Gastro Intestinal Physiology Flashcards

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1
Q

Digestion Process Steps

A
  1. Ingestion
  2. Propulsion
  3. Digestion
  4. Abosorbtion
  5. Defecation
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2
Q

Ingestion

A
  1. Mastication
  2. Deglutition
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3
Q

Mastication

A

chewing

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4
Q

Deglutition

A

swallowing

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5
Q

GI PHYSIOLOGY

Propulsion

A

movement of food

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6
Q

Digestion

A

breakdown of food by:
1. Mechanical action
2. Chemical processes

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7
Q

Digestion

Mechanical Action

A

chewing food into smaller pieces

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8
Q

Digestion

Chemical Processes

A

mixing food with acids, enzymes, and emulsifiers to breakdown food

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9
Q

Absorbtion

A

passage of nutrients into circulatory and lymphatic systems for distribution throughout the body

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10
Q

Defecation

A

elimination of indigestible substances

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11
Q

Divisions of the GI system

A
  1. Alimentary Canal
  2. accessory Digestive Organs
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12
Q

Alimentary Canal

A

tube that winds through the body

mouth, pharynx, esophagus, stomach, small intestine, large intestine, rectum

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13
Q

Accessory Digestive Organs

A

contribute to the breakdown of food

teeth, tongue, salivary glands, pancreas, liver, gall bladder

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14
Q

4 Layers of the Alimentary Canal Wall

A
  1. Tunica Mucosa
  2. Tunica Submucosa
  3. Tunica Muscularis
  4. Tunica Serosa

Innermost to outermost

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15
Q

Alimentary Canal Wall

Sublayers of the Tunica Mucosa

A
  1. Epithelium lining
  2. Lamina Propia
  3. Muscularis Mucosa

innermost to outermost

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16
Q

Epithelium Lining of the Tunica Mucosa

A

absorbtion/protection/secretion, mucous production, glands-digestive enzymes

inner layer

stratified squamous or simple columnar

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17
Q

Lamina Propia of the Tunica Mucosa

A

immune protection, contains capillaries and lymphatics

middle layer

loose connective tissue

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18
Q

Muscularis Mucosa of the Tunica Mucosa

A

folds to increase surface area, local movement of GI epithelium

outer layer

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19
Q

Alimentary Canal Wall

Tunica Submucosa

A

highly vascularized, innervated by the ANS, binds tunica mucosa to tunica muscularis, contains meissners plexus

2nd from middle

dense irregular connective tissue,

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20
Q

meissners plexus

A

tells glands to secrete, tells muscularis mucosae to contract

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21
Q

Alimentary Canal Wall

Tunica Muscularis

A

mechanical digestion, propulsion, contains Auerbach’s Plexus,

3rd from middle

smooth muscle, controlled by ANS

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22
Q

Auerbach’s Plexus

A

located between muscle layers, controls GI motility

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23
Q

Tunica Serosa

A

fluid secreting membrane, visceral peritioneum on organs, parietal peritoneum lines cavities

outermost layer

simple squamous epithelium

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24
Q

Blood Flow of GI system

A

25% of cardiac output, liver recieves blood from hepatic artery and portal veins from organs.

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25
Q

Liver Functions

A
  1. Carbohydrate Metabolism (stores glycogen, releases glucose)
  2. Lipid Metabolism (manufacture of cholesterol (HMG CoA Reducatse)
  3. Protein Synthesis (albumins, fibrinogens, prothrombin)
  4. Breakdown of old RBC hemoglobin into bilirubin
  5. Bile Production (used for emulsification of fats)
  6. Detoxification (chemically alters alcohol, drugs, etc into kidney exretable compounds such as urea, ammonia, uric acid)
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26
Q

Portal Triad

A

portal vein, hepatic artery, bile duct

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27
Q

portal vein

A

deoxygenated blood into the liver

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28
Q

hepatic artery

A

oxygenated blood into the liver

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29
Q

Hepatic Sinusoids process

A
  1. Kuffler cells break down RBC’s
  2. Hemoglobin broken down into Iron + Bilirubin
  3. Bilirubin binds to Albumin
  4. Absorbed by Liver cell
  5. Processed into Bile Salts
  6. Stored by the Gall Bladder
  7. Released by common bile duct
  8. bile salts are recirculated multiple times per day in GI tract
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30
Q

