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Patho Summer Test #1 > Gastrointestinal Module #2a > Flashcards

Gastrointestinal Module #2a Flashcards

1
Q

Where does the duodenum span from?

A

Duodenal Bulb –> Ligament of Treitz

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2
Q

What does the hepatopancreatic ampula (Sphincter of Oddi) do?

A

Allows bile/pancreatic enzyme secretions

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3
Q

Where are Brunner’s Glands (submucosal glands) found?

A

Proximal duodenum

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4
Q

What do Brunner’s Glands (submucosal glands) do?

A

Secrete bicarbonate rich mucous:

    -  protect against acidic chyme entering 
       duodenum
    -  lubricate intestinal wall
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5
Q

What is the function of the duodenum?

A

Enzymatic digestion/breakdown of food

Provide feedback to regulate rate of gastric emptying

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6
Q

How does the duodenum function in the digestion/breakdown of food?

A

Stimulate release of digestive enzymes from pancreas/gall bladder

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7
Q

How does the duodenum provide feedback to regulate the rate of gastric emptying?

A

Long loop reflexes

Short loop reflexes

Release hormone messengers to inhibit stomach motility/acid production

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8
Q

How do long loop reflexes work?

A

mechanoreceptors/chemoreceptrs stimulate CNS to increase sympathetic and decrease parasympathetic to stomach

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9
Q

How do short loop reflexes work?

A

Mechanoreceptors/chemoreceptors in DUODENUM stimulate ENTERIC NEURONS in stomach to decrease stomach motility

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10
Q

What are the hormones that are released in the duodenum and inhibit stomach motility/acid production?

A

Secretin

VIP

CCK

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11
Q

What does secretin do?

A

Regulate pH in duodenum

Inhibit gastric activity

Facilitates digestion

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12
Q

What stimulates secretin?

A

Acidic chyme (pH < 4 - 5) containing fats, partially digested protein, hyper/hypotonic fluids

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13
Q

What does secretin do to the stomach?

A

Inhibit gastric secretions (inhibit gastrin)

Inhibits motility

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14
Q

What does secretin do to the pancreas?

A

Stimulate pancreas to secrete watery bicarbonate solution

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15
Q

What does secretin do to the liver?

A

Stimulate bile output –> fat digestion

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16
Q

What does secretin do to the Brunner’s Glands of the duodenum?

A

Stimulate secretion of “alkaline rich mucous”

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17
Q

What does CCK (cholecystokinin) do?

A

Promote bile/pancreatic enzyme release

Inhibits gastric activity

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18
Q

What are the stimuli of CCK?

A

Fatty chyme entering duodenum

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19
Q

What does CCK do to the stomach?

A

Inhibits gastric motility/secretions

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20
Q

What does CCK do to the pancreas?

A

Stimulate release of pancreatic enzymes

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21
Q

What does CCK do to the liver?

A

Stimulates bile output (promote fat digestion)

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22
Q

What does CCK do to the gallbladder?

A

Stimulates contraction to release stored bile

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23
Q

What is GIP (gastric inhibitory peptide) related to?

A

Secretin

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24
Q

What is the stimulus of GIP?

A

Chyme entering duodenum

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25
Q

What does GIP do to the stomach?

A

Inhibit gastric motility/secretions

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26
Q

What does GIP do to the pancreas?

A

Stimulates insulin release

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27
Q

What is the stimulus of VIP (vasoactive intestinal peptide)?

A

Chyme entering the duodenum

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28
Q

What does VIP do to the stomach?

A

Inhibit gastric acid secretion

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29
Q

What does VIP do to the intestine?

A

Vasodilate BV

Promote intestinal motility

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30
Q

What is the stimulus of intestinal gastrin?

A

Chyme entering the duodenum

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31
Q

What does intestinal gastrin do to the stomach?

A

Stimulate gastric motility and secretions

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32
Q

What does intstinal gastrin do to the intestines?

A

Stimulate motility

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33
Q

What is the stimulus of motilin?

A

Fasting or periodic release (every few hours)

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34
Q

What does motilin do?

A

“Housekeeper of intestinal tract”

Empties gastrointestinal tract of residual stuff

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35
Q

What is the effect of motilin on the intestines?

A

Initiates MMC (migrating motor complex)

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36
Q

Where does the jejunum/ileum span?

A

Begins @ ligament of Treitz

Ends @ ileocecal valve

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37
Q

What is the function of the jejunum?

A

Major site of digested fat, carbohydrate, protein, water and electrolyte absorption

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38
Q

What is the function of the ileum?

A

Absorb Vitamine B12, bile salts and remaining digested nutrients and water not absorbed in jejunum

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39
Q

What are the anatomical features that optimize absorption in the jejunum and ileum?

A

Mucosal Folds

Villi

Lamina Propria Layer

Crypts of Lieburkuhn

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40
Q

What do the mucosal folds of the jejunum and ileum do?

A

Physically slow the passage of food

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41
Q

What do villi do in the jejunum and ileum do?

