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Medical Physiology > Gastrointestinal Physiology- 1 > Flashcards

Gastrointestinal Physiology- 1 Flashcards

GI Overview Motility, Secretion- Mouth and Esophagus Gastric Phases

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USMLE® Step 1 flashcards
1
Q

vascular bed and adrenergic sympathetic cells

A

vascular bed constriction

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2
Q

The stomach paracrine signal of ECL

A

histamine

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3
Q

local circuit coordination of peristalsis

A

sensory –> enteric interneurons (myenteric plexus) –> excit/inhib motor neurtons

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4
Q

During the inhibition of gastric acid secretion, D cells are stimulated by this to produce a compund that functions both as a hormone and a paracrine signal.

A

D cell stimulation by: luminal acid and gastrin

D cell secretion- somatostatin

D cell inhibition by: ACh

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5
Q

cephalic phase- results and consequences

A

inc. excit parasympathetic outflow to the GI from brain stem. leads to salivation, gastric secretion, pancreatic secretion, galbladder secretion, relaxation of the sphincter of the oddi

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6
Q

Name a hormone that a- increases motility b- decrease motility

A

a- motilin- M cells b- somatostatin and GIP- ( From D cells and K cells)

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7
Q

distention of the duodenum relaxes the orad portion of stomach via local enteric circuit. And nutrients in duodenum incudes the release of this hormone

A

cholecystokinin (CCK)

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8
Q

The duration of Ca++ based- muscle action potential - Basics of muscle oscillation

A

long

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9
Q

emptying rate of isotonic fluid (osmolality of the content)

A

rapid

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10
Q

The action potential that occurs on top of slow waves

A

induce contraction with a frequency dependent upon the frequency of the underlying waves

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11
Q

salivary acinar cells

A

secrete protein and mucus in an isotonic solution

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12
Q

Cephalic Phase

In response to these compounds parietal cells release acid during the cephalic phase

A

Ach, Histamin and Gastrin

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13
Q

accessory organs of GI

A

pancreas, liver, gall bladder, parotid glands, salivary glands

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14
Q

location of M cells, and function

A

Duodenum and jejunum- secrete motilin increase motility

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15
Q

This sub-layer of the gut wall contains the following: capillaries, central lymph vessel, lymphoid tissue and glands with ducts that allow the mucus and serous secretions into the mucosal surface.

A

lamina propria

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16
Q

CN V

A

trigeminal

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17
Q

GI location dependent frequency stomach duodenum colon

A

the freq of slow waves varies with location along the GI tract. Ranges from 1-3 cyc/min in the caudad region of the somach to 12 cyc/min in duodenum. Then progressively lower to 2-4 in the colon.

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18
Q

Stimulation of Gastric Acid Secretion During the Intestinal Phase

A

During the intestinal phase the products of protein digestions stimulate intestinal G cells to secrete Gastrin

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19
Q

digested last in the stomach

A

little mixing occurs in orad section fat forms a layer on top of the other stomach content and is digested last.

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20
Q

digestion stops along this GI portion

A

large intestine

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21
Q

Pernicious anemia

cause and treatment

A

anemia caused by B-12 deficiency due to absence of IF

Gastric bypass surgery- prescribed for morbid obesity- eliminates the IF production.

Treatment- B12 injection ( oral administeration not as effective)

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22
Q

Which part of the stomach contracts during the emptying phase

A

orad

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23
Q

Name a cell type that is both oxynic and pyloric

A

D cells- secrete somatostatin

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24
Q

function of submucosal plexus

A

stimulates secretion and promotes digestion

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25
Q

the phase in which the secretion of salivary glands is stimulated

A

cephalic phase

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26
Q

distention of the duodenum relaxes the orad portion of stomach via this circuit.

A

local enteric circuit- during the feedback relaxation

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27
Q

detect content of the chime and control the pylorus

A

chemoreceptors of duodenum and illium

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28
Q

A thin sheet of CT outside of mucosa

A

lamina propria (mucosa layer composed of: mucosal epithelium, lamina propria and muscularis mucosae)

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29
Q

relaxation of the sphincter of the oddi is the result of this phase

A

cephalic phase

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30
Q

What follows after the entery of acid into duodenum

A

entery of acid into duodenum –> S cell stimulation –> secretin (hormone) release –> cheif cell stimulation –> pepsinogen secretion

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31
Q

uvula moves up

A

nasopharynx blocked passage to pharynx opens

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32
Q

site of submucosal plexus

A

submucosa

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33
Q

the pathway of gastric reflex that is called gastro-gastric reflex

A

adaptive relaxation reduction of muscle tone via local enteric circuits

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34
Q

Regulation of pepsinogen

A

1- secretion in response to ACh

2- entery of acid into duodenum

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35
Q

emptying of low PH chime

A

low PH slow emptying

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36
Q

The sub layer next to the serosa

A

longitudinal outer layer (thick smooth muscle layer- externa)

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37
Q

Gastric anatomy divisions of the stomach

A

fundus, body, antrum

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38
Q

metaplasia Example- gastroesophageal reflux disease (GERD)

A

transformation of one adult cell type into another. In GERD–> esophageal epithelium differentiate from a stratified squamous form into columnar.

