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CBL Year 1 > Gastrointestinal tract > Flashcards

Gastrointestinal tract Flashcards

1
Q

How many portions of fruit or veg should you eat a day

A

5

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2
Q

Whats happening in energy intake (EI)

A

fat
alcohol
carbohydrate
protein

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3
Q

what is happening in energy expenditure (EE)

A

basal metabolic rate (BMR)
Thermogenesis
Physical activity

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4
Q

What BMI is classed as underweight

A

<18.5 kg/m^2

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5
Q

What BMI is classed as normal

A

18.5-24.9 kg/m^2

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6
Q

What BMI is classed as overweight

A

25-29.9 kg/m^2

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7
Q

What BMI is classed as obese

A

30-39.9 kg/m^2

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8
Q

What BMI is classed as morbidly obese

A

> 40 kg/m^2

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9
Q

What are some obesity contributors

A 
endocrine disorders
psychological
cultural
psychiatric disorders
environmental disorder
environmental factors
genetics
medications
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10
Q

What are some generic obesity treatment options

A

lifestyle changes
pharmacotherapy
bariatric surgery

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11
Q

What are things to do with lifestyle changes for managing weight

A

reduced energy diet

increased physical activity

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12
Q

What things does pharmacotherapy do

A

appetite suppressants

Fat absorption inhibitors

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13
Q

What things does bariatric surgery do

A

gastric band
gastric bypass
sleeve gastrectomy

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14
Q

Symptoms of malnutrition

A 
loss of appetite 
weight loss (unintentional 5-10% of bodyweight in 3-6 months)
tiredness
reduced ability to perform normal tasks
reduced physical performance
altered mood
poor concentration
poor growth in children
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15
Q

Define digestion

A

processes by which foodstuffs are degraded to produce smaller molecules that can be absorbed

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16
Q

Define absorption

A

processes by which nutrient molecules are absorbed by cells that line the GI tract and enter the bloodstream

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17
Q

Define protection

A

the processes by which lining of the GI tract is protected from damage during digestion of foodstuffs

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18
Q

Layers that make up the GI tract (from middle to outward (abdomen))

A 
mucosa
epithelium
lamina propia
muscular mucosae
submucosa
muscular externa 
serosa
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19
Q

What is GALT

A

gut associated lymphoid tissue

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20
Q

What are lymph nodes or GALT important in

A

recognising foodstuffs and protecting against infection

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21
Q

Where are glands in submucosa located

A

at the bottom of the oesophagus and bottom of the small intestine (duodenum)

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22
Q

What are the submucosa glands in the duodenum known as

A

brunners gland

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23
Q

What is the myenteric plexus also known as and where is it located

A

Auerbach’s plexus

located in submucosa throughout the GI tract

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24
Q

What is the submucosal plexus also known as and where is it located

A

meissners plexus

found in small and large intestine

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25
Q

What are the 5 major sites of GI secretions

A 
salivary glands
gastric glands
exocrine pancreas
liver-biliary system
small intestine
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26
Q

Total amount of GI secretions a day

A

6-7L a day

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27
Q

What do GI secretions contain

A

enzymes, ions, water, and mucus

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28
Q

Function of GI secretions

A

breakdown large compounds, regulate pH, dilute and protect

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29
Q

What does endocrine do

A

release of a transmitter into blood for delivery to distant target cell

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30
Q

What does paracrine do

A

release of a transmitter from a sensor cell to affect adjacent target cells without entering the blood or activating neurones

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31
Q

What does neuronal refer to

A

electrical signalling via neurons

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32
Q

What cells produce gastrin and where are they located

A

G cells located in the stomach

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33
Q

What cells produce cholecystokinin (CCK) and where are they located

A

I cells located in the small intestine

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34
Q

What cells produce secretin and where are they located

A

S cells located in the small intestine

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35
Q

What cells produce glucose-dependent insulinotropic peptide (GIP) and where are they located

A

K cells located in the small intestine

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36
Q

What cells produce somatostatin and where are they located

A

D cells located in the stomach, pancreatic islets and small intestine

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37
Q

Three phases of GI control

A

cephalic
gastric
intestinal

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38
Q

What is the cephalic phase

A

sight, smell, taste and chewing

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39
Q

What is the gastric phase

A

distention and acidity

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40
Q

What is the intestinal phase

A

distention, acidity and osmolarity

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41
Q

Three functions of motor activity

A

non propulsive movements (segmentation)
peristaltic movements
reservoir function

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42
Q

What are the two types of muscle contraction and how long do they typically last

A

phasic (seconds)

tonic (minutes-hours)

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43
Q

What are sphincters

A

specialised circular muscles that separate two adjacent compartments of the GI tract

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44
Q

What does antegrade mean

A

regulate forwards

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45
Q

what does retrograde movement mean

A

reverse movement

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46
Q

Location of sphincters

A 
upper oesophageal sphincter (UES)
lower oesophageal sphincter (LES)
pyloric sphincter
iliocecal sphincter
internal and external anal sphincter
sphincter of odd
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47
Q

