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Physiology II > GI: Principals, Swallowing, Etc. > Flashcards

GI: Principals, Swallowing, Etc. Flashcards

1
Q

What is the progression of sphincters in the GI tract?

A

UES → LES → Pyloric → Ileocecal → Internal/External Anal

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2
Q

The mouth secretes ______ and is responsible for what two actions?

A

saliva

chewing/swallowing

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3
Q

The esophagus secretes ______ and has what two motile actions?

A

mucus

peristalsis/swallowing

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4
Q

Oral and anal events have what type of neural control and muscles?

A

somatic nervous system

skeletal muscle

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5
Q

mid-esophagus to internal anal sphincter have what neural control and muscle type?

A

ANS

smooth muscle

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6
Q

Mechanical digestion is accomplished via what three mechanisms in the mouth, stomach and small intestines respectively?

A

chewing: mouth

churning/mixing: stomach

segmentation: small intestine

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7
Q

Name the layers of the GI tract from superficial to deep…

A

Serosa → Longitudinal M. → Myenteric Plexus → Circular M. → Submucosa → Submucosal Plexus → Mucosa

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8
Q

Name the three mucosal layers from superficial to deep…

A

Muscularis Mucosae → Lamina Propria → Epithelium

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9
Q

The enteric nervous system is composed of…

A

Myenteric Plexus + Submucosal Plexus

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10
Q

The submucosa contains what structures? (4)

A

collagen, elastin, glands, blood vessels

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11
Q

This is the outermost layer which continues to the mesentary…

A

serosa

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12
Q

What part of the mucosa has the following characteristics?

changes shape of epithelial layer

A

Muscularis Mucosae

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13
Q

What part of the mucosa has the following characteristics?

Contains connective tissue, some blood/lymph vessels

A

Lamina Propria

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14
Q

What part of the mucosa has the following characteristics?

absorptive, secretory functions

A

Epithelial Cells

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15
Q

What artery supplies the liver, stomach, spleen and pancreas?

A

celiac a.

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16
Q

What artery supplies the pancreas, small intestine, colon?

A

SMA

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17
Q

the IMA supplies…

A

colon

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18
Q

What is the progression of venous drainage of all GI structures?

A

Portal V. → Liver → Hepatic Veins → IVC

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19
Q

Circulation in the GI tract is both parallel and series.

Parallel allows what?

A

regulation of flow to individual organs

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20
Q

Circulation in the GI tract is both parallel and series.

Series allows…

A

liver exposed to all absorbed substances

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21
Q

What effect does the ANS have on ENS?

A

modulates ENS function… not required

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22
Q

The ENS has 10^8 neurons, which is similar to…

A

Spinal cord

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23
Q

This part of the ENS:

Longitudinal & Circular m. Innervation

Control of Gut Movements

A

Myenteric (Auerbach’s) Plexus

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24
Q

The SNS in the GI releases _____ and has a _______ effect

A

NE, inhibitory

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25
Q

Which SNS ganglia innervates the following structures?

Salivary Glands

A

Cervical Ganglia

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26
Q

Which SNS ganglia innervates the following structures?

Esophagus, Pancreas, Liver, Gallbladder, Stomach, Small Intestine, Proximal Colon

A

Celiac Ganglia

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27
Q

Which SNS ganglia innervates the following structures?

Distal Colon

A

Superior Mesenteric Ganglia

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28
Q

Which SNS ganglia innervates the following structures?

Rectum

A

Inferior Mesenteric Ganglia

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29
Q

The PNS innervation on the GI tract releases _______ and has ______ effects

A

ACh, excitatory

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30
Q

PNS innervation of salivary glands…

A

CN VII and IX

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31
Q

PNS innervation of:

Esophagus, Pancreas, Liver, Gallbladder, Stomach, Small Intestine, Proximal Colon

A

CN X

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32
Q

PNS innervation of the distal colon?

A

sacral n.

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33
Q

PNS innervation of the rectum

A

pelvic n.

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34
Q

Describe the mechanism of release of hormones from GI endocrine cells…

A

GI Cell Chemoreceptors LUMEN → Secretory Granule Stimulation → Peptide release to portal circ. → Gen. Circ.

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35
Q

What are the four most important GI hormones?

A

Gastrin, CCK, Secretin, GIP

36
Q

GIP release is stimulated by what three substances?

A

Fatty Acids
AAs
Oral Glucose

37
Q

GIP has what two effects?

A

↑ Insulin Secretion

↓ Gastric H+

38
Q

Secretin release is stimulated by what two factors?

A

H+ in Duodenum

Fatty Acids in Duodenum

39
Q

Secretin release has what three effects?

A

↑ Pancreatic/Biliary HCO3

↓ Gastric H+

Inhibit gastrin mediated growth

40
Q

Which GI hormone has the following effects?

↑ Pancreatic Enzymes
↑ Pancreatic HCO3
Growth of exocrine pancreas

Contraction of Gallbaldder
Relax sphincter of Oddi

Inhibit Gastric Emptying

A

CCK

41
Q

CCK release is stimulated by…

A

small peptides, AAs, FFAs

42
Q

Gastrin release is stimulated by…

A

Small Peptides & AAs
Stomach Distension
Vagal Stim. (GRP)

43
Q

Gastrin release has what two effects?

A

↑ Gastric H+

Growth of Gastric Mucosa

44
Q

What are the two important GI paracrines?

A

somatostatin, histamine

45
Q

Somatostatin is released by what cell type and has what effect?

A

D cells, inhibitis gut hormone release

46
Q

Which GI neurocrine has the following effects?

↑ Secretion, ↑ Smooth Muscle Contraction, Relax sphincters,

A

ACh (PNS)

47
Q

Which GI neurocrine has the following effects?

Sphincter Contraction, Smooth Muscle Relaxation

A

NE (SNS)

48
Q

Which GI neurocrine has the following effects?

Relax Smooth Muscle, ↑ Secretion

A

Vasoactive Intestinal Peptide (PNS, ENS)

49
Q

GRP has what effect and is released by the____NS

A

(PNS): ↑ Secretion

50
Q

What is the functional unit of the GI tract smooth muscle?

A

bundles

51
Q

What allows electrical propagation between GI smooth muscle cells?

A

low resistance gap junctions

52
Q

What is responsