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G.I Flashcards

1
Q

During the fasting state what movements occur in the stomach and what induces them and how regular are they?

A

Migratory Motor Complex

Motilin

every 90 -120mins

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2
Q

What are the Enterogastrones that reduce acid secretion?

A

Secretin

CCK

GIP

Peptide YY

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3
Q

What are the main mechanisms that allow the stomach to accomodate more food?

A

Vagas Vagal Reflex

Entero - Gastric Reflex

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4
Q

What is the muscle contractions that happen in the stomach to force chyme through the pyloric sphincter?

A

Pyloric Pump Contractions - 20% of the Basic Electrical Rate

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5
Q

What is the term for the electrical activity that occurs in the stomach when food is present that helps mix?

A

Basic Electrical Rate

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6
Q

Where does Secretin come from and how does it work to inhibit HCl?

A

S cells of the dudoneum

Increases:

  • somatostatin
  • Reduces Gastrin
  • Directly inhibits Parietal cells
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7
Q

What are the stages of Migratory Motor Complex?

A

Stage I: Quiescence

Stage II: Increased frequency of contraction

Stage III: Peak electrical and mechanical activity

Stage IV: Decline in activity leading to stage I

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8
Q

What are the movements in the Large intestines?

A

Mass movements

Haustra movements

Segmental propulsion

Main action is to mix the content well

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9
Q

What is the reflex that stimulates mass movement? can be triggered by intake of food.

A

Gastro- Coelic reflex

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10
Q

How do D cells work to control acid secretion?

A

If the pH drops they release somatostatin which acts directly on the G cells and parietal cells

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11
Q

When HCO3 is produced from HCl production, how is it transported out of the cell?

A

Cl- transporters. The Cl- which comes in is then used to make the HCl.

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12
Q

During swallowing what substances cause relaxation of the esophagus?

A

Nitric oxide

Vaso active peptide

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13
Q

During swallowing what substances cause constriction of the esophagus?

A

ACh

Substance P

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14
Q

How long does swallowing take?

A

8 - 10 seconds

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15
Q

What cranial nerves are involved in afferent stimulation of swallowing?

A

Trigeminal : V

Glossopharangeal : IX

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16
Q

What cranial nerves are involved in efferent stimulation of swallowing?

A

Trigeminal: V

Glossopharangeal: IX

Vagus: X

Hypoglossol : XII

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17
Q

What is the enzyme that converts Non Heme (Fe3+) into Heme Iron (Fe2+)

A

Duodenal Cytochrome B

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18
Q

Which transporter moves Fe2+ out of the lumen and into the cell and what cell is this?

A

Divalent Metal Transporter - 1

Enterocyte

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19
Q

What is the Transporter that moves Fe2+ out of the enterocyte and into the blood?

A

Ferroportin -1

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20
Q

What hormone released by the liver inhibits the movement of Fe2+ from the enterocytes into the blood and what transporter does it work on?

A

Hepcidin

Ferroportin - 1

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21
Q

What is the fate of Fe2+ when it enters the enterocyte?

A

Transported out of the cell into blood via ferroportin- 1

stored as:
Hemosiderin
Ferritin

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22
Q

What is the transporter of Fe2+ in the blood, and what happens if the levels of Fe2+ are sensed to be higher? and what if sensed to be lower?

A

Transferrin

if high levels of Fe2+ , the synthesis of transferrin decreases

if levels are sensed to be low then synthesis of transferrin increases

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23
Q

What are the two major movements of the small intestines?

A

Segmentation

Peristalsis

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24
Q

What controls peristalsis with brief overview

A

Myenteric plexus

Ascending: circular constriction - ACh and Substance P

Descending - dilation and longitudinal - NO and VIP

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25
What is the electrical activity that governs the contractions in the small intestines?
Basic Electrical Rhythm
26
What is the BER in the small intestines?
Duodenum: 12/ min Jejunum: 10/ min Ileum: 9/ min
27
What are the folds in the Intestine called?
Plicae Circularis / Valves of Kerkring
28
What is at the bases of the Villi and where are they most prominent?
Intestinal Glands Most commonly seen in Jejunum
29
What cells are found in the intestinal Glands?
Stem Cells Entero - endocrine cells Panath cells
30
What do Entero - endocrine cells release?
CCK Secretin 5 - hydroxytryptamine - serotonin
31
In the ileum what defensive structure is found in the submucossa and what cells are present?
Peyer's patch's M - cells Dentritic cells lymphocytes
32
What is the most potent stimulation for pancreatic enzyme release?
CCK - stimulation of pancreatic enzymes release Secretin - stimulation of Bicarbonate VIP - relaxation of ampulla of vater
33
What is the stimulator for bicarbonate secretion from the pancreas?
Secretin and Vagus reflex
34
What cells in the pancreas produce Bicarbonate?
Intercalated duct cells
35
What Can be a useful distinguishing feature of duodenum?
Lack of mesentery
36
What nerve controls the external anal sphincter?
Pudendal Nerve
37
What is the transporter than secretes Cl- into the lumen called?
Cystic Fibrosis Transmembrane Regulator
38
At the intestinal glands Cl- is secreted, with Na2+ and H2O following. These are then reabsorbed with more. what is the process of secretion and re absorption called?
Fluid Circuit Hypothesis
39
For the absorption of di and tri peptide chains - what is the driving force?
H+ ions which were pumped out in order to create a gradient to allow their absorption
40
Single amino acids are co-absorbed with?
Na2+
41
What is the protein that regulates Cl- secretion in the G.I system?
Cystic fibrosis trans-membrane regulator
42
What GLUT receptors are present on the small intestines? and what does each transport?
GLUT 1: co transporter with NA2+ and glucose GLUT 5: Fructose GLUT 2: on basal lateral aspect. transports glucose etc into blood
43
What is the functions of the greater omentum?
1. Fat disposition 2. infection and wound localisation control 3. Immune contribution Can be used during surgery of pelvic cavity to reduce spread of infection
44
What do the I cells release?
CCK
45
What is the normal LOS pressure?
10-15mmHg
46
How long is the normal oesphagus?
~25cm long
47
What receptor does Gastrin on the parietal cells stimulate?
Cholecytokinin - 2 receptor
48
What type of protease is pepsin and trypsin?
Endopepsidases
49
What glucose transporter found in the small intestines?
SGLT-1
50
Through which intracellular processes does ACh and Gastrin produces HCl?
Activation of Phospholipase C > IP3 and DAG > Protein kinase > activation of tubular vesicles
51
Through which intracellular processes does Histamine Activate HCl production?
Adenly cyclase > cAMP > Protein kinase A
52
What hormone is related to Gastrin?
CCK
53
What cells release CCK?
I cells of the duodenum
54
Where does GIP come from?
K cells of the duodenum
55
Outwith reducing reducing the stomach activity, what else will GIP do, and why?
Stimulate insulin from pancreas. this is because it is an incretin.
56
What are the layer's of the external muscle of the stomach from inside to outside?
Oblique > circular > longitudinal
57
Name some disease which cause unconjugated bilirubin in the blood.
Anemia haemloylsis - malaria Gilbert's syndrome Viral Hepatitis Yellow fever
58
What protects the stomach from acid?
Mucus production tight junctions bicarbonate release
59
What are the non-proteolytic enzymes from the pancreas?
Lipases Amylase Ribonucleases Deoxyribosnucleases
60
How much Iron is needed to be absorbed per day?
20mg
61
With regard to the muscle, how does peristalsis work?
First: Circular contract behind bolus Second: longitudinal contract in front shortening the tube

Medicine 2 (28 decks)

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