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Phase 1 Medicine - Riona > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What are the 9 sections of the abdomen?

A

R hypochondriac, epigastric, L hypochondriac
R lumbar, umbilical, L lumbar
R iliac, hypogastric, L iliac

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2
Q

In what directions do the 3 oblique muscles of the abdominal wall run?

A

External - downwards oblique
Internal - upwards oblique
Transverse - horizontal

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3
Q

What is the muscle that forms 2 strips running vertically?

A

Rectus abdominis

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4
Q

What do the 3 muscles aponeuorse & converge onto?

A

Linea alba

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5
Q

Where do the oblique fibres pass above the arcuate line?

A

External & half of internal pass in front of rectus abdomens
Transverse & half of internal pass posteriorly
Form rectus sheaf

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6
Q

What is the foregut & what is it innervated by?

A

Mouth to 2nd segment of duodenum

Greater splanchnic nerve T5-9

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7
Q

What is the midgut & what is it innervated by?

A

2nd segment of duodenum to 2/3 along transverse colon

Lesser splanchnic nerve T10-11

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8
Q

What is the hindgut & what is it innervated by?

A

2/3 along transverse colon to rectum

Least splanchnic nerve T12

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9
Q

What are the 2 layers of the peritoneum?

A

Parietal (external)

Visceral (internal)

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10
Q

What does it mean to be a retroperitoneal organ?

A

It is on the outside of the peritoneal cavity

Covered only anterior by peritoneum

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11
Q

Which organs are retroperitoneal?

A 
SAD PUCKER
Suprarenal glands
Aorta/IVC
Duodenum (middle 2 segments)
Pancreas (excluding tail)
Ureter
Colon (ascending & descending)
Kidneys
(o)Oesophagus
Rectum
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12
Q

What is a mesentary?

A

Reflections of peritoneum that attach the intraperitoneal organs to the posterior abdominal wall

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13
Q

Where does the greater omentum attach to?

A

Greater curvature of stomach to the transverse colon

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14
Q

Where does the lesser omentum attach to?

A

Lesser curvature of stomach to liver

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15
Q

How are the greater & lesser sacs connected?

A

Epiploic foramen

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16
Q

What are the sections of the stomach?

A 
Cardia
Fundus
Body
Antrum
Pylorus
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17
Q

What does the location of the sphincter of Oddi depict?

A

Opening of ampulla of Vater

End of foregut

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18
Q

In which region of the duodenum are Brunner’s glands?

A

Superior/1st section

Neutralise chyme from sphincter by secreting high levels of HCO3-

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19
Q

What does the coeliac trunk branch into?

A

Splenic artery > spleen
Left gastric artery > lesser curvature of stomach
Common hepatic artery

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20
Q

What does the splenic artery give rise to?

A

Short gastric artery > fundus

Left gastroepiploic artery > greater curvature of stomach

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21
Q

What does the common hepatic artery give branches of?

A

Gastroduodenal artery > pylorus & proximal part of duodenum
Proper hepatic artery > liver

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22
Q

What does the gastroduodenal artery give rise to?

A

Right gastroepiploic artery > greater curvature of stomach

Superior pancreaticoduodenal artery > pancreas & duodenum

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23
Q

What does the right hepatic artery give rise to?

A

Cystic artery > gallbladder

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24
Q

What is the blood supply of the midgut?

A

Superior mesenteric artery (at L1)

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25
Q

What makes the jejunum different from the ileum?

A 
Both intraperitoneal
Mainly in upper L not lower R quadrant
Thick not thin intestinal wall
Longer vasa recta
Fewer arcades
Red not pink
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26
Q

Does the jejunum or ileum have Peyer’s patches?

A

Ileum

Patches of lymphatic tissue

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27
Q

What are taenia coli?

A

3 longitudinal muscles which contract to short & widen sections
Causes large intestine wall to bunch into haustrations

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28
Q

What are the epiploic appendices

A

Small patches of peritoneum filled with fat along the colon

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29
Q

What are the branches of the SMA?

A

Middle colic artery > transverse colon
Right colic artery > ascending colon
Ileocolic artery > into ileal & colic arteries
Inferior pancreaticoduodenal artery > some of pancreas, ucinate process, duodenum

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30
Q

What is the blood supply of the hindgut

A

Inferior mesenteric artery (at L3)

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31
Q

What are the branches of the IMA?

A

Left colic artery

Sigmoid arteries

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32
Q

What does the marginal artery of Drummond do?

A

Connects middle colic artery to left colic artery - anastomosis

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33
Q

Define swallowing

A

The process by which food/liquid is passed from the oral cavity, through the pharynx & down the oesophagus, to the stomach, whilst simultaneously closing the epiglottis in order to prevent anything going down the trachea

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34
Q

What occurs during the oral phase of swallowing?

