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Physiology Unit 3 > GI day 2 (motility and liver function) > Flashcards

GI day 2 (motility and liver function) Flashcards

1
Q

What is peristalsis and what controls it

A

Smooth muscle contraction that occurs in waves
Control: Reflexive response to stretch of GI tract wall

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2
Q

Which parts of the GI tract have Peristalsis

A

From Esophagus to anus

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3
Q

What is segmentation

A

Function is to slow the transit time
Occurs via circular muscle
blocks a portion of the GI tract to slow time

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4
Q

Deglutition

A

Swallowing

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5
Q

Tonic contractions and where they occur

A

Prolonged contractions ( occur in sphincters)

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6
Q

What allows peristalsis to be rythymic

A

we have automatic depolarizing cells (cells of cajal) that set the rythym of the GI tract

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7
Q

What are the spontaneous depolarizing cells of the GI tract

A

Cells of cajal

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8
Q

Smooth muscle cells membrane potential

A

-65 to -45 (spontaneously fluctuate between these two)

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9
Q

What ion is responsible for rhythmic depolarization/ repolarization in peristalsis

A

Depolarization: Ca influx
Repolarization: K efflux

((CA(CA)lifornia is so IN and I will K(K for potassium)nock you OUT if you don’t think so))

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10
Q

What leads to contractions but only during BER depolarization periods

A

spike potentials

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11
Q

What are the spontaneous flucutations in membrane potential of smooth muscle cells between -65 to -45 called

A

Basic electrical rythym

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12
Q

Function of BER

A

Sets rythym of peristaltic contractions

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13
Q

Effect of Ach on peristalsis

A

Parasympathetic NS- decreases time between depolarization (more depolarization, want more contractions b/c resting and digesting)

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14
Q

Effect of epinephrine on peristalsis

A

Increase time between depolarization, want less digestion in stressful times

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15
Q

Describe the phases 1, 2, and 3 of Migrating motor complexes (MMCs)

A

Phase 1: Quiescent period (no activation)
Phase 2: Small, irregular contractions
Phase 3: 5 minutes of irregular contractions

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16
Q

How many minutes after a meal do the MMCs begin

A

90-120 minutes

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17
Q

What stimulates migrating motor complexes

A

Motilin

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18
Q

What types of secretions do MMC contractions lead to

A

secretions of biliary, gastric, and pancreatic juices

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19
Q

What inhibits MMCs

A

Eating inhibits (MMCs begin 90-120 mins after)

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20
Q

What causes gurgling when hungry

A

MMCs

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21
Q

Part of pharynx behind nose

A

nasopharynx

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22
Q

Part of pharynx behind mouth

A

oropharynx

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23
Q

Part of pharynx behind epiglottis

A

laryngopharynx

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24
Q

What is the function of the soft palate during chewing

A

soft palate tips upwards to prevent food from entering nasal passage

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25
Q

What tips downwards to prevent food from entering the respiratory tract during chewing

A

The epiglottis tips downwards and covers the trachea

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26
Q

What does the esophagus connect

A

the laryngopharynx to stomach

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27
Q

Where is the gastroesophageal/cardiac/lower esophageal sphincter

A

Between esophagus and stomach

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28
Q

3 components of the lower esophageal sphincter

A
  1. intrensic (smooth muscle controlled via vagus nerve)
  2. Extrensic (crural portion of diaphram, controlled via phrenic nerve)
  3. Flap valve (oblique fibers in stomach)
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29
Q

Extrensic control of the Lower esophageal sphincter is coordinated with what

A

respiration (same innervation–phrenic nerve– as diaphragm)

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30
Q

What does a hiatal hernia lead to

A

GERD (the diaphragm was helping the sphincter, but now the sphincter is above the diaphragm

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31
Q

What are the 4 reflexive actions in deglutition

A

peristalsis, opening of sphincter, block nasopharynx, block larynx

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32
Q

Which phase of deglution is food formed into a bolus

A

voluntary phase

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33
Q

In the pharyngeal phase, what occurs with the soft palate?

A

The soft palate blocks the nasopharynx by moving upwards

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34
Q

What occurs with the trachea and pharyngeal muscle during the pharyngeal phase

A

The larymx lifts up and blocks the trachea, the eppiglottis tips down to close the glottis.
The pharyngeal muscle contraction moves the bolus into the esophagus

35
Q

What occurs in the esophageal phase of deglutition

A

Upper esophageal sphincter opens
peristaltic contractions move bolus down to stomach
Gastroesophageal (lower esophageal( sphincter opens, bolus enters stomach)

36
Q

Contractions in the stomach are stimulated by

A

stretch due to food

37
Q

Gastric motility has 2 actions to digest food in the stomach. What are they?

