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Year 1 Body Systems > GI Physiology > Flashcards

GI Physiology Flashcards

1
Q

What are the 4 types of teeth?

A

1) Incisors
2) Canines (cuspids - single root, spike and tear)
3) Pre molar (2 roots - bicuspids - crushing and grinding)
4) Molar (3/4 roots - crushing and grinding)

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2
Q

What are the 4 main components of saliva and their roles?

A

1) Serous fluid and mucous - lubrication of mouth and food and cleaning, dissolve food stuffs to facilitate taste
2) Anti bacterial enzymes (lysozyme, IgA) - protection about bacteria
3) Bicarbonate and calcium - protection against acid, replaces Ca2+ ions lost from teeth
4) Salivary amylase (ptyalin, lingual lipase) - digestion

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3
Q

How is saliva production regulated?

A

Entirely neural
Parasympathetic - produces a more watery serous secretion
Sympathetic - produces a more mucous secretion

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4
Q

How is parasympathetic input to the salivary glands controlled?

A

By the salivary center in the brain stem, controlled by:

1) local stimuli: taste and touch in mouth
2) central stimuli: smell and sight of food
3) Learned reflex: pavlovs dogs

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5
Q

What are the 2 stages in saliva production?

A

1) Initial isotonic fluid in the acinus containing NaCl, protein and/or mucous
2) Passes along duct, get salt and water reabsorption and HCO3- (and K+) secretion leads to a hypotonic alkaline solution
NB. flow rate is important

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6
Q

What does the enzyme ptyalin a-amylase found in saliva do? What is its optimum pH and when is it denatured?

A

breaks down starch and large polysaccharides. breaks alpha 1-4 linkages (but not adjacent to 1-6 linkages which cause branches and cannot be cut by this salivary enzyme)
Optimum pH is 7, denatured at pH 4

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7
Q

What does the enzyme lingual lipase found in saliva do? What is its optimum pH and when is it denatured?

A

Cleaves the outer fatty acids from tricglycerides to leave diacyglycerol
pH optimum is 4, therefore its stable in stomach and works with gastric lipase but is denatured by pancreatic protease

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8
Q

What are the 3 main salivary glands?

A

1) Parotid (biggest)
2) Sublingual
3) Submandibular

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9
Q

What is the secretions and neural control of parotid salivary glands?

A

secretion: mostly serous, source of amylase, proline rich proteins, 25% of volume of total saliva
Parasympathetic control form CN IX (glosso pharyngeal)
Sympathetic control from superior cervical ganglion

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10
Q

What is the secretions and neural control of the sublingual salivary glands?

A

Secretion: mostly mucous, source of lingual lipase and makes up 5% of total saliva secreted
Parasympathetic control is from CN VII (facial)
Sympathetic control is from superior cervical ganglion

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11
Q

What is the secretions and neural control of the submandibular glands?

A

Secretion: mostly serous and mucous, source of lysozyme and lacto peroxidase (another anti bacterial), makes up 70% of total volume of saliva secreted
Parasympathetic control from CN VII (facial)
Sympathetic control from the superior cervical ganglion

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12
Q

What happens in the 4 stages of swallowing:

1) Voluntary phase
2) Pharyngeal phase
3) 3rd phase
4) Oesophageal phase?

A

1) Voluntary phase - soft palate controls food bolus, epiglottis open can still breathe
2) Pharyngela phase - nasopharynx closed, food in oropharynx, help up by epiglottis
3) Epiglottis movers down (trachea closed) and upper oesophageal sphincter opens
4) Oesophageal phase - peristalsis, upper oesophageal sphincter closes

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13
Q

What are the 3 types of taste buds and where are they located?

A

1) Fungiform - tip of tongue
2) Circumvalate - one strip along superior surface
3) Foliate - lateral to circumvalate

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14
Q

How are taste buds structured and what is their nerve supply?

A

Sense cells surrounded by supporting cells, have a narrowed tip, sense cells synapse with afferent sensory neurones,
Supplied by cranial nerve VII (facial)

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15
Q

What are the 2 types of specialised taste cells and what do they detect?

A

1) Ion channel based - detect salty (Na+) and sour (H+) stimulus
2) GPCR based - detect sweet, umami and bitter stimulus

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16
Q

How do ion channel based taste sensors work?

A

Na+ (Salty stimulus) through ENaC channel, H+ (sour stimulus) through TRPP channel
Entry of these molecules depolarises the membrane, opens voltage gated calcium channels, calcium moving in (from outside and from ER) causes neurotransmitter to be released

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17
Q

How do GPCR based taste sensors work?

