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Anatomy > GI- Peritoneum and Stomach > Flashcards

GI- Peritoneum and Stomach Flashcards

1
Q

mucosa

A

innermost layer of the human digestive tract; epithelium lamina propria, muscularis mucosa

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2
Q

submucosa

A

layer of CT directly under the mucosa

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3
Q

muscularis

A

smooth muscle w/ 2 layers; inner circular and outer longitudinal responsible for peristalsis

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4
Q

serosa/adventitia

A

outermost layer incl. mesothelium and thin CT; when we reach the abdominal pelvic cavity, adventitia → serosa (thin layer of epithelium secreting serosal fluid to allow organs to move around in abdominal pelvic cavity; has some CT to glue epithelium down to muscularis)

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5
Q

enteric nervous system

A

helps coordinate peristalsis

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6
Q

peristalsis

A

alternating waves of muscle contraction and relaxation used to move food through the GI tract

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7
Q

what are the components of the ENS?

A

myenteric plexus, submucosal plexus, interstital cells of Cajal

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8
Q

myenteric plexus

A

nerve supply between the two layers of the muscularis externa; provides smooth, coordinated contraction for peristalsis

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9
Q

submucosal plexus

A

neuronal network in submucosa of esophageal, stomach, and intestinal walls that regulates enzyme secretion

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10
Q

interstitial cells of Cajal

A

pacemaker cells of the gut

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11
Q

ENS role

A

generate localized reflexes

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12
Q

what do sensory neurons from mucosal epithelium detect?

A

stretch, pH changes or chemical composition to regulate activities of either plexus (parasympathetic and sympathetic responses of the ANS)

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13
Q

what is sensory info. also shared with in the ENS?

A

shared with the spinal cord (stretch as a pain signal)

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14
Q

what does parasympathetic output do?

A

SLUDD, also fine tunes the end muscles or epithelium and glands (major innervation by CN X)

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15
Q

what does sympathetic output do?

A

decreases SLUDD, mainly by constricting blood vessels to gut

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16
Q

sympathetic innervation for the gut

A

ganglia are located at the collateral ganglia

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17
Q

what are the 3 collateral ganglia?

A

celiac, superior mesenteric, inferior mesenteric; they sit at the base of major arteries supplying blood to GI tract and follow blood supply to get to the wall
- communicate input all at once to “shut down” function in fight or flight response

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18
Q

parasympathetic innervation

A

cranial and sacral output innervating mostly proximal and some distal parts of the GI tract (CN X); ganglia sit in the walls of organs

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19
Q

what part of the gut does the vagus nerve innervate?

A

liver, stomach, small intestine, 2/3 of the large intestine

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20
Q

what nerve innervates the sigmoid colon?

A

pelvic splanchic nerves; sacral in origin (lower spinal cord) to initiate the defecation reflex

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21
Q

peritoneum

A

a multilayered membrane that protects and holds the organs in place within the abdominal cavity

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22
Q

parietal peritoneum

A

the outer layer of the peritoneum that lines the interior of the abdominal wall

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23
Q

visceral peritoneum

A

the inner layer of the peritoneum that surrounds the organs of the abdominal cavity

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24
Q

what are the 5 folds of the peritoneum?

A

falciform ligament, lesser omentum, greater omentum, mesentery, and mesocolon

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25
Q

falciform ligament

A

attaches liver to anterior abdominal wall and diaphragm and divides it into 2 major lobes

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26
Q

lesser omentum

A

structure attached to the lesser curvature of the stomach and attaches it to the inferior surface of the liver

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27
Q

greater omentum

A

hangs down from the greater curvature of stomach and folds back up to attach to large intestins; is first fold seen containing lots of adipose, blood vessels and lymphatic tissue

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28
Q

mesentery

A

Suspends the small intestine; huge double layer of the parietal peritoneum that attaches parts of the intestine to the posterior abdominal wall

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29
Q

mesocolon

A

suspends the transverse colon from the posterior abdominal wall; allows it to freely move when feces are moving through the large intestine

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30
Q

which structures in the abdominal cavity are retroperitoneal?