A
  1. Relax fundus ( relaxation to recieve the food from the esophagus)
  2. Peristaltic contractions of antrum (antral systole–>pyloric region–>duodenum)
38
Q

Why are contractions of the pyloric regions of the stomach slightly before the antral region

A

Stops larger food from getting to the pyloric sphincter

39
Q

What is absorbed in the stomach

A

Alcohol
Some drugs (i.e. asprin)

40
Q

which factors regulate contraction of the stomach

A

peptide YY and CCK inhibit gastric emptying ( PYY in jejunum and CCK in upper small intestine are released to inhibit more gastric emptying)

41
Q

What neurotransmitter released by EC cells trigger vomitting

A

Serotonin released by enterocromaffin cells trigger vomitting
- Serotonin antagonists like zofran work to decrease

42
Q

Which receptors and where trigger vomitting

A

Dopamine receptors in medulla
- Dopamine antagonists (haladol, antipsychotic) are able to have an inverse effect

43
Q

What is the ileocecal valve opening based on

A

pressure- opens when pressure in lieum exceeds pressure in colon.

44
Q

What is aerophagia

A

swollowed air (some absorbed, some belched, some in colon)

45
Q

What produces gas in the colon

A

Bacteria byproducts (methane, CO2, sulfides)

46
Q

What is rumbling noise known as in the gi tract

A

borborygmi

47
Q

Extra carbs in colon leads to what

A

more gasses (i.e. lactose intolerance)
- usually only starch makes it that far, but in lactose intolerance, so does sugar b/c not broken down

48
Q

Is the external or internal anal sphincter voluntary

A

External is voluntary skeletal muscle

49
Q

How much pressure does it take to activate internal anal sphincter

A

18mm Hg

50
Q

How much pressure does it take to activate external anal sphincter involuntarily

A

55mg Hg

51
Q

What happens to the puborectalis muscle when bearing down

A

Typically it is contracted, but when we are bearing down, it relaxes, so we can poop

52
Q

Describe the gastrocolic reflex

A

Food enters the stomach, cause contraction of rectum, amplified by gastrin release

53
Q

Which artery delivers o2 rich blood to liver

A

hepatic artery

54
Q

Which artery delivers nutrients for processing from the small intestine to the liver

A

hepatic portal vein

55
Q

What kind of cells are in direct contact with blood in the liver

A

hepatocytes

56
Q

Where does blood from the hepatic artery and hepatic portal vein go

A

to the central vein–> hepatic vein

57
Q

Which 3 things are in the portal triad

A

Bile duct, portal venule, hepatic arteriole

58
Q

What are the macrophages in the liver called

A

kupffer cells (immune function, help break down RBCs)

59
Q

Kpuffer cells function

A

Immune function, help break down RBCs

60
Q

Symptoms of gallstones

A

deep pain in abdomen and right arm or between sholder blades

61
Q

What are gall stones made of

A

cholesterol or bilirubin

62
Q

What proteins does the liver make

A

albumin, clotting factors, hormone binding proteins

63
Q

Which organelle does blood detoxification occur in the liver

A

in the smooth ER (one of the most developed in the body)

64
Q

Which nutrient metabolism occurs in the liver

A

Glycogen, vitamin A, iron, fats, proteins, cholestorol, lipoproteins

65
Q

What is the primary contributer to oncotic pressire (osmolality of blood)

A

alblumin

66
Q

What are acute phase proteins

A

made in the liver, secreted into the blood on exposure to stressful stimuli

67
Q

What does IL-6 do in the liver

A

an acute phase protein- secreted by kupffer cells when exposed to inflammatory stimuli–> stimulate hepatocytes to release APPs

68
Q

If you are in a time of intense stress, which protein is likely to be found in your blood?

A

C reactive protein (sign of active inflammation)
Example of Acute phase protein
Made in liver, emptied to blood in stressful times

69
Q

Which cells are the only cells in the body that can complete the whole urea cycle

A

hepatocytes (turn NH3 into urea)

70
Q

Hepatitis A transmission, infection, and symptoms

A

Transmitted by feces, food
Infected–>28 day incubation
Symptoms: weight loss, sore under ribs, sore muscles, jaundice

71
Q

Hepatitis B transmission, infection, and symptoms

A

40% of cases
Transmission by blood, sexual contact

72
Q

Does Hep A or b last longer

A

B (increases risk of liver cancer, too, goes away on its own)

73
Q

Hepatitis c transmission, infection, and symptoms

A

NO vaccine
Lasts for years, might never go away
transmissed by sexual contact
symptoms: dark urine, itchy skin

74
Q

What is the primary hepatitis

A

hep b

75
Q

What causes you to bleed and bruise easily in cirrhosis

A

clotting factors in the body are decreased (Liver produces clotting factors, but is damaged and can’t keep up)

76
Q

What causes you to swell in abdomen or legs in regards to cirrhosis

A

increase portal vein blood pressure, decrease in osmotic pressure)
- Inverse of what we want- we wnat lower portal vein pressure and higher osmotic pressure to push out fluid

77
Q

Why are we extra sensitive to medicines in liver failure

A

detoxification is impaired

78
Q

Why is blood sugar uncontrolled with liver failure

A

send too much glucose into the blood because cant filter

79
Q

What is the new name for NAFLD

A

Metabolic dysfunction associated steototic liver disease

80
Q

Where does NAFLD and MDASLD occur

A

in type 2 diabetes and obesity

81
Q

Cause of NAFLD

A

visceral adipose tissue

82
Q

What is type of heptatitis that increases the risk of liver cancer

A

hep b

83
Q

which type of hepatitis can last for years and might never go away, but also sometimes has no symptoms?

A

hep c

Physiology Unit 3 (6 decks)

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