Gastrointestinal Physiology Flashcards
Intrinsic regulation involves (2) and is responsible for
local nervous and endocrine systems; specific GI functions
Extrinsic regulation involves (3) and is responsible for
CNS, ANS, endocrine system; broad promotion or inhibition of GIT activity
the myenteric plexus controls ________ and gets its sensory info from _________
motility; mechanoreceptors
the submucosal plexus controls _______ and gets its sensory info from __________ in ________
secretions; chemoreceptors; mucosa
What coordinates motor and secretory activity in the GIT
interneurons (between myenteric and submucosal plexus)
describe nerve endings in the ENS
no synapse; NT is released diffusely within tissue; motor axons end in varicosities
varicosities release _________, which are (2)
neurocrines; NTs or hormones
what enteric NTs are excitatory
acetylcholine, tachykinins (substance P)
substance P is involved in (2)
pain; vomiting (via CTZ in medulla)
what enteric NT peptides are inhibitory
somatostatin; NE/E; PACAP
what enteric NT non-peptides are inhibitory
NO, ATP
what enteric NT is inhibitory to muscle but stimulatory to glands
VIP (vasoactive intestinal peptide)
most of the GI tract is supplied by what nerve
vagus
the pelvic nerve supplies
descending colon and rectum (and bladder)
the vagus nerve uses what NT
ACh (stimulatory to gut muscle and secretions; vasodilates; relaxes sphincters)
sympathetic afferent nerves synapse in (2) ganglions
celiac and mesenteric
splanchnic nerves release what NT
NE (inhibits motility and secretions; contracts sphincters; vasoconstricts)
_________ afferent nerves (which are _________) mediate normal gut function, whereas ___________ afferent nerves (which are ___________) signal pathological conditions
vagal, parasympathetic; splanchnic, sympathetic
where is information from visceral afferents integrated
brainstem mainly
most GI functions are (conscious or subconscious)
sunconscious
T/F GI functions are completely subsconscious
F
intrinsic gut hormones are mainly _________ released from ________ cells
peptides; enteroendocrine
T/F enteroendocrine cells look alike because they each secrete multiple hormones
F; they look alike but each secretes a single hormone
enteroendocrine cells have what effects
autocrine, paracrine and endocrine
how are some GI hormones involved in cancers
some promote mucosal growth
cytokines released by the mucosal immune system affect gut (2)
mucosal immune system; motility and secretions
T/F the GIT is predominantly self-regulated by intrinsic nerves and hormones
T
what is transit time
time taken by food to travel from one gut location to another
what are the 4(5) functions of the GI tract and examples of each
- propel ingesta (peristalsis)
- retain ingesta (sphincter contraction)
- break up and mix ingesta (segmentation)
- circulate ingesta (segmentation)
T/F GI smooth muscle contains gap junctions to electrically couple the cells
T
what are the pacemaker cells of the GI smooth muscle
Interstitial Cells of Cajal (ICCs)
what are slow waves
ICCs intrinsically, rhythmically depolarize (and then repolarize)
T/F slow waves cause firing of APs and contraction
F; the waves are of subthreshold depolarization
when does contraction of GI muscle occurs
when slow waves coincide with excitatory NT release
slow waves determine _________ whereas NTs determine ___________
pattern of contraction; whether the contraction occurs or not
waves travel in what direction along GI smooth muscle
aborally
contractions in the proximal stomach are _________ whereas those in the antrum are __________
weak; strong
the peristaltic reflex is entirely _________
internal to the ENS
distention of a food bolus ____________ circular muscle proximally and ____________ circular muscle distally
stimulates (Ach, substance P); relaxes (ATP, NO, NE, VIP)
mouth/pharynx/larynx is controlled by ________, esophagus in ruminants/dogs is controlled by ________, esophagus in cats and horses is controlled by _________ and the stomach and intestines are controlled by ________
CNS; ANS; ANS/ENS (cranial vagus, caudal ANS/ENS); ENS
prehension means
grasping food
prehension is controlled by ________ muscles and involves cranial nerves (3)
skeletal; facial, glossopharyngeal, trigeminal
what can cause issues with mastication
poor dentition and gum disease
the voluntary stage of deglutition involves _________; the involuntary stage of deglutition involves __________ and cranial nerves
