GHM L3 Flashcards

1
Q

What is the GI tract?

A

Passageway of the digestive system, runs from the mouth to the anus

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2
Q

Describe the tissue structure of the GI tract

A
  1. Mucosa
  2. Submucosa
  3. Muscularis Externa
  4. Serosa
  5. Lumen
  6. Mesentery
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3
Q

What does the mucosa consist of?

A
  1. Epithelium
  2. Lamina propria
  3. Muscularis Mocosae
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4
Q

What does the muscularis externa consist of?

A

Circular muscle
Longitudinal muscle

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5
Q

What does the serosa consist of?

A

Connective tissue
Epithelium

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6
Q

Different parts of mouth

A
  1. Lips + cheeks
  2. Palate
  3. Tongue
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7
Q

What do the lips and cheeks consist of?

A

Orbicularis oris muscles, buccinator muscles

Vestibule

Oral Cavity - lies between teeth + gums

Labial frenulum - median attatchment of each to each gum

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8
Q

What does the palate consist of?

A
  1. Hard palate
  2. Soft Palate
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9
Q

State the function of the hard palate

A

Made from palatine bones + palatine processes from maxillae

It is corrugated which helps it created friction between tongue + pallate

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10
Q

State the function of the soft palate

A

Fold in palate, formed by skeletal muscle

  1. Closes nasalpharynx when swallowing
  2. Downward projection off soft palate - uvula
  3. Anchored by palatoglossal + palotopharyngeal arches
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11
Q

State the functions of the tongue

A
  1. Mixing of food when chewing
  2. Produces bolus
  3. Initiates swallowing, taste, speech
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12
Q

What are the intrinsic muscles of the tongue responsible for?

A

Change in shape of tongue

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13
Q

What are the extrinsic muscles of tongue responsible for?

A

Change in position of tongue

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14
Q

What is the lingual frenulum responsible for?

A

Medial attacthment between tongue and floor of mouth

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15
Q

What is ankyloglossia?

A

Fused tongue
Tied tongue
Short frenulum

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16
Q

How is ankyloglossia treated?

A

Surgery

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17
Q

What are the 4 digestive processes in the mouth?

A

Ingestion
Mechanical digestion (mastication)
Chemical digestion
Propulsion

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18
Q

Name a drug which can be absorbed through the oral mucosa

A

Nitroglycerine - used to alleviate angina pain

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19
Q

Describe the process of mastication

A
  1. Cheeks + lips closed. Holds the food between the teeth, the tongue mixes food with saliva to soften it
  2. Teeth cut + break down solid food
  3. Voluntary contractions of muscles that close the jaw
  4. Rythm / pattern of jaw movements controlled by stretch reflexes + responses to pressure inputs from receptors in cheeks, gums, tongue
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20
Q

State 4 functions of the Saliva

A
  1. Dissolve + moiston food
  2. Contains enzymes which start breakdown of starch
  3. Production of bolus
  4. Cleans mouth
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21
Q

How are chemoreceptors stimulated?

A

By acidic substances

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22
Q

How are mechanoreceptors stimulated?

A

By mechanical stimuli

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23
Q

Xerostomia

A

Strong sympathetic stimulation
Salivation inhibited

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24
Q

What are the 3 extrinsic salivary glands?

A
  1. Parotid
  2. Submandibular
  3. Sublingual
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25
Q

What are buccal salivary glands?

A

Intrinsic salivary glands
Scatted across oral mucosae
Keeps mouth moist

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26
Q

Describe the composition of saliva

A

Secreted by serous cells and mucous cells

99.5% water, slighly acidic:

  1. Electrolytes e.g. Na+
  2. Metabolic waste, urea
  3. Salivary amylase, lingual lipase
  4. Lysozymes, Defensins
  5. Mucin
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27
Q

What is the role of “friendly bacteria”?

A

Convert nitrates from food derived into nitric oxide

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28
Q

How can saliva be used in medicine?

