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DMD 5249 > Gastrointestinal A&P (11) > Flashcards

Gastrointestinal A&P (11) Flashcards

1
Q

What are the characteristics of the three salivary glands

A 
parotid
- largest, affected by mumps, mostly serous, 25%
Submandibular
- serous and mucous, 70%
Sublingual
- mostly mucous, 5%
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2
Q

How do parasympathetics and sympathetics control the salivary glands

A

parasympathetics stimulate saliva secretion
mild sympathetics inhibit saliva secretion (dry mouth)
strong sympathetics stimulate saliva secretion of mucous (foaming at the mouth)

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3
Q

besides parasympathetics, and sympathetics what can control saliva secretion

A

tactile stimulation (object in the mouth)

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4
Q

What is the pharynx, and what are its parts

A

the common passageway for air, foods, and liquids. it is made up of the nasopharynx, oropharynx, and laryngopharynx.

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5
Q

What is the esophagus

A

a hollow muscular tube that takes food from the pharynx to the stomach

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6
Q

where does the esophagus start, what does it pass through, and where does it end

A

it starts posterior to the cricoid cartilage with the upper esophageal sphincter, passes through the esophageal hiatus, and ends at the lower esophageal sphincter.

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7
Q

What parts of the esopahgus are controlled by voluntary and involuntary muscle, and what innervates it

A

the top 1/3 is voluntary
the bottom 1/3 is involuntary
and it is innervated by the esophageal plexus

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8
Q

what is deglutition

A

swallowing

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9
Q

what are the phases of deglutition

A

Buccal phase
pharyngeal phase
esophageal phase

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10
Q

what happens in the buccal phase of deglutition

A

bolus is compressed against the hard palate, and the soft palate which closes of nasopharynx. reflex begins and the bolus is moved toward the stomach
(volulntary)

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11
Q

What happens in the pharyngeal phase of deglutition

A

bolus comes into contact with posterior pharyngeal wall
bolus passes glottis by elevation of the larynx and folding of the epiglottis
uvula and soft palate block passage into nasopharynx

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12
Q

what happens in the esophageal phase of deglutition

A

pharyngeal muscles contract and force the bolus into the esophagus
peristalsis moves the bolus to the stomach

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13
Q

what is peristalsis

A

wave of relaxation followed by a wave of contraction of the circular muscles in the esophagus that propels the bolus toward the stomach.

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14
Q

how many waves of peristalsis is usually needed

A

1, if the bolus gets stuck stretch receptors will activate and cause more and more forceful peristalsis waves until the bolus is moved into the stomach

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15
Q

What are the 4 major functions of the stomach

A

store ingested food
mechanically breakdown food
disrupt chemical bonds in food by acid and enzymes
produce intrinsic factor (required for absorption of B12 in small intestine)

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16
Q

What are the 5 regions of the stomach

A 
cardiac
fundus
body
antrum 
pyloris
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17
Q

what are the two sphincters of the stomach

A 
Gastroesophageal (lets food in)
pyloric sphincter (lets food out)
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18
Q

What innervates the stomach

A

PNS
SNS
Enteric NS

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19
Q

What kind of epithelium lines all of the stomach

A

simple columnar epithelium (secretes mucus that covers the stomach)

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20
Q

What are the special cells in the gastric pits of the stomach and what is their function

A 
mucous neck cells (produce mucous)
parietal cells (produce HCl, and intrinsic factor)
Chief cells (pepsinogen)
Endocrine cells in pylorus (serotonin, gastrin)
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21
Q

What are the layers of the stomach

A

mucosa
muscularis mucosae
submucosa
muscularis externae

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22
Q

How does digestion and absorption occur in the stomach

A

digestion
- food becomes more fluid, pH around 2, pepsin activity increases, protein disassembly begins
Absorption
- None

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23
Q

What are the three phases of Gastric activity

A

cephalic
gastric
intestinal

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24
Q

what is the cephalic phase of gastric activity

A

the production of acid and enzymes that are controlled by the CNS, ENS reflexes, and Digestive hormones

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25
Q

What is the gastric phase of gastric activity

A

food in the stomach
stretch receptors
increase in enzyme release

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26
Q

what is the intestinal phase of gastric activity

A

small food enters intestine causing gastrin release, peristalsis of the stomach

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27
Q

What happens in the small intestine

A

complete enzymatic digestion of all foods
90% of absorption
receives pancreatic secretion

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28
Q

What are the three parts of the small intestine

A

duodenum
jejunum
ileum

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29
Q

What is segmentation (how does it differ from peristalsis)

A

it is contractions of the smooth muscle that breaks down the food, segments it, and mixes it up with digestive juices to increase absorption (peristalsis doesn’t break up food, just moves it)