A

Sweet, umami and bitter stimulus bind to GPCR which causes calcium release partly through second messengers (IP3) and partly through Na+ entry leading to depolarisation again causes calcium entry from outside and ER which causes neurotransmitter to be released

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18
Q

ʜow is the oesophagus innervatedʔ

A

Fibres from the oesophageal plexus

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19
Q

What happens to the lower oesophageal sphncter after food passes throughʔ

A

Closes firmly and then relaxes slightly but still has significant tone

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20
Q

ʜow long and wide is the oesophagusʔ

A

25cm long, 2cm wide

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21
Q

Why do the submucosal oesophageal glands secrete mucousʔ

A

To facilitate the passage of a food bolus

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22
Q

What is the cephalic phase of ɢɪ activityʔ

A

To do with sight and smell of food etc. Some concious and some unconcious stimuli, mediated by the parasympathetic nervous system.
Cranial nerves Vɪɪ and ɪX cause salivary secretion
Vagus nerves carry afferent fibres which contribute to feedback system

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23
Q

What occurs in the acinar portions of salivary glandsʔ

A

A primary secretion is produced, isotonic with lots of Cl- and ɴa+
These are the sights of neural contact, ACh from parasympathetic and Adr from the sympathetic
1) ɴa+/K+ ATPase on basal membrane keeps intracellular ɴa low
2) Use that gradient to co transport Cl-, K+ and ɴa+ into cell through basal membrane
3) Cl- , ʜCO3- and K+ pass passively out of cell on apical membrane
4) ɴa+ travels paracellularly pulling water with it into lumen

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24
Q

What occurs in the duct portions of the salivary glandsʔ

A

1) ɴa+/K+ATPase on basal membrane still keeping intracellular ɴa+ low
2) ʀesorb ɴa+ and K+ from the lumen passively through apical membrane
3) Cl- swapped for ʜCO3- on apical membrane to make an alkaline and hypotonic solution
4) Tight junctions get tighter and water can no longer pass paracellularly so get a more dilute solution

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25
Q

What are the 3 layers of muscle in the stomach wallʔ

A

1) ʟongitudinal
2) Circular
3) Oblique (deepest)

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26
Q

What is the main function of the fundus and body of the stomachʔ

A

Mainly storage

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27
Q

What are the parts of the stomach in orderʔ

A

1) ʟower oesophageal sphincter (Opens into cardia)
2) Fundus
3) Body
4) Antrum
5) Pylorus
6) Pyloric canal
7) Pyloric sphincter
8) Duodenum

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28
Q

What are the secretions and functions of the lower oesophageal sphincter and cardiaʔ

A

Mucous, ʜCO3-

Prevention of reflux, entry of food, regulation of belching

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29
Q

What are the secretions and functions of the fundus and bodyʔ

A

ʜ+, ɪntrinsic factor, Mucous, ʜCO3-, Pepsinogens, ʟipase

ʀeservoir (stores food), Tonic force during empylys

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30
Q

What are the secretions and functions of the fundus and bodyʔ

A

ʜ+, ɪntrinsic factor, Mucous, ʜCO3-, Pepsinogens, ʟipase

ʀeservoir (stores food)

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31
Q

What are the secretions and functions of the antrum and pylorusʔ

A

Mucous, ʜCO3-

Mixing, grinding, sieving,

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32
Q

What are the secretions and functions of the antrum and pylorusʔ

A

Mucous, ʜCO3-

Mixing, grinding, sieving, regulation of emptying

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33
Q

Which parts of the stomach secrete ʜ+, intrinsic factor, pepsinogens and lipaseʔ

A

Fundus and body

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34
Q

ɪn the stomach what is passive relaxation and active accomodationʔ

A

2 of the roles of gastric motility, they allow the stomach to expand when it fills with food

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35
Q

What are the cells and secretions of gastric pitsʔ

A

Mucous cells, secrete mucous and also protective ʜCO3-

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36
Q

What are the cells of the gastric glands and what do they secreteʔ

A

1) Parietal cells (oxyntic cells) - secrete ʜCʟ and intrinsic factor in fundus and body
2) Chief cells (peptic cells) - secrete pepsinogen (in fundus and body)
3) ɢ cells - at the bottom of the glands, secrete gastrin (into blood stream), mainly in antrum and pylorus

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37
Q

What is gastrin and what is its action and receptorʔ

A

Peptide hormone, shares receptors with CCK-PZ, gastrin receptor is CCK-B receptor.
Main action on stomach is to stimulate acid secretion and promote mucosal growth