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39
Q

primary goal of submucosal plexus and its fiber type

A

to stimulate secretions required for digestion afferent fibers

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40
Q

Duodenum chemoreceptors detect acid, fat, tonicity and products of protein degradation. In response, the followings are released:

A

CCK GIP Gastrin All induce contraction of the pylorus

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41
Q

CN X

A

vagus

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42
Q

Contraction of pyloric S. induced by —— and relaxation induced by ——.

A

contraction-excitation relaxation- inhibition

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43
Q

Contraction begins in middle of body and gets progressively stronger toward ———– sphincter. gastric patterns of motility

A

pyloric sphincter

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44
Q

site of myenteric plexus

A

muscularis propria, between the inner circular and outer longitudinal muscle layers

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45
Q

hepatic portal vein empties into

A

the liver

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46
Q

regulators of motility within GI

A

intrinsic and extrinsic factors

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47
Q

Hormonal regulation of pylurus The hormone(s) that induce contraction of the pylorus

A

CCK, GIP and Gastrin

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48
Q

layers of the gut wall ( from innermost)

A

mucosa submucosa muscularis propria serosa

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49
Q

areas covered by submucosal plexus and myenteric plexus

A

submucosal- limited to SI and LI myenteric extends through the entire GI

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50
Q

Sympathetic projection of enteric NS

A

via PREvertebral ganglia

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51
Q

blood glucose and regulation of food intake

A

direct and indirect (via insulin) inhibits feeding

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52
Q

regulation of deglutition

A

swallowing is regulated by CNS’s brainstem swallowing center. info travels in trigeminal, vagus, and glossopharyngeal nerves.

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53
Q

protects B12 from bacterial degradation in the gut

A

IF

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54
Q

CN IX

A

glossopharyngeal

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55
Q

activation of mechano and chemo receptors that and consequent reduction of muscle tone via local enteric circuits is a response to

A

gastrin release by gastric cells

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56
Q

the basis of slow waves

A

ICC

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57
Q

gherlin

A

GI hunger hormone

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58
Q

serosa is absent in this portion of the intestinal tract. This portion instead is bounded by a fibrous covering termed adventitia.

A

esophagous

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59
Q

vascular bed and parasympathetic release of VIP and ACh

A

vascular bed dialation- ACh via NO. (see autonomic lecture)

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60
Q

The absence of this layer contribute to the tendency of esophageal cancers to spread locally before detection, and the subsequent poor prognosis of this type of cancer.

A

serosa is absent- instead fibrous covering-adventitia

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61
Q

breathing resumes at the end of this phase

A

oropharyngeal- when the Upper. E. S relaxes and bolus enters the esophagus

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62
Q

the largest endocrine organ

A

GI- known as enteric endocrine system

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63
Q

Name several oxynic glands and their secretions

A

mucous neck cells- mucus and bicarbonate

parietal cell- HCL and Intrinsic factor

enterochromaffin-like cell (ECL)- histamine, an HCL regulator

Chief cell- pepsinogen and gastric lipase

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64
Q

myoepithelial cells of salivary gland

A

eject saliva into mouth when stimulated by ANS

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65
Q

Stimulation of Gastric Acid Release During the Gastric phase

A

1- distention of the stamach –>

a- reflexive ACh from ENS

b- activation of preganglionic parasympathetic cells

2- similar consequences as the cephalic phgase: histamine release from ECL and Gastrin release from G cell. Gastrin functioning as a hormone

3- Gastrin stimulates acid secretion by parietal cells

4- G cells are stimulated by the products of protein digestion

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66
Q

two methods by which myenteric plexus increases intestinal motility

A

1- stimulating peristalsis 2- inhibiting sphincter contraction

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67
Q

The inner and outer muscular layers of externa (muscularis propria)

A

inner circular outer longitudinal

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68
Q

esophageal phase

A

when food is transferred to the esophagus transport of the food from mouth to stomach and protection of airways from food

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69
Q

parasympathetic innervation of enteric NS

A

PREGANGLIONIC PARASYMPATHETIC cells innervate the enteric NS

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70
Q

slow waves are initiated at this boundry

A

orad and caudad

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71
Q

salivary ductal cells

A

alter acinar secretion by differential absorption and secretion of ions resulting in hypotonic saliva

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72
Q

PP (pancreatic poly peptide)

A

PP is an inhibitory hormone from the pancreases- inhibits search for food and feeding behavior.

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73
Q

serous

A

watery secretion

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74
Q

Inhibition of Gastric Acid Secretion

The cells involved

A

a- stimulation of D cells

b- inhibition of parietal cells

c- furthur inhibition of other cells

d- D cell inhibition

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75
Q

inhibitory motor neurons that are activated by excitatory neurons secret (during gastric relaxation)

A

VIP and NO

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76
Q

The most important component in regulation of saliva secretion and blood flow

A

regulated by ANS with the PARASYMPATHETIC being the most important.

