GI Physiology Flashcards
What is the splanchnic blood system?
from heart through abdominal organs back to heart
What things increase blood flow during increase GI activity?
effect of gut activity and metabolic factors; release of dilator substance (CCK, VIP, gastrin, secretin), release of kinins (bradykinin-dilator peptide), decreased oxygen concentration in the gut wall (adenosine); more sensitive to ischemia than other tissues
What is the use of the countercurrent blood flow in the villi? complications from this?
blood can be shunted from one side to the other bypassing some tissue during exercise or shock; short term cells will die and be replace by stem cells; long term leads to necrosis and then sepsis
How does the neural system control blood flow through the GI?
PS- stomach, SI, LI, increases blood flow and glandular secretions; Symp- direct effect on entire GI via intense vasoconstriction of arterioles and reduction of flow
What are the 4 main systems controlling splanchnic circulation?
autonimics (PS, S, enteric, and sensory), cardiovascular (CO, art press, BV), Digestive system control (vasodilator metabolites and paracrines, local mech- myogenic, posprandial hyperemia, O2 countercurrent) and endocrine and paracrine control (vasoconstrictor and GI hormones, immunologic paracrines)
What are the five distinct functions of the GI tract?
secretion, motility, digestion, absorption, immunity
What role does the GI system play in immunity?
largest area of the body with direct contact with infectious/toxic substances, 80% immunoglobulin producing cells are in the SI; also have acid, mucous and motility to protect
What are the sphincters under total CNS control?
upper and lower esophageal sphincter, ileocecal and anal
Which sphincters are under minimal CNS control?
pyloric and oddi
What is the swallowing reflex?
UES opens due to pressure generated by bolus of food pushed back followed by peristaltic waves of relaxation and contraction
What is the function of the LES?
prevent stomach acid and contents from entering the esophagus
What is GERD?
failure of LES to contract following ingestion, heartburn feeling due to stomach contraction pushing stomach contents into the esophagus, antihistamines can be used to reduce acid (H2 receptor antagonist) or proton pump inhibitor (H-K-ATPase)
What is achalasia?
absence of relaxation of LES or impaired peristalsis in distal esophagus; probly loss of Vagal inhibitory
What is the function of the pyloric valve?
regulates movement of chime from stomach into small intestine to ensure adequate digestion
What is the function of the sphincter of oddi? What mechanism causes it to open?
guards exit of common bile duct and pancreatic duct; CCK produces contraction of gall bladder driving bile down the duct; when chime enters the duodenum, this sphincter prevents chime from entering the ducts
What is the function of the internal anal sphincter?
circular and longitudinal smooth muscle under involuntary control; prevent movement of fecal matter through anus unless external anal sphincter is relaxed; forced open by pressure
What is the function of the external anal sphincter?
Encircles rectum, contains only striated muscle, under voluntary control; pelvic cholinergic nerves cause tonic contraction to hold everything in
What is the general function of the myenteric plexus?
controls GI movements
What are the two divisions of the enteric nervous system?
submucosal plexus (meissner’s) and myenteric plexus (auerbachs)
What is BER?
basic electrical rhythm; cycling of RMP from -60 to -40 to -60 etc.
What stimuli cause depolarization in the enteric NS
stretch, ACh, PS
What stimuli cause hyperpolarization of the enteric NS?
noradrenaline, sympathetics
Where is the myenteric plexus located? main type of neurons found there?
between circular and longitudinal muscle layers, most are motor neurons
What is the excitatory role of the myenteric plexus?
control movement of GI tract; when stimulated it increases intensity of rhythmic contractions, increases rate of rhythmic contractions, increases velocity of conduction of excitatory waves along the gut wall (more peristalsis); motor excitatory neurons release ACh and substance P onto smooth muscle receptors
What is the inhibitory role of the myenteric plexus?
some neurons secrete VIP and NO that inhibit contraction of GI smooth muscle, inhibit movements of GI tract
Where is the submucosal plexus found? What do most of the neurons do?
in submucosal layer; regulate glandular, endocrine and epithelial cell secretion and GI blood flow, mostly sensory, release Ach onto glandular or epithelial cells to stimulate secretion; receives signals from epithelium and stretch receptors
Where do chemo and stretch receptors in the GI epithelium synapse to ?
enteric system, prevertebral ganglia, spinal cord and brain
What PS nerves affect the enteric NS?
pelvic (just myenteric) and vagus (myenteric, submucosal and epithelial cells)
What are the different types of neurons in the myenteric plexus and their corresponding NT?
stimulatory motor-ACh, inhibitory motor-NO, Ascending and descending interneurons-ACh, 5-HT, and sensory neurons- substance P
What are the different types of neurons in the submucosal plexus and their corresponding NT?
noncholinergic secretomotor- VIP, cholinergic secretomotor- ACh, sensory neurons- substance P (small peptide, pain and vasodilator)
What are the localized GI reflexes?
entirely in the enteric NS, GI secretions, peristalsis, and mixing, intrinsic, travel short distances and distention is the usual stimulus
What is the gastrocolic reflec?
from stomach(during emptying of stomach after ingestion of meal) to colon in order to evacuate the colon; probly mediated by gastrin; well developed in infants
What is the enterogastric reflex?
from colon or SI to stomach, inhibit gastric motility and secretions, release of gastrin is shut off; probably stimulated by acid in the duodenum
what is the colonoileal reflex?
from colon to ileum, inhibit contents at ileocecal valve from emptying into the colon
What systems act on the extrinsic reflexes of the GI?
components contained within GI, can be modulated by extrinsic factors
What are some general features of neurohormonal regulation of the GI tract?
mediated by peptides, amino acid derivatives, lipids and steroids; GI hormones are peptides but not all peptides are hormones; mediators have both membrane and intracellular targets, intricate and redundant, crosstalk between systems allow for integrated regulation
What methods of signaling are used in neurohormonal control of the GI?
endocrine, paracrine, neurocrine, immune/juxtacrine
What 4 things establish the existence of GI hormones?
event in one segment alters activity of another (except autocrine), effect persists after neural connections have been severed (except neurocrine), capable of reproducing the effect if injected into the blood (must be isolated from site of stimulation), hormone must be id chemically and structure confirmed by synthesis
What is the source, stimuli for release and main action of gastrin?
G cells (somach, prox SI), peptides, AA, neural (GRP, vagal), stretch, inhibited by acid; increases HCl secretion, parietal cell growth (make pepsin and enzymes)
What is the source, stimuli for release and main action of CCK?
CCK cells (I cells) duodenum and jejunum; CCK-RP, fatty acid, AA, neural; pancreatic enzyme secretion, gallbladder contraction, pancreatic growth, inhibits gastric motility
What is the source, stimuli for release and main action of secretin?
S cells in duodenum and jejunum; luminal pH <4 and FA; ductal secretion in pancreas (HCO3) and bile ducts, pancreatic growth, inhibits acid secretion; more potent than CCK
What is the source, stimuli for release and main action of somatostatin?
D cells, nerves; fat, protein, low pH; decreases acid, enzyme secretion and inhibits gastrin
What are the endocrine mediators involved in response to meal?
CCK, gastrin, GIP, pancreatic polypeptide
What are the neurpcrine mediators involved in response to meal?
ACh, CCK, GRP (gastrin releasing peptide), NO, Substance P, VIP, 5-hydroxytryptamine
What are the paracrine mediators involved in response to meal?
CCK, Histamine, 5-hydroxytryptamine, somatostatin
What are the two CCK receptor types? What do they bind with?
CCK A just CCK; CCK B (smaller binding site, gastrin 2 sites and CCK