Gastrointestinal Physiology: Motility II Flashcards
In general, the duodenal cap is relaxed when the
Pyloric antrum contracts
Contractions are irregular, affected by both the gastric and post-bulbar duodenal
Pacemakers
A few gastric longitudinal muscle fibers enter the transitional zone of the duodenum, and the enteric system is
Continuous
Caused by the entering chyme
-may initiate contraction
Lumenal distension
The most common mechanical process seen in the small intestine
Rythmic segmentation
Intracellular gastric and intestinal smooth muscle structure and tissue organization allows for changes in volume with little change in
Pressure
Allow for efficient electrical communication between cells leading to waves of rings of contractions
Gap Junctions
Contractile mechanism of gastric and intestinal smooth muscle allows for tonic contractions, a process called
Latching
An inherent rhythmical fluctuation in the resting membrane potential of the muscle cells
Slow waves, Basal Electrical Rythm (BER), and Electrical Control Activity (ECA)
The amplitude (5 to 15 mV), duration (1-5 sec), and frequency of ECAs vary along the
Gut
Lie between the circular and longitudinal muscle layers and within the inner dense circular muscle layer and generate ECAs
Interstitial cells of Cajal
ECAs are communicated to the muscle cells via
Gap Junctions
Caused by fluctuations in ion conductance in the plasma membrane
ECA’s
The rising phase of the ECA is due to influx of Ca2+ or
Ca2+ and Na+ voltage-gated channels
Is the balance of Ca2+ and Na+ influx with K+ efflux via Ca2+ activated K+ channels
The ECA plateau phase
Is closure of Ca2+ and Na+ channels and continued K+ efflux via Ca2+ activated and delayed K+ channels
Falling phase of ECA
The frequency is regulated by pacemaker areas located along the track. What is the frequency of
- ) Gastric ECA
- ) Small intestinal ECA?
- ) 3/min
2. ) 8-12/min proximal to distal
An ECA with spike potentials on the plateau. These occur when depolarization is sufficient to activate the appropriate voltage-dependent Ca2+ channels
Electrical Response Activity (ERA) or spike potential
Elicit muscle contraction by allowing more Ca2+ to enter the smooth muscle cells.
ERAs
Have a 1:1 relationship with contractions
ERAs
May modulate, but not initiate ECAs
Neuroendocrine agents
Such input may change (increase or decrease) the number of ERAs by altering
Ion channel activity
CAN induce ERAs
-leads to longer, stronger contractions
Excitatory neurotransmitters such as ACh and gastrin
The inhibitory neuroendocrines (e.g., norepinephrine, VIP, nitric oxide and epinephrine) can
Reduce ERAs
In summary, ECA frequency determines the
Maximum rate of contraction
Whereas ERAs initiate
Contraction
Excitatory mediators increase the number and strength of contractions by increasing the number of
ECAs
In the stomach and intestine, is a wave of 1) contraction of the longitudinal muscle and relaxation of the circular muscle aboral to a site, and 2) relaxation of the longitudinal muscle and contraction of the circular muscle oral to, and at, the site
Peristalsis
These motor activities involve the enteric nervous system and GI peptides `setting the stage’, and ECAs inducing
Contractions
Muscle contraction and relaxation are coordinated by
Interneurons
Dependent on where and how strongly muscles are contracting and relaxing
Rate of movement of luminal contents
There is an increase in the amount (but not the strength) of muscle contraction in the stomach and small intestine during the
Digestive period (compared to interdigestive period)
However, movement of chyme from the stomach through the small intestine by segmentation during the digestive period is
Slower
What is the average resident (or transit) time in the stomach?
2-4 hrs
What is the average transit time in the small intestines?
2-4 hour transit time
What is the minimum transit time in the large intestines?
Minumum 12-18hr. (average is 42-52 hrs)
Causes a reduction of enteric inhibitory neuron activity that results in a generalized increase in the tone of GI muscles, particularly sphincters
-Increases transit time
Morphine
Can actually reduce diarrhea or abnormally rapid transit time
Morphine