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77
Q

Major triggers for mucus exocytosis

A

ACh secreted by:

parasympathetic postganglionic cells

and

prostaglandins

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78
Q

Through receiving the input from enteric neurons, these cells can influence amplitude of slow waves but not frequency.

A

Amp and not freq. is impacted once the ICC cells receive input from enteric neurons.

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79
Q

vascular supply of the intestinal tract

A

celiac a. Superior Mesenteric Artery- SMA IMA

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80
Q

Name an endoprotease, produced in an inactive form

A

Pepsinogen –> acidic condition –> pepsin

PH< 3.5

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81
Q

the phase before food is ingested

A

cephalic phase

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82
Q

stimulation of secretion

A

1- cholinergic parasympathetic via CN VII and CNIX –> muscarinic receptor –> PKA activation –> inc. [Ca2+] –> secretion 2- adrenergic sympathetic –> secretion _DIRECT and adrenergic symp –> [Ca2+] inc. –> secretion

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83
Q

smooth muscle of LES

A

high tension due to cholinergic input from parasympathetic tonic tension due to myogenic (latch state). less negative resting membrane potential spontaneous AP firing

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84
Q

symptoms of gastroparesis

A

delayed stomach emptying and severe vomitting

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85
Q

medication with Xerostomia side effect

A

medications with anticholinergic properties such as antipsychotics have dry mouth side effects

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86
Q

Components of lamina propria

A

connective fiber matrix with cells of immune system, lymph and blood vv.

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87
Q

this phase activates GI for ingestion

A

cephalic phase

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88
Q

hepatic portal vein and hepatic arteries empty into

A

live (2nd capillary)

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89
Q

a-amylase is secreted by and functions in

A

acinar cells and begins starch digestion- also travels with the food

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90
Q

the two arteries that empty into the 1st capillary beds

A

splenic artery and mesenteric artery

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91
Q

emptying rate depends on

A

content of the chime particle size strength of gastric contraction and the pressure gradient between the antrum and duodenum

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92
Q

secretory cells of SI

A

goblet enteroendocrine tuft paneth

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93
Q

emptying rate and the following contents: amino acids and fats

A

both slow emptying rate

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94
Q

the morphology of epithelial cells of the esophagus (mucosa layer)

A

stratified squamus

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95
Q

Two ways to activate pepsinogen

A

a- acidic condition and an spontaneous breakdown of pepsinogen to pepsin

b- active pepsin can also digest pepsinogen

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96
Q

Stimulates D cells to secrete somatostatin

Hint: Putting on the breaks

A

Gastrin stimulates D cells to secrete somatostatin

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97
Q

Intrinsic factor (IF)

A

reguired for vitamin B12 (cobalamin) absorption

protects B12 from gut bacterial degradation

critical for DNA synthesis, amino acid metabolism and gatty acid metabolism.

Its defeciency profoundly effects blood and CNS.

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98
Q

Its distention relaxes the orad portion of stomach

A

duodenum- during feedback relaxation

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99
Q

pacemaker activity due to opening of Ca dependent Cl channel results in

A

repolarization

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100
Q

produced by K cells in the duodenum and jejunum

A

Gastric Inhibitory Polypeptide- inhibits gastric motility

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101
Q

net H+ movement in the duct of salivary gland

A

absorption

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102
Q

Total number of neurons in enteric nervous system

A

equals the total number of neurons in spinal chord

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103
Q

Source of ACh during cephalic phase

A

Parasympathetic

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104
Q

water movement and acinar secretion

A

water movement largely paracellularly driven by ion export

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105
Q

A water- solubale vitamin that is critical for DNA synthesis, amino acid and fatty acid metabolism. It requires intrinsic factor for absorption.

A

Cobalamin- Vit. B12

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106
Q

compare the glia of enteric cells to that of CNS and periphery

A

the glia of enteric cell types are RELATED to glia of CNS rather than periphery.

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107
Q

Trigger for the release of secretin, a hormone, during the intestinal phase.

A

Entery of acid into duodenum triggers relerase of secretin from the S cells.

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108
Q

Stimulation of gastric acid secretion during:

a- cephalic phase

b- gastric phase

c- intestinal phase

A

a- ACh from parasympathetic, histamine, gastrin and gastrin as a hormone

b- Stomach distention, and ACh from reflexive ENS, gastrin as a hormone and digested protein particles

c- products of protein digestion

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109
Q

Na+ and Cl - concentration of saliva after modification compared to plasma

A

lower than plasma

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110
Q

*** The Frequency of the movement of content during mixing Orad–> Caudad –> Orad –> Caudad

A

f= 15-20 secs

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111
Q

* two phases that induce saliva secretion

A

cephalic and oral

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112
Q

Somatostain functions as a hormone, not a paracrine signal, to ihibit the following cells

Hint: inhibitiob of gastric acid secretion

A

parietal cell and ECL

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113
Q

weaker gastric contraction rate means

A

slower rate of emptying

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114
Q

high fat storage inhibits feeding via

A

leptin

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115
Q

NTS

A

hypothalamus, relay center, nucleus tractus solitarius

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116
Q

dephosphorylation of myosis during the latch state

A

dephosphorylation of myosin occurs before release of myosin from actin.

