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Physiology II > GI II > Flashcards

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
Q

what does a vagotomy impair in the stomach

A

relaxation of the stomach (cant eat as much)

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26
Q

does the stomach use segmentation or peristalsis?

A

both

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27
Q

enterogastric reflex description

A

slows motion of chyme or food and allows more time for digestion in the stomach
triggers are acidity, fat and AA in duodenum

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28
Q

what are the 3 pathways for enterogastric reflex

A

short through ENS
long through CNS
secretion of CCK and secretin

all inhibit motion

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29
Q

dumping syndrome

A

moves through too quickly after GI surgery

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30
Q

delayed emptying

A

gastroparesis, pain causes this, narcotics, diabetes

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31
Q

list in order gastric emptying compounds

A

liquids>CHO>Pro>Fat
isotonic>non tonic
low fiber>high fiber

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32
Q

how long until liquid is emptied? CHO? Pro? Fat?

A

liq 1hr
cho 1.5 hr
pro 2.2 hr
fat 3hr

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33
Q

what things increase gastric emptying

A 
increase peristaltic force stomach
decrease tone of pyloric sphincter
ansence of segmental contraction SI
less acidic, isotonic chyme
tonic tone of orag stomach
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34
Q

what things decrease gastric emptying

A 
decrease peristaltic force stomach
increase tone of pyloric sphincter
sgmentation contractions SI
enterogastric reflex
relaxation of orad stomach
35
Q

duodenum fx

A

mixing, tonicity, acid neutralization

36
Q

jejunum fx

A

enzymatic digestion and absorption

37
Q

ileum fx

A

b12 and bile absorbtion

38
Q

what types of motility does the SI use?

A

peristalsis and segmentation

39
Q

what is sterlings law of intestine

A

distention >ENS> contracts proximal and relaxes distal to move food along

40
Q

intestino-intestinal reflex

A

severe distention causes inhibition of the bowel

41
Q

what is the BER along the SI?

A

as you move futher throught the SI the BER becomes less

42
Q

what is the UES controlled b

A

skeletral muscle

43
Q

what is the LES controlled by

A

smooth muscle

44
Q

how does food go from SI to LI

A

gastroileal reflex

45
Q

gastroileal reflex

A

iluem distends and relaxes ileocecal sphincter

when the colon distends the sphincter closes to prevent backflow

46
Q

fx of LI

A

absorb water 1.5 L, electrolytes, mass movement of waste

47
Q

contents of LI in order

A

fluid then mush then solid

48
Q

what are the best types of poo

A

type 3 and 4

49
Q

why do i have to poo after meal

A 
gastrocolic reflex (food in stomach)
duodenocolic reflex (chyme in duo)

both stimulate mass movement in colon

50
Q

what are the three levels of control for why you get the urge to poo

A

intrinsic, spinal cord, brain

51
Q

which is voluntary the internal or external anal sphincter

A

external sphincter

52
Q

how does the brain send a signal to let you know you need to poo

A

PUdendal nerve to the external anal sphincter

53
Q

does the LI have more peristalsis or segmental contractions

A

segmental

BER is slower but gradually increases as you move along

54
Q

what can diarrhea do to you? why?

A

dehydrate you because most of the fluid that need to be absorbed is from your secretions

55
Q

how are water soluble vitamins C and B absorbed?

A

passive diffusion and Na vitamin symporters

SI

56
Q

how are fat soluble vitamins A D E K absorbed?

A

digested, absorbed, transported with dietary fat
stored in liver and fat cells
SI

57
Q

how are most minerals absorbed

A

depends on what complex they are with

SI

58
Q

where are biotin and vit K produced

A

in LI by bacteria and absorbed there

59
Q

describe b12 absorption from stomach to ileum

A

stomach R protein and IF find Cbl
duodenum proteases degrade R protein
jejunum Cbl and IF bind
Lower ileum most absorption

60
Q

how is b12 stored

A

50% liver

50% other tissue

61
Q

perniclous anemia

A

decrease in RBC bc lack of B12 absorbtion

usually bc of degradation of parietal cells and no IF

62
Q

what are the 3 phases of intestinal digestio

A 
luminal (mixing of chyme, acid, enzym)
brush border (enzymes on surface of luminal surface)
cytosolic (interal digestion in enterocytes
63
Q

how to get from droplets to FFA?

A

lipase can bind droplet
lipase displaced by bile salts
lipase and colipase bind and breakdown fat

64
Q

how are LCFA absorbed?

A

diffusion into cell made into Triglyceride by smooth ER
coated by rough ER and exocytosed
into lym system

65
Q

how are glycerol, short and medium chain FA absorbed?

A

transcellular absorption- cap-portal vein-liver
intracell absorption not resynthesized
lymp or cap

66
Q

failure to digest or absorb lipids may cause what

A

ssteatorrhea (fatty poo)

67
Q

where is most lipids absorbed?

A

jejunum

68
Q

what are the cholesterol transporters?

A

ABCG5 and ABCG8

NPC1L1 ** key to chol. homeostasis

69
Q

what do ABCG5 and ABCG8 do

A

prevent accumulation of dietary cholesterol

70
Q

sitosterolemia

A

mutation in ABCG5&8
hypercholesterolemia
xanthoma (fat grown underneath skin)
atherosclerosis

71
Q

what does ezetrol inhibit

A

NPC1L1 and causes hypercholesterolemia

72
Q

what two enzymes are involved in CHO digestion

A

amylases (breakdown polysac to di and tri)

disaccharidases (breakdown di to mono)

73
Q

what are the two sites of CHO digestion

A

intestinal lumen

brush border membrane

74
Q

where is most of the CHO absorption

A

duodenum and jejunum

75
Q

activation of pancreatic proteases in SI lumen

A

enterokinase activates trypsin

trypsin activates all other peptidases

76
Q

what does trypsin and chymotrypsin break down?

A

protein>peptide>AA

77
Q

what does elastase breakdown

A

elastin fibers and free AA

78
Q

what does carboxypeptidase breakdown

A

AA from PP

79
Q

what are the 3 sites of protein digestion

A

lumen (gastric and pancreatic enzymes)
brush border (enzymes and AA transporter)
cytoplasm (enzymes and AA transporter)

80
Q

what do the AA transport proteins work with?

A

Na

81
Q

what does PEPT1 do?

A

proton coupling and pumps in di-tri peps with H+ and degrade in cytosol
basolateral transport export of AA

82
Q

where are most of the proteins absorbed?

A

jejunum > ileum > duo

83
Q

roux en Y gastric bypass

A

gold standard for weight loss surgery
60% weight gone
correct T2D

84
Q

what are the 6 probelms with RYGB surgery?

A 
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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