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38
Q

ʜow is secretion of gastrin from ɢ cells regulatedʔ

A

1) ʟumenal proteins stimulate its release
2) PS input (cephalic phase) mediated by gastrin releasing peptides from interneurones
3) ʀeleased is inhibited by [ʜ+] = negative feedback

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39
Q

What is intrinsic factor and what is its roleʔ

A

Secreted by parietal cells in gastric glands, 55kDa protein, binds to cobalamin (B12), intrinsic factor-cobalamin complex formed in the stomach and absorbed in the terminal ileum

40
Q

What is pepsinʔ

A

Proteases secreted from chief cells inn gastric glands, secreted as a pro enzyme and cleaves spontaneously at low pʜ (

41
Q

ʜow is pepsin secretion from chief cells controlledʔ

A

Secretion is stimulated by ACh (parasympathetic nervous input), [ʜ+], minor effects of secretin, CCK and gastrin (CCK-a receptor)

42
Q

What is somatostatin and what is its actionʔ

A

Peptide hormone, 14 & 28 aa (2 forms).
ʀeleased from D cells of the stomach, duodenum and pancreas. ɪnvolved in paracrine signalling (Acts on adjacent cells).
ɪnhibits the release of CCK and secretin and acts on ɢ cells to inhibit the release of ɢastrin

43
Q

ʜow is the release of somatostatin controlledʔ

A

ʀelease is stimulated by [ʜ+] and inibited by ACh (from parasympathetic nervous system)

44
Q

What are the 3 phases of gastric motilityʔ

A

1) Propulsion phase
2) Emptying phase
3) ʀetropulsion phase

45
Q

What are the three sections of the antrumʔ

A

1) proximal
2) middle
3) terminal

46
Q

What happens in the phases of gastric motilityʔ

A

1) propulsion phase - wave goes over proximal antrum and food is propelled into relaxing terminal antrum
2) emptying phase - perilstaltic wave over middle antrum, pylorus opens and some food is swept into the duodenum and some food swept back, assoicated with back flow and mixing of contents
3) retropulsion phase - contraction of the terminal antrum, pylorus closes, contents of the terminal antrum are swept retrograde into the relaxing middle antrum, jet like propulsion grinds food into smaller particles

47
Q

What are the main differences in gastric motility after a liquid compared to a solid mealʔ

A

ʟiquid meal - food pushed through quickly - shallower perilstaltic waves
Solid meal - initial lag phase, food retained in the stomach and get mixing and grinding of food - deeper perilstaltic waves

48
Q

Why is gastric motility slowed in a calorific mealsʔ

A

Duodenum senses the sugars and signals to the stomach to slow movement, giving time for absroption

49
Q

What happens to parietal cells when they become activatedʔ

A

in resting state cell has tubulovesicles, when activated the vesicles fuse to create a big surface area with loads of proton pumps in the membrane, pumps protons into the space (ʜCl) using a K+/ʜ+ATPase transporter

50
Q

What are the stimulators and inhibitors of parietal cellsʔ

A

Stimulatorsː
1) ɢastrin and PS nervous system (ACh) act directly on cells
2) ɢastrin and PS nervous system also act on ECʟ cells causing them to release histamine which acts directly on parietal cells causing secretion
ɪnhibitors
1) prostaglandins (PɢE2) and somatostatin act directly on parietal cells inhibiting ʜCl secretion

51
Q

Why do ɴSAɪD’s lead to stomach ulcersʔ

A

Stop you producing prostaglandins so cant stop acid production by parietal cells, too much acid = stomach ulcer

52
Q

ɪn the stomach what is an alkaline tideʔ

A

As ʜ+ is pumped out of parietal cells, ʜCO3- is produced which goes into the blood stream, alkaline tide refers to the rise of alkali in the blood following a big meal

53
Q

Why does the surface epithelium of the stomach secrete ʜCO3-ʔ

A

Protect the surface epithelium, ʜCO3- in mucous holds the pʜ of surface epithelium ~ pʜ 7 (gastric juice pʜ 2)

54
Q

What are the simulators of pepsinogen secretion from chief cellsʔ

A

Stimulatorsː

1) [ʜ+] and PS nervous system (ACh) acting through enteric plexus of stomach under PS control
2) ɢastrin and secretin have moderate effects on the secretion of pepsinogen

55
Q

What is gastric lipase and what does it doʔ

A

Similar to lingual lipase, cleaves one fatty acid chain off triglycerides leaving a diacylglycerol
Optimum pʜ is 4, stable in the stomach but is denatured by pancreatic proteases, works with lingual lipase