movement of the bolus into the oropharynx by the tongue; movement of the bolus from the oropharynx to the esophagus; cranial nerves 5, 7, 9, 10, 12
the upper esophageal sphincter is called the
cricopharyngeal sphincter
what is an important roleof the cricopharyngeal sphincter that prevents colic
prevents swallowing of air, which can cause colic
what propels food from pharynx to stomach; what muscle type and nerves are involved
peristalsis in the esophagus; striated mostly; vagus
T/F with fragmentation,there is net forward movement
F
functions of saliva (5)
lubricates; digests (amylase and lipase); antibacterial (lysozyme); grooming; thermoregulation
salivation is stimulated by ________ (what molecule) and inhibited by ________ (what molecule)
the facial nerves that control salivation are (2)
Ach (released by glossopharyngeal and facial); NE/E
two broad categories that stimulate salivation
ANS (and CNS) and natural stimuli
acini in salivary glands secrete (4)
mucus, enzymes, electrolytes (Na, Cl), water
when dehydrated, aldosterone stimulates _________ (2) to be reabsorbed in the salivary gland and _________ (2) to be secreted; this makes the saliva (2)
Na/Cl reabsorbed; K/HCO3 secreted; saliva becomes hypotonic and neutral to alkaline
parotid salivary glands primarily have ________ secretion
serous
ruminant saliva characteristics
voluminous, alkaline, high in Na and HCO3; helps buffer rumen contents
roles of the stomach (4)
stores food, breaks down food, starts digestion (HCl and proteolytic enzymes), released chyme
stomach movements are controlled by (3)
ANS, ENS, gut hormones
the _________ of the stomach is responsible for storage
proximal part (antrum and most of body)
the _______ of the stomach is responsible for churning and mixing
antrum
as food enters, the proximal stomach ______ due to ________ innervation
relaxes; vagus
T/F salivary enzymes can digest food throughout the entire stomach
F; only in the proximal stomach
stomach motility is controlled by (2)
ENS and vagus (PSNS)
what controls that only small particles can leave the pylorus
significant smooth muscle tone in the pylorus
gastric emptying is promoted by ______________ factors and inhibited by ________________ factors
gastric factors (secretion of gastrin due to stretch and composition of food); duodenal factors (that reflect newly arrived bolus such as low pH, high osmolarity)
once chyme enters the duodenum, it inhibits further emptying of the stomach by stimulating (3)
Afferent neurons in vagus -> decrease vagal tone/increase sympathetic tone
Afferent ENS cells
Secretion of cholecystokinin and somatostatin (from duodenal enteroendocrine cells)
what is the migrating motor complex? when does it occur
occurs between meals; pylorus relaxes and a strong wave of peristalsis sweeps the antrum, forcing less digestible food out en masse to the duodenum and colon
cyclical release of ______ from the ____ stimulates the migrating motor complex
cyclical release of motilin from the SI (stimulated by ACh)
during vomiting, intercostal and abdominal muscles __________ whereas stomach muscles _______
contract; relax
the pH of vomited food is _________ and comes from the ________ stomach whereas the pH of regurgitated food is _________ and comes from the _______ stomach
<5; distal; >7; proximal
The cardiac glands consist of
mucous cells
The fundic glands consist of
mucous cells, parietal cells, chief cells, enteroendocrine cells, mast cells
The pyloric glands consist of
mucous cells, a few G cells, a few parietal cells
surface mucous cells in all areas of the stomach secrete
neutral to alkaline mucous
parietal cells secrete (2)
HCl and intrinsic factor
chief cells secrete
zymogens
parietal cells contain receptors for (6)
ACh (+), histamine (+), gastrin (+), CCK (+), somatostatin (-), secretin (-)
what is the best method to inhibit gastric acid secretion by parietal cells
proton pump inhibitors; eventually H+ concentration rises high enough that CA catalyzes the reverse reaction
T/F we manipulate transport of Cl to the lumen as a way to inhibit gastric acid production
F; we only manipulate H+ secretion
Chief cells secrete _______________ zymogens, which are cleaved by ______________ into ______ enzymes that digest ___________
inactive (pro-enzyme); HCl; active; proteins
In monogastric animals the inactive zymogen is ____________ which becomes __________ once activated by HCl
pepsinogen; pepsin
In ruminants the inactive zymogen is ___________ which becomes __________ once activated by HCl
prochymosin; chymosin
