GI, Hepatic, Panc, BIL, Liver Flashcards
Purpose of the digestive system
digest and absorb ingested nutrients, excrete waste products
reverse peristalsis
contraction muscles of peristalsis move backwards instead of forwards (vomiting)
The little or second brain of the GI tract
ENS (enteric nervous system)
Signs of GI disease
- it starts to…?
-how is nausea induced?
nausea, vomiting, fatigue (it also starts to pull in other symptoms)
by sensation because the nerve endings do not know how to respond so that causes reverse peristalsis
The intrinsic component is the _____ nervous system
-functions independently to control? type of reflex?
The extrinsic autonomic component is the _______ and ______ ______ that comes from the CNS
-of the two components from the CNS what do they do? type of reflex?
-enteric, digestive activities (that is why it’s called the second brain)
-short reflex
-para, symp innervation
-para = enhances digestion, symp= inhibits digestion
-long reflex
What system regulates gastric acid secretion?
intrinsic - enteric nervous system
The 4 layers of the GI wall from deep to superficial
mucosa, submucosa, muscularis, serosa
Where does digestion start
mouth
What secretes gastric acid (HCl-)
parietal cells
Pepsinogen
what releases pepsin
a stomach enzyme that serves to digest proteins
chief cells
Chyme
acidic fluid that goes from the stomach to the small intestine composed of incomplete digested food
Common causes of peptic ulcer disease
complications
treatment
H. Pylori
NSAIDs (low does aspirin)
corticosteroid use
dehydration
bleeding
stop taking NSAID
antibiotic for pylori
Pyloric stenosis
who does it affect
narrow opening between duodenum and stomach, blocks food from getting to small intestine
infants
Stereotypical peristaltic behavior is a
2 directional set of muscle contractions
Most of the water we absorb is in the
small intestine (up to 80%)
Name the segments of the small intestine and what they absorb
Duodenum: carbs
Jejunum: fats + proteins
Ileum: vitamins/ reabsorption of bile
Abnormal frequency, volume or quality of stool
caused by
complications
diarrhea
- poor absorption (more secretion than reabsorption)
(increased enteric activity) - dehydration, hypOtension
constipation
causes primary vs secondary?
clinical complications
infrequent bowel movement or difficulty evacuating stools
primary constipation: nuero/myopathic
secondary: hypercalcemia, hypothyroidism
bowel incontinence and bladder dysfunction
When increased intra - abdominal pressure leads to protrusion of stomach and abdominal viscera into the mediastinum
most commn type?
complications
hiatal hernia
type 1 (sliding)
HTN, GERD
Dyssynergia
it is an _____ behavioral disorder due to _______
inability to coordinate abdominal, anorecto, or pelvic floor muscle during defecation
acquired, direct trauma or disuse
GERD
most prevalent in ____ but is usually resolved by
also can cause
a build up of bilirubin in blood stream causing yellow skin
clinical complications of GERD
gastroesophageal reflux disease
kids
1 year old (>50%)
hiccups in babies
jaundice
cancer risk and renal disease
Signs of typical vs atypical GERD
med mngmnt
T: heartburn, chest pain, gas
A: persistent cough, asthma, chronic sore throat
weight loss, proton pump inhibitor
Osteoporisis
This is a ___ ___ disorder because?
Bone disease that develops when bone mineral and bone mass decreases
GI tract.. malabsorption of calcium and magnesium
Symptoms of malabsorption
muscle weakness, muscle wasting
The hormone in the small intestine secreted into the blood upon ingestion of food
CCK
Where is bile formed
where is it stored
liver
gallbladder (yellow to green fluid)
What does CCK do
functions of released ____ ?
what is zymogen
stimulates the gallbladder to. contract and release stored bile into the intestine
- emulsify fat in small int (in order to digest more)
- aids digestion of fat soluble vitamins
-neutralize acidic chyme - excrete bilirubin and cholesterol (up to 10% a day)
-bactericide food
enable the production of inactive enzymes within the cell that are not activated until after they are secreted
Central storage of cholesterol
Liver
Most common type of stones in gallstone disease
where is the most common site of referred pain
mixed (75-90%)
upper right quadrant: shoulder
Left over RBC’s (breakdown of hemoglobin)
it is very toxic in the ______?
gives ____ and ____ its color
bilirubin
blood
feces and pee
Major papilla (ampulla of vater)
Accessory papilla
common bile duct
accessory duct
Most common disease effecting billiary system
symptoms often occur when
primary trx
gallstone disease
postprandial (after eating)
cholecystectomy
Pancreas divisum
congenital disorder - birth defect in which parts of the pancreas do not join together
Endocrine functions of the pancreas
exocrine
- Makes insulin
- secretion of digestive enzymes into duodenum
islets of langerhans
pancreatic cell that produces hormones (insulin and glucagon) secreted into the bloodstream
Pancreatic acinar cells
Pancreatic ductal cells
What enzyme is a precursor to protease
secretion of pancreatic digestive enzymes in the lumen
secrete bicarbonate solution/ deliver enzymes to duodenum
zymogen
The 3 phases of digestion
all 3 phases lead to ….. because?
cephalic (nervous-vagus)
gastric (hormonal-gastrin)
intestinal (hormonal-scretin, cholecystokinin)
secretion of pancreatic juice, the pancreas needs time to start producing enzymes
Cause of acute pancreatitis
this can lead to
chronic pancreatitis leads to inflammation and fibrosis which causes
med management
alcohol, gallstones
systemic multiple organ failure (because if the pancreas is injured so are others)
decrease in exocrine - acinar
decrease in endocrine - islets of langerhans (impaired control of metabolism)
PERT
Liver does protein synthesis of?… (6)
(largest protein circulating through the blood)?
albumin (largest protein circulating through the blood)
fibrinogen
plasminogen
transferrin (stored in ferretin)
IGF - 1
angiotensinogen
Main functions of the liver
liver dysfunction leads to a build up of
lipid/glycogen storage
cholesterol formation
bile formation/ bilirubin
immune
metabolism of T4-T3; estrogen
estrogen
urea cycle
occurs?
converting ammonia into urea
liver
nutrients stored in the liver
2 blood supplies to the liver
Vitamin A,D,E,K,B12, Iron, Copper
hepatic artery
hepatic portal vein
Kupffer cells (in liver)
!specialized macrophages
protect from foreign/bacteria viruses!
detoxification
descry “old” RBC
Stellate cells (in liver)
!storage of vitamin A!
activated through injury (we don’t really want them activated)
3 stages of the liver
cirrhosis causes
normal-fibrotic-cirrhotic
ascites