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117
Q

CCK release is triggered by this and causes muscle relaxation via this route- feedback relaxation.

A

nutrients in duodenum CCK –> muscle relaxation via vagal route

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118
Q

electrical coupling of ICC

A

interstitial cells of cajal ICC are electrically coupled to each other and to UNITARY muscles

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119
Q

name 3 duct modification of secretion

A

modification of acinar secretion with respect to osmolarity, ion content and PH which occurs in the duct

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120
Q

muscularis mucosa is innervated by

A

submucosal plexus

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121
Q

covers glottis

A

epiglottis

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122
Q

GLP-1

A

Glucangon-Like -1 GI inhibitory hormone

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123
Q

the part of the brain which mediates the effect of GI, pancreas and adipocyte hormones participating in regulation of food iantake

A

hypothalamus mediates the affects of regulatory hormones

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124
Q

sepsis and GI microbiome

A

penetration of bacteria through GI is pathological and can result in sepsis

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125
Q

salivary gland cells

A

myoepithelial acinar ductal

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126
Q

vago-vegal reflex coordination of peristalsis

A

sensory –> dorsal vegal complex –> preganglionic parasympathetic neurons –> excit/inhib motor neurons

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127
Q

LES- bolus entry is assisted by

A

orad peristaltic contraction and negative pressure in gastric cavity

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128
Q

part of hypothalamus that serves as a relay for some of the regulatory signals

A

NTS Nucleus tractus solitarius

129
Q

NT of excitatory enteric neuron synapsing on ICC

A

ACh- muscarinic

130
Q

swallowing

A

part of oral phase involuntary behavior, initiated by somatosensory neurons - somatic control and skeletal muscles

131
Q

the three salivary glands

A

sublingual parotid submandibular

132
Q

thiocyanite ion of saliva

A

a bactericide along with proteolytic enzymes that allows the bactericide to enter the bacteria

133
Q

causes of hirschprung’s disease

A

obstruction of the regions affected due to congenital absence of ENS in part of colon

134
Q

ATP supply during latch state

A

NO CONTINUOUS ATP Supply

135
Q

xerophthalmia

A

dry eyes

136
Q

parasympathetic profection of enteric NS

A

via the vagus ( CNX) and Sacral spinal chord (lower 1/3 of colon)

137
Q

mesenteric artery empties into

A

the 1st capillary bed of the intestine

138
Q

plexus organization

A

organized into ganglia- 5 to a few hundred. Plexus are interconnected by nerve bundles to the ganglia

139
Q

The base of muscle action potential - Basics of muscle oscillation

A

Ca2+

140
Q

** Regulation of all motility in pharynx and UES

A

reflexes between sensory and motor somatic division of NS.

141
Q

axons of enteric neuronal cells

A

fine axons and unmyelinated

142
Q

two phases of swallowing

A

oropharyngeal and esophageal

143
Q

the differentiates cell types of SI

A

absorptive and secretory

144
Q

EEC and ECL

A

enteroendocine cell and enterochromaffin-like cells are cells of enteric endocrine system that don’t form glands but rather are scattered among the epithelial cells lining of the GI tract.

145
Q

these cells of salivary gland (multilobulated) secret protein and mucus into an isotonic solution

A

acinar cells

146
Q

the two blood supplies for the liver (2nd capillary bed)

A

hepatic portal vein and hepatic arteries

147
Q

The cells of endocrine system that DO NOT form glands but rather are scattered among the epithelial lining of the GI tract

A

EEC and ECL

148
Q

the site of a plexus which innervates the muscularis mucosae

A

submucosal plexus

149
Q

PYY

A

peptide YY- GI inhibitory hormone

150
Q

Sympathetic innervation of the enteric NS

A

POSTganglionic sympathetic cells innervate the enteric NS

151
Q

xerostomia

A

dry mouth

152
Q

outermost cellular membrane present in most of the intestinal tract that is continuous with peritoneal lining

A

serosa

153
Q

pyloric stenosis

A

more freq in males- pylorus fails to relax after the meal symp: vomiting, malnutrition and dehydration

154
Q

ovula contraction results in

A

blocking the nasal passage

155
Q

BER

A

Basic Electrical Rhythm (slow wave)

156
Q

Stimulate cheif cells to secrete pepsinogen

A

Secretin stimulates chief cells to secrete pepsinogen.

entery of acid into duodenum –> S cell stimulation –> secretin (hormone) release –> cheif cell stimulation –> pepsinogen secretion

