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Chiro Essentials Physiology > Gastrointenestinal and MSK Review > Flashcards

Gastrointenestinal and MSK Review Flashcards

1
Q

Functions of the GI tract

A

Digestion, absorption excretion, endocrine

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2
Q

Mouth releases what proteins? What do they break down?

A

Salivary amylase - CHO/starch into maltose

Lingual lipase - fats into smaller fats

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3
Q

Gastric gland mucosal/neck cells secrete what?

A

Mucus

G cells produce gastrin

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4
Q

Function of gastrin?

A

Stimulate hydrochloric acid secretion from parietal cells

Stimulate gastric motility

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5
Q

Chief cells in the gastric glands produce what?

A

Pepsinogen

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6
Q

Parietal cells in the gastric glands secrete what? Functions?

A

Hydrochloric acid - activate pepsinogen, destroy bacteria

Intrinsic factor - absorb Vit B12

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7
Q

Mast cells in the gastric glands secrete?

A

Histamine

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8
Q

Food + gastric secretions =

A

Chyme

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9
Q

The presence of chyme in the small intestine causing S-cells in the duodenum to release? what does it do?

A

Secretin - stim pancreatic acinar cells to release bicarb and water, decrease gastric motility

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10
Q

Bicarbonate-rich mucus is secreted by what in the duodenum?

A

Brunner’s glands

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11
Q

Function of bicarbonate mucus?

A

Neutralize gastric acid in SI and make pH alkaline (protection)

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12
Q

Presence of fat in duodenum stimulates release of what from the I-cells of the duodenum? Function?

A

CCK - gallbladder contractin, sphincter of Oddi to relax, bile excretion into duodenum, stimulates pancreatic secretion of pancreatic amylase

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13
Q

Function of pancreatic amylase

A

Breakdown starch into maltose

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14
Q

Maltase breaks down maltose into?

A

2 molecules of glucose

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15
Q

Lactase breaks down glucose into?

A

Glucose and galactose

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16
Q

Sucrase breaks down sucrose into?

A

Glucose and fructose

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17
Q

Lactase, sucrase, maltase are found where in the enterocyte?

A

Brush border

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18
Q

Glucose is ACTIVELY transported into intestinal cells by?

A

Na+-G carrier

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19
Q

Digest fat is absorbed into central lacteals which drain where? Everything else goes where?

A

The Thoracic Duct

The liver

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20
Q

Fat breakdown products in the SI?

A

Fatty acids, glycerol

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21
Q

Starch, sucrose, lactose breakdown products in the SI?

A

Glucose, fructose, galactose

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22
Q

Protein breakdown products in the SI?

A

Amino acids

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23
Q

Exocrine cells in the pancreas are arranged into?

A

Acini

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24
Q

Exocrine cells of the pancreas secrete? which do?

A

Trypsinogen - activated to trypsin by enterokinase from enterocytes in the small intestine
Chymotryspin, carboxypolypeptidase, proelastase
Pancreatic amylase aids in digestion of starch to produce maltose
Lipase breaks down fat into fatty acids and glycerol

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25
Q

Endocrine cells in the pancreas are located where?

A

Islets of langerhans

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26
Q

Endocrine cell secretions from which cell type?

A

Glucagon - alpha cells
Insulin - beta cells
Somatostatin - delta cells

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27
Q

Where is most of the water absorbed in the GI tract?

A

Large intestine

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28
Q

Bacteria in the large intestine produce what Vitamin?

A

Vitamin K

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29
Q

Large intestine goblet cell secrete what? Why?

A

Mucus, aid in passage of feces

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30
Q

Fat soluble vitamins are?

A

ADEK

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31
Q

Water soluble vitamins enter enterocytes via 2o active transport using Na+-amino acid co-transporters except!!!

A

B12

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32
Q

How do water soluble vitamins exit enterocytes?

A

Diffusion into portal circulation

33
Q

Folic acid and iron are absorbed where?

34
Q

Iron + apotransferrin in blood =

A

Transferrin

35
Q

Transferrin carries iron to where?

A

Liver, spleen, bone marrow

36
Q

In the liver, spleen, bone marrow iron is bound to what?

A

Apoferritin

37
Q

Iron + apoferritin =

38
Q

B12 attaches to what to be delivered to the terminal ileum?

A

Intrinsic factor

39
Q

B12 is bound to what in the terminal ileum?

40
Q

B12 diffuses out of enterocytes into?

A

Portal vein

41
Q

Roles of the liver

A

CHO, protein, lipid metabolism
Store glycogen, Vitamins A, D, B12
Detoxifies hormones, drugs, poison (alcohol)
Makes bilirubin, antibodies, steroid hormones, clotting factors, RBC in fetus
Immune system - Kupffer cells

42
Q

Bilirubin is a byproduct of?

A

RBC breakdown in the spleen

43
Q

Old RBCs (>120 days) are broken down into?

A

Heme, globin

44
Q

Heme in bilirubin metabolism is broken down into?

A

Bilirverdin and iron

45
Q

Biliverden is converted to? Carried in blood attached to what?

A

Bilirubin

Albumin

46
Q

Bilirubin is insoluble or soluble in water? lipids?

A

Insoluble in water

Soluble in lipids

47
Q

The liver conjugates bilirubin with? By what

A

Glucuronide

UDPG transferase

48
Q

Conjugation does or does not make bilirubin soluble in water?

A

It does :D

49
Q

Conjugated bilirubin is secreted into? Stored in? Excreted by?

