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GI II Flashcards

1
Q

peristalsis? where does this occur?

A 
propulsion through the area
esophagus
stomach
Small intestine
large intestine
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2
Q

segmentation? where does this occur?

A

used for mixing
stomach
small intestine
large intestin

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3
Q

tonic contraction? where does this occur?

A

just a held contraction of sphincters

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4
Q

mastication

A

chewing

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5
Q

deglutition

A

swallowing

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6
Q

describe the 4 phases of chewing and swallowing

A

phase 1 oral chew: voluntary .1 sec
phase 2 oral propulsive: voluntary .5sec
phase 3 phayngeal: involuntary swallow reflex .5sec
phase 4 esophageal: involuntary peristalsis

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7
Q

what are the goals of chewing and swallowing

A

grind food
introduce salivary lipase and amylase
lubricate
small bolus

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8
Q

what are the two forms of peristalsis

A

primary and secondary

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9
Q

primary peristalsis

A

intially swallow food
UES and LES open
ANS= long reflex

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10
Q

where does the vaso-vagal response coordinate with?

A

dorsal vagal complex in medulla oblongata

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11
Q

is primary or secondary peristalsis impaired by vagotomy?

A

primary peristalsis

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12
Q

secondary peristalsis

A

distension from food in esophagus
LES opens
ENS- short reflex

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13
Q

which peristalsis creates orad contraction and caudad distension?

A

primary

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14
Q

GERD

A

LES too relaxed

laying down after meals or being pregnant

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15
Q

what are some side effects of GERD

A

asthma (aspiration)
chronic sinus infxn (reflux into throat)
stricture of esophagus (scar tissue)
barretts esophagus leads to throat cancer

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16
Q

what are tonic LES contraction decreased with

A

alchohol
chocolate
smoking

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17
Q

what are tonic LES contractions increased with

A

acid and protein

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18
Q

achalasia

A

LES too constricted (ENS myoenteric plexus dysfunction)

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19
Q

symptoms of achalasia

A

weight loss, belching, dysphagia (trouble swallow) halitosis

rupture of esophagus

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20
Q

halitosis

A

bad breath

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21
Q

how much can the achalasia LES hold?

A

1L of food or drink

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22
Q

what inhibits motilin?

A

feeding

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23
Q

what is the migrating motor complex

A

induced by ghrelin after 90min cycles to ensure gastric emptying and SIBO (phase 2)
motilin induces step 3 that causes meaningful contractions