157
Q

this reflex causes brief relaxation of the fundus (gastric relaxation) when the food is detected in the mouth and pharynx

A

vago-vegal reflex during receptive relaxation

158
Q

Major paracrine signals of the GI

A

5-HT from ECC histamine from ECL NO and Adenosine

159
Q

serous fluid of saliva

A

dilutes the food

160
Q

the sites of absorptions

A

small and large intestine

161
Q

the side effects of anticholinergic medications

A

dry mouth and constipation

162
Q

activation of pharyngeal pressure receptor sends messages to this center and leads to

A

activation of pharyngeal P. Receptor initiate reflexes from medulla ( swallowing centers)

163
Q

*** slow wave

A

spontaneous oscillation of smooth muscle membrane potential. In the stomach and the rest of GI smooth muscles.

164
Q

parasympathetic contact —— neurons, which are

A

enteric neurons. enteric are the parasympathetic postganglionic cells

165
Q

regulation of vascular dilation on salivary gland

A

vascular dilation is regulated by ANS and bradykinin- The latter paracrine is released by salivary gland in response to ANS stimulation

166
Q

Elicits the reflexive release of ACh from enteric NS

A

Distention of the stomach

167
Q

level of saliva secretion between meals except during sleep and during feeding

A

low level maintained High during feeding 1ml/min

168
Q

fold of the epithelial cells in the large intestine (colon)

A

crypts

169
Q

tonicity and PH of saliva

A

hypotonic with PH ~8

170
Q

adaptive relaxation

A

induction of the activity inm mechano- and chemo- receptors that reduces muscle tone via local enteric circuits in response to gastrin release by gastric cells

171
Q

HCO3- of saliva

A

buffering and reduction in bacterial growth

172
Q

hypothesis for contracted muscles of the sphincter during closed state

A

muscles are in latch state

173
Q

contraction of caudad section and its freq.

A

regular contraction. f= 3-4 cycles min

174
Q

enteric nervous system

A

submucosal and myenteric plexuses

175
Q

the salivary gland with mucus secretion

A

sublingual

176
Q

Motilin

A

a hormone produced by M cells in duodenum and jejunum which increases motility

177
Q

the term reserved for the endocrine cells that are not directly in contact with the blood

A

enterochromaffin-like cells (ECL)

178
Q

distribution and location of GI microbiome

A

density varies with location some on epithelial surface and some in lumen

179
Q

synchronizes the electrical activity of the smooth muscles of the GI

A

GAP junctions

180
Q

composition of GI tracts from lower part of esophagus to anal external sphincter:

A

beyond the region of striated muscle, esophagus and rest of GI tract to anal external sphincter is composed of smooth muscle

181
Q

——— cells of this oxynic gland secrete pepsinogen.

A

Chiefcells

182
Q

this layer is responsible for gross folds of the GI wall

A

muscularis mucosae (thin smooth muscle)

183
Q

lingual lipase secreted by

A

ductal cells and begins lipid digestion

184
Q

Name two cell types that are pyloric glands and their secretion

A

mucous cells- protective coaring, bicarbonate and mucus

G cells- gastin , an HCL regulator

185
Q

GI inhibitory hormones

A

GLP-1, OXM and PYY

186
Q

stimulation of taste and somatosensory afferents leads to this

A

initiation of production and secretion of secretory products in anticipation of ingestion. the stimulation of taste and somatosensory afferent ramps up the production as food enters the mouth,.

187
Q

***Freq and Amplitude regulation of contraction

A

Freq is intrinsic to stomach. ANS modifies amplitude: PNS- ACh- Increase Contraction SNS- decreases contraction

188
Q

muscular composition of the pharynx and upper part of the esophagus

A

striated muscles controlled by somatic CNS

189
Q

Acinar secretion

A

a- amylase acinar portion secrete enzymes, electrolytes in plasma like concentration (isotonic). besides Na+, CL-, K+ other ions exist in saliva: Ca2+, Mg2+ and F-

190
Q

Two sources of ACh for regulation of pepsinogen

A

Secretion in response to ACh regulates pepsinogen

a- ACh (via PLC 2nd cascade) from enteric

b- ACh from parasympathetic (cephalic and gastric phases)

191
Q

sustained tension during latch state

A

no additional ATP is required to sustain the tension –> less o2 and ATP required by smooth muscles in this state

192
Q

entrocytes

A

epithelial cells which absorb lumen content

193
Q

pacemaker activity due to opening of Ca vot-gated channels at resting potential

A

depolarization

194
Q

ICC and action potential

A

ICC don’t fire action potential

195
Q

control of pylorus to regulate the rate of emptying

A

hormones intrinsic reflexes via enteric symp. and parasym. input

196
Q

UES is always closed except

A

deglutition UES relaxes during pharyngeal phase allow opening access to esophagus

197
Q

Name 3 cells that produce a protective coating consisting of mucus and bicarbonate

A

mucous neck cells (oxynic gland)

mucous cells (pyloric gland)

surface epithelial cells

198
Q

importance of electrolyte secretion within the GI

A

provides osmotic gradient

199
Q

The role of GI STRETCH in regulation of food intake

A

stretch inhibits

200
Q

cell types of epithelium

A

enterocytes, endocrine and secretory cells

201
Q

an exception to the fact that adrenergic sympathetics do not operate directly on glands

A

stimulation of saliva secretion and inc. [Ca2+]

202
Q

In the small intestine, the fold of the cells in mucosa are called —– and each projection of each individual cell is called.