A

Voluntary
Moistening & mastication
Intrinsic muscles of tongue contract to form trough
Mylohyoid muscle elevates tongue to roof of mouth to form slope
Pressure receptors stimulated, impulses to swallowing centre in medulla

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35
Q

What occurs during the pharyngeal phase of swallowing?

A

Involuntary
Impulses send that inhibit respiration, elevate larynx, close epiglottis
Tensor palatini tenses soft palate
Levator palatini elevates soft palate
Closes off nasopharynx
Pharyngeal constrictor muscles push bolus down pharynx

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36
Q

What occurs during the oesophageal phase of swallowing?

A

Involuntary
Skeletal muscle in upper 1/3rd CNX
Smooth muscle in lower 2/3rds CNX
Propagation of bolus

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37
Q

What is the gag reflex?

A

Reflex elevation of pharynx

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38
Q

What are the sensory and motor limbs of the gag reflex?

A

Sensory - CNIX

Motor - CNX

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39
Q

What are the 3 main salivary glands?

A

Parotid
Submandibular
Sublingual

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40
Q

What nerve passes through the parotid gland?

A

Facial

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41
Q

What type of saliva does the parotid gland have?

A

Serous

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42
Q

What type of saliva does the submandibular gland have?

A

Serous & mucous

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43
Q

What type of saliva does the sublingual gland have?

A

Mucous

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44
Q

What innervates the submandibular and sublingual salivary glands?

A

Facial nerve CNVII

45
Q

What are the types of acinar cell?

A

Serous & mucous
Serous - alpha amylase, digests carbs
Mucous - mucins, lubrication

46
Q

What do the cells in ducts secrete and reabsorb?

A

Via ion transport proteins
Secrete K+, HCO3-
Absorb Na+, Cl-

47
Q

What are the main functions of saliva? (4)

A

Lubrication
Oral hygiene
Buffer
Digestion

48
Q

Define BMR

A

Total amount of energy produced her unit time

49
Q

How much fuel is stored in each substance? (3)

A

Glycogen - 15kg
Lipid - 350g
Protein - 6kg

50
Q

What are the fat soluble vitamins?

51
Q

What is the use of vitamin A?

A

Cellular growth & differentiation

Production of llymphocytes

52
Q

What is the use of vitamin B12?

A

Brain development
DNA synthesis
Formation of RBCs

53
Q

What is the use of vitamin C?

A

Collagen production
Absorption of iron
Neurotransmitter synthesis
Antioxident

54
Q

What is the use of vitamin D?

A

Aids absorption of calcium from gut

55
Q

How is vitamin B12 absorbed?

A

B12 binds with R-protein in mouth
R-protein protects B12 from HCl in stomach
Protease in duodenum releases B12 from R-protein
Intrinsic factor helps B12 be absorbed

56
Q

Where are the vitamins absorbed?

A

A - jejunum

C, D, K - jejunum & ilium

57
Q

What are the 3 layers of muscle in the stomach? (from superficial to deep)

A

Longitudinal
Circular
Oblique

58
Q

What are rugae?

A

Folds of the stomach wall which increase SA & allow the stomach to expand

59
Q

What do goblet cells secrete?

60
Q

What do parietal cells secrete?

A

Gastric acid

Intrinsic fator

61
Q

What do chief cells secrete?

A

Pepsinogen

62
Q

What do enterochromaffin-like cells secrete?

63
Q

What do D cells secrete?

A

Somatostatin

64
Q

What do G cells secrete?

65
Q

What stimulates release from the parietal cells?

A

ACh
Gastrin
Histmine

66
Q

What stimulates release from chief cells?

A

ACh

Acid secretion

67
Q

What stimulates release from D cells?

A

Acid in stomach

68
Q

What is the function of gastrin?

A

Stimulates gastric acid stimulation

69
Q

What is the function of gastric acid?

A

Activates pepsin

Kills bacteria

70
Q

Where are the parietal cells in the stomach?

A

Fundus & body

71
Q

How is gastric acid produced and secreted?

A

CO2 + H2O > H2CO3 in cytoplasm of parietal cell
H2CO3 > H+ + HCO3-
HCO3- pumped out in exchange for Cl- in
H+ from H2CO3 + OH- > H2O
Then dissociates again H+ + OH-
H+ actively transported out of cells & K+ actively transported in
Converts one ATP > ADP + Pi
Cl- & K+ that have been pumped into cell (capillary side) diffuse out of parietal cell into stomach lumen

72
Q

What stimulates release from enterochromaffin-like cells

A

ACh

Gastrin

73
Q

What are the phases of gastric acid secretion regulation?