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30
Q

What are the features of the small intestine that increase absorption

A
  1. length
  2. circular folds (plicae circulares) (increase surface area, slows down chyme)
  3. vili (movable, enhance efficiency)
  4. Microvili (increase absorptive surface, contain enzymes to complete digestion)
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31
Q

What are the intestinal glands of the small intestine

A

mucous cells between epithelial cells that secrete mucus,

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32
Q

What are the brush border enzymes

A 
sucrase
lactase
glucoamylase (maltase)
alpha dextrinase (isomaltase)
peptidases (cytosolic, enterokinase, enteropeptidase)
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33
Q

What are the cells in the small intestine, and what do they do

A

enterocytes - absorption
goblet cells - mucin to lubricate and protect
Enteroendocrine cells - CCK stimulates pancreatic enzymes and bicarbonate
paneth cells - defensive functions (defensins)
Duodenal (brunner’s) glands - alkaline mucous to protect from low pH

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34
Q

What happens in the duodenum

A

mixing

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35
Q

what happens in the jejunum

A

chemical digestion

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36
Q

What happens in the ileum

A

absorption

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37
Q

what are peyers patches, and where are they found

A

they are pouches of lymphatic tissue (like nodes) in the walls of the ileum

38
Q

What are the accessory organs of the digestive system

A

pancreas
liver
gall bladder

39
Q

what attaches the pancreas to the duodenum

A

the pancreatic duct

40
Q

what is 90% of the pancreas composed of

A

ductal and exocrine cells (acinar)

41
Q

What are the endocrine secretions of the pancreas

A

insulin and glucagon

42
Q

what are the exocrine (pancreatic Acini) secretions of the pancreas

A 
pancreatic alpha amylase (breaks down starches)
pancreatic lipase (breaks down complex lipids)
Nucleases (breaks down Nucleic acids)
proteolytic enzymes - trypsin
43
Q

What are proteases and peptidases, where are they from and where are they active

A

proteases are enzymes the break down large proteins
peptidases break down small peptides into AA
they are from the pancreas, but only active in the small intestine

44
Q

is pancreatic juice alkaline or acidic

A

alkaline

45
Q

what is the liver organized into

A

hexagonal lobules with a cental vein in the middle, and a triad at each corner

  • hepatic portal vein branch
  • hepatic artery branch
  • bile duct branch
46
Q

what is the main type of cell in the liver

A

the hepatocyte

47
Q

what are the functions of the liver

A
  1. metabolic regulation
  2. detoxification
  3. plasma protein synthesis
  4. production and storage of glycogen
  5. removal or hormones and antibodies
  6. partial activation of vit D
  7. removal of bacteria and RBC
  8. excretion of bilirubin
  9. bile formation and secretion
48
Q

What does the liver make bile salts from

A

cholesterol

49
Q

what is the common bile duct that goes into the duodenum

A

the duct composed of the common hepatic duct and the cystic duct (from gall bladder)

50
Q

where does the common bile duct enter the duodenum

A

at the duodenal ampulla with the pancreatic duct

51
Q

what is the function of the gall bladder

A

stores and concentrates bile, then secretes it when CCK stimulates it

52
Q

What is the function of bile

A

emulsifies fats

53
Q

What are the enzymatic steps of digestion

A
  1. gastrin (stomach) = acid production and mixing
  2. GIP (SI) = release of insulin
  3. secretin and CCK (SI) = pancreatic buffers and enzymes, and bile
  4. VIP (SI) = dilation of intestinal capillaries

all of which lead to absorption and utilization by the tissues

54
Q

what are the parts of the large intestine (in order)

A 
appendix
ascending colon
transverse colon
descending colon
sigmoid colon
rectum
anus
55
Q

What are the functions of the large intestine

A

absorb water from food
absorb salts and some vitamins
forms, stores, and expels feces

56
Q

what part of the small intestine receives material from the ileum

A

cecum

57
Q

what are haustra

A

pouches in the large intestine that allow for expansion and elongation

58
Q

does the colon have vili or enzyme secretions

A

nope

59
Q

what happens to 94% of the bile salts secreted by the liver

A

they are reabsorbed in the terminal ileum, then the rest are absorbed in the cecum

60
Q

What are the three vitamins produced in the large intestine

A

Vitamin K - liver needs it for making clotting factors
Biotin - used in glucose metabolism
Vitamin B5 - used in steriod and neurotransmitter production

61
Q

what is produced by bacteria breaking down feces in large intestine

A

ammonia
indole and skatole - nitrogen “smelly”
hydrogen sulfide - rotten egg smell
gas