A

Biliary tract
Gallbladder
Gallbladder

50
Q

Bile in bilirubin saponifies fat making is more or less accessible to pancreatic lipase?

51
Q

Bilirubin in the gut is converted by bacteria into?

A

Urobilinogen

52
Q

Most of urobilinogen goes where? Where else?

A

90% into blood stream, some into urine (urobilin = yellow), or converted to stercobilinogen in gut where it oxidizes and makes stool brown

53
Q

Role of gallbladder?

A

Store 50 cc and concentrate bile

excrete bile when fat is in duodenum and prescence of CCK

54
Q

Bile is made of?

A

Water, bile salts, phospholipids, cholesterol, bilirubin

55
Q

K cells in the Small Intestine secrete?

A

Gastric inhibitory peptide

Glucagon-like peptide

56
Q

Function of GIP

A

Inhibit effect of gastrin on parietal cells

Decrease gastric acid secretion

57
Q

Glucagon-like peptide function?

A

Inhibits gastric emptying

58
Q

Ghrelin is secreted by?

A

P cells in the stomach

59
Q

Motilin is secreted by? Stimulated by?

A

M cells in the duodenum

Fasting

60
Q

The sarcomere lies between two _ lines which bisect the I band

61
Q

The A band contains?

A

Actin and myosin

62
Q

The M line bisects?

A

The H band

63
Q

The H band contains?

A

Myosin - thick filaments

64
Q

The I band contains?

A

Actin, troponin, tropomyosin - thin filaments

65
Q

What part of the sarcomere remains the same length in contraction?

66
Q

What part of the sarcomere disappears with full contraction?

67
Q

Differences between Troponin C, T, I?

A

C: binds to calcium ions
T: binds to tropomyosin and prevents X binding
I: binds to actin and inhibits interaction between actin and myosin

68
Q

Actin and myosin at what ratio in skeletal muscle?

69
Q

Describe the neuromuscular junction and how messages are sent to the muscle?

A

Alpha motor neurons connected to motor end plates via a bouton filled with vesicles that release ACh when stimulated and Ca2+ flows into bouton and ACH is released goes through presynaptic membrane into synaptic cleft and diffuses to nicotinic ACH receptor on muscle and cause an end plate potential to cause contraction of the skeletal muscle and acetylcholinesterase in the synaptic cleft breaks down ACH and choline is reabsorbed and combined w/acetyl CoA in presynaptic vesicles

70
Q

Describe the sliding filament model

A

Na+ into sarcolemma generating action potential to T tubules which release Ca2+ from cisterna of sarcoplasmic reticulum and Ca2+ binds to Troponin C which changes shape displacing tropomyosin so myosin can break down ATP and form a X bridge with actin and pull actin closer to middle and it detaches when ATP binds during relaxation Ca2+ pumped back into sarcoplasmic reticulum by Ca2+ pump

71
Q

Slow twitch type 1 vs fast twitch type 2

A

I: red, more in long distance runners, smaller fiber size, less glycogen, more mitochondria increase aerobic metabolism, more myoglobin, resistant to fatigue
II: white, more common in sprinters, large fiber sie for greater contraction, large glycogen stores, few mitochondria for increased anaerobic glycolysis, less myoglobin, easily fatigued

72
Q 
Types of contraction:
Isometric
Isotonic
Isokinetic
Concentric
Eccentric
A

Isometric: fibers lengths don’t change (push against wall)
Isotonic: load remains the same (flex elbow w/fixed weight)
Isokinetic: speed of contraction same
Concentric: muscle shortens in contraction (flex elbow w/weight in hand)
Eccentric: muscle lengthened in contraction (ext elbow slowly with weight in hand)

73
Q

Describe smooth muscle contraction:

A

Influx of Ca+ into sarcoplasm, Ca2+ binds to calmodulin which activates myosin light chain kinase, phosphorylates myosin so myosin-P binds to actin and causes contraction, when myosin-P is dephosphorylated relaxation occurs

74
Q

Ratio of actin to myosin in smooth muscle?

75
Q

Describe the flexor withdrawal reflex?

A

Painful stimulus along afferent axons of A-delta and class C dorsal root fibers in DRG, dendrites synapse in dorsal horn of SC w/interneuron synapses w/alpha motor neuron in ventral horn and efferently innervates a flexor muscle to withdraw from painful stimulus

76
Q

The Flexor withdrawal reflex falls under what classification of reflex?

A

Somatosomatic reflex

77
Q

Describe the crossed extensor reflex?

A

Activated by noxious stimuli on the skin, excites A-delta and class C dorsal root fibers enter dorsal horn and activate multiple interneurons in grey matter through polysynaptic pathways linked w/extensor muscles on both sides of cord so while flexor withdrawal is facilitated by contraction on same side of stimulus the extensors are contracted on the opposite limb providing support of body during withdrawal as a righting reflex

78
Q

Describe the Stretch/Deep tendon/Myotatic reflex

A

Striked muscle tendon causes spindles to stretch sending an impulse along an afferent neuron which synapses w/alpha motor neuron of stimulated muscle which contracts and also synapses with Renshaw cell (lamina IX) which synapses with same alpha motor neuron and glycine is released from the Renshaw cell to cause antagonists to relax and this can be further modified from the brain

79
Q

Characteristics of an upper motor neuron lesion:

A

spastic paralysis, hyperreflexia, babinski sign, no atrophy, no fasciculations

Chiro Essentials Physiology (5 decks)

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