Gastrointestinal Tract Flashcards
What are the 6 major functions of the gastrointestinal tract?
- Ingestion of food
- Secretion of fluids and digestive enzymes
- Mixing and movement of food and wastes through the body
- Digestion of food into smaller pieces
- Absorption of nutrients
- Excretion of wastes
Describe the gross structure of the GI tract in carnivores.
Stomach > small intestine > large intestine
Describe the gross structure of the GI tract in ruminants.
Fore stomachs, where fermentation occurs > stomach/abomasum > small intestine > large intestine
Describe the gross structure of the GI tract in simple-stomached herbivores.
Stomach > small intestine > large intestine, where fermentation occurs
What 3 adaptations of the GI tract allow for increased surface area?
- Folding of mucosa
- Villi
- Microvilli
Describe the bloods supply to the GI tract.
Coeliac artery supplies hepatic artery to the liver and the splenic artery to the stomach, spleen and pancreas.
Cranial mesenteric artery supplies small intestine.
Caudal mesenteric artery supplies the large intestine.
Describe the venous drainage of the GI tract.
Hepatic portal vein drains the stomach, spleen, pancreas, small intestine and large intestine to the liver.
Hepatic vein drains the liver to the caudal vena cava.
Describe the motor activity and regulation of the GI tract.
- Contractile tissue is smooth muscle
- Contraction has region specific patterns in motility, which relates to functions, such as mixing and propulsion.
- Motility regulated and coordinated by the enteric nervous system, hormones and the autonomic nervous system.
- Valves called sphincters are under control of enteric nervous system, with eth exception of the external anal sphincter, which is under somatic nervous control.
What is the function and motility at the ileocaecal sphincter?
Controls movement in one direction from the small to the large intestine.
- Distending ileum relaxes sphincter to aid movement into the colon
- Distending colon contracts sphincter to prevent retrograde movement from colon to ileum.
What is the cephalic phase of gastric secretion from the stomach?
Autonomic via the vagus nerve.
- Sight, smell, taste, chewing of food sends signals to the brain.
- Nerve impulses sent down vagal nerve.
- Impulses act on chief cells to release pepsinogen and parietal cells to release HCl.
- Impulses also act on endothelium of the stomach to release gastrin, which is released to the blood and acts on parietal cells to release HCl.
- The nerve pulses cause acetylcholine to stimulate chief cells to secrete pepsinogen.
What is the gastric phase of gastric secretion from the stomach?
Involves stretch receptors causing direct stimulation of gastrin release and stimulates reflexes.
- Food stimulates gastric phase.
- Sensory cells in stomach release short and long reflexes.
- Chief cells stimulated to release pepsinogen and parietal cells stimulated to release HCl.
- Sensory cells in stomach release short and long reflexes and products of digestion stimulate gastrin-producing cells to release gastrin.
- Gastrin in the blood stimulates parietal cells to release HCl.
How is parietal cell secretion controlled?
Stimulation (all 3 receptors necessary):
- Acetylcholine – vagus nerve stimulation
- Gastrin – G cells stimulated by vagus nerve and mechanical stimulation
- Histamine – ECL cells stimulated by gastrin
Inhibition:
- Somatostatin receptors inhibit adenylyl cyclase, opposite effect to histamine
- Low pH inhibits release of gastrin
- Histamine receptor type 2 blockade (Zantac)
- Proton pump inhibitors
Which 2 things allow for epithelial protection?
Mucus layer from glycoproteins, which are resistant to enzymes and also secrete bicarbonate into the gel layer of cells formed.
Exchange of bicarbonate and chloride ions with epithelium close to pH7. Bicarbonate comes from plasma. Parietal cells secrete protons causing a surge of alkaline blood after a meal and secreted by gut mucosa and pancreas.
What stimuli are sent to the vomiting centre of the medulla oblongata?
- Psychological factors via the cerebral cortex
- Opiates, anaesthetics, ipecac, urea via the chemical trigger zone
- Bacterial, viral toxins/distention via the vagus nerve
- Motion or infection via the vestibular apparatus
Describe the process of vomiting.
- Distension or irritation of the duodenum, pain or tickling at the back of the throat causes small intestinal antiperistalsis.
- Mechanoreceptors in the throat, stomach and duodenum and chemoreceptors in the stomach and duodenum send signal to the vomiting centre. Labyrinthine receptors stimulated from pregnancy hormones, chemical trigger zones and general anaesthetics also send signals to the vomiting centre in the medulla oblongata.