Jaundice Causes

A

bile tract blockage, liver failure, hemolysis

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31
Q

Nutrient Absorbtion

A

most enzymes from Pancreas, bile for fat emulsification, from liver

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32
Q

Carbohydrate Absorbtion steps

A
  1. broken down by Amylase (pancreas)
  2. absorbed in mono and disaccharide form into capillaries
  3. absorbtion coupled with Na+ down concentration gradient
  4. secondary active transport
  5. transport into liver via hepatic portal system
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33
Q

Protein Absorbtion steps

A
  1. Broken down by stomach acid, pepsin, trypsin(pancreas)
  2. absorbed as AA’s and small peptides into capillaries
  3. absorbtion coupled with Na+ down concentration gradient
  4. Secondary active transport
  5. Transport to liver via hepatic portal sytem
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34
Q

Fat and Cholesterol Absorbtion

A
  1. Emulsified via action of Bile(liver)
  2. broken down into fatty acids or monogylcerides by lipases(pancreas)
  3. Lipids absorbed as FFA’s and monoglycerides in small intestine
  4. conjugated with Apoproteins by mucosal cell form Chylomicron
  5. exocytosis via mucosal cells releases Chylomicrons
  6. forms lacteals of lymphatic system for transport
  7. stored as peripheral fat in the venous system
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35
Q

normal cholesterol level

A

200 mg/dl and below

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36
Q

LDL

A

low density lipoprotein, remains in circulation and promotes plaque formation

bad cholesterol

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37
Q

HDL

A

high density lipoprotein, promotes storage of cholesterol in the liver

good cholesterol

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38
Q

Ideal LDL level

A

LDL<130mg/dl

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39
Q

Ideal HDL level

A

HDL>45mg/dl

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40
Q

At risk cholesterol levels

A

cholesterol 240mg/dl or above
LDL>160mg/dl
HDL<35mg/dl

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41
Q

Natural Treatment of High Cholesterol

A

low fat diet with moderate alcohol

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42
Q

Cholestyramine

A

binding resin, forms insoluable bile/fat complexes that are excreted

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43
Q

Statins

A

binds to HMG CoA Reductase, reduce cholesterol synthesis by Liver, decreases LDL’s, increases HDL’s

Lovastatin(mevacor), Simvastatin(Zocor), Atorvastatin(Lipitor), Pravastatin(Pravachol), Rosuvastatin(Crestor)

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44
Q

Ezetimibe(Zetia)

A

binds to NPC1L1 protein on enterocytes and hepatocytes, mediator of dietary absorbtion,

lower absorbtion rate enhances uptake of LDL by peripheral cells

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45
Q

Vytorin

A

Zocor + Zetia

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46
Q

Inputs of Water Balance

A

1200ml drinking/food
1500ml saliva
2000ml stomach
500ml bile
1500ml pancreas
1500ml small intestine

8200ml total

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47
Q

Reabsorbtion in water balance

A

8500ml small intestine
350ml large intestine

exrete 150ml in feces

8850ml total

48
Q

Water Absorbtion

A

water is absorbed until is is isoosmotic with plasma, the max urine flow is 16ml/min

49
Q

Water Intoxication

A

Water intake above the max urine flow or if too much exogenous ADH is administered, swelling of brain, convulsions, coma, death

max urine flow is 16ml/min

50
Q

Minimum Amount of Water Excreted

A

600mosm/L/day

51
Q

Kidney Max Urine Concentration of Water

A

1200 mosm/L/day

52
Q

Amount of Water Excreted in Urine

A

0.5L/day

53
Q

Max Kidney Urine Concentration of Seawater

A

1400 mosm/L

54
Q

Digestion

Sight and Smell of food

A

stimulates salivary and gastric secretions

55
Q

Chemoreceptors in the Stomach

A

detects HCl levels

56
Q

Mechanoreceptors in the Stomach

A

detects distension and pressure in the stomach

57
Q

Neural Control of Digestion

Long Relex Innervation

A

connects parts of the GI tract together, connects to CNS, stimulated by Vagus nerve, ACh, and Serotonin,

activates Meissners and Auerbachs Plexus, Splanchnic Nerves are inhibitory

58
Q

Splanchnic Nerves

A

sympathetic fibers that inhibit Long Reflex Innervation

stimulated by NE and E

59
Q

Short Reflex Innervation

A

mediated through nerves confined to the GI tract, stimulated by chemicals, hormones, and distension

activates endocrine glands and smooth muscles in the tract

60
Q

Components of GI System

Mouth

A

Ingestion and digestion, contains salivary glands, buccal glands, parotid glands, submandibular glands, submaxillary glands, and sublignual glands.

entrance of Alimentary Canal, Mucosa lined

61
Q

Salivary Glands

A

saliva production, contains Compound Acinar Gland

accessory digestive organs

62
Q

Compound Acinar Gland

A

makes Amylase for starch digestion, makes Lipase for fat digestion

serous and mucous

63
Q

Mumps

A

virus that causes inflammation of the parotid glands

64
Q

Deglutition Steps

A
  1. Medulla Signals Swallowing
  2. Trigeminal, Glossopharyngeal, Vagus, and Hypoglossal Innervate
  3. Mouth Closes
  4. Tongue pushes food back
  5. Contraction of Pharynx
  6. Inhibition of respiration (Larynx raises, epiglottis closes)
  7. Upper Esophageal Sphincter Relaxes
  8. Peristaltic Wave initiated
  9. Lower esophageal sphincter relaxes
  10. Second painful Peristaltic wave if unsuccessful

Liquids via gravity

65
Q

Stomach

A

widest part of Alimentary Canal, distentable/contractable, produces enzymes and acids

food storage, mechanical and chemical digestion

66
Q

Cardiac Sphincter

A

sphincter at the upper end of the stomach

67
Q

Heartburn

A

reflux of acid at the cardiac sphincter

68
Q

Mucosa

A

protects from acids, secretes mucous, acids, and enzymes, absorbes water, alcohol, and drugs

has folds called Rugar, made from Simple Columnar Epithelium

69
Q

Gastric Pits

A

contains stomach glands which produce Chyme, contains specialized cells

70
Q

Gastric Pit Cells

Mucous Neck Cells

A

produce mucous for protection

71
Q

Gastric Pit Cells

Parietal Cells

A

produce HCl, absorb Vitamin B12

72
Q

Pernicous Anemia

A

insufficient RBC production due to Vitamin B12 deficiencies

can be caused due to issues with Parietal Cells

73
Q

Gastric Pit Cells

Chief Cells

A

secretes Pepsinogen with acid to activate Pepsin, acts in protein digestion

these cells can be digested by the enzymes they secrete (autolyse)

74
Q

Gastric Pit Cells

G Cells or “APUD”

A

activated by food in the stomach and releases Gastrin into the blood causing increased Parietal Cell acid secretion and increased GI motility

when activated they speed up digestion

75
Q

Gastric Pit Cells

Enterochromaffin Cells

A

produce histamine, acid secretion stimulator

76
Q

Gastric Pit Cells

D Cells

A

produces somatostatin, acid secretion inhibitor

77
Q

Tunica Muscularis Layers

A
  1. Inner Oblique
  2. Middle Circular
  3. Outer Longitudinal

Innermost to Outermost

78
Q

Pyloric Sphincter

A

controls the emptying of the stomach into the duodenum

79
Q

Acid Production in the Stomach

A
  1. H+ is exchanged with K+ and moves into the gastric lumen
  2. HCO3- is exchanged with Cl-
  3. cAMP activates protein kinase which drives the pump
  4. ACh and Gastrin both increase Ca++ and also stimulate protein kinases
  5. Histamine will activate cAMP
  6. PGE2 will deactivate cAMP

HCl moved into gastic lumen and HCO3- is moved into the blood

80
Q

Stomach Acid Inhibitors

A
  1. ACh antagonists (Atropine)
  2. Histamine blockers
  3. Gastrin Blockers
81
Q

Omeprazole

A

blocks H+/K+ ATPase pump

82
Q

Acidity and Gastrin

A

high acidity in the stomach inhibits gastrin release and slows down the movement of HCl into the stomach

83
Q

Acid Production

high protein meals

A

high protein meals buffer acidity and stimulate acid production

84
Q

Acid Production

Empty Stomach

A

An empty stomach is high in acidity and inhibits Gastrin release

85
Q

Ulcers

A

caused from a hyper secretion of acid or a lack of mucous protection, lesser curvature, pyloris, and duodenum are the most vulnerable,

usually caused by bacteria

86
Q

Ulcer Treatments

A

H2 blockers, Omeprazole, Vagotomy(removal of part of the vagus nerve)

87
Q

Vomiting Process

A
  1. Irritation trigger vomiting center in the brain
  2. Saliva Secretions Stimulated
  3. Squeezing of the stomach beginning with the diaphragm and abdominal muscles (increased pressure)
  4. Sphincters open

excessive vomiting can cause alkalosis due to vomiting out acids which would cause more acid to move into the stomach and more base to move into the blood

88
Q

Small Intestine

A

longest portion of the Alimentary Canal, basic pH

89
Q

Small Intestine Functions

A
  1. Enzymatic Digestion (enzymes from pancreas)
  2. Emulsification of Fats (via bile from the liver)
  3. Absorbtion of Nutrients (capillaries and lacteals)
  4. Secretion of Hormones
90
Q