chymosin is found in the __________ of ruminants
abomasum
what does chymosin do in ruminants
digests kappa-casein, which curdles the milk, slowing transit time and allowing better digestion in young ruminants
what is the role of mast cells in the stomach
secrete histamine, which acts via H2 receptors on parietal cells to stimulate HCl secretion
what is the stimulus/signal for g cells to release gastrin
peptides, amino acids and calcium in the stomach lumen
gastrin stimulates (2)
HCl secretion from parietal cells directly; histamine release from mast cells (which indirectly causes parietal cells to secrete HCl)
During the cephalic (anticipation) phase of HCl secretion, release of _______ from ________ stimulates _______ receptors on ________ and _________ cells, which overall acts to ________ HCl secretion
ACh; vagus; muscarinic; parietal; G-cells; increase
During the gastric phase of HCl secretion, ______________ and ____________ trigger ______ release of _____; food in the stomach raises pH, which further stimulates __________
chemoreceptors and stomach distension; ENS; ACh (stimulates parietal directly and gastrin secretion); further increases gastrin secretion
what inhibits HCl secretion
- low pH inhibits gastrin secretion (which reduces parietal HCl secretion)
- chyme in duodenum triggers release of somatostatin (inhibits parietal HCl secretion) and secretin (stimulates somatostatin and PGE2, also triggers bicarb release)
the endocrine pancreas is responsible for __________ and the exocrine pancreas is responsible for ___________
regulation of blood glucose; secretion of digestive enzymes
pancreatic enzymes function best in what environment
neutral to alkaline
what pancreatic cells secrete HCO3 and H2O
centroacinar and duct
what is an indigestible carbohydrate
cellulose
most enzymatic digestion occurs by
hydrolysis (for lipids, carbs and proteins)
lipase hydrolyzes____ into ____ and requires
neutral lipids into fatty acids and monoglycerides; co-lipase
cholesterol esterase hydrolyzes
cholesterol esters
phospholipase function
splits fatty acids from phospholipids
pancreatic zymogens include
trypsinogen -> trypsin, chymotrypsinogen -> chymotrypsin; proelastase -> elastase; procarboxypolypeptidases -> carboxypeptidase
what activates intestinal zymogens
mainly trypsin
why doesn’t the pancreas digest itself (1)
secretes inactive zymogens; trypsin inhibitors released alongside zymogens (gets diluted in intestinal lumen)
when does EPI usually occur
secondary to chronic pancreatitis
pancreatic cells have receptors for
ACh (enzymes and HCO3), gastrin (enzymes), CCK (enzymes), secretin (HCO3)
decreased pH in the duodenum stimulates the release of
secretin (secretes HCO3)
increased peptides and fat in the duodenum stimulates
CCK secretion (gallbladder contraction and release of pancreatic enzymes)
proteins and Ca in the pylorus stimulates
gastrin release, which acts on parietal cells/M cells AND stimulates the release of pancreatic enzymes
what provides negative feedback on pancreatic enzyme/HCO3 secretion
rise in duodenal luminal pH; chyme digestion/absorption
what does splanchnic circulation supply
stomach, small intestines, colon, pancreas, liver, spleen
T/F the splanchnic circulation has some degree of autoregulation
T
approx 75% of blood flow in GIT is to
mucosa
two main molecules that increase bloodflow to the GIT are
prostaglandins and ACh
two main molecules that decrease bloowflow to the GIT are
NE and PGF
nutrient absorption and increased metabolic _______ bloodflow to the GIT
increase
gastric ulcers can be caused by
chemicals, pathogens, decreased gastric bloodflow (ex. inhibition of prostaglandins by NSAIDs and glucocorticoids)
villi are very sensitive to ________ because of __________
hypoxia (end-organs); countercurrent O2 exchange
mild ischemia causes _____________, moderate ischemia causes _________ and severe ischemia causes __________
diarrhea; ulceration and bleeding; perforation and peritonitis
why does decreased bloodflow lead to ulcers
HCO3 production and mucus production relies on water, which comes from blood supply
the 2 roles of bile are
lipid digestion and waste elimination
bile salts, which are made from _______________, act like __________ to ___________lipid droplets
cholesterol; detergents; disperse
in hepatocytes, bile acids are _____________, which ______________
conjugated to amino acids; inhibits reabsorption from the biliary tract and duodenum
bile acids are ____________ transported into hepatic canaliculi
actively