroom shaped elevations that are scattered over the entire surface of the tongue
-contain 5 taste buds each-
What is the in submucosa layer of the esophagus
Areolar CT, blood vessels and mucous glands
Where are the parotid glands located
Located inferior and anterior to the ears between the skin and the Masseter muscle
What are the 9 essential amino acids
PVT TIM HaLL
Phenylalanine Valine Tryptophan Threonine Isoleucine Methionine Histidine Lysine Leucine
What are the 5 major folds of the peritoneum
The greater and lesser omentum
Falciform ligament
The Mesentery
Mesocolon
Micelles dump their contents into
enterocytes
What are the 4 parts of the Colon
Ascending, Transverse, Descending, and sigmoid
What happens to TAGs in the golgi
TAGs are packaged with cholesterol and lipoproteins
Forming a chylomicron
How long does it take solid/ semi solid food to pass from the mouth to the stomach
4-8 seconds
What is the most important cell in the stomach
Mucosal (goblet) cells
Without them HCl would eat a whole though your stomach
What are the two divisions of the peritoneum
The parietal and Visceral peritoneum
What does bilirubin become in the Large intestine>?
Urobilirubins that can become either urobilins (excreted in urine, yellow color) or sterecobilins (excreted in feces, brown color)
Everyday the pancreas produces _______ of pancreatic juice
1200-1500 ml
What does the palate allow us to do while chewing food
Breathe
What is the approx length and diameter of the S. Intestine
10 ft in length
And 1 in in diameter
What are the two sphincters of the esophagus
Upper and lower esophageal sphincter
Upper is skeletal muscle
Lower is smooth muscle
What are the functions of papillae
- taste buds
- receptors for touch
- helps to increase friction between food and tongue
Describe the mesocolon
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
Lipids need to be broken down into
Fatty Acids or Monoglycerides
What is the soluabilty of carbs and proteins
Water soluable
Where is the appendix and what is its approx size
Attached to the cecum
3 inches long
At what pressure does the interval sphincter relax
~55mmHg
How much bile is made each day
600-1000 ml
What’s the difference between internal and external hemorrhoids
Internal originate above the pectinate line
External originate below the pectinate line
What is another name for the hepatopancreatic ampulla
The ampulla of Vater
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
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)
Where is bilirubin synthesized
In a two stage process in the Kupffer cells and in the reticuloenothlial cells (spleen)
What are the enzymes secreted by the brush border
Alpha-dextrinase Maltase Sucrase Lactase Aminopeptidase Dippeptidase Phopholipase B1
What is tonus
A state of sustained contraction exhibited by the GI tract
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
Where is midgut pain referred to
Peri-umbilical region via lesser splanchic nerves
T10-T11
Where are sublingual glands
Beneath the tongue and just superior to the submandibular glands
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
What are the three phases of deglutition
Voluntary stage
Pharyngeal stage
Esophageal stage
What are the layers of the L. Intestine
Serosa- contains the Omental appendices
Muscularis- contains teh tenia coli and haustra
Submucosa- areolar CT
Mucosa
What is deglutition
Swallowing
Where does most of the pancreas lie
In the retro peritoneal space
Tail is peritoneal
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)
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
What are crypts of Lieberkuhn
Deep crevices in the mucosal lining called intestinal glands
What are the 3 frenula
Labial frenula (mandibular and the maxillary)
Lingual frenula
What is the function of HCl
Deactivated salivary amylase
Activates lingual lipase
Activates pepsinogen
Where do the sympathetic nerves that supply the GI tissue arise from
The thoracic and upper lumbar regions of the spinal cord
What makes up the peritoneum
A layer of simple squamous epithelium (mesothelium) with an underlying layer of areolar CT
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)
Liver Function:
Bile
Many endogenous waste products are deposited into bile
Promoted digestion of lipids in the S. Intestine
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
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
During swelling the soft palate and uvula are drawn…
Superiorly
What is a sialogogues
Stimulates salivation
Lemon drops
Sour Candies
Describe chief cells
Stimulated by luminal peptides (proteins) And HCL
Secrete pepsinogen that becomes pepsin
pepsin is the CHIEF digesting enzyme in the stomach
What is the role of phopholipase
Phospholipid digestion
Where is bilirubin carried to… and by what?
Carried to the glomerulus to be excreted in the urine
Carried by albumin
In order to absorbed at the cellular level, lipids have to be…
Hydrolyzed
Approx how long is the Jejunum
3 feet long
The pyloric sphincter opens every..