A

Cover the mucosal folds

Considered the functional unit of the small intestine –> site of both secretion and absorption

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42
Q

What makes up the villi?

A

Goblet cells = mucus secreting

Absorptive columnar cells = site of absorption

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43
Q

Where are microvilli found?

A

Columnar cells –> form the brush border of the mucosal surface

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44
Q

What is found along the surface of the brush border and what does it do?

A

Thin layer of fluid –> facilitates absorption of all substances except water/electrolytes

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45
Q

What is the lamina propria layer made of?

A

Lacteal

Central Arteriole

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46
Q

What is the function of the central arteriole?

A

Capillary = transport of carbs, proteins and (very litle) fats (free fatty acids and glycerol) directly to liver via hepatic portal vein

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47
Q

What is the function of the lacteal?

A

Transport fat molecules (monoglycerides and fatty acids)/substances to systemic circulation via thoracic duct

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48
Q

Where are the crypts of lieburkuhn found?

A

@ base of villi

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49
Q

What are the crypts of lieburkuhn composed of?

A

Precursor Cells of SI Epithelium (goblet and columnar cells)

Paneth Cells

Secretory Cells

50
Q

What is the function of the precursor cells in the crypts of lieburkuhn?

A

Act as a production factory of epithelial cells –> turnover of intestinal epithelial cells

51
Q

Describe how cells are turned over in the Villi of the small intestine

A

Precursor cells migrate to tip of villi from crypts of lieburkuhn

Mature SI epithelial cells slough off into intestine and serve as source of (endogenous) protein

**Complete turnover of SI ~ 4 - 7 days

52
Q

What is the function of paneth cells in the crypts of lieburkuhn?

A

Immune function –> produce/secrete antibotic peptides

53
Q

What is the function of the secretory cells in the crypts of lieburkuhn?

A

Secrete brush border digestive enzymes

54
Q

What is the average transit time of food in the small intestine?

A

1 - 3 hours

55
Q

What are the stimuli of small intestine motility?

A

Small Intestine Hormones: Secretin, CCK, gastrin

Intestinal Reflexes

56
Q

What are the 3 motility patterns seen in the small intestine?

A

Segmentation

Peristalsis

Migrating Motor Complex (MMC)

57
Q

When does segmentation motility occur?

A

During feeding

58
Q

Describe segmentation motility

A

Frequent rhythmic contractions of circular muscle

59
Q

What is the function of segmentation motility?

A

Mixes chyme to allow contact w/ brush border

60
Q

When does peristalsis motility occur?

A

During feeding

61
Q

Describe peristalsis motility

A

Coordinated waves of contraction/relaxation of longitudinal muscles

62
Q

Describe HOW peristalsis moves

A

Short segments –> 10 cm

Moves slowly –> 1 -2 cm/sec to allow for digestion/absorption

63
Q

What is the function of peristalsis motility?

A

Moves chyme toward large intestine

64
Q

When does migrating motor complex (MMC) motility occur?

A

During fasting

65
Q

Describe migrating motor complex motility (MMC)

A

Slow periodic waves of peristalsis

**occurs ever 1 - 2 hours; originates in stomach –> intestines

66
Q

What is the stimulus of migrating motor complex motility?

A

Motilin

67
Q

What is the function of the migrating motor complex (MMC) motility?

A

“House cleaning” –> sweeps out stomach/small intestine

Pushes along residual chyme, non-digested substances (fiber, bones, etc)

68
Q

What are the intestinal motility reflexs?

A

Ileogastric Reflex

Intestinointestinal Reflex

Gastroileal Reflex

69
Q

What is the stimulus of the ileogastric reflex?

A

Distended Ileum

70
Q

What is the action of the ileogastric reflex?

A

Inhibits gastric motility

71
Q

What is the result of the ileogastric reflex?

A

Slows down adding more chyme to small intestine –> allow terminal ileum to empty contents into large intestine

72
Q

What is the stimulus of the intestinointestinal reflex?

A

Section of small intestine becomes distended

73
Q

What is the action of the intestinointestinal reflex?

A

Relaxes distal small intestine

74
Q

What is the result of the intestinointestinal reflex?

A

Allows chyme to be moved toward large intestine

75
Q

What is the stimulus of the gastroileal reflex?

A

Increased stomach (gastric) motility/secretion

76
Q

What is the action of the gastroileal reflex?

A

Promotes terminal ileum motility/ileocecal valve relaxation

77
Q

What is the reult of the gastroileal reflex?

A

Empty small intestine so it can receive more chyme from stomach

78
Q

How does the ileocecal valve open?

A

Similar to LES and pyloric valve in stomach

79
Q

What is the stimulus to open the ileocecal valve?

A

Approaching peristaltic wave in the ileum

80
Q

What is the action to open the ileocecal valve?

A

Relaxation of the ileocecal sphincter

81
Q

What is the stimulus that closes the ileocecal valve?