A

villi, microvilli

203
Q

The stimuli and source of ACh during the gastric phase

A

Distention of the stomach during the gastric phase elicit reflecive release of ACH from the enteric NS.

204
Q

relaxation of circular muscles orad –> bolus is induced by

A

inhibitory enteric motor neurons

205
Q

compare and contrast the submucosa layer with lamina propria

A

both are similar BUT submucosa layer contains secretory glands that extend up to epithelium and a neuronal network.

206
Q

fold of epithelial cells in the intestine

A

villi

207
Q

the shape of the epithelial cells of the GI tract

A

columnar

208
Q

Cause of non-drug induced gastric ulcer

A

Helicobacter pylori

209
Q

T/F Only parasympathetic visceral afferent is present in GI.

A

False Both parasympathetic and sympathetic visceral afferents are present.

210
Q

5-HT

A

seretonin- a paracrine signal secreted from ECL

211
Q

its stimulation increases intestinal motility by stimulating peristalsis and also by inhibiting contractions of sphincter muscles

A

myenteric plexus (located between inner circular and outer longitudinal muscle layers of muscularis propria

212
Q

status of smooth muscles when sphincters are closed

A

contracted

213
Q

three pathways of gastric relaxation

A

receptive, adaptive and feedback

214
Q

peristalsis regulation

A

local circuit and vago-vagal reflex

215
Q

—— is interposed between enteric motor neurons and smooth muscle

A

ICC- a specialized smooth muscle which is important element in regulating muscle contraction.

216
Q

mucus component of saliva

A

glycoproteins and mucin

217
Q

epithelial cells of the gut wall

A

stratified squamous in esophagus Columnar in GI until dentate line squamous in rectum

218
Q

the phase corresponding to the food in the mouth

A

oral phase

219
Q

components of the oral phase

A

taste sensation mechanical sensation mastication swallowing

220
Q

Inhibition of Gastric Acid Secretion

Name the compounds involved for each section:

a- stimulation of D cells- somatostatin secretion

b- inhibition of parietal cells

c- furthur inhibition of other cells (cells that stimulate pariatal cells)

d- D cell inhibition

A

a- stimulation of D cells- by luminal acid and gastrin

b- inhibition of parietal cells- by somatostatin (Acting as a Hormone)

c- furthur inhibition of other cells.

G cell- somatostatin (as paracrine signal)

ECL cells- somatostatin (Hormone)

d- D cell inhibition- by ACh

221
Q

the components of saliva

A

mucus, serous, a-amylase, lingual lipase, antibodies thiocyanate ion

222
Q

OXM

A

Oxytomodulin GI- inhibitory hormone ( other GI inhibitory hormones are PYY, CCK and GLP-1)

223
Q

closing of glottis is the result of this muscle contracting

A

laryngeal muscle contraction

224
Q

PH range for pepsin activity

A

Pepsin only active when PH< 3.5

acidic condition- pepsinogen –> pepsin

as a result of spontaneous breakdown

Pepsin inactivated by PH> 3.5

225
Q

saliva

A

composed of numerous compounds such as mucin and enzymes

226
Q

The sphincter between the small and large intestines

A

iliocecal

227
Q

feeding inhibitory hormones secreted from the pancreas

A

insulin and PP

228
Q

Orad section is ensheathed by ——— & ——— muscles.

A

thin and weak. Thus little mixing with fat oily layer on top.

229
Q

the deglutition info start in brainstem swallowing center and travels down the following nerves:

A

trigeminal- CN V. vagus- CN X. glossopharyngeal- CN IX.

230
Q

Regulation of Acid Secretion by Pepsinogen

A

polypeptides and amino acids products of pepsinogein digestion stimulate G cells

231
Q

Chyme

A

once the content passes through the pylorus

232
Q

HCO3- and K+ concentration of saliva after modification compared to plasma

A

higher concentration for K+ and HCO3-

233
Q

targets of sympathetic projections

A

1- enteric neurons 2- smooth muscle 3- secretory cells 4- endocrine cells 5- ICC

234
Q

muscles that contract during oropharyngeal stage

A

laryngeal muscle contraction and ovula contraction

235
Q

pharyngeal phase

A

transport bolus to stomach

236
Q

the two layers connected by submucosa

A

mucosa and muscularis propria

237
Q

primary goal of myenteric plexus

A

coordination of intestinal motility

238
Q

the salivary gland with serous secretion

A

parotid

239
Q

two types of motor efferent

A

excitatory or inhibitory

240
Q

ACh Action During Cephalic Phase

A

ACh drives histamine release from ECL and gastrin from G cells.