What happens in the swallowing reflex

A

food goes to touch receptors (back of tongue) which goes to the medulla and lower pons
This stimulates the vagus nerve to the oesophagus and cranial nerves to the pharynx and upper oesophagus

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48
Q

3 Phases of swallowing

A

oral phase (voluntary phase)
pharyngeal phase
oesophageal phase

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49
Q

What is the oral phase of swallowing

A

tongue presses food against hard palate

bolus is forced into the pharynx and stimulates touch receptors

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50
Q

What happens in the pharyngeal phase of swallowing

A

soft palate elevates
epiglottis closes trachea
upper oesophageal sphincter relaxes

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51
Q

What happens in the oesophageal phase of swallowing

A

upper oesophageal sphincter closes

peristalsis starts

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52
Q

What is peristalsis

A

the sequential contraction of ring of muscle

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53
Q

What happens during vomiting

A

forced inspiration occurs against a closed epiglottis
diaphragm is lowered
decreases intrathoracic pressure
as a consequence intraabdominal pressure increases
reflex relates the upper oesophageal sphincter

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54
Q

Describe peristalsis in the stomach

A

contractions begin in the corpus and travel towards the pylorus (propulsion)
they increase in force and velocity as they approach the gastroduodenal junction
mixing (grinding) occurs mainly in the antrum
retropulsion is very effective at mixing and breaking down gastric content

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55
Q

Non-propulsive movements motility in the small intestine

A

most frequent type of movements in the small intestine
caused by rhythmic contraction and relaxation of the muscular externa
effectively mixes chyme and brings digested nutrients into contact with the mucosal surface

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56
Q

Peristalsis in the small intestine

A

occurs at low frequency
caused by contraction of successive sections of muscularis externa
propels chyme for a short distance, allowing time for digestion and absorption

57
Q

Functions of colonic contractions in the large intestine

A

mixing the chyme, to improve the absorption of water and salts from the colon
kneading the semisolid contents
moving the contents towards the anus (5-10cm an hour)(termed segmentation)

58
Q

mass peristalsis in the large intestine

A

specialised type of movement

1-3 times a day, move the colonic contents towards the anus

59
Q

What happens in defaecation

A

distention of rectum
relaxation of internal and external anal sphincter
contraction of abdominal wall muscles and relaxation of pelvic wall muscles
flexure of hips and descent of pelvic floor

60
Q

Four functions of liver and gallbladder

A

metabolism
synthetic function
biliary system
storage

61
Q

What does the liver store

A

glycogen

62
Q

Another word for aminotransferases

A

transaminases

63
Q

What is ALT

A

alanine aminotransferase

64
Q

What does raised levels of ALT suggest

A

sign of hepatocellular damage

65
Q

Where should aminotransferases be

A

in hepatocytes not bloodstream

66
Q

What is the synthetic function of the liver

A

albumin
clotting factors
acute phase proteins - CRP (C-reactive protein)

67
Q

What percentage does albumin make up of plasma proteins

A

50%

68
Q

Reference range of albumin

A

35-45g/L

69
Q

What is albumin a main factor in

A

maintaining oncotic pressure

70
Q

Causes of hypoalbuminaemia

A

liver disease
nephrotic syndrome
malnutrition
burns

71
Q

What does low albumin cause

A

peripheral oedema

72
Q

What is cholestasis

A

malabsorption of vitamin K

73
Q

What are bile acids synthesised from

A

cholesterol

74
Q

Salivary secretion from parotid gland

A

serous (watery) secretion rich in ⍺-amylase

75
Q

Salivary secretion from submandibular and sublingual glands

A

seromucous secretion

76
Q

3 roles of stomach in digestion

A

reservoir - gastric motility
digests proteins - pepsins
essential for the absorption of vitamin b12-intrinsic factor

77
Q

Composition of gastric secretions

A

HCl, pepsins, intrinsic factors, mucus and HCO3-

78
Q

What are ECLs

A

entrochromatin like cells

79
Q

What do ECLs secrete

A

histamine

80
Q

What do mucus neck cells secrete

A

mucus

81
Q

optimal pH of pepsins

A

<3

82
Q

Functions of HCl

A

promotes the activation and activity of pepsins
kills and inhibits microorganisms
stimulates secretions in the small intestine

83
Q

What regulates mucus and HCO3-

A

acetylcholine and prostaglandins

84
Q

describe the secretions from the pancreas

A

1.5 litres a day
pH: 7.8-8.4
composed of salts and enzymes

85
Q

Describe the secretions from the liver

A

0.5 litres a day
pH: 7.4
composed of bile acids, cholesterol and phospholipids

86
Q

Describe the secretions from the small intestine

A

1 litre a day
pH: 7.6
composed of mucus enteropeptidase, salt and water

87
Q

Endocrine pancreatic secretions

A

insulin and glucagon

88
Q

exocrine pancreatic secretions

A

salts and water, enzymes

89
Q

Functions of pancreatic juice

A

salts and water (HCO3-, NaCl, H2O): create the right environment for enzymes to work
enzymes: important for digestion of all major classes of foodstuffs