A

pancreas, duodenum, ascending and descending colon, kidneys

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31
Q

in addition to the 4 layers, what are the alterations in the stomach?

A

rugae, the innermost oblique muscle layer and serosa

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32
Q

rugae

A

specialized foldings of the mucosa allowing the stomach to expand for larger capacity

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33
Q

innermost oblique muscle layer

A

third layer aiding mechanical digestion (churning to mix gastric secretions to pulverize food)

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34
Q

what are the regions of the stomach?

A

cardia, fundus, body, pylorus

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35
Q

cardia

A

area around the opening of the esophagus and closest to the heart

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36
Q

fundus

A

Very top of the stomach; holding area for semi-digested food

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37
Q

body of the stomach

A

greatest region where 3 muscular laters are most developed w/ intense rugae

38
Q

pyloric region

A

3 subregions:
Antrum
Canal
Pyloric

39
Q

curvatures of the stomach

A

greater and lesser

40
Q

what are the main functions of the stomach?

A

having an extremely acidic environment to digest proteins and break down + mix chyme to be put into the duodenum, produce intrinsic factor for vitamin B12 absorption in the small intestine

41
Q

what is the significance of vitamin B12?

A

DNA synthesis; since it is an animal source the protein must first be natured to release the vitamin which the intrinsic factor will then bind, absorb drugs

42
Q

venous drainage of the stomach

A

superior mesenteric v. drains R gastro-omental, splenic vein drains L gastro-omental and short gastric v., L and R gastric veins; all of which drain into the hepatic portal vein

43
Q

hepatic portal system

A

all capillary beds within the wall of the GI tract converge and form veins that enter the liver, which then disperse into another set of capillary beds; the ultimate goal os to detoxify and process nutrients

44
Q

what layer of the GI wall contains gastric pits?

A

the mucosa

45
Q

gastric pit histology

A

apical region (mucus cells), parietal cells, chief cells, G-cells

46
Q

mucous cells of gastric pit

A

substances contain mucin and some water + lots of HCO3- (protect stomach and epithelial damage from stomach acid)

47
Q

parietal cells of gastric pit

A

secrete HCl and produce intrinsic factor

48
Q

chief cells of gastric pit

A

secrete pepsinogen, gastric lipase

49
Q

G-cells of gastric pit

A

secrete gastrin (released locally in stomach and acts on nearby cells, endocrine to act on distal cells on other parts of stomach/intestine)

50
Q

what is the role of gastrin?

A

stimulates gastric acid secretion by increasing parietal and chief cell activity, tighten the LES, increase gastric motility and relax the pyloric sphincter

51
Q

HCl production in stomach

A

carbonic acid dissociates into bicarb and H+; H+ is pumped out of gut in exchange for K+, meanwhile bicarb. travels down [ ] gradient using an antiporter which simultaneously pulls in Cl- from the blood, HCl combines in the lumen while bicarb. is used for protective mucus

52
Q

how is HCl secretion regulated?

A

promoted by gastrin from eneteroendocrine cells, ACh from parasympathetic nerve fibres, and histamine from mast cells (lamina propria = proton pump (H+/K+ ATPase)

53
Q

what are the 3 digestion phases?