Gastrin, acts as hormone to furthur excite ECL and parietal cells.

241
Q

contraction of circular muscles- orad –> bolus- is induced by

A

excitatory enteric motor neurons via ICC. Transmitter of synapse on ICC is ACh- muscarinic.

242
Q

effector substances that stimulate secretion

A

secretagogues

243
Q

a layer of loose CT that connects the mucosa to the the layer containing thick smooth muscles (muscularis propria)

A

submucosa

244
Q

efferent (neuronal) cell types

A

project to: 1- ICC- special smooth muscle 2- smooth muscle (all 3 layers and vasculature) 3- endocrine cells 4- secretory cells 5- endothelial smooth muscles

245
Q

the enteric nervous system that extends through the entire GI tract

A

myenteric

246
Q

enumerate the divisions of GI tract

A

mouth- pharynx (UES), esophagus (LES), stomach (Pyloric S), SI: duodenum. jejunum. ilium (iliocecal S), LI/colon: ascending. transverse. descending. sigmoid. rectum (internal anal and external anal Sphincters), anus. accessory organs

247
Q

important element in muscle contraction

A

ICC- by forming a sheet of electrically coupled cells

248
Q

motor unit of smooth muscles of GI

A

unitary motor unit

249
Q

ICC

A

intestinal cells of cajal

250
Q

afferent neuronal cells types

A

chemoreceptors and mechanoreceptors some send info to ANS ganglia

251
Q

smooth muscle morphology

A

single nuc. spindle shaped when relaxed, globular when contracted NO myofibril NO sacromeres dense bodies similar to Z lines of muscle in protein constituents SR poorly developed and sparse NO T TUBULE

252
Q

symptoms of Hirschprung’s disease

A

no bowel movement w/in 48 hours of birth abdominal distention functional obstruction of the colon, typically sigmoid colon and vomitting

253
Q

reflux through LES causes

A

GERD

254
Q

*Result of subthreshold depolarization

A

little or no contraction

255
Q

Is required for cobalamin absorption

A

Vitamin B12

256
Q

CCK

A

Cholecytokinin along with stretch inhibits feeding.

257
Q

facilitate synchronized contraction of the GI unitary motor unit

A

GAP junctions between the cells to synchronize the electrical activity

258
Q

blockage of food movement into larynx

A

epiglottis down larynx up

259
Q

progenitor cells of SI and their location within SI

A

transit-amplifying (TA) along the walls of the crypt

260
Q

ENS

A

third division of ANS same number of neurons as the spinal chord Autonomous to some extend without CNS input

261
Q

retropulsion

A

As the food is pushed agst pyloric S. some may move into duodenum, while most is pushed back

262
Q

mucus

A

viscous secretion

263
Q

multiple thin layers of smooth muscle which, seperates the lamina propria from submucosa

A

muscularis mucosa

264
Q

NT of inhibitory enteric motor neurons

A

VIP and NO

265
Q

hypotonic saliva isdifferential absorption and secretion of the following ions by ductal cells

A

K+ and HCo3- added to saliva Na+ and Cl- taken away

266
Q

The role of gastrin during cephalic phase

A

Gastrin (released from G cells in response to parasympathetic ACh), acts as a hormone to furthur excite ECL cells (secrete histamine) and Parietal cells.

267
Q

Is secreted by parietal cells in response to the same stimuli that induce HCL secretion from thsoe cells

A

IF

268
Q

emptying rate as the pressure gradient between the antrum and duodenum decreases

A

slower

269
Q

Three distinct layers of mucosa ( the inner most layer of the gut wall)

A

mucosal epithelium lamina propria muscularis mucosa

270
Q

Stem cells of the SI within the crypt

A

+4 stem cell QSC Crypt Base Columnar Cells CBCC/ASC

271
Q

Release of ACh and the activation of preganglio nic parasympathetic cells are stimulated by …….. during gastric phase.

Waht is the consequences of such action

A

Distention of the stomach –>

1- Reflexive ACh release from the ENS

2- Distention stimuli is relayed to the brainstem –> activation of preganglionic parasympathatic cells.

Consequences are as in the cephalic phase

272
Q

Somatostatin is also called

A

growth hormone-inhibiting hormone

273
Q

the importance GI microbiome

A

important for nutrient absorption

274
Q

Causes repolarization - basics of muscle oscillation

A

K+ efflux

275
Q

receptive relaxation

A

vago-vagal reflex brief relaxation of the fundus when food is detected in the mouth and pharynx

276
Q

degeneration of ICC in patient suffering from oxidative stress of diabetes lead to

A

diabetic gastroparesis

277
Q

GIP

A

Gastric Inhibitory Polypepride

278
Q

connection between the ganglia and plexus

A

nerve bundles

279
Q

the most numerous cells of the epithelial layer of GI wall

A

enterocytes (absorption in lumen)

280
Q

Drug induced gastric ulcer

A

aspirin damages the mucosa.

aspirin inhibits cyclooxygenase- COX- and enxyme in prostaglandin synthesis. In the stomach it modulates mucosal defense including eliciting mucus secretion.