15-20 seconds allowing about 3 ml of chyme to pass
What are the tonsils
Small masses of lymphatic tissue that produce antibodies to fight infections
What is the midgut
Supplied by the Superior Mesenteric artery
Middle and distal duodenum, jejunum, appendix, ascending colon, and proximal 2/3 transverse colon
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
Where is the majority of bilirubin produced
From the degradation of RBCs
What deactivates salivary amylase
Stomach acid
Are enzymes secreted into the colon
NO
What digests lipids in the S. Intestine
Pancreatic lipases
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)
What are the 4 layers of the GI tract
Serosa
MMuscularis
Submucosa
Mucosa
What are the layers of the stomach
Serosa Muscularis (3 layers of smooth muscle) Submucosa (Areolar CT) Mucosa (Lamina propia and muscularis mucosae)
Parotid glands secrete saliva to the oral cavity via
The parotid duct aka stenson duct
What CN supplies parasympathetic innervation to the GI
The Vagus
CN X
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
At what pressure does the conscious desire to defecate happen
~18 mmHg
Where does most digestion and absorption of nutrients occur
In the small intestine
What makes a bile salt
When bile acids conjugate with taurine or glycine in the liver they are then known as bile salts
what is the color and pH of bile
Yellowish, brown, olive green liquid
PH: 7.6-8.6
What are the minor salivary glands
Labial
Buccal
Palatal
Lingual
What is the terminal 1 inch of the Rectum
The anal canal
What supplies motor nuerons to the secretly cells of the mucosa epithelium
The Submucosal (Meissner) plexus
What is responsible for the movement of food from the lower esophagus to the rectum
Peristalsis from smooth muscles
What system is the GI system closely related to
Cardiovascular
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
Ulcerative colitis can cause damage to the intestine where?
At the microvili / absorptive cells
The open end of the cecum merges with ..
The colon
What are the readily absorbable forms of Carbs
Glucose, Frutcose, Galactose
Proteins are broken down into
Amino acids or small chains of amino acids (di/tripetides)
What is the role of elastase
Protein digestion
What is the duct of Wisung
The pancreatic duct
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
Describe filiform papillae
Pointed threadlike
Found on entire surface of tongue
Contain no tastebuds
Have tactile receptors
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
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
The greater curvature of the stomach serosa continues as the
Greater omentum
What type of fluid do sublingual glands secrete
-mucous
What are the 4 types of papillae
Vallate
Fungiform
Foliate
Filiform
What is the primary duct in the pancreas
The duct of Wirsung aka the pancreatic duct
How early does the guy “differnetiate” in embryonic development
Week 3
Foregut, midgut, hindgut
What is the pH of the intestinal juices
7.6 (alkaline)
What do the surface mucous/ goblet cells of the stomach mucosa secrete
Mucous rich bicarbonate to protect the stomach wall from HCL
What is the role of trypsin
Protein digestion
What is pepsin’s role
Is made from pepsinogen in chief cells
Most effective in acidic environment
Chemical digestion
What is the plexus of Meissner
An extensive network of enteric nuerons
Describe Vallate papillae
approx~ 12
Form an inverted V at the back of the tongue
-Contain 100-300 taste buds per papillae-
What pH do lingual and gastric lipases work at
Below 6.9
What is the role of enterochromaffin-like cells
Secrete histamine
-activate parietal cells to produce more HCl
What are the 3 layers of the mucosa of the esophagus
Muscularis (smooth muscle)
Lamina propia (Areolar CT)
Nonkeratinized startified squamous epithelium,
What are the three parts of the pharnyx
The nasopharynx (respiration)
Oropharynx (digestion and RR)
Hypo/larnygopharynx (digestion and RR)
What is the only proteolytic enzyme of the stomach
Pepsin
Liver functions:
Processes drugs and hormones
Detoxifies alcohol and excretes drugs such as penicillin into the bile
Chemically alters and deactivates T3T4
Where is foregut pain referred to
To the epigastrum via the greater splanchic nerves
T5-T9
What isn’t the pathway for blood vessels entering the liver
The lesser omentum
What are Micelles
A transport vesicle made of Monoglycerols and Fatty acids mixed together with bile
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
What is the foregut
Supplied by branches of the celiac artery
Is salivary glands, esophagus, stomach, liver, gall bladder, pancreas, and proximal duodenum
Where is the plexus of Auerbach
In the muscularis layer of the GI
Describe the G- Cells of the stomach
Found only in the pyloric antrum
Secretes Gastrin
What is the Ligament of treitz
Aka Suspensory Ligament of the Duodenum
Is actually a suspensory MUSCLE covered by a fold of the peritoneum
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
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
What is the uvula
- hangs from the free border of the soft palate
- conical muscular process
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)
What allows the stomach to be distensible
Rugae
What effect does pancreatic amylase have of cellulose
None
What is the location of the pancreas
Lies posteriorly to the greater curvature of the stomach
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
What is the pH of the stomach
4-6 when there is no food
Down to 2 when there is food and HCl secretion
Chlyomicrons can make the blood appear
Turbid
What is the definition of constipation
Infrequent or difficult defecation caused by decreased motility of the intestines
What are the cells found in the crypts of lieberkuhn
S-cells I- Cells Absorptive cells Goblet Cells Paneth Cells
The pancreas and the tongue are considers
Accessory digestion organs