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Phys Exam 6 > GI 4 > Flashcards

GI 4 Flashcards

1
Q

What is the flow of bile from the liver to the duodenum?

A

Bile duct -> common hepatic duct -> cystic duct -> common bile duct -> sphincter of Oddi -> duodenum

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2
Q

How much of the pancreas is exocrine?

A

90%

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3
Q

_____ cells of pancreas synthesize and secrete hydrolases for digestion

A

–Acinar cells

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4
Q

____ cells of pancreas secrete bicarbonate and water

A

Duct cells

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5
Q

____ cells of pancreas are involved in Luminal digestion of carbohydrate, protein, fat.
–Impaired function causes maldigestion and
malabsorption.

A

Acinar cells of pancreas

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6
Q

_____ cells of pancreas are involved in neutralizing gastric H+ :secretes HCO3- into duodenum up to 145 mEq/L

A

Duct cells of pancreas

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7
Q

Proteolytic enzymes synthesized, stored and secreted as _______

A

inactive precursors.

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8
Q

Why Doesn’t the Pancreas Digest Itself?

A

Proteolytic enzymes synthesized, stored and secreted as inactive precursors.

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9
Q

Where are the inactive precursors activated?

A

In intestinal lumen

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10
Q

____ is synthesized, stored, and secreted with the precursors to make sure the inactive precursors don’t get activated prematurely in pancreas

A

Trypsin inhibitor

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11
Q

_______:
Blocked bile ducts lead to enzyme overrun of trypsin inhibitors that lead to active enzymes in pancreas beginning to digest it

A

Acute pancreatitis

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12
Q

What are the 2 stimuli for acinar cell enzyme secretion?

A
  1. CCK

2. ACh/GRP (vagovagal reflex)

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13
Q

What are the 2 indirect paths of CCK production?

A

Monitor peptide and CCK-RP

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14
Q

______ is involved in the following:

  • Gallbladder contraction
  • Acinar secretion of pancreas
  • Stimulates receptive relaxation, reduces emptying, and reduces HCl secretion of stomach
  • Relaxes sphincter of Oddi
  • Protein, carb, lipid absorption and digestion
  • Matching of nutrient delivery to digestive and absorptive capacity
A

CCK

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15
Q

What are the Two Stimuli for Ductal Cell Secretion of H2O and HCO3-?

A
  1. *Secretin (Secretin receptor)

2. Ach (M3 receptor)

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16
Q

Secretin released when pH < ____

A

4.5.

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17
Q

_____ is released when pH < 4.5.

A

Secretin

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18
Q

Below pH = ___, secretin release is maximal in segment of duodenum. Further release of secretin depends upon area of small intestine affected.

A

3,

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19
Q

What 2 phases are mediated by vagovagal reflex - low volume, high enzyme secretion (Ach/GRP)?

A

Cephalic and Gastric

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20
Q

At Low secretion rates of pancreatic juice -
bicarbonate concentration is ____
chloride concentration is ____

A

low; high

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21
Q

At High secretion rates of pancreatic juice -bicarbonate concentration is ____
chloride concentration is ____

A

high; low

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22
Q

What 2 ions remain constant at all flow rates in pancreas?

A

Na and K

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23
Q

What is the tonicity of pancreatic juice?

A

Isotonic

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24
Q

The secretion rate of the pancreas is proportionate to what three things?

A

Secretin, Ach, and CCK

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25
Q

_____ is a disorder caused by a defective CFTR

A

CF

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26
Q

Abnormal sweat composition.
Decreased pulmonary and pancreatic secretion.
Mendelian autosomal recessive occurrence.

A

CF

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27
Q

Defective ____ seen in CF causes:
–Sweat Cl- reabsorption;
–Pancreatic duct cell function;
–Pulmonary mucus clearance.

A

CFTR

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28
Q

In _____ pancreatitis, –Trypsin activation causes pain, inflammation

A

Acute

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29
Q

In _____ pancreatitis, destroys acini

A

Chronic

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30
Q

What 2 things can cause duct obstruction?

A

Gallstones

Tumors

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31
Q

Consequences of ______ reflect decreased digestive enzyme production

A

Pancreatitis

32
Q

Without pancreatic enzymes, what percentage of fat is not absorbed causing steatorrhea?

A

60%

33
Q

Without pancreatic enzymes, what percentage of protein and carbs are not absorbed?

A

30-40%

34
Q

_______ functions:
Cleansing and storage of blood
Metabolism of nutrients
Synthesis of proteins (coagulation factors, plasma proteins, angiotensinogen)
Metabolism of hormones, chemicals
Storage of energy, vitamins, iron
Excretion of lipid-soluble waste products
Marked capacity for cellular regeneration

A

Hepatic functions

35
Q

What range of bile is secreted each day?

A

600-1000 mL

36
Q

Liver has ____ blood flow and lymph flow

A

High

37
Q

What percentage of CO is set to liver?

A

27%

38
Q

Resistance of vessels in liver to blood flow is _____

A

Low

39
Q

Cirrhosis increases resistance, produces _______: back up of blood in digestive tract; Increase NFP leading to ascites

A

portal hypertension

40
Q

Hepatic lymph accounts for ____% of total body production.