281
Q

intestinal cells of cajal

A

specialized smooth muscle form a sheet of electrically coupled cells

282
Q

absorptive cells of the SI

A

entrocytes

283
Q

Its receptors detect acids, fats, tonicity and products of protein degradation

A

chemoreceptors of duodenum

284
Q

The main cause of xerostomia

A

due to: 1- increased viscosity of saliva because of vascular constriction and 2- inhibition of parasympathetic input

285
Q

ICC network and oxidative stress

A

ICC volunarable to oxidative stress which occurs with diabetes

286
Q

Name the layer of the gut wall that a- contains blood vessels b- contains a central lymph c- contains capillaries

A

a- submucosa b- lamina propria of mucosa c- lamina propria of mucosa

287
Q

innervation of the lower 1/3 of colon

A

sacral spinal chord- a parasympathetic projection

288
Q

triggers of cephalic phase

A

cognitive olfactory auditory stimuli

289
Q

feeding inhibitory hormones secreted by adipocytes

A

leptin

290
Q

sphincters surrounding the anal canal

A

internal and external sphincters

291
Q

D cells location and function

A

Location: Stomach, duodenum and the pancreatic islets Secrete somatostatin which inhibits motility.

292
Q

interneurons of enteric cells

A

both ascending and descending

293
Q

ECL

A

enterochromaffin-like cells of enteric endocrine system.

294
Q

GI hormone that promotes feeding

A

the hunger hormone- gherlin

295
Q

paracrine signals of enteric endocrine system

A

seretonin (5-HT) secreted from ECC- enterochromaffin cells stomach- histamine from ECL others NO and adenosine

296
Q

fold of epithelial cells in the stomach

A

rugae

297
Q

mastication (part of oral phase)

A

teeth (incisors and molars) mastication is reflexive for the most part leads to bolus formation and facilitation of taste

298
Q

the GI component with the highest density of bacterial population

A

colong

299
Q

oral phase

A

prepares food for swallowing

300
Q

the long-term regulator of energy balance that functions by inhibiting food intake

A

leptin from adipocytes

301
Q

emptying rate and the particle size

A

slower as the size inc. only particles <1mm pass through

302
Q

The hormones secreted from the cells of duodenum and jejunum that either increase or decrease gastric motility

A

increase- motilin (M cells) decrease- GIP (K cells)

303
Q

Somatostain functions as a paracrine signal and not a hormone to ihibit the following cell(s).

Hint- inhibition of gastric acid secretion

A

G cells- somatostatin as a paracrine

Parital and ECL cell- somatostatin as a hormone

304
Q

gives rise to efferent fibers that synapse directly on mucosal epitheliam

A

submucosal plexus

305
Q

Activation of inhibitory motor neurons which secrete VIP and NO is by the release of ———– from ———. Gastric relaxation

A

ACh and substance P from excitatory neurons.

306
Q

functional division of gastric anatomy and the muscular structure of each one

A

Orad- towards the mouth- thin smooth muscle layer caudad- thick smooth muscle layer.

307
Q

excitatory neurons activate inhibitory motor neurons by secreting (during gastric relaxation).

A

ACh and Substance P

308
Q

the layer that plays an important role in intestinal motility

A

muscularis propria (inner/circular- outer/longitudinal)

309
Q

the major contributor of the maintenance of hypotonicity of saliva

A

hypotonicity maintained due to water impermeability of cells _ ductal_ and removal of Na and Cl.

310
Q

By being placed between 3 different muscle fibers form a 3D network

A

ICC Non-neuronal modified smooth muscle serve as the basis for slow waves

311
Q

the enteric nervous system limited to small and large intestine

A

submucosal

312
Q

chronic inflammation of exocrine glands- Symp: xerostomia (dry mouth), xerophthalmia (dry eyes), parotid gland enlargement, difficulty swallowing and difficulty with speech

A

Sjogren syndrome

313
Q

trigger of relaxation for both UES and LES

A

arrival of peristaltic wave

314
Q

**** The initiation of the underlying slow wave causing a freq, of 15-20/secs during mixing and for the following pattern Orad–> Caudad –> Orad –> Caudad

A

underlying slow wave initiated at boundary of orad and caudad compartments.

315
Q

****Basic Electrical Rhythm

A

The regular depolarization-hyperpolarization cycles

316
Q

second capillary bed empties into

A

hepatic vein

317
Q

the salivary gland with both mucus and serous

A

submandibular gland

318
Q

Third division of ANS

A

Enteric nervous system

Medical Physiology (21 decks)

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