Gastrointestinal System Flashcards
What is the primary function of the digestive system?
To break down food into smaller molecules that can be absorbed and used by the body.
What are the main components of the digestive system?
The mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus, as well as accessory organs such as the liver, pancreas, and gallbladder.
What is peristalsis?
Coordinated muscle contractions that propel food through the digestive tract.
What are sphincters and what is their role?
Muscular rings that control the flow of food between different sections of the digestive tract.
What are the four main layers of the GI tract wall?
Mucosa, Submucosa, Muscularis externa, Serosa
What is the function of the omentum?
A double layer of peritoneum that connects the stomach to other abdominal organs, providing support and protection.
What is the role of the enteric nervous system (ENS)?
To control the movement and function of the digestive system, often referred to as the “second brain” of the gut.
What are the two main branches of the autonomic nervous system that regulate digestion?
The sympathetic and parasympathetic nervous systems.
How does the sympathetic nervous system affect digestion?
It generally inhibits digestive processes, diverting blood flow away from the digestive system during times of stress or danger (“fight-or-flight” response).
How does the parasympathetic nervous system affect digestion?
It stimulates digestive processes, promoting digestion and absorption of nutrients (“rest-and-digest” response).
What are the two main plexuses of the ENS?
The myenteric (Auerbach’s) plexus and the submucosal (Meissner’s) plexus.
What is the function of the myenteric plexus?
Primarily controls the motility of the GI tract.
What is the function of the submucosal plexus?
Primarily regulates secretions and blood flow in the GI tract.
Name some major neurotransmitters involved in the ENS.
Acetylcholine, dopamine, serotonin (5-HT), norepinephrine, vasoactive intestinal peptide (VIP), and nitric oxide.
What is the role of commensal bacteria in the gut?
They aid in digestion, nutrient absorption, and protection against harmful bacteria.
What is the approximate volume of fluid processed by the GI tract daily?
Approximately 8.5 liters.
What is the net driving force for water movement in the GI tract?
Pnet = ΔP – Δπ (where ΔP represents the hydrostatic pressure difference and Δπ represents the osmotic pressure difference).
Appendix is thought to be leftover from the __________.
cecum
What is the primary force driving water movement across epithelia in the GI tract?
The osmotic pressure difference (Δπ).
How is water movement regulated in the GI tract?
Primarily by regulating the movement of solutes.
What is the role of cholecystokinin (CCK)?
A hormone that stimulates the release of digestive enzymes from the pancreas and bile from the gallbladder.
What is the role of Gastric Inhibitory Peptide (GIP)?
A hormone that inhibits gastric acid secretion and stimulates insulin release.
True or False: Bacterial cells in a human outnumber human cells in said human.
True
What are the general functions of the upper GI tract?
Ingestion, initial digestion, and propulsion of food.
What are the general functions of the small intestine?
Primary site of nutrient absorption
What are the general functions of the large intestine?
Absorption of water and electrolytes, formation and storage of feces.
Where is the pyloric sphincter located and what is its function?
Located between the stomach and the small intestine, controlling the flow of chyme from the stomach into the duodenum.
Where is the ileocecal valve located and what is its function?
Located between the small intestine and the large intestine, preventing backflow of fecal material into the small intestine.
What are some potential diseases of the GI tract?
Gastroesophageal reflux disease (GERD), peptic ulcer disease, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and colorectal cancer.
What are some potential therapeutic approaches for GI disorders?
Lifestyle modifications, medications (e.g., antacids, proton pump inhibitors, antidiarrheals), and surgery.
What does cholera toxin activate?
CFTR
A majority of ________ (type of neurotransmitter) is used in the gastrointestinal system.
serotonin
What is the role of the central timing network (CTN) in chewing?
The CTN in the pontine & medullary brain stem is responsible for the rhythmic pattern of chewing.
How is chewing regulated?
Chewing is regulated by sensory feedback from the mouth and jaw muscles, which modulates the activity of the CTN.
What is the approximate daily volume of saliva production?
Saliva production is approximately 1.5 L per day.
List the accessory organs involved in upper GI processes.
Salivary glands are the accessory organs in the upper GI tract.
