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Physiology > GI > Flashcards

GI Flashcards

1
Q

What nervous system uses ACh?

A

Enteric and Parasympathetic

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2
Q

What are the functions of ACh?

A

increases motility (contraction of smooth muscle),
increases secretion
relaxation of sphincters

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3
Q

What nervous system uses Substance P?

A

Enteric and Para

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4
Q

What are the functions of Substance P?

A

increase motility

acts on NK-1 Receptor to promote salivary secretion

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5
Q

What are the actions of Nitric Oxide and what Nervous System uses it?

A

Para and ENS

muscle relaxation by inhibition of smooth muscle

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6
Q

Actions of Norepinephrine and used by what nervous system?

A

Sympathetic
decrease motility, blood flow, secretion
increase sphincter tone

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7
Q

Actions of Neuropeptide Y and used by what nervous system

A

Symp and ENS

decreases motility and secretion

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8
Q

What are the actions of Vasoactive Intestinal Polypeptide and what Nervous System uses it?

A

Enteric
muscle relaxation, increase secretions
acts on salivary glands to increase salivation and blood flow

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9
Q

What are the actions of Opiods (Met & Leu enkephalins) and what Nervous System uses it?

A

decreases motility and secretion

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10
Q

What are the actions of Serotonin(5-HT) and what Nervous System uses it?

A

ENS
initiate a local peristaltic reflex in sensory intrinsic neurons
transmit a discomfort signal in extrinsic sensory nervs

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11
Q

What are the actions of GABA and what Nervous System uses it?

A

ENS

Inhibits motility and secretion

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12
Q

What type of cells secrete Gastrin and where are theses cells located?

A

G cells

antrum of stomach

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13
Q

What stimulates the release of Gastrin

A
  1. small peptides and amino acids
  2. distention of stomach
  3. vagal stimulation
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14
Q

What inhibits Gastrin?

A

decrease in pH

somatostatin

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15
Q

What are the actions of Gastrin?

A
  1. stimulates H+ secretion of parietal cells

2. stimulates growth of the gastric mucosa (trophic effect)

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16
Q

What type of cells secrete CCK and where are theses cells located?

A

I cells

Duodenum, jejunum

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17
Q

What stimulates the release of CCK?

A

monoglycerides & fatty acids, small peptides, a.a

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18
Q

What are the 3 actions of CCK?

A
  1. contraction of the gallbladder with simultaneous relaxation of the sphincter of oddi
  2. increase pancreatic lipases
  3. along with Secretin acts to slow down gastric emptying and increase secretion of bicarbonate from the pancreas
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19
Q

What do Pancreatic lipases digest

A

lipids to fatty acids, monoglycerides, cholesterol

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20
Q

Pancreatic amylase digest_____?

A

carbohydrates

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21
Q

Pancreatic proteases digest ______?

A

protein

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22
Q

CCK is a part of what family and why?

A

gastrin- CCK family

C-terminal pentapentide is identical

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23
Q

CCKa receptor is most selective to what hormone and why?

A

CCK

sulfating of tyrosine residue on CCK makes it selective for receptor

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24
Q

CCKb receptor is selective to what hormone?

A

CCK and gastrin equally

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25
Q

What type of receptors are CCKa and b?

A

G-coupled Receptors

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26
Q

What type of cells and where is secretin produced?

A

S cells of the duodenum

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27
Q

What stimulates secretin?

A

H+
fatty acids
(secreted when acid contents arrive in the duodenum

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28
Q

What are the actions of Secretin?

A

increase pancreatic and biliary bicarbonate to neutralize H+
allow for pancreatic lipases to become activated(need pH of 6-8)
inhibits the effects of gastrin on parietal cells ( acts as an enterogastrone)

29
Q

What type of cells and where is Glucose Dependent Insulinotropic Peptide produced?

A

K cells of the duodenum and jejunum

30
Q

What Stimulates GIP?

A

Fatty acids and carbohydrates

31
Q

What are the actions of GIP?

A

stimulates insulin secretion and decreases H+

32
Q

Why is oral glucose more effective at increasing insulin than IV glucose?

A

oral glucose stimulates GIP and Beta cells in pancreas while IV glucose only stimulates Beta cells

33
Q

When is Motilin secreted?

A

fasting state

34
Q

What action does motilin have?

A

increases motility during the fasting state

35
Q

What are the 5 paracrines in the GI?