90
Q

What do enzymes are in pancreatic juice and what do they do

A

proteases- digest proteins
lipases- digest fats
⍺-amylase - digest carbohydrates

91
Q

Where are secretions of the liver specifically secreted from and where are they stored

A

secreted from hepatocytes

stored in gallbladder

92
Q

what do bile acids, cholesterol and phospholipids form

A

micelles for the absorption of fatty acids

93
Q

What does the enterohepatic circulation do

A

control of bile synthesis and secretion

94
Q

what happens if blood glucose drops below 2mM

A

brain becomes starved of fuel

95
Q

What do humans synthesise glucose from

A

pyruvate, glycerol and amino acids

96
Q

what is gng

A

gluconeogenesis

97
Q

Where is the main site for gng

A

the liver

98
Q

Can we use lactate to synthesise glucose

A

yes

99
Q

What does GNG cost

A

4 ATP, 2 GTP, and 2 NADH per glucose molecule

100
Q

What is glycogen synthase activated for

A

to convert excess glucose into glycogen

101
Q

What is glycogen phosphorylase activated for

A

to convert glycogen into glucose-1-phosphate

102
Q

what is glycogen synthase activated by

A

glucose and glucose-6-phosphate

103
Q

What is glycogen phosphorylase activated by

A

AMP (Adenosine monophosphate) and Ca2+ in muscle

104
Q

What hormones are glycogen synthase and glycogen phosphorylase under the control of

A

insulin, glucagon and adrenaline

105
Q

When does homeostasis occur

A

when metabolite concentrations are at a steady state

106
Q

Average half-life in days of following tissues: liver, kidney, heart, brain, muscle

A 
liver-0.9
kidney-1.7
heart-4.1
brain-4.6
muscle-10.7
107
Q

what is hexokinase inhibited by

A

glucose-6-phosphate

108
Q

what is phosphofructokinase inhibited by

A

ATP

109
Q

What does AMPK do generally speaking

A

shifts metabolism away from energy consuming synthetic pathways

110
Q

What does AMPK do in extra hepatic tissues

A

shifts the metabolism towards the use of fatty acids

111
Q

What does AMPK do in the liver

A

triggers GNG to provide glucose for the brain and slows synthetic pathways

112
Q

What does AMPK do in the brain

A

stimulates feeding behaviour to provide more dietary fuel

113
Q

What is AMPK activated by

A

AMP, by the sympathetic nervous system, exercise and by peptide hormones produced in adipose tissue

114
Q

Where does one-third of our energy needs come from

A

dietary triglycerides

115
Q

What are fats used for

A

long-term energy needs

116
Q

what’re glucose and glycogen used for

A

short-term energy needs

117
Q

Where are dietary fatty acids absorbed

A

in the vertebrate small intestine

118
Q

What do intestinal lipases do

A

degrade triglycerides

119
Q

what are chylomicrons

A

the product of triglycerides and cholesterol and apolipoproteins

120
Q

What do chylomicrons do

A

move through lymphatic system and bloodstream to tissues

121
Q

how are fatty acids transported into the mitochondria

A

the carnitine shuttle

122
Q

Stages of the carnitine shuttle

A

stage 1: β oxidation. Fatty acids are oxidised two carbons at a time and combine with CoA to form acetyl-CoA, and high energy electrons in the form of NADH and FADH2
Stage 2: Acetyl CoA enters the citric acid cycle and is used to form NADH and FADH2
Stage 3: the high energy electrons in NADH and FADH2 are used to synthesise ATP in oxidative phosphorylation

123
Q

What three ketone bodies are produced in the liver

A

acetoacetate, β-hydroxybutryate, and some acetone

124
Q

What are ketone bodies a major fuel source for

A

the heart, skeletal muscle and kidneys

125
Q

What vitamins are fat soluble

A

A, B-12, D,E,K

126
Q

Function of vit A

A

rhodopsin, retinoic acid/antioxidant

127
Q

Function of vit C

A

collagen synthesis/antioxidant

128
Q

Function of vit D

A

calcium absorption/antioxidant

129
Q

Function of vit E

A

Mixed/antioxidant

130
Q

Function of Vit K

A

formation of blood clotting factors/coenzyme

131
Q

Function of thiamine B1

A

precursor of dehydrogenase cofactor

132
Q

Function of riboflavin B2

A

precursor of FAD/FADH2

133
Q

Function of niacin B3

A

precursor of NAD and NADP

134
Q

Function of vit B6

A

cofactor in amino acid metabolism

135
Q

Function of biotin

A

cofactor of carboxylases

136
Q

Function of pantothenic acid (formation of B3 and B5)

A

precursor of CoA

137
Q

Function of folic acid

A

DNA synthesis, etc.

138
Q

Function of cobalamin B12

A

DNA synthesis, etc.

CBL Year 1 (7 decks)

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