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24
Q

how does your stomach fit so much food

A

1 stretch
2 ENS local
3 ENS> vago vagal
2 and 3 release NO and VIP

4 food in duodenum releases CCK which causes more relaxation by trigger 2 and 3

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25
what does a vagotomy impair in the stomach
relaxation of the stomach (cant eat as much)
26
does the stomach use segmentation or peristalsis?
both
27
enterogastric reflex description
slows motion of chyme or food and allows more time for digestion in the stomach triggers are acidity, fat and AA in duodenum
28
what are the 3 pathways for enterogastric reflex
short through ENS long through CNS secretion of CCK and secretin all inhibit motion
29
dumping syndrome
moves through too quickly after GI surgery
30
delayed emptying
gastroparesis, pain causes this, narcotics, diabetes
31
list in order gastric emptying compounds
liquids>CHO>Pro>Fat isotonic>non tonic low fiber>high fiber
32
how long until liquid is emptied? CHO? Pro? Fat?
liq 1hr cho 1.5 hr pro 2.2 hr fat 3hr
33
what things increase gastric emptying
``` increase peristaltic force stomach decrease tone of pyloric sphincter ansence of segmental contraction SI less acidic, isotonic chyme tonic tone of orag stomach ```
34
what things decrease gastric emptying
``` decrease peristaltic force stomach increase tone of pyloric sphincter sgmentation contractions SI enterogastric reflex relaxation of orad stomach ```
35
duodenum fx
mixing, tonicity, acid neutralization
36
jejunum fx
enzymatic digestion and absorption
37
ileum fx
b12 and bile absorbtion
38
what types of motility does the SI use?
peristalsis and segmentation
39
what is sterlings law of intestine
distention >ENS> contracts proximal and relaxes distal to move food along
40
intestino-intestinal reflex
severe distention causes inhibition of the bowel
41
what is the BER along the SI?
as you move futher throught the SI the BER becomes less
42
what is the UES controlled b
skeletral muscle
43
what is the LES controlled by
smooth muscle
44
how does food go from SI to LI
gastroileal reflex
45
gastroileal reflex
iluem distends and relaxes ileocecal sphincter | when the colon distends the sphincter closes to prevent backflow
46
fx of LI
absorb water 1.5 L, electrolytes, mass movement of waste
47
contents of LI in order
fluid then mush then solid
48
what are the best types of poo
type 3 and 4
49
why do i have to poo after meal
``` gastrocolic reflex (food in stomach) duodenocolic reflex (chyme in duo) ``` both stimulate mass movement in colon
50
what are the three levels of control for why you get the urge to poo
intrinsic, spinal cord, brain
51
which is voluntary the internal or external anal sphincter
external sphincter
52
how does the brain send a signal to let you know you need to poo
PUdendal nerve to the external anal sphincter
53
does the LI have more peristalsis or segmental contractions
segmental | BER is slower but gradually increases as you move along
54
what can diarrhea do to you? why?
dehydrate you because most of the fluid that need to be absorbed is from your secretions
55
how are water soluble vitamins C and B absorbed?
passive diffusion and Na vitamin symporters | SI
56
how are fat soluble vitamins A D E K absorbed?
digested, absorbed, transported with dietary fat stored in liver and fat cells SI
57
how are most minerals absorbed
depends on what complex they are with | SI
58
where are biotin and vit K produced
in LI by bacteria and absorbed there
59
describe b12 absorption from stomach to ileum
stomach R protein and IF find Cbl duodenum proteases degrade R protein jejunum Cbl and IF bind Lower ileum most absorption
60
how is b12 stored
50% liver | 50% other tissue
61
perniclous anemia
decrease in RBC bc lack of B12 absorbtion | usually bc of degradation of parietal cells and no IF
62
what are the 3 phases of intestinal digestio
``` luminal (mixing of chyme, acid, enzym) brush border (enzymes on surface of luminal surface) cytosolic (interal digestion in enterocytes ```
63
how to get from droplets to FFA?
lipase can bind droplet lipase displaced by bile salts lipase and colipase bind and breakdown fat
64
how are LCFA absorbed?
diffusion into cell made into Triglyceride by smooth ER coated by rough ER and exocytosed into lym system
65
how are glycerol, short and medium chain FA absorbed?
transcellular absorption- cap-portal vein-liver intracell absorption not resynthesized lymp or cap
66
failure to digest or absorb lipids may cause what
ssteatorrhea (fatty poo)
67
where is most lipids absorbed?
jejunum
68
what are the cholesterol transporters?
ABCG5 and ABCG8 | NPC1L1 ** key to chol. homeostasis
69
what do ABCG5 and ABCG8 do
prevent accumulation of dietary cholesterol
70
sitosterolemia
mutation in ABCG5&8 hypercholesterolemia xanthoma (fat grown underneath skin) atherosclerosis
71
what does ezetrol inhibit
NPC1L1 and causes hypercholesterolemia
72
what two enzymes are involved in CHO digestion
amylases (breakdown polysac to di and tri) | disaccharidases (breakdown di to mono)
73
what are the two sites of CHO digestion
intestinal lumen | brush border membrane
74
where is most of the CHO absorption
duodenum and jejunum
75
activation of pancreatic proteases in SI lumen
enterokinase activates trypsin | trypsin activates all other peptidases
76
what does trypsin and chymotrypsin break down?
protein>peptide>AA
77
what does elastase breakdown
elastin fibers and free AA
78
what does carboxypeptidase breakdown
AA from PP
79
what are the 3 sites of protein digestion
lumen (gastric and pancreatic enzymes) brush border (enzymes and AA transporter) cytoplasm (enzymes and AA transporter)
80
what do the AA transport proteins work with?
Na
81
what does PEPT1 do?
proton coupling and pumps in di-tri peps with H+ and degrade in cytosol basolateral transport export of AA
82
where are most of the proteins absorbed?
jejunum > ileum > duo
83
roux en Y gastric bypass
gold standard for weight loss surgery 60% weight gone correct T2D
84
what are the 6 probelms with RYGB surgery?
``` 1 faster so less dig/abs 2 dumping diarhhea 3 intake less water bc feel full consti. 4 decrease glucose absorption 5 vit B12 def 6 mineral (iron and calcium) def ```

Physiology II (10 decks)

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