56
Q

Why is ptyalin-a-amylase present in the stomachʔ

A

Digests polysaccharides, produced by the salivary glands and still hangs around in the fundus and bpdy where there is lots of food but isnt well mixed with acid yet (denatured at pʜ 4)

57
Q

What reflexes occur when you vomitʔ

A

1) reflex closure of the soft palate and glottis

2) Opening of upper and lower oesophageal sphincters

58
Q

ʜow is vomiting controlledʔ

A

Centrally controlledː area postrema = chemoreceptor trigger zone

59
Q

What are the 5 causes of vomitingʔ

A

1) Vagal afferent, in response to irritants in or around the bowel
2) Psychogenic pain/revulsion (severe pain or shock)
3) Motion sickness/labrythe disorders (problems with middle ear)
4) Drugs/toxins with a direct effect
5) Pregnancy

60
Q

What are the consequences of vomitingʔ

A

Salivation, sweating, hyperventilation, retrograde peristalsis, retching, cardia displaced into thorax, emptying of gastric (and sometimes small intestine) contents

61
Q

What muscle contractions occur in the small intestine to facilitate peristalsisʔ

A

1) Circular muscle contracts behind bolus of food, and ahead relaxes
2) ʟongitudinal muscle ahead of food bolus contracts, shortening adjacent segments
3) Wave of contraction of circular muscle pushes food bolus forwards

62
Q

What muscle contractions occur in the small intestine to facilitate segmentationʔ

A

Alternate contractions of neighboring segments, churns, fragments and mixes food with intestinal secretions

63
Q

What is the migrating motor complex and when does it occurʔ

A

When emptying the gut get a MMC every 90 mins, stimulated by motilin and inhibited by feeding
strong, slow peristaltic waves, pyloric sphincter is relaxed
They keep the gut clean, prevent reflux and reduce bacterial growth

64
Q

What are APUD cells and where are the foundʔ

A

ʟike out of place neural cells, apical membrane detects whats happening and basolateral membrane secretes hormones, found in the small intestine

65
Q

Where do secretions come from in the small intestineʔ

A

Crypts of lieberkuhn

Submucosal Brunner’s glands in duodenum

66
Q

What hormones are secreted from the Sɪ and from what cellsʔ

A

1) CCK (same as CCK-PZ) from ɪ cells
2) Secretin from S cells
3) Motilin from M cells
4) ɢastrin from ɢ cells
5) Bicarbonate secretion (ʜCO3-) from pancreatic duct cells
6) Mucous secretion from goblet cells

67
Q

What hormones are secreted from the Sɪ and from what cellsʔ

A

1) CCK (same as CCK-PZ) from ɪ cells
2) Secretin from S cells
3) Motilin from M cells
4) ɢastrin from ɢ cells
5) Bicarbonate secretion (ʜCO3-) from pancreatic duct cells
6) Mucous secretion from goblet cells

68
Q

What are the 2 general categories of peptidaseʔ

A

1) Endopeptidases (cut within the chain - trypsin, chymotrypsin, elastase)
2) Exopeptidases (Cut at the last peptide bond - carboxypeptidases)

69
Q

ʜow does fat digestion occur in the small intestineʔ

A

1) Fat arrives in small intestine as big globules - but enzymes to digest fats only work at the aqueous interphase
2) Use bile salts to break up lipid droplets increasing surface are
3) ʟingual and gastric lipase have chopped off one chain, pancreatic lipase cleaves off 2nd fatty acid leaving 2 fatty acids and a monoglyceride
4) fatty acids and monglycerides complex with bile salts to form mixed micelles (solubilise the fats)

70
Q

ʜow are fats absorbed from the small intestine lumen (after digestion)ʔ

A

1) Mixed micelles diffuse close to brush border delivering their contents to the membrane
2) Fatty acids and monoglycerides diffuse across the membrane

71
Q

What happens to fatty acids and monoglycerides once they have been absorbed into enterocytes of Sɪʔ

A

1) triglycerides are resynthesised and packaged into chylomicrons
2) Chylomicrons are exocytosed into the interstitium but are too big to pass into the capillaries so pass into lymphatic lacteals
3) Chylomicrons travel via the lymphatic system into the ɪVC
ɴB. Short chain fatty acids and glycerol can however pass straight into the bloodstream

72
Q

What are the pancreatic pro enzymes released that break down proteins?

A

1) trypsinogen
2) Chymotrypsinogen
3) Proelastase
4) Procarboxypeptidase A
5) Procarboxypeptidase B

73
Q

Which enzyme cleaves trypsinogen (released from the pancreas) to its active form?