Name the three major salivary glands.
The three major salivary glands are the parotid, submandibular, and sublingual glands.
What are the primary constituents of saliva?
Saliva consists of water, electrolytes, enzymes like amylase, and mucus.
Blockage of the parotid salivary ducts can cause _________, which is a common ailment in the elderly.
swelling
What is the basic chemical formula of starch?
The basic chemical formula of starch is (C6H10O5)n.
What is the function of salivary amylase?
Salivary amylase initiates the digestion of starch, breaking it down into smaller sugar molecules.
What are the key functions of saliva?
Saliva lubricates food for swallowing, dissolves food for taste, initiates starch digestion, and helps maintain oral hygiene by neutralizing acids and washing away food debris.
What is the first enzyme encountered in the GI system?
Amylase (technically any in the saliva, but he emphasized this one)
What is Sjogren’s syndrome?
Sjogren’s syndrome is an autoimmune disorder characterized by chronic inflammation of the salivary and lacrimal glands, leading to dry mouth and eyes.
The submandibular gland contributes ____% of total saliva.
71%
Describe the osmolarity of saliva as it is initially secreted from the acini.
Saliva is initially secreted as an isosmotic fluid from the salivary acini.
Which receptors mediate the parasympathetic regulation of salivary secretion?
M1 and M3 muscarinic receptors on acinar cells mediate parasympathetic regulation of salivary secretion.
True or False: In humans, lingual lipase is a relatively minor portion of digestion.
True (it’s fine if you don’t have it)
What is the role of Ca2+ signaling in the regulation of salivary fluid secretion?
Increased intracellular Ca2+ levels activate ion channels and transporters, driving the secretion of electrolytes and water into the acinar lumen.
Which ion channel plays a primary role in saliva secretion?
CaCC (TMEM1) is the primary ion channel driving salivary secretion.
What is the role of the salivary ducts in modifying the composition of saliva?
Salivary ducts reabsorb Na+ and Cl- while secreting K+ and HCO3-, resulting in hypotonic saliva.
Saliva that leaves the salivary glands is _______osmotic (hyper/hypo) to plasma.
hypo
Which transporter is involved in bicarbonate secretion in salivary ducts?
The SLC26s transporter family is involved in bicarbonate secretion in salivary ducts.
How does the sympathetic nervous system regulate salivary secretion?
Sympathetic stimulation, acting via β1-adrenergic receptors, primarily increases amylase secretion and also causes vasoconstriction.
What is an example of an experiment that demonstrates the cephalic phase?
Pavlov’s dog (salivation)
What is the medical term for excessive drooling during sleep?
Sialorrhea is the medical term for excessive drooling during sleep.
Explain why drooling can occur during sleep.
Drooling during sleep can occur due to reduced swallowing frequency while saliva production continues at a baseline rate.
What is the primary function of the esophagus?
The esophagus transports food from the pharynx to the stomach.
What is a hiatal hernia?
A hiatal hernia occurs when the upper part of the stomach protrudes through the diaphragm into the chest cavity.
What is the role of the nucleus tractus solitarius (NTS) in swallowing?
The NTS in the brainstem receives sensory input from the pharynx and esophagus, coordinating the swallowing reflex.
Why have saliva produced also in the sympathetic response?
To fight physically (via biting, evolutionarily) and to fight off infection
Describe the two main vagal efferent pathways involved in esophageal motility.
The vagus nerve has two pathways: an excitatory pathway using acetylcholine and an inhibitory pathway using nitric oxide.
What is the function of the lower esophageal sphincter (LES)?
The LES prevents the reflux of stomach contents into the esophagus
What is transient LES relaxation (TLESR)?
TLESR is a brief relaxation of the LES that can allow for the expulsion of gas from the stomach but may also contribute to acid reflux.
True or False: More saliva is produced during sleep.
False, less is produced (you also swallow less, hence drooling can occur)
How is the LES regulated?
The LES is regulated by a balance of excitatory and inhibitory neural inputs, as well as hormonal and myogenic factors.
Which neurotransmitter is involved in the inhibitory pathway of esophageal peristalsis?