A

Distention of the cecum/ascending large intestine

82
Q

What is the action that closes the ileocecal valve?

A

Constriction of the ileocecal valve

83
Q

Where does the large intestine span from?

A

Ileocecal valve –> anus

84
Q

What are the unique arrangements of the circular/longitudinal muscles of the large intestine?

A

Teniae coli

Haustra

O’Bierne Sphincter

85
Q

What is the teniae coli?

A

3 longitudinal bands of muscles that span the length of the colon

86
Q

What are haustra?

A

Pouches formed from circular muscle layer of intestine

87
Q

What does the O’Bierne sphincter do?

A

Controls passage of chyme from sigmoid colon into rectum

88
Q

What are the motility movement patterns in the large intestine?

A

Segmental

Peristalsis

89
Q

When do haustral segment contractions occur?

A

During fasting

90
Q

Describe the haustral segment contractions

A

Individual haustra segments push contents (fecal mass) back and forth

91
Q

What is the function of haustral segment contractions?

A

Maximize absorption of water and electrolytes

**occurs 90% of the time

92
Q

When does multihaustral segmentation contractions occur?

A

During fasting

93
Q

Describe multihaustral segmentation contractions?

A

Several haustral segments contract/relax as single unit

94
Q

What is the function of the multihaustral segmentation contractions?

A

Push contents (fecal mass) short distance forward

**occurs 10% of the time

95
Q

What is the function of mass movement peristalsis?

A

Promote emptying of the intestine into the sigmoid colon and rectum

96
Q

What are the intestinal reflexes of the colon?

A

Orthocolic reflex

Gastrocolic reflex

97
Q

What is the stimulus of the orthocolic reflex?

A

Upon awakening –> standing first thing in the morning = peristalsis of LI

98
Q

What is the action of the orthocolic reflex?

A

Peristalsis propels fecal mass into sigmoid colon/rectum

99
Q

What is the stimulus of the gastrocolic reflex?

A

Ingestion of food (during or immediately after eating)

100
Q

What is the action of the gastrocolic reflex?

A

Peristalsis propels fecal mass into sigmoid colon and rectum

**continuation of gastroileal reflex

101
Q

What is the stimulus of the rectal reflex?

A

Stretch of the rectum wall

102
Q

What is the action of the rectal reflex?

A

Relaxation of internal anal sphincter –> urge to have BM

103
Q

Can the rectal reflex be voluntarily inhibited?

A

Yes –> cerebral cortex input/motor pathways in spinal cord = contract the external anal sphincter

104
Q

What happens during cauda equina syndrome?

A

Damage to nerve roots of lower spine –> loss of bowel control

105
Q

Where does digestion of carbohydrates begin?

A

Mouth

106
Q

What is the enzyme(s) found in the mouth and what do they do?

A

Salivary amylase –> starches break down into smaller molecules (dextrin/oligosaccharides)

107
Q

What does the pancreas release that is involved in the digestion of carbohydrates?

A

Pancreatic amylase

108
Q

What does pancreatic amylase do?

A

Furthur breakdown starches into major oligosaccharides (lactose, maltose, sucrose)

109
Q

What are the brush border enzymes involved in carbohydrate digestion?

A

Lactase

Maltase

Sucrase

110
Q

Where are the brush border enzymes involved in carbohydrate digestion secreted from?

A

Secretory cells of base of villi (Cyrpts of Lieburkuhn)

111
Q

What is the action of the brush border enzymes in the digestion of carbohydrates?

A

Breakdown oligosaccharides (lactose, maltose, sucrose) into monosaccharides (galactose, glucose, fructose)

112
Q

Where are carbohydrates absorbed in the small intestine?

A

Brush Border of Villi

113
Q

After being absorbed by the brush border villi where do monosaccharides go?

A

Directly to liver via hepatic portal vein

**insulin NOT required for absorption here

114
Q

Where does protein digestion begin?

A

Stomach

115
Q

What is the enzyme released in the stomach that is responsible for beginning digestion of proteins?

A

Pepsin

**pepsinogen is released from cheif cells and converted into pepsin when exposed to HCl

116
Q

What is the action of pepsin?

A

Breaks down proteins into smaller protein molecules (proteoses, peptones)

117
Q

What are the pancreatic enzymes that are responsible for digesting proteins?

A

Trypsin

Chymotrypsin

Carboxypepsidase

118
Q

What is the action of pancreatic protein digesting enzymes?

A

Breakdown proteins into smaller peptides (polypeptides and dipeptides)

119
Q

What are the brush border enzymes involved in protein digestion?

A

Aminopeptidases

Dipeptidase

120
Q

Where are the brush border enzymes involved in protein digestion secreted from?

A

Secretory cells of base of villi (Crypts of Lieburkuhn)

121
Q

What is the action of brush border protein digesting enzymes?

A

Breakdown smaller peptides (polypeptides and dipeptides) into amino acids

Patho Summer Test #1 (8 decks)

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