A

Cephalic
Gastric
Intestinal

74
Q

Describe the phases for the secretion of gastric acid

A

Cephalic phase:
environmental stimuli
ACh released & acts directly on parietal cells
release of gastrin & histamine
Gastric phase:
gastric distension & peptides & amino acids presence
gastrin & histamine released (feedback on eachother)
presence of protein causes rise in pH (as buffer)
decreases secretion of somatostatin

75
Q

Describe the phases for the inhibition of the secretion of gastric acid

A

Gastric phase:
low pH inhibits secretion of gastrin & indirectly histamine
somatostatin secretion stimulated by low pH
Intestinal phase:
duodenal distension, low intestinal pH, amino acids & fatty acids
release of enterogastrones secretin & CCK
secretin inhibits gastrin release & promotes somatostatin release
CCK stimulates contraction of gallbladder

76
Q

What catalyses the conversion of pepsinogen to pepsin?

A

HCl

Pepsin

77
Q

What is the role of pepsin?

A

Accelerates protein digestion

78
Q

What mixes the contents of the stomach?

A

Peristaltic waves

79
Q

What cells determine the frequency of peristaltic waves?

A

Pacemaker cells - cells of Cajal

80
Q

What are peristaltic waves strengthened by?

A

Gastrin

Gastric distension

81
Q

What are peristaltic waves weakened by?

A 
CCK
Duodenal distension
Increased duodenal fat
Increased duodenal osmolarity
Decreased duodenal pH
Increased sympathetic NS action
Decreased parasympathetic NS action
Fats & amino acids in duodenum
82
Q

What are some defences against acid secretion?

A

Mucous
Tight junctions
Feedback loops

83
Q

How is Na+ transported into the epithelial cells in the intestine?

A

Actively transported by pumps

84
Q

How is K+ transported into the epithelial cells in the intestine?

A

Passive diffusion

85
Q

How is Cl- transported into the epithelial cells in the intestine?

A

Absorbed in exchange for HCO3-

86
Q

What are two types of proteolytic enzyme?

A

Endopeptidases - break non-terminal bond

Exopeptidases - break terminal peptide bond

87
Q

What is the bond between glycerol & a fatty acid?

A

Ester bond

88
Q

Where is the protein co-lipase secreted from?

A

Pancreas

ended to help lipase digest fats

89
Q

How do bile salts emulsify fats?

A

Detergent action
Form micelles
Further solubilises lips & provides a mechanism for their transport
Can enter cell by passive diffusion

90
Q

What are chylomicrons?

A

Droplets of fat containing triglycerides & cholesterol

91
Q

Define malnutrition

A

State of nutrition in which deficinecy/excess of energy/nutrients causes adverse effects on body

92
Q

What is the epithelia of the submandibular glands?

A

Simple/stratified columnar

93
Q

What parts of the GI system have stratified squamous keratinised epithelium? (3)

A

Gums
Top of tongue
Hard palate

94
Q

What is the epithelia of the oesophagus?

A

Stratified squamous non-keratinised

95
Q

What is the epithelia of the stomach?

A

Simple, columnar & non-ciliated

gastric epithelium

96
Q

What is the epithelia of the small and large intestines?

A

Simple, columnar & non-ciliated

intestinal epithelium

97
Q

What is the epithelia of the rectum?

A

Simple, columnar & non-ciliated

98
Q

What are the two types of epithelium in the anus?

A

Upper - simple columnar

Lower - stratified squamous & keratinised

99
Q

What is the epithelium of the mesothelium of the body cavities? (pleura/peritoneum)

A

Simple squamous

100
Q

What are the 3 main papillae in the tongue?

A

(dorsum of tongue in complex folds)
Filiform - tall, pointed, anterior 2/3rds
Fungiform - mushroom shaped, tips & sides
Circumvallate - separate anterior 2/3rd & posterior 1/3d
They bear taste buds

101
Q

What are the 3 layers of the oesophageal mucosa?

A

Mucosa
Submucosa
Muscular externa

102
Q

What makes up the upper oesophageal sphincter?

A

Cricopharyngeus

103
Q

Where are the chief cells found in the stomach?

A

Body & fundus

104
Q

What are the differences between the gastric glands of the cardia and of the pyloric region?

A

Pyloric region - glands shorted & coiled

105
Q

What are the plicae circulares?

A

Circular folds in the intestine

Most in jejunum, least in distal colon

106
Q

What is a major absorptive cell of the intestines?

A

Enterocyte

107
Q

What do Paneth cells do & where are they found?

A

Help regulate bacterial flora

Small intestine

108
Q

What are the plexuses in the gut?

A

Meissner’s Plexus

Auerbach’s Plexus

Phase 1 Medicine - Riona (13 decks)

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