- Postural adaptation
- Salivation stimulated
- Respiratory inhibitory muscles inhibited to decrease intrathoracic pressure
- Glottis closes and larynx raised
- Soft palate lifted
- Diaphragm and abdominal muscles contract to increase intra-abdominal pressure
- Intragastric pressure raised against constricted/closed lower oesophageal sphincter, causing retching
- LOS relaxes and the gastric contents are expelled in vomiting.
What are some normal physiological causes of vomiting?
- Normal voiding of indigestible items from stomach
- Over-distention of the stomach (mainly dogs)
What are some chemical causes of vomiting?
Chemical – iatrogenic or intoxication is pathogen derived
- Commonly used drugs, such as opioids
- Enteric pathogens
- Bacterial or viral toxins
What are some pathological causes of vomiting?
- Inflammation or ulceration of stomach
- Elevated blood urea or ammonia in liver or kidney origin
- Infections of GI tract
- Blockade of small or large bowel
What could be implicated if vomiting is chronic?
- Significant loss of fluid = dehydration and CVS impairment
- Loss of acid = metabolic alkalosis
- Avoidance of foods consumed prior to vomiting = ‘train’ avoidance (emetics to food)
- Pancreatitis - from reflux of gut contents into pancreatic ducts, diagnosed by pancreatic enzymes in blood
What are the species differences in vomiting?
Rodents, horses, rabbits (and possibly foxes) do not vomit.
Horses partly anatomical
Rodents partly neuroanatomical - mutations has broken the chain linking stimuli to the mechanics of emesis.
How is the GI tract coordinated and controlled?
- Salivary glands are almost entirely controlled by parasympathetic nervous system
- Stomach is evenly controlled by neural, hormonal and local (physical/stretch and chemical, such as histamine) control
- The pancreas is largely hormonal control but also parasympathetic control
- Small intestine and most of the large intestinal are largely due to local stimulation with some parasympathetic stimulation
- The last part of the large intestine is largely parasympathetic stimulation with a small amount of local control
Describe neural coordination of the GI tract.
- Stimuli from GI tract lumen stimulate sensory cells.
- Signals to nerve plexuses to smooth muscle and glands or signals to the CNS.
- CNS also sends signals to nerve plexuses going tp smooth muscle and glands, and signals to salivary glands, pancreas and liver.
Which stimuli can trigger a response in GI tract epithelia?
Presence of peptides Products of digestion Osmolarity pH Presence of irritants
Describe enteric control of the GI tract.
- Sensory neurone is stimulated and a signal travels to motor fibres via an interneurone.
- Signals sent to gland cells and smooth muscle cells.
- Motor fibres send signals to preganglionic parasympathetic nerve fibres to the CNS.
- Signals from the CNS sent down pre and post-ganglionic sympathetic nerve fibres, acting on arterioles supplying the wall of the GI tract.
Describe the organisation of the enteric nervous system.
Myenteric plexus:
- Between muscle layers
- Regulates muscular activity
- Major transmitters of acetylcholine, nitrogen oxide and VIP
- 1/3 of neurones are sensory
Submucosal plexus:
- At submucosa circular boundary
- Regulates mucosal glands – secretion
- Major transmitters of acetylcholine and VIP
- Some sensory neurones
What are short and long reflexes in the enteric nervous system?
Short: signals from the stomach to the small bowel.
Long: signals from the stomach goes to the CNS and are sent to the large bowel via parasympathetic and sympathetic nerve fibres.
Name and describe 4 types of non-transmitter chemical messengers of GI tract control.
- Endocrine – secreted and enters the bloodstream in order to reach its target
- Paracrine – secreted into the extracellular fluid and diffuses a short distance to act on a different size of a cell
- Autocrine – secreted into the extracellular fluid and diffuses a short distance to act on the same type of cell that released it
- Neurocrine – released by a neurone to act on a different type of cell
Where is gastrin produced, its stimuli and effects?
Distal part of the stomach.
Peptides in the stomach and gastrin releasing peptide produced by the vagus nerve.
Stimulation (with ACh and histamine) of HCl production and supports growth of mucosa.
Where is secretin produced, its stimuli and effects?
Mainly duodenum
Low pH in the small bowel
Stimulates production of bicarbonate by the pancreas and Brunner’s glands.
Where is CCK produced, its stimuli and its effects?
Mainly duodenum
Fatty acids, monoglycerides and amino acids in the small bowel.
Stimulates enzyme production in the pancreas and gall bladder contraction.
Where is GIP produced, its stimuli and effects?
Proximal small bowel
Fat, glucose and amino acids in the small bowel.
Reduces HCl production and stomach emptying
(stimulates insulin release).