Nitric oxide is the primary inhibitory neurotransmitter in esophageal peristalsis.
What happens to the distribution of excitatory and inhibitory innervation along the length of the esophagus?
Excitatory innervation decreases distally, while inhibitory innervation increases distally in the esophagus.
How does the changing distribution of innervation contribute to peristalsis?
The gradient of innervation ensures that contraction occurs sequentially along the esophagus, propelling food toward the stomach.
What is the role of the dorsal motor nucleus in esophageal peristalsis?
The dorsal motor nucleus of the vagus nerve contains preganglionic neurons that control both excitatory and inhibitory pathways involved in esophageal peristalsis.
What is the purpose of stratified squamous epithelial cells in the esophagus?
Protection (similar to skin, can lose top layer due to abrasion and still have layers)
In the DMN, the _________ is an excitatory pathway while the _________ is an inhibitory pathway.
rostral, caudal
What is the primary function of the stomach?
The stomach stores food, mixes it with gastric secretions, and begins the process of protein digestion.
What are the key regions of the stomach?
The stomach is divided into the fundus, body, antrum, and pylorus.
What are rugae?
Rugae are folds in the stomach lining that allow for expansion as the stomach fills with food.
What are the major cell types found in the gastric glands?
The gastric glands contain mucous cells, parietal cells, chief cells, and enteroendocrine cells.
What is the role of surface mucus cells?
Surface mucus cells secrete mucus and bicarbonate, which protect the stomach lining from the acidic environment.
What is the primary function of parietal cells?
Parietal cells secrete hydrochloric acid (HCl) and intrinsic factor.
Describe the process of HCl production in parietal cells.
Parietal cells use carbonic anhydrase to convert carbon dioxide and water into carbonic acid, which then dissociates into H+ and HCO3-. H+ ions are actively pumped into the stomach lumen by the H+/K+ ATPase pump, while HCO3- is exchanged for Cl- across the basolateral membrane. Cl- then enters the lumen through Cl- channels, combining with H+ to form HCl.
What is the role of intrinsic factor?
Intrinsic factor is necessary for the absorption of vitamin B12 in the small intestine.
What are the three phases of HCl secretion regulation?
The three phases are the cephalic phase, gastric phase, and intestinal phase.
Describe the cephalic phase of HCl secretion.
The cephalic phase is triggered by the sight, smell, taste, or thought of food, and is mediated by vagal nerve stimulation, which releases acetylcholine (ACh) and gastrin-releasing peptide (GRP). ACh stimulates parietal cells directly, while GRP stimulates gastrin release from G cells. Gastrin further enhances HCl secretion.
Describe the gastric phase of HCl secretion.
The gastric phase is initiated by the presence of food in the stomach, leading to distension and the release of gastrin and histamine.
Describe the intestinal phase of HCl secretion.
The intestinal phase begins when chyme enters the small intestine. Initially, it stimulates HCl secretion, but as digestion progresses, it inhibits HCl secretion through the release of hormones like secretin and gastric inhibitory peptide (GIP)
How is parietal cell HCl production inhibited?
HCl production is inhibited by negative feedback mechanisms involving somatostatin and prostaglandins. Low pH in the stomach stimulates somatostatin release, which inhibits gastrin release. Prostaglandins also inhibit acid secretion and stimulate mucus and bicarbonate production.
What is the role of chief cells?
Chief cells secrete pepsinogen, the inactive precursor to the enzyme pepsin.
How is pepsinogen activated?
Pepsinogen is activated to pepsin by the low pH in the stomach lumen. Pepsin then autocatalytically activates more pepsinogen.
What is the function of pepsin?
Pepsin is a proteolytic enzyme that initiates protein digestion in the stomach.
What is gastric accommodation?
Gastric accommodation refers to the relaxation of the stomach fundus in response to food intake, allowing the stomach to expand without significant increases in intragastric pressure. This process is mediated by vagal reflexes and the release of nitric oxide.
How does the stomach mix food with gastric juices?
The stomach mixes food with gastric juices through peristaltic contractions that originate in the pacemaker region of the stomach. These contractions propel food towards the pylorus, where it is mixed with gastric secretions and gradually emptied into the duodenum.