A

Can detect conditions
Including oral cancer, diabetes

Can detect hormones

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29
Q

State two patholgies related to the salivary glands

A
  1. Mumps
  2. Sjogrens syndrome
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30
Q

Describe what causes Mumps

A
  1. Inflammation of parotid gland
  2. Caused by myxovirus

Easily transmited through saliva

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31
Q

Symptoms of Mumps

A
  1. Sterelity in males
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32
Q

What causes Sjogrens syndrome

A
  • Autoimmune condition
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33
Q

Symptoms of Sjogrens syndrome

A

-Affects salivary + lacrimal glands
-Xerostomia

34
Q

Function of intrinsic salivary glands

A

Continuosly keep mouth moist

35
Q

Function of extrinsic salivary glands

A

Produce secretions when ingested food stimulates chemoreceptors and mechanorecptors in mouth

36
Q

What increases salivation

A

Ingested food in mouth
Thought of food
Smell of food
Irritants in lower regions of GI tract
Sympathetic stimulation

37
Q

What decreases / inhibits salivation

A

Dehydration
Extremely strong sympathetic stimulation

38
Q

Describe the position of the oesophagus

A

Oesphagus runs through the thorax, from the pharnyx to the stomach

It joins onto the stomach via the cardiac orifice

It pierces the diaghragm at the oesophagul haitus

39
Q

How does the oesphagus join to the stomach?

A

It joins onto the stomach via the cardiac orifice

40
Q

How does the oesphagus join to the diaphragm?

A

It pierces the diaghragm at the oesophagul haitus

41
Q

What are the different layers of the oesphagus?

A
  1. Mucosa
  2. Submucosa
  3. Adventitia
  4. Muscularis Externa
42
Q

What type of epithelium is the mucosa made of?

A

Stratifed squammus epithelium

43
Q

What is the function of the submucosa?

A
  1. Mucus secretion
  2. arealor connective tissue
44
Q

What are the two layers of the muscularis externa?

A
  1. Longitudinal
  2. Circular
45
Q

Describe the muscle composition of the muscularis externa

A

Proximal third = skeletal muscle
Middle - mix of skeletal + smooth
Inferior - smooth

46
Q

What is the adventitia made of?

A

Fibrous connective tissue
Instead of serosa

47
Q

What are the different types of epithelium

A

8 Different types:

  1. Simple squamous
  2. Stratified squamous
  3. Simple cuboidal
  4. Stratified cuboidal
  5. Simple columnar
  6. Pseudostratified columnar
  7. Stratifed comumnar
  8. Transitional
48
Q

State the function and location of simple squamous epithelium

A

Lungs, lymphatic vessels, blood vessels

Diffusion, filtration, lubrication

49
Q

State the function and location of stratified squamous epithelium

A

Oesophagus, mouth, vagina

Protection against abrasion

50
Q

State the function and location of simple cuboidal epithelium

A

ducts, secretory regions of small glands, kidney tubules

section + absorpiton

51
Q

State the function and location of stratified cuboidal epithelium

A

Secretory glands (salivary, sweat)

Protection

52
Q

State the function and location of simple columnar epithelium

A

Cilliated tissue, found in bronchi
Non-cilliated in digestive tract
Secretion (mucus + enzymes), absorption

53
Q

State the function and location of pseudostratified columnar epithelium

A

Cilliated tissue, trachea
Secrete mucus

54
Q

State the function and location of stratified columnar epithelium

A

Urethra
Protection

55
Q

Compare and contract the adventitia and the serosa

A

The adventitia is made of dense fibrous connective tissue. The serosa is made of connective tissue surrounded by mesothelium (provides friction)

The adventitia is retroperitoneal, and serosa is intraperitoneal

Adventitia is found in mouth, pharynx, oesophagus, pylorus of stomach, distal duodenum, ascending colon, descending colon, anal canal

Serosa is found in most of stomach, duodenum, caecum, sigmoidal canal, transverse canal, rectum

56
Q

Describe the function of the pharynx

A

Allows passage for fluid, food, air
Pharyngeal constrictor muscle contracts, propels food into oesophagus

57
Q

Type of epithelium in pharynx

A

Stratified squamous epithelium

58
Q

Describe the structure of the pharynx

A

Allows passage for food, fluid, air

Histology similar to oral cavity

Stratified squamous epithelium

2 layers of skeletal muscle:
inner layer: longitudinal musckle
outer layer: pharyngeal contrictor muscle

59
Q

What is deglutition

A

Chewing

60
Q

What is the “boccal phase” of deglutition?

A

Voluntary contractions of the tongue

61
Q

What is the “pharyngeal-oesophagal phase” of deglutition?

A

Involuntary contractions of the tongue

62
Q

Which parts of the upper GI system does deglutition involve?