A

cephalic phase, gastric phase, intestinal phase

54
Q

cephalic phase

A

the earliest phase of digestion, in which sensations and thoughts of food prepare the stomach to secrete enzymes and contract (vagus n. output)

55
Q

gastric phase

A

phase of gastric secretion that begins when food enters the stomach; stretch receptors detect distention, dumping of food intensifies activity locally through ENS (food presence also causes pH to become alkaline as detected by chemoreceptors- alkaline tide)

56
Q

intestinal phase

A

intestines communicate neural and hormonal responses to talk back to stomach

57
Q

secretin

A

enteroendocrine cells stimulates the pancreas to release bicarbonate to neutralize acid in duodenum (inhibit actions of submucosal plexus)

58
Q

CCK

A

stimulates gall bladder to secrete bile to emulsify fats in the small intestine and act on myenteric plexus to slow contraction

59
Q

enterogastric reflex

A

causes parasympathetic output to the stomach to decrease and less chyme leaves the stomach; long acting and neural involving the brainstem (via medulla)

60
Q

why do we vomit (emesis)?

A

extreme distention and irritants (bacterial toxins, ethanol, certain foods/drugs)

61
Q

what does vomiting involve?

A

afferent signals to the medulla (vomit center)
and efferent signals to the diaphragm, abdominal muscles, relaxation of esophageal sphincters, closing off of nasopharynx (soft palate)

62
Q

What cranial nerve innervates the ANS AND ENS?

A

Cn 10- vagus

62
Q

Where do the collateral ganglia sit?

A

Sit on major blood vessels going out to GI tract

63
Q

Does sympathetic stimulation increase or decrease the activity of submucosal plexus and superior mesenteric?

A

Decrease

64
Q

Where does the vagus nerve end?

A

Sigmoid colon

65
Q

What serves as a highway for blood vessels nerves and lymphatics in and out of GI?

A

Folds

66
Q

Is there fat within the folds (mesentery)?

A

Yes

67
Q

What is in the potential space of abdominal cavity?

A

No air just lubricating fluid

68
Q

Where do immune responses occur?

A

Greater omentum

69
Q

What is sometimes considered its own organ?

A

Mesentery

70
Q

What food is the only food that suspends an organ from the inferior surface of the diaphragm and the anterior abdominal wall?

A

Falciform; sickle shaped

71
Q

What substance does the innermost oblique layer make?

A

Milky white substance called chyme which gets sent to the intestines

72
Q

Does the rugae act to increase surface area for absorption?

A

No; we do not absorb nutrients in the stomach as it’s not broken down yet

73
Q

Function of pyloric antrum

A

Opening to pyloric canal

74
Q

Function of pyloric canal

A

Directs stuff towards pylorus

75
Q

Function of pylorus

A

Delivers chyme to small intestines

76
Q

Function of pyloric sphincter

A

End of stomach; separates contents of stomach from contents of intestine; smooth muscle

77
Q

Layer of pyloric and function

A

Longitudinal, circular, and oblique

- help produce churning action of stomach

78
Q

pH of the stomach

A

1.5-3.5

79
Q

Functions of stomach

A
  • absorbs some drugs and alcohol
  • very little absorption
  • breaks down and mixes and out chyme into duodenum
  • hydrochloric acids denature and digest proteins
  • produces intrinsic factor for B12 absorption
80
Q

How do cells get in and out and access energy into adipocytes

A

Gastro-mental surfaces provides blood vessels that run through the greater omentum

81
Q

Where does all the blood go from the GI?

A

One big portal system.. hepatic portal vein

82
Q

What does the left and right gastric drain?

A

Lesser curvature of the stomach

83
Q

What does the superior mesenteric vein drain?

A

left and right gastro omentals

84
Q

Superior mesenteric vein drains..

A

A lot of small intestine because it’s an early vein and some of the large intestine but not all

85
Q

What does the splenic vein drain?

A

Draining left gastro omental and short gastric artery… area of stuff that needs addition vein for drainage

86
Q

Whole goal of blood drainage

A

All ingested and absorbed nutrients from gi will enter the Venice blood and it’s the livers job to do things like detoxify things that are bad and also process nutrients and proteins

87
Q

How much chyme is release during each peristaltic wave?

A

3ml

88
Q

What promotes increased gastric emptying?

A

Increase secretion of gastric

89
Q

What inhibits gastric emptying?

A

Increased secretion of CCK

Anatomy (14 decks)

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