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ESA 3 > GI > Flashcards

GI Flashcards

1
Q

Describe the brief role of the mouth and oesophagus in digestion.

A

Mastication (chew)

Salivation

  • protect mouth
  • lubricate food
  • starts digestion

Swallowing
-forms bolus

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2
Q

What is the role of the stomach in digestion?

A

Stores food

Mixes and disrupts

  • secretes acids and enzymes to break down tissues and disinfect
  • now called CHYME
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3
Q

What does the duodenum do to chyme in digestion?

A

Dilutes and neutralises it

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4
Q

What is the role of the small intestine in digestion?

A

Absorbs nutrients and electrolytes

Absorbs MOST water

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5
Q

What is the role of the large intestine in digestion?

A

Small bit of water absorption
Sloooow transit
Faeces form and accumulate in descending and sigmoid colon

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6
Q

Is chyme hypertonic, hypotonic or isotonic?

A

Hypertonic

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7
Q

What is the name of the subdivision of the autonomic ns that controls the GI tract?

A

Enteric nervous system

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8
Q

What is dysphagia?

A

Difficulty swallowing

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9
Q

What type of tumour affects the superior oesophagus and which inferiorly?

A

Superior-squamous cell carcinoma

Inferior-adenicarcinoma

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10
Q

A defect in which sphincter causes reflux?

A

Lower oesophageal sphincter

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11
Q

What causes Barrett’s oesophagus and what metaplasia occurs?

A

Reflux

Stratified squamous to simple gastric columnar (stomach epithelial)

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12
Q

What causes oesophageal varices?

A

Cirrhosis causing overload in venous portal system

-blood diverted to to oesophagus through connecting vessels leading to dilation of submucosal veins in lower oesophagus

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13
Q

What causes peptic ulceration?

A

Irritation from gastric acid

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14
Q

How can you tell if someone has pancreatitis?

A

Release of amylase into bloodstream

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15
Q

What causes pre and post hepatic jaundice?

A

Pre-excess Hb breakdown

Post-blockage of bile duct causing backing up of bile containing bilirubin

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16
Q

How are gallstones formed and what type of pain do they produce?

A

Precipitation of cholesterol and bile acids in gallbladder

If moving around can cause biliary colic

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17
Q

At what vertebral level does appendicitis visceral pain occur?

A

T10 level of umbilicus

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18
Q

What condition causes blood to be present in stools due to inflammation of anal vessels?

A

Haemorrhoids

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19
Q

What is prolapse?

A

Organs falling out of place e.g. Rectum

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20
Q

Define sigmoid colon diverticulum

A

Most common place due to high vasculature and weak area

Pouch formation due to high pressure

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21
Q

What is meckels diverticulum? List five features

A 
Small outpouching from small intestine formed as a remnant of vitelline duct 
Present in:
-2 yr olds
-2% population
-2:1 ratio of male to female

Site for ectopic gastric secretion causing irritation

  • 2 feet proximal to ileocecal valve
  • 2 inches in length
22
Q

What 2 structures run through the inguinal canal in males and females?

A

Both-ilioinguinal nerve
Male-spermatic cord
Female-round ligament of uterus

23
Q

Name the borders of hesselbachs triangle.

A

Inferior-inguinal ligament
Medial-lateral border of rectus abdominis
Lateral-inferior epigastric artery

24
Q

Where do epigastric hernias occur?

A

Midline between xiphoid process and umbilicus through linea alba

25
Q

What are the lateral and medial borders of the femoral canal?

A

Lateral-femoral vein

Medial-lacunar ligament

26
Q

Where can a femoral hernia protrude to and what gender are they more common in and why?

A

Saphenous opening

Females-wider pelvis

27
Q

What are the borders of the inguinal canal?

A

Roof-internal oblique and transversus abdominus
Floor-inguinal ligament
Anterior-aponeurosis of external oblique
Posterior-transversalis fascia

28
Q

What cells produce HCL?

A

Parietal

29
Q

What do chief cells produce?

A

Pepsinogen and gastric lipase

30
Q

What cells produce mucous in the stomach?

A

Surface and neck mucous cells

31
Q

What type of cells produce gastrin?

A

G cells

32
Q

What do enterochromaffin like cells (ECL) produce? What other type of cell also produces the same substance as ECL cells?

A

Histamine

Mast cells

33
Q

What cells produce somatostatin?

A

D cells

34
Q

Parietal cells have many mitochondria allowing them to produce a lot of H+ ions. These shouldn’t stay within cells, so how is H+ excreted?

A

Invagination in cell wall with cannaliculi

Contain proton pump which pumps h+ out against conc gradient making it an energy intensive process

35
Q

What three things stimulate parietal cell secretions?

A

Gastrin, Ach, histamine (gah!!)

36
Q

What inhibits gastrin release?

A

Low Ph in stomach (neg feedback)

37
Q

Digestion is aided by which part of the autonomic nervous system?

A

Parasympathetic

38
Q

What, about food, stimulates Ach release? Give three

A

Sight of food
Smell of food
Swallowing
Distension of stomach

39
Q

How does arrival of food at the stomach stimulate gastrin release?

A

Slightly alkali and buffers Ph causing it to rise and thus gastrin disinhibited

40
Q

Give two occasions when gastrin secretion is reduced.

A

Chyme enters intestine (food no longer buffers PH and it decreases)
Hormones CCK and GiP (gastric inhibitory polypeptide)

41
Q

What two substances act on parietal cells BUT also upregulate histamine action on parietal cells?

A

Gastrin

Ach

42
Q

Name two ways acid secretion can be inhibited and give a named example for each.

A

Histamine H2 receptors
Cimetidine (removes amplification by Ach and gastrin)

PPI
Omeprazole (stops excretion of H+ ions from parietal cells)

43
Q

How does mucus prevent dissolving of stomach mucosa?

A

Sticky and basic
Stops ions moving through it easily
H+ reacts with basic groups on mucus and secreted HCO3-

44
Q

What is the PH around surface cells of stomach?

A

Well above 6

45
Q

What stimulates HCO3- and mucus secretion from surface and neck cells?

A

Prostaglandins

46
Q

What three things breach the stomachs defences and why?

A

Alcohol disssolves mucus and so acid attacks stomach
H pylori infect surface cells, reducing mucus and HCO3- secretion
NSAIDS inhibits prostaglandins reducing defences

47
Q

What does breaching of the stomachs defences result in?

A

Peptic ulcers

48
Q

How would you treat peptic ulcers and breaching of the stomachs defences?

A

That h pylori with antibiotics

Use acid secretion methods (H2 antagonist and PPis)

49
Q

How does the vagus nerve asssist in limiting reflux?

A

Relaxes stomach wall as food passes down oesophagus

Pressure does not increase in stomach, allowing large meals to be consumed

50
Q

Name the two types of muscle in the stomach

A

Circular and longitudinal

51
Q

What causes the peristalsic contractions in the stomach?

A

Pacemaker cells in cardia region causes peristaltic contractions towards pylorus

52
Q

What three things slow gastric emptying?

A

Fat, low PH and hypertonicity in duodenum

ESA 3 (2 decks)

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