A

50%

41
Q

______ and _______ required for digestion(emulsification) and absorption(micelles) of dietary fat.

A

Bile salts (acids) and lecithin

42
Q

Biles is involved in the _______ of lipophilic metabolites (bilirubin), excess cholesterol, other waste products, drugs, and toxins.

A

Excretion

43
Q

Bile ____ are involved in emulsification of facts

A

Salts

44
Q

Bile _____ are waste products

A

Bile pigments

45
Q

_______ secrete bile salts, cholesterol, lecithin, bilirubin, many other lipophilic substances

A

Hepatocytes

46
Q

_______ modify primary secretion, add HCO3

A

Duct epithelial cells

47
Q

Storage and concentration of bile in ______.

A

gallbladder

48
Q

________ reabsorbs some components.

A

Enterohepatic circulation

49
Q

____ secrete organic component of bile into bile ducts-Bile Salts (produced from cholesterol)-Cholesterol-Organic substances

A

Hepatocytes

50
Q

What are the 3 organic components that hepatocytes secrete into bile ducts?

A

Bile salts
Cholesterol
Organic substances

51
Q

What are the 2 places bile is transported?

A

Small intestine for fat digestion

Gall Bladder for storage

52
Q

What are the 3 things bile duct cells secrete?

A

Water
Na+
HCO3-

53
Q

The gallbladder reabsorbs what 2 things?

A

Na and H2O

54
Q

Does the gall bladder concentrate or dilute bile?

A

Concentrates bile

55
Q

What is the max volume that can be stored in gall bladder?

A

30-60 mL

56
Q

Substance secreted into bile by hepatocytes.
Delivered to lumen of ileum, then reabsorbed.
Transported to hepatocytes via sinusoids
94% of bile salts recirculated
Bile salts circulate 17x before lost in feces.

A

Enterohepatic circulation

57
Q

What percentage of bile salts are recirculated?

A

94%

58
Q

What is the the transporter involved in active absorption of bile salts in enterohepatic circulation?

A

Apical sodium-dependent bile salt transporter (ASBT)

59
Q

Drugs that inhibit Bile Recycling
Used to lower LDL levels in blood
Hepatocyte production of bile increases 6-10x if bile salt recycling reduced.
LDL taken up from blood via hepatocytes as source of cholesterol for bile salts
Drugs work in intestinal lumen (do not need to be absorbed)
Reduce harmful side effects

A

BARI (Bile Acid Reabsorption Inhibitors)

60
Q

____ is a type of BARI that Bind to bile salts in intestinal lumen and block transport

A
  1. Bile acid sequestrants
61
Q 
Low \_\_\_\_ is associated with the following things:
Crohn’s disease
Congenital 1° bile acid malabsorption
Idiopathic chronic diarrhea
Irritable Bowel Syndrome
A

ASBT

62
Q

Low ASBT is associated with what 4 things?

A

Crohn’s disease
Congenital 1° bile acid malabsorption
Idiopathic chronic diarrhea
Irritable Bowel Syndrome

63
Q

_____ dysfunction impairs bilirubin, bile salt secretion:
–Drugs (acetaminophen), viral hepatitis, toxins;
–Fibrosis, cirrhosis.

A

Hepatocyte

64
Q

______ defects impair bile salt reabsorption.

A

Intestinal mucosal

65
Q

(stomach)
amino acids and peptides
distention
(H+ inhibits)

A

Gastrin

66
Q

______ (stomach)
 absence of nutrients
(inhibited by stretch)

A

Ghrelin

67
Q

______ (Small Intestine)

 H

A

Secretin

68
Q

___ (Small Intestine)
amino acids and peptides
fatty acids
Indirectly via secretion of CCK-RP and Monitor peptide

A

CCK

69
Q

______ (Small intestine)

Glucose

A

GIP, GLP-1

70
Q

_____ (Small Intestine)
stimulus unknown
some studies suggest that an alkaline pH in the duodenum stimulates its release.

A

Motilin

71
Q 
\_\_\_\_\_
↑ Histamine Release (ECL cell)
↑ H+ Secretion (Parietal Cell)
↑ Gastric emptying
Trophic affects on Mucosa
A

Gastrin

72
Q

______

↑ Hunger

A

Ghrelin

73
Q

______
↑ Gastric Motility (MMC/Fasting)
↑ Intestinal Motility (MMC/Fasting)

A

Motilin

74
Q

_______
↑ Insulin response to glucose
↓ Gastric Acid Secretion
↓ Gastric emptying

A

GIP, GLP-1

75
Q 
\_\_\_\_\_\_\_\_
↑ Panc & Biliary HCO3- secretion 
Trophic affects on Exo. Pancreas
↓ Gastric Acid Secretion
↓ Gastric emptying
A

Secretin

76
Q 
\_\_\_\_\_\_\_
↑ Pancreatic enzyme secretion
↑ Gall Bladder Contraction
Trophic affects on Exo. Pancreas
↓ Gastric emptying
↓ Gastric Acid Secretion
Relaxation of Sphincter of Oddi
Gastric receptive relaxation
A

CCK

Phys Exam 6 (4 decks)

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