Main Parts of the Small Intestine

A
  1. Duodenum
  2. Jejunum
  3. Ileum
91
Q

Cell Types of the Small Intestine

A
  1. Absorbative
  2. Goblet (mucous)
  3. Enteroendocrine (hormones)
  4. Paneth (antibacterial enzymes)
92
Q

Small Intestine

Tunica Mucosa

A

different from usual as it has a greater surface area due to three modifications

93
Q

Small Intestine

Tunica Mucosa Modifications

A
  1. Simple Columnar Epithelium with Microvilli
  2. Arranged in Villi (contain artery, capillary, and vein)
  3. Plica Sircularis (folds of mucosa and submucosa, where Enteroendocrine and Paneth cells are located)
94
Q

Small Intestine Hormones

A
  1. GIP-Gastric Inhibitory Peptide
  2. CCK-PZ Cholecystokinin-Pancreozymin
  3. Secretin
  4. Motilin
  5. VIP

produced by Enteroendocrine cells

95
Q

Small Intestine Hormones

GIP-Gastrin Inhibitory Peptide

A

released from duodenal filling or inceased acid in duodenum, inhibits GI motility and acid production,

increases time for absorbtion

96
Q

Small Intestine Hormones

CCK-PZ Cholecystokinin-Pancreozymin

A

released from duodenal filling, increased acid, increased protein, or increased fat in the duodenum, inhibits GI motility, stimulated Gall Bladder Contraction, stimulates Pancreatic secretion(digestive enzymes)

gall bladder releases bile for fat emulsification and pancreas releases enzymes for protein digestion

97
Q

Small Intestine Hormones

Secretin

A

released due to acid in duodenum, stimulates HCO3- release from Pancreas,

makes intestine basic which shuts down its secretion

98
Q

Small Intestine Hormones

Motilin

A

responsible for MMC(migrating motor complex), emptys stomach

99
Q

Migrating Motor Compex (MMC)

A

peristaltic wave from esophagus to small intestine

during the interdigestive period, emptys stomach

100
Q

Small Intestine Hormones

VIP

A

decreases smooth muscle motility, dilation for peripheral vessels, inhibits acid secretion

101
Q

Small Intestine

Segmentation

A

mixing of Chyme and Enzymes, brings digested nutrients into contact with villi and microvilli for absorbtion

controlled by ANS(Auerbach’s Plexus) and hormones

102
Q

Small Intestine

Peristalsis

A

propulsion of chyme along the small intestine, pumping up and down of villi and microvilli by Mucous Mucosa

controlled by ANS(Auerbach’s Plexus) and hormones, Meissners Plexus

103
Q

Pancreas

Exocrine Functions

A

secretion into a duct of digestive enzymes and alkaline juice

104
Q

Acinar Cells

A

produce Pancreatic Juice and digestive enzymes secreted into Pancreatic duct and moved into the Small Intestine

105
Q

Alkaline Juice

A

neutralizes stomach chyme, HCO3- secretion in lumen, H+/Na+ exchange, Na+ secretion in lumen

106
Q

Enzymatic Digestion Enzymes

A

Amylase, Trypsin, Lipase

the pancreas can digest all portions of a meal

107
Q

Pancreas

Endocrine Function

A

hormonal regulation of blood sugar with insulin and glucagon hormones

108
Q

Large Intestine Functions

A
  1. Abosrbtion of water and electrolytes
  2. Vitamin production, K and B
  3. Expulsion of Feces by mass peristalsis movements
109
Q

Parts of the Large Intestine

A
  1. Cecum
  2. Colon (ascending, transverse, descending, sigmoid)
  3. Rectum

First to Last

110
Q

Large Intestine

Tunica Muscosa Tissue Makeup

A

simple columnar but statified squamous at rectum

111
Q

Large Intestine

Tunica Muscularis Structure

A

contains Taenia Coli and Haustra

112
Q

Taenia Coli

A

rope-like thickening of longitudinal muscle

113
Q

Haustra

A

puckered pouches that form as a result of distension of one haustra, causes propulsion of contents into next haustra

114
Q

Diverticulitis

A

diet lacks bulk causing outward herniation of Haustra wall

can become infection

115
Q

Hirschsprung’s Disease

A

constriction of large intestine wall (aganglionic megacolon)

feces backs up

116
Q

Hemmorroids

A

varicose veins in anal canal, itching throbing, bleeding

destroyed by burning, cutting, or rubber banding

117
Q
A