A

Pharynx
Oesophagas
Soft Palate
Tongue
22 muscle groups

63
Q

Describe the 4 stages of deglutition

A

1.Upper oesophagal sphincter contracted - closed.
2. BOCCAL PHASE: Tongue touches hard palate, this forces food bolus into oropharynx
3. Involunary phase / pharyngeal-oesophagal phase, larynx + uvula rise to prevent food bolus from entering respiaratory passageways, tongue blocks off mouth, upper oesophagal sphincter relaxes, therefore, opens, food bolus can enter
4. Outer pharyngeal constrictor muscles contract, propels food bolus into oesophagas
5. Food bolus moves from oesophagas to stomach via peristalsis
6. Gastroesophagal sphincter relaxes, opens, food enters stomach

64
Q

What causes hitaus hernia?

A
  1. Abonormal location of oesophagogastric junction
  2. This leads to gastric cardia above diaphragm

THIS CAN BE CAUSED BY OBESITY

65
Q

What does hitaus hernia lead do?

A

Weakened diaphragm, increased intra-abdomenal pressure

Acid reflux

66
Q

Describe the anatomy of the stomach

A

Refer to diagram L3

  1. Cardia - surrounds cardiac orifice
  2. Fundus - bulges over cardia, dome shaped below diaghragm
  3. Body - midportion
    PYLORIC REGION
    pylorus - gate keeper
    funnel shaped
    pyloric sphincter
  4. Greater curvature - Convex lateral surface, contain ruggae, longitudinal folds
  5. Lesser curvature - concave medial surface
67
Q

What is the function of the stomach?

A

Turns food bolus into chyme

68
Q

What are omenta?

A

Omenta are mesenteries which arise from the curvatures of the stomach

They “tether” the stomach to body wall and other body organs

69
Q

State the two types of omenta and describe their structure and positioning

A

Lesser omenta - from liver to lesser curvature

Greater omenta - drapes from greater curvature
contains fatty deposits

70
Q

Which 2 vessels are involved in the blood supply of stomach?

A

Celiac trunk

Veins of hepatic portal system

71
Q

What is the sympathetic ANS supply of stomach?

A
  1. Splanchnic nerve
  2. Celiac PLEXUS
72
Q

What is the parasympathetic ANS supply of stomach?

A

Vagus nerve

73
Q

What happens during physical digestion in the stomach?

A

Denaturation of proteins
By enzymatic digestion of proteins by enzyme pepsin (or renin in infants)

Stomach secretes Intrinsic factor required in absorption of vitamin B12 - lack of intrinsic factor, lack of absoprtion of b12, pernicous anemia

Physical digestion delivers chyme to small intestine

74
Q

Describe the tissue structure of the stomach wall

A

Diagram L3

Mucosa
Submucosa
Muscularis externa
Serosa
Lumen

75
Q

Production of gastric juice

A
  • Mucus produces gel like substance which protects mucosa from gastric juice

-Mucus traps bicarbonate rich fluid beneath it

-This produces Smooth lining of mucosae has deep gastric pits which develop tubular gastric glands which secrete gastric juice

-Gastric juice contains pepsionogens (chief cells) and HCl (parietal cells)

-Stomach produces 2.5L gastric juice

76
Q

pH in lumen of stomach wall

A

1-2

77
Q

pH above mucosa in stomach wall

A

6-7

78
Q

Describe the mucosa of the stomach

A

Simple columnar epithelium, composed of mucous cells

These mucous cells produce a cloudy, protective double layer of alkaline mucus. The outer layer / surface layer is viscous insoluble mucus which traps a layer of bicarbonate-rich fluid underneath

The inner layer is a smooth lining consisting of many gastric pits which lead to gastric glands which produce gastric juice

79
Q

State the function of mucous neck cells

A

Help produce double layer of mucus in the stomach mucosa

80
Q

What is the mucosal barrier and how is it formed?

A

Portective layer of bicarbonate-rich mucous

Formed by tight junctions between epithelial cells

(surface mucous cells produce HCO3- and mucus, mucous neck cells produce mucus, this combines to form bicarbonate rich mucus which forms the mucosal barrier, pH 7)

81
Q

Why does the stomach renew its surface epithelium often (every 3-6 days) ?

A

Epithelial cells which are damaged are quickly replaced by dividing stem cells

(Stem cells divide to form daughter cells which can specialise into epithelial cells)

82
Q

State 2 glandular cells found in the gastric glands and state their functions

A

Parietal cells - secrete HCl - digestion, disinfectant

Chief cells - secrete pepsinogen - produces pepsin - protein digestion