What factors influence the rate of gastric emptying?
The rate of gastric emptying is influenced by factors such as the volume and composition of the chyme, as well as hormonal and neural signals from the duodenum.
What is the role of the pyloric sphincter?
The pyloric sphincter regulates the flow of chyme from the stomach into the duodenum.
Describe the process of the vomiting reflex.
The vomiting reflex is a complex process coordinated by the vomiting center in the medulla oblongata. It is triggered by various stimuli, including toxins, motion sickness, and distension of the stomach or duodenum. The reflex involves a sequence of events, including nausea, retching, and forceful expulsion of stomach contents through the mouth.
What is an anastomosis?
An anastomosis is a surgical connection created between two tubular structures, such as blood vessels or loops of intestine. In the context of the GI tract, an anastomosis may be created after surgical removal of a portion of the intestine.
What are enteroendocrine cells?
Enteroendocrine cells are specialized cells in the gastric mucosa that release hormones, including gastrin, histamine, and somatostatin, which regulate various aspects of gastric function.
What is the role of histamine in gastric acid secretion?
Histamine, released from enterochromaffin-like (ECL) cells, acts as a potent stimulator of parietal cell HCl secretion.
What is the effect of NSAIDs on parietal cell function?
Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit prostaglandin synthesis, which can reduce mucus and bicarbonate production, potentially increasing the risk of gastric ulcers.
What is the role of somatostatin in regulating gastric function?
Somatostatin, released from D cells in the stomach, acts as a general inhibitor of gastric function, suppressing HCl secretion, gastrin release, and pepsinogen secretion.
What is Zollinger-Ellison syndrome?
Zollinger-Ellison syndrome is a rare condition characterized by gastrin-secreting tumors, leading to excessive HCl production and severe peptic ulcers.
What are some common therapeutic approaches to managing gastric acid-related disorders?
Therapeutic approaches include lifestyle modifications, antacids, H2 receptor blockers, proton pump inhibitors, and in some cases, surgery.
What is gastroparesis?
Gastroparesis is a condition characterized by delayed gastric emptying, often due to nerve damage or other factors that disrupt normal stomach muscle function.
What are some potential complications of chronic vomiting?
Chronic vomiting can lead to dehydration, electrolyte imbalances, malnutrition, and esophageal damage.
The two parts of the omentum are known as the _______ omentum and the _________ omentum.
lesser, greater
Name the types of bacteria found in the stomach.
Lactobacillus, Candida, Streptococcus, Helicobacter pylori, Peptostreptococcus
Approximately how many bacteria live in the stomach?
0-100 (1E2)
Name the types of bacteria found in the colon.
Bacteroides, Bifidobacterium, Clostridium coccoides, Clostridium leptum/Fusobacterium
Approximately how much bacteria live in the colon?
10E11
What are the four major functions of the digestive system (broad summary)?
Digestion, Absorption, Secretion, Motility
What are the two types of muscle (shape) that are found throughout the GI system?
Circular, longitudinal
_________ muscle exists between the Myenteric plexus and the Submucosal plexus.
Circular
What class of macromolecules are gastrin, CCK, secretin, and GIP?
Peptides
Where is gastrin produced?
Antrum of stomach
Where is CCK produced?
Small intestine
Where is secretin produced?
Small intestine
Where is GIP produced?
Small intestine
What are the factors that inhibit gastrin release in the stomach?
Acid in the stomach; somatostatin
Gastrin ________(inhibits/stimulates) acid secretion in the stomach.
stimulates
CCK _________(inhibits/stimulates) acid secretion in the stomach.
inhibits
Secretin __________(inhibits/stimulates) acid secretion in the stomach.
inhibits
Secretin __________(inhibits/stimulates) motility in the stomach.
inhibits
CCK __________(inhibits/stimulates) motility in the stomach.
inhibits
Gastrin __________(inhibits/stimulates) motility in the stomach.
inhibits
Gastrin __________(inhibits/stimulates) motility in the small intestine.
stimulates (ileum)
Gastrin __________(inhibits/stimulates) mass movement in the large intestine.