A
  1. Somatostatin
  2. Histamine
  3. Prostaglandins
  4. Serotonin (5-HT)
  5. Adenosine
36
Q

What type of cells secrete somatostatin?

A

D cells in the pancreas and hypothalamus

37
Q

what are the actions of somatostatin?

A

decreases luminal pH

inhibits gastic H+ secretion

38
Q

Histamine is secreted by ____.

A

endocrine type cells in the H+ secreting region of the the stomach

39
Q

What are the actions of Histamine?

A

stimulates H+ secretion by the Parietal cells

40
Q

What are the actions of prostaglandins?

A

stimulates bicarbonate secretion to help protect the gastric barrier

41
Q

what are the actions of adenosine?

A

causes vasodilation

modulation of motility reflexes and colonic chloride secretion

42
Q

Ptyalin is produced what salivary gland and what cells?

A

P, SM acinar

43
Q

Lingual Lipase is produced by____?

A

SL acinar cells

44
Q

Kallikrein is produced by ___?

A

P,SM, SL acinar cells

45
Q

What neurotransmitters regulate salivary secretion?

A

Para: ACh –> M3 (blocked by atropine)
Substance P –> NK-1
Symp: Beta and Alpha receptors

46
Q

what neurotransmitters stimulate blood flow?

A

para: ACh and VIP

increases in salivation itself directly dilates the bld vessels , more kallirein is secreted

47
Q

In the peristaltic reflex which neurotransmitters cause muscle contraction?

A

Ach and Substance P

48
Q

In the peristaltic reflex which neurotransmitters cause muscle relaxation?

A

NO and VIP

49
Q

Muscle tone of the LES and distal esophagus is determined by what?

A

Myogenic Activity

50
Q

What happens to muscle tone with bilateral vagotomy?

A

LES tone may not be altered since excitatory and inhibitory influences are removed in equal amount

51
Q

What happens to LES muscle tone if atropine is taken?

A

selective removal of only excitatory influence can lead to relaxation due to NO/VIP input dominating.

52
Q

What is dysphagia?

A

difficulty swallowing

53
Q

What is achalasia?

A

idiopathic destruction of parasympathetic ganglia of myenteric plexus –> failure of LEX to relax, impaired peristalsis in distal esophagus

54
Q

Two major factors that slow or inhibit gastric emptying?

A
  1. Fat: mediated by CCK which is secreted when fatty acids arrive in the duodenum. CCK slows gastric emptying
  2. H+: ENS via myenteric plexus ensures that the gastric contents delivered to duodenum are neutralized
55
Q

Migrating motor complex is mediated by _____?

A

Motilin

56
Q

Food entering the stomach requires what two things?

A

receptive relaxation and accommodation

57
Q

what is accommodation?

A

increase in volume without increasing in pressure

58
Q

What increases stomach peristalsis?

A 
carbs
distension
gastrin
motilin
ACh
59
Q

What decreases stomach perstalsis/ slows emptying?

A 
Fat
Over distention
GIP, VIP, CCK
Peptide YY
GLP-1 & 2
NE
60
Q

What speeds stomach emptying at the pylorus?

A

Gastrin

ACh

61
Q

What slows stomach emptying at the pylorus?

A

Secretin
CCK
NE

62
Q

Pancreatic Secretion has what two components?

A

The primary secretion by the acinar cells secrete an isotonic flood which is the enzymatic component
The aqueous component is provided by the ductal secretion.

63
Q

Pancreatic enzymes are stored in zymogen granules at the apical end. By what process and what neurotransmitters will stimulate their release?

A

Exocytosis by activation of cAMP through secretin –> SCTR, VIP–>VPAC2 or Ca2+ pathway through ACh –>M3, GRP, CCK –>CCKa

64
Q

Define the osmolarity of pancreatic juice?

A

isotonic

65
Q

During what phase is pancreatic secretion initiated?

A

cephalic phase

66
Q

During what phase is most pancreatic secretion released?

A

intestinal phase

67
Q

Pancreatic secretion during the intestinal phase is mediated by what nervous system?

A

ENS

enteropancreatic reflex involving ACh, CCK and VIP

68
Q

What is the difference in stimuli for CCK and secretin?

A

CCK is released in response to free FA, other paracrine enterocytes that release CCK-releasing peptide, and monitor peptide from acinar cells.
Secretin is released by S cells sensing the pH in the lumen.

Physiology (2 decks)

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