A

Enterokinase on epithelial cells, secreted by crypt cells

74
Q

Which enzyme cleaves most of the pancreatic proenzymes which digest proteins?

A

Trypsin

75
Q

What happens to di peptides or amino acids which are produced from proteolysis in the small intestine lumen?

A

1) Diffuse to the brush border
2) Amino acids are taken up by Na+ linked secondarily active transporters
3) Di (and tri) peptides taken up by H+ linked secondarily active transporters
4) Then get passive transport across the basolateral membrane into the blood

76
Q

What is the role of protein absorption from the small intestine in immunology?

A

1) Small amounts of protein taken up by endocytosis
2) Some of that protein is taken into M cells which overly Peyer’s patches
3) This allows the immune system to adapt to what we eat and probably plays a role in tolerence

77
Q

How much proteolysis takes place in the stomach before the food reaches the small intestine?

A

~15%

78
Q

In the small intestine what lumenal digestion of carbohydrates occurs?

A

Soluble amylases break a-1-4 bonds and you get left with di and tri saccharides

79
Q

What digestion of carbohydrates happens through brush border enzymes in the small intestine and what enzymes are involved?

A

Di and tri saccharides you are left with after lumenal digestion are broken down by brush border enzymes
ISOMALTASE - breaks 1-6 links
GLUCAMYLASE - breaks down anything with glucose in it
LACTASE - breaks down lactose

80
Q

How are monosaccharides absorbed into the enterocytes of the small intestine?

A

1) Na+/K+ATPase on basolateral membrane keeps intracellular Na+ low
2) SGLT-1 sodium co transporter on apical membrane takes up 2Na+ and either glucose or lactose (secondarily active)
3) GLUT 5 on apical membrane takes up fructose passively
4) GLUT 2 on basolateral membrane, all 3 monsaccharides exit passively into the blood

81
Q

At what part of the small intestine is iron generally taken up?

A

In the lower part of the duodenum

82
Q

How is iron absorbed from the small intestine?

A

1) Arrives at the brush border as Fe3+, needs to be Fe2+ to be absorbed so it reduced by brush border enzyme Dcytb
2) Fe2+ taken up by co transport with H+ (enzyme = DMT)

83
Q

What happens to Fe2+ once it has been absorbed into the cell from the lumen of the small intestine?

A

1) Fe2+ transferred to mobilferrin
2) Mobilferrin acts as a buffering system to stop toxicity with Fe2+
3) Fe2+ leaves cell via ferroportin (FP1) and after haphaestin oxidises it back to Fe3+ the iron binds to transferrin in the plasma

84
Q

How and where are conjugated bile salts absorbed from the small intestine?

A

In the terminal ileum

Actively absorbed by Na+ co transport

85
Q

What happens to bile salts not absorbed in the terminal ileum?

A

Some bile salts escape to the colon and then may become conjugated by bacteria making them lipophillic so they can be passively reabsorped in the colon
About 5% are lost in the faeces

86
Q

What are the fat soluble vitamins?

A

ADEK

87
Q

How are fat soluble lipids absorbed?

A

Dissolved in lipid droplets -> micelles -> chylomicrons

88
Q

How are water soluble vitamins generally absorbed?

A

Na+ linked

89
Q

How are water soluble vitamins generally absorbed?

A

Na+ linked

90
Q

What kind of transport is Ca2+ absorbed in the small intestine by?

A

Active transport (some passive but this is paracellularly and not under hormonal control)

91
Q

Where is Ca2+ actively absorbed in the small intestine?

A

In the duodenum

92
Q

How is the absorption of Ca2+ in the small intestine regulated?

A

By Vitamin D, does so by increasing the number of calcium channels in the apical membrane of the enterocytes of the duodenum

93
Q

What happens to Ca2+ once it is inside the enterocytes of the duodenum?

A

1) Once in the cell Ca2+ gets bound to calbindin (so cant signal to cell)
2) Have a sodium exchanger for Ca2+ to pass into the blood

94
Q

How is Vit B12 (cobalamin) absorbed in the small intestine?

A

1) cobalamin bound to proteins in the food
2) In stomach acid pH and pepsin release it from protein
3) Gastric glands secrete heptacorrin which binds to cobalamin
4) Gastric parietal cells secrete intrinsic factor
5) Pancreas secretes proteases & HCO3-
6) Cobalamin is released after degradation of protein heptacorrin
7) Intrinsic factor - cobalamin complex forms
8) Ileal enterocytes absorbs intrinsic factor-cobalamin complex

95
Q

Where is vit b12 absorbed?

A

Terminal Ileum

Year 1 Body Systems (17 decks)

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