stimulates
CCK __________(inhibits/stimulates) enzyme secretion in the pancreas.
stimulates
CCK _________(inhibits/stimulates) contraction of the gallbladder.
stimulates
CCK _________(constricts/relaxes) the Sphincter of Oddi.
relaxes
GIP ___________(inhibits/stimulates) insulin secretion in the pancreas.
stimulates
Secretin ___________(inhibits/stimulates) bicarbonate secretion in the pancreas.
stimulates
Secretin ___________(inhibits/stimulates) bicarbonate secretion in the liver.
stimulates
In regards to bicarbonate secretion in the pancreas, CCK potentiates ________’s actions.
secretin
In regards to bicarbonate secretion in the liver, CCK potentiates _________’s actions.
secretin
In regards to enzyme secretion in the pancreas, secretin potentiates _______’s actions.
CCK
Cholecystokinin (CCK) _______(increases/decreases) enzyme secretion in the pancreas and ________(increases/decreases) contraction in the gallbladder.
increases, increases
Gastric Inhibitory Peptide (GIP) _________(increases/decreases) fluid absorption when acting in an exocrine manner, and ________(increases/decreases) insulin release when acting in an endocrine manner.
decreases, increases
Gastrin-releasing peptide ________(increases/decreases) gastrin release.
increases
Guanylin ________(increases/decreases) fluid absorption.
increases
Motilin ________(increases/decreases) smooth muscle contraction.
increases
Peptide YY _________(increases/decreases) vagally-mediated acid secretion, and _________(increases/decreases) enzyme and fluid secretion.
decreases, decreases
Substance P acts as a __________.
neurotransmitter
Secretin _________(increases/decreases) fluid secretion by pancreatic ducts, __________(increases/decreases) gastric acid secretion, and ________(increases/decreases) gastrin release.
increases, decreases, decreases
Somatostatin __________(increases/decreases) fluid absorption, _________(increases/decreases) fluid secretion, _________(increases/decreases) smooth muscle contraction, _________(increases/decreases) endocrine and exocrine secretions, and _________(increases/decreases) bile flow.
increases, decreases, increases, decreases, decreases
VIP __________(increases/decreases) smooth muscle relaxation, __________(increases/decreases) secretion by the small intestine, and ________(increases/decreases) secretion by the pancreas.
increases, increases, increases
What does neurotensin do?
Vasoactive stimulation of histamine release
What are the stimuli for release of gastrin?
Amino acids, peptides in stomach; parasympathetic nerves
What are the stimuli for release of CCK?
Amino acids, fatty acids in small intestine
What are the stimuli for release of secretin?
Acid in small intestine
What are the stimuli for release of GIP?
Glucose, fat in the small intestine
What percentage of blood flow to the liver comes from the portal vein?
Approximately 72%
Which major blood vessels supply the liver?
The portal vein and the hepatic artery
What are the three main functions of the liver?
Metabolic regulation, detoxification, and protein synthesis
What is the structural and functional unit of the liver?
The hepatic lobule
What does Metabolic Regulation mean (in regards to the liver)?
Processing nutrients, producing bile, and storing vitamins and minerals.
What does Detoxification mean (in regards to the liver)?
Filtering toxins from the blood
What does Protein Synthesis mean (in regards to the liver)?
Producing proteins essential for blood clotting and other bodily functions.
Describe the flow of blood through a hepatic lobule.
Blood flows from the portal vein and hepatic artery through sinusoids to the central vein.
What are the major cell types found in a hepatic lobule?
Hepatocytes, Kupffer cells, and endothelial cells
What is the primary function of hepatocytes?
Hepatocytes are the metabolic “factories” of the liver, responsible for most of the liver’s functions.
What is the function of Kupffer cells?
Kupffer cells are macrophages that engulf and destroy bacteria, cellular debris, and other foreign substances in the liver.
What is unique about the endothelial cells lining the hepatic sinusoids?
They are fenestrated, meaning they have pores that allow for easy exchange of substances between the blood and hepatocytes.
What is bile?
A yellow-green fluid produced by the liver that aids in the digestion and absorption of fats.
What are the main components of bile?
Bile salts, cholesterol, bilirubin, and water