GI/Liver Flashcards by Jacob Marthinsen

__________: aka the GI system has a 2nd nervous system.

____________ responsible for
GI movement/peristalsis

______________
Secretions/blood flow

Enteric NS: aka the GI system has a 2nd nervous system.

Myenteric/Auerbach’s plexus (My/Our)
GI movement/peristalsis

Submucosal/Meissner’s plexus
Secretions/blood flow

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GI Primary parasympathetic:
GI Sacral parasympathetic:

Primary parasympathetic: Vagus nerve up to transverse colon. )1/2 of large intestine)
Sacral parasympathetic: Transverse colon to anus (second half large intestine down)

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Acetylcholine =_______
NE = ________

Acetylcholine = excites GI
Norepinephrine = inhibits (T5-L2) GI

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The hormone ________, aka HCl, aka stomach acid
Bottom of the stomach secreted by ________.
Secreted to break ______ down.

Gastrin, aka HCl, aka stomach acid
Bottom of the stomach, G cells. (G for gastric)
Secreted to break proteins down.

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what hormone releases bile?
INHIBITOR OF GASTRIC EMPTYING
The reason _______ are filling; bile is for_______ breakdown

Cholecystokinin/CCK, releases bile (gallbladder contraction)
INHIBITOR OF GASTRIC EMPTYING
The reason fats are filling; bile is for fat breakdown

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What hormone secretes everything except gastric acid and insulin.
Actually inhibits gastrin along with _______

Secretin
Secretes everything except gastric acid and insulin
Actually inhibits gastrin along with gastric inhibitory peptide

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What hormone is responsible for:
Insulin Release, inhibits gastric acid.
One of ozempic’s cousins can work on this

Gastric inhibitor peptide
Insulin Release, inhibits gastric acid.
One of ozempic’s cousins can work on this

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what hormone is responsible for Motility?

Motilin
Motility

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Very important to know what CCK does and what triggers it.

Very important to know what CCK does and what triggers it.
Fats trigger, it makes you feel full.

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GI Blood flow uses ___________
AKA blood flows through the _________ on return.

___________ get absorbed earlier than _______.

Uses splanchnic circulation
AKA blood flows through the portal vein on return.
Carbs and protein get absorbed earlier than fats.

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Know the two main arteries off the aorta:

Know the two main arteries off the aorta: SupMesentericArt and IMA.
SMA is probably most important.

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_______ are the functional unit of the liver (the nephron of the liver)

Lobules are the functional unit (the nephron of the liver)

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You must know the order of blood flow through liver:

You must know the order of blood flow:
Portal veins
Sinusoids
Central veins
Hepatic veins
IVC

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_________ eat toxins/bacteria as the blood flows through them. (aka the detox part of your liver)

________ are pretty much just small canals.

Kupffer cells eat toxins/bacteria as the blood flows through them. (aka the detox part of your liver)

Canaliculi are pretty much just small canals.

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The stomach mixes food for a while until it turns into _______, aka food + gastric secretions.

The _______ is the end of the stomach, and it prevents you from dumping your entire meal into your intestines immediately.

The stomach mixes food for a while until it turns into chyme, aka food + gastric secretions.

The pylorus is the end of the stomach, and it prevents you from dumping your entire meal into your intestines immediately.

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Gastric glands in the beginning have multiple cell types:

Chief Cells
Parietal Cells

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Chief cells secrete ________
Parietal cells secrete _______

Pyloric glands mainly just secrete _______

Chief cells:
Pepsin
Parietal cells:
HCl and intrinsic factor

Pyloric glands mainly just secrete gastrin.

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Intrinsic factor is very important, because

Intrinsic factor is very important, because you cannot absorb B12 in your small intestine without it.

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__________ mainly secrete gastrin, and they are like the last stop. Imagine if a bunch of food reaches the end of your stomach but you need more acid to break it down more. It can then secrete gastrin to up your acid secretion.

Pyloric glands mainly secrete gastrin, and they are like the last stop. Imagine if a bunch of food reaches the end of your stomach but you need more acid to break it down more. It can then secrete gastrin to up your acid secretion.

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After your stomach is the __________, the first part of the small intestine.

The presence of fats specifically is one of the indicators for your _________ to _________ gastric emptying. AKA _______ and ______

After your stomach is the duodenum, the first part of the small intestine.

The presence of fats specifically is one of the indicators for your duodenum to slow gastric emptying. AKA CCK and GIP

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The duodenum runs a series of checks on what’s exiting your stomach. If it’s getting too much, it will get ____________, so it will ________ your gastric emptying. If its too acidic or there’s weird stuff in it, it can also________ gastric emptying.

The duodenum runs a series of checks on what’s exiting your stomach. If it’s getting too much, it will get distended or irritated, so it will inhibit your gastric emptying. If its too acidic or there’s weird stuff in it, it can also inhibit gastric emptying.

The _______ is both an exocrine and endocrine gland.

Exocrine cells are called ________

Pancreas

Acini Cells

Pancreas Exocrine function:
Acini cells:
_________
Proteins: ______ + _________ + __________ (all start inactivated)
Carbs: _____________
Fats: __________ + _________ + _____________

Exocrine function:
Acini cells:
Bicarbonate
Proteins: Trypsin + chymotrypsin + carboxypolypeptides (all start inactivated)
Carbs: Pancreatic amylase
Fats: Pancreatic lipase + Esterase + Phospholipase

Multiple ways the SI increases absorption/surface area.