62
Q

What is the rectum

A

the anus or last 6 inches of the large intestine, which is expandable to store feces and causes urge to deficate

63
Q

What is the anal canal

A

The last part of the rectum

64
Q

What are the different digestions locations of carbs and sugars

A

Mouth with salivary amylase
none in the stomach
Small intestine
pancreatic amylase - starches to maltose, maltotriose, and alpha-dextrin
Glucoamylase - short chains to glucose
alpha dextrinase - branched chains to glucose
lactase - lactose to glucose and galactose
sucrase - sucrose to glucose and fructose

65
Q

what happens to the glucose, fructose, and galactose once it makes it into the blood

A

they go to the liver, where there are converted into glucose-6-phosphate. then to glycogen or fat (fat if there is excess glycogen)

66
Q

What are the different locations of protein digestion

A

none in the mouth
pepsin in the stomach (converts proteins to short peptides)
pancreatic enzymes in the small intestine break those down into AAs or even smaller peptides
2-4 AA peptides can go into the brush border cells, where most are converted into AAs

67
Q

What happens to the AAs once they are absorbed

A

they go to the liver, some pass right through, some are stored. if excess amino acids are present, or blood glucose is low they can be converted into glucose or ketone bodies or triglycerides

68
Q

What are the steps of lipid digestion

A
  1. 10% digested in the mouth by lipases
  2. bile emulsifies the lipid (smaller lipid droplets)
  3. pancreatic lipases hydrolize the lipid droplet to form monoglyceride and free fatty acids
  4. those accumulate with bile salts, phospholipids and cholesterol to form micelles
  5. micelles allow for a lot of lipase activity and it allows the micelle to move right into cells
  6. in the cell they are resynthesized into triglycerides
  7. those are packed into a chylomicron which is carried in the lymphatic system into the blood
69
Q

where is appetite regulated

A

arcuate nuclei in the hypothalamus

70
Q

what are the two pathways the arcuate nucleus of the hypothalamus regulated appetite

A

NPY/AgRP = increase appetite
POMC/CART = decrease appetite
they are usually oppositely activated

71
Q

how is appetite affected neuronally

A

fatty acids and amino acids, as well as stretching of the GI tract inhibit appetite by activating affarent vagus nerves and sympathetic nerves

72
Q

How do hormones affect appetite

A 
Grehlin
CCK
PP (pancreatic polypeptide)
GLP1
 and other gut hormones
Insulin
Amylin
glucagon

all inhibit appetite

73
Q

What is leptin

A

a hormone produced by fat cells that inhibits appetite

74
Q

What is the effect of glucocorticoids on appetite (cortisol)

A

they increase appetite partially by inhibiting the action of leptin.

75
Q

what causes increased secretion of glucocorticoids and thus causes increased appetite

A

stress

76
Q

What mechanical activities happen at each location in the GI tract

A 
mouth - mastication
Esophagus - swallowing
Stomach - peristalsis, contractions
SI - peristalsis and segmentation
LI - peristalsis and mass movement
77
Q

Where does amylase come from and what does it breakdown

A

saliva and SI

it breaks down carbs

78
Q

where does maltase come from and what does it break down

A

the SI and it breaks down maltose

79
Q

Where does pepsin come from and what does it break down

A

the stomach

it breaks down proteins

80
Q

where does trypsin come from and what does it break down

A

pancreas

proteins

81
Q

where does peptidase come from and what does it break down

A

SI

peptides

82
Q

where does nuclease come from and what does it break down

A

pancreas

DNA and RNA

83
Q

where does nucleosidase come from and what does it break down

A

pancreas

nucleotides

84
Q

Where does lipase come from and what does it break down

A

pancreas

lipids

85
Q

What is the function of gastrin

A

stimulates peristalsis of the stomach and relaxation of the pyloric sphincter
stimulates pepsinogen secretion
Gastrin
HIstamine

86
Q

What is the function of CCK

A

stops peristalsis and contracts pyloric sphincter

it opposes gastrin

87
Q

What is pepsinogen

A

the inactive form of pepsin that is converted into pepsin by HCl

88
Q

What is the affect of alcohol, caffeine, and nicotine on gastric secretion

A

they increase gastrin, pepsin, histamine, HCl and inhibit mucus and bicarbonate
therefor this causes stomach and heart burn

89
Q

what increases pancreatic secretion as well as bile secretion

A

PNS
CCK
Gastrin
Secretin - bicarbonate

90
Q

What is the function of enteropeptidase

A

it converts the inactive trypsinogen to the active trypsin, which in turn converts other inactive pancreatic enzymes into active enzymes

DMD 5249 (10 decks)

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