GI Motility Flashcards
Describe Xerostomia
- Atrophy/destruction of salivary glands
- Many causes like Sjogren’s, Radiation, medications, etc
- Results in dental caries and halitosis, difficulty speaking and swallowing
- Oral pilocarpine helps but has side effects
Describe Candida albicans and related pathology of it vs a viral esophagitis
- pathologic yeast
- Cause Adynophagia and oral thrush
- Viral esophagitis has no dys[phagia or thrush
- Viral is usually immunosuppressive patients
What is Zenker’s diverticulum?
- Herniation of esophageal mucosa though esophageal wall
- Weak cricothyroid muscle is rock factor
- Symptoms: Dysphagia, Regurgitation, and foul smelling breath
Describe Barrett’s esophagus.
- Abnormal healing of erosive esophagitis
- Columnar cells take place of squamous cells
- increased risk of esophageal cancer
Describe Achalasia and treatment for it
- Inability to swallow solids and liquids
- Differs from stomach cancer (Starts as solids and progresses to liquids)
- Bolus retained at LES
- Treated with Botox
What are the two main types of esophageal cancer?
Squamous cell Carinoma —> Upper Esophagus from smoking/alcohol
Adenocarcinoma —> Lower 1/3; Barrett’s esophagus; uncontrolled reflux
How does CCK affect the stomach?
- Increases distensibility
- Inhibits gastric emptying
Describe the Vago-vagal reflex
Distal Stomach wall Stretch receptor —> Vagus nerve (Ach) —> Proximal stomach relaxation Through VIP/NO.
What is the role of Motilin?
Motilin is an enzyme which is highly associated with Phase II Gastric High amplitude contractions
*** Most patients with a motility disorder have problems with Motilin
Describe normal MMC and associated pathology.
- During fasting, Undigested material are moved along the GI track a.k.a. “Housekeeping.”
- This is mediated by the MMC
- Bezoars is the absence of MMC contractions leading to accumulation and obstruction (Particularly in the stomach)
What are the two motility patterns of the SI and it’s role?
Segmental: Mixing
Peristaltic: Moving along GI tract
Which chemical is used in producing peristaltic contractions? Which cell is responsible?
Enterochormatin cells release 5HT
Describe the Slow waves produced in peristalsis.
- Generated by no Contractile pacemaker Interstitial cell of Cajal
- Lowest in stomach, highest in Duodenum
- Slow waves determined frequency of contractions in GI
- Oral to anal direction
What are the types of motility int he LI?
Segmental: Mixing
Mass movement: Propels content from one segment to another
Defecation: Voluntary/involuntary reflexes which cause evacuation through anal canal
Describe Dumping syndrome
- Obese patient’s stomach stapled
- If larger meals are eaten, Rapid absorption of glucose occurs resulting in rapid release of Insulin leading to HYPOGLYCEMIA
- Symptoms: weakness, dizziness, and SWEATING a.k.a. “Dumping”