Valvulae Conniventes (_______x)

Villi (__________x)

Brush border Microvilli (________x)

Overall: _________x

Multiple ways the SI increases absorption/surface area.

Valvulae Conniventes (3x)

Villi (10x)

Brush border Microvilli (20x)

Overall: 1000x

Carb types:

Monosaccharides: (AKA simple sugars) Disaccharides: Polysaccharides:

Monosaccharides (AKA simple sugars) types:

Monosaccharides: (AKA simple sugars) Glucose Fructose (sweetest) Galactose (never found naturally alone, always as lactose)

Disaccharides:

Disaccharides: ***Sucrose*** (MC disaccharide) = glucose + fructose ***Lactose*** (least sweetest) = galactose + glucose Maltose (beer, cereals, germinating seeds) = 2 glucose

Sucrose =

Sucrose (MC disaccharide) = glucose + fructose

Lactose =

Lactose (least sweetest) = galactose + glucose

Maltose =

Maltose (beer, cereals, germinating seeds) = 2 glucose

Polysaccharides:

Starch Glycogen

________ are first digested by ________ amylase, then _________ amylase ***(note you have two sources of amylase)***

Carbs are first digested by salivary amylase, then pancreatic amylase ***(note you have two sources of amylase)***

Each of the disaccharides has a enzyme for it, aka sucrose has ________.

Each of the disaccharides has a enzyme for it, aka sucrose has sucrase.

_______ is used for breakdown of the COMPLEX carbs/polysaccharides.

Hydrolysis is used for breakdown of the COMPLEX carbs/polysaccharides.

_______ is used for breakdown of triglycerides to _______ and ______ via _________

Hydrolysis is used for breakdown of triglycerides to 3 FAs + glycerol via pancreatic LIPASE

Hydrolysis used for the breakdown of: Hydrolysis used for the breakdown of:

Used for breakdown of the ***COMPLEX carbs/polysaccharides.*** Used for breakdown of ***triglycerides to 3 FAs + glycerol via pancreatic LIPASE*** Theres extra lipase in the intestine (enteric, but very minimal).

Fat digestion: _________+_________= Emulsified fats Emulsified fats + ________ =________________

Fat Digestion: _________ via bile acids Bile acids + agitation = ___________ __________ get broken down _________ are formed (smaller things)

Emulsification via bile acids Bile acids + agitation = emulsified fat droplets Triglycerides get broken down Micelles are formed (smaller things)

Protein Digestion: Proteins require ___________ to break down. Digestion doesn’t really take place until the_________. __________ (inactive form), doesn’t get activated until the stomach via ________.

Proteins require a lot of enzymes to actually break down. Digestion doesn’t really take place until the stomach. Pepsinogen (inactive form), doesn’t get activated until the stomach via HCl.

Lipoproteins: It goes from VLDL (very low density) to HDL (high density) Density refers to how much _______ is in it, aka a VLDL is mainly just ______ and ________. LDL = _______, HDL = _______ cholesterol Mostly stored as __________ in ________ cells or in the _______.

It goes from VLDL (very low density) to HDL (high density) Density refers to how much protein is in it, aka a VLDL is mainly just lipids and cholesterol. LDL = bad, HDL = good cholesterol Mostly stored as TriGlyceridess in adipose cells or in the liver.

GI Disorders: many mechanisms, but they all have to do with nerves.

Swallowing paralysis: many mechanisms, but they all have to do with nerves.

GI Disorders: hypercontractile lower esophageal sphincter (LES)

Achalasia = hypercontractile lower esophageal sphincter (LES) = the sphincter right before the stomach.

GI Disorders: H. pylori infection or excess NSAID use. Too much acid erodes the mucusa.

Peptic Ulcer Disease = H. pylori infection or excess NSAID use. Too much acid erodes the mucusa.

GI Disorders: Gallstones or ETOH binge for MCC

Pancreatitis = Gallstones or ETOH (ethanol) binge for MCC

GI Disorders: _______ Non-tropical vs Tropical Non-tropical = _______ = _____________ Tropical = ________ = ________

Sprues: Non-tropical vs Tropical Non-tropical = celiac = gluten will actually kill your SI villi. (familial inheritance) Tropical = bacteria induced = treat with abx

GI Disorders: _________ is a subtype of IBD (Inflammatory bowel disease), not the same as IBS. MC affects ______ and _________

Ulcerative Colitis is a subtype of IBD (Inflammatory bowel disease), not the same as IBS. MC affects sigmoid colon and rectum.

________ becomes as issue because the death of your SI villi is not really reversible. You will gradually lose villi, and without villi, you cannot absorb ___________. __________ people can develop deficiencies very easily as a result, such as _______.

Celiac disease becomes as issue because the death of your SI villi is not really reversible. You will gradually lose villi, and without villi, you cannot absorb nutrients properly. Celiac people can develop deficiencies very easily as a result, such as B12 anemia.

VLDLs have

High concentrations of TG Moderate c of cholesterol and phospholipids

IDLs have:

Some TGs removed Higher concentration of cholesterol and phospholipids than VLDLs

LDLs have:

Almost no TGs Very high conc of cholesterol Moderate conc of phospholipids

HDLs have:

High protein Small amounts of cholesterol and phospholipids