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Surgery > GI > Flashcards

GI Flashcards

1
Q

gastric parietal cells make

A

HCl, intrinsic factor

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2
Q

chief cells make

A

pepsinogen

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3
Q

g cells make

A

gastrin, they are found in the antrum

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4
Q

mucous neck cells make

A

bicarbonate mucus

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5
Q

what is pepsin

A

proteolytic enzyme that hydrolyzes peptide bonds

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6
Q

what is intrinsic factor

A

protein secreted by the parietal cells that combines with vit B12 and enables absorption in the terminal ileum

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7
Q

name 3 receptors on the parietal cell that stimulate HCL release

A

HAG: histamine, acetylcholine, gastrin

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8
Q

what is the enterohepatic circulation

A

circulation of bile acids from the liver to the gut and back to the liver via the portal vein

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9
Q

where are most of the bile acids absorbed

A

terminal ileum

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10
Q

how many times is the entire vile acid pool circulated during a typical meal

A

twice

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11
Q

what are the stimulators of gallbladder emptying

A

CCK, vagal input

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12
Q

what are the inhibitors of gallbladder emptying

A

somatostatin, sympathtics (it’s impossible to flee and digest at the same time), vasoactive intestinal polypeptide (VIP)

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13
Q

what is the source of CCK

A

duodenal mucosal cells

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14
Q

what stimulates CCK release

A

fat, protein, AAs, HCl

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15
Q

what inhibits CCK release

A

trypsin and chymotrypsin

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16
Q

what are the actions of CCK

A

empties gallbladder, opens ampulla of vater, flows gastric emptying, stimulates pancreatic acinar cell growth and release of exocrine products

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17
Q

what is the source of secretin

A

duodenal cells (specifically the argyrophilic S cells)

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18
Q

what stimulates secretin release

A

pH <4.5, fat in the duodenum

19
Q

what inhibits secretin release

A

high pH in the duodenum

20
Q

what are the actions of secretin

A

releases pancreatic bicarb/enzymes/h2o, releases bile/bicarb, decreases lower esophageal sphincter tone, decreases release of gastric acid

21
Q

what is the source of gastrin

A

gastric antrum G cells

22
Q

what stimulates its release

A

stomach peptides/AAs, vagal input, Ca

23
Q

what inhibits gastrin release

A

pH <3.0, somatostatin

24
Q

what are the actions of gastrin

A

release of HCl from parietal cells, trophic effect on mucosa of the stomach and small intestine

25
Q

what is the source of somatostatin

A

pancreatic D cells

26
Q

what stimulates somatostatin release

A

food

27
Q

what are the actions of somatostatin

A

globally inhibits GI fxn

28
Q

what is the purpose of the colon

A

reabsorption of h2o and storage of food

29
Q

what is the main small bowel nutritional source

A

glutamine

30
Q

what is the main nutritional source of the colon

A

butyrate (short-chain FA)

31
Q

where is Ca absorbed

A

duodenum actively, jejunum passively

32
Q

where is Fe absorbed

A

duodenum

33
Q

where is vit B12 absorbed

A

terminal ileum

34
Q

which hormone primarily controls gallbladder contraction

A

CCK

35
Q

what supplement does a patient need after removal of the terminal ileum or stomach

A

vit B12

36
Q

name the main constituents of bile

A

water, phospholipids (lecithins), bile acids, cholesterol, and bilirubin

37
Q

what are most gallstones made of

A

cholesterol

38
Q

how do opiates affect the bowel

A

by stimulating Na absorption and inhibiting secretion in the ileum as well as decreasing GI motility by incoordinates peristalsis (therefore, place patients on stool softeners when dispensing pain meds)

39
Q

which type of muscle fibers, smooth or striated, does the esophagus contain

A

both: upper third - striated muscle, middle third - mixed, lower third - smooth, primarily under vagal control

40
Q

which electrolytes does the colon actively absorb

A

Na, Cl

41
Q

which electrolyte does the colon actively secrete

A

K

42
Q

what is the gastroclonic reflex

A

increased secretory and motor functions of the stomach result in increased colonic motility

43
Q

what is the blood supply to the liver

A

75% from the portal vein, rich in products of digestion, 25% from the hepatic artery, rich in O2 (but each provide 50% of oxygen)

44
Q

what are the peyer patches

A

nodules of lymphoid tissue with B and T lymphocytes in the small intestine that selectively sample lumenal antigens found in the terminal ileum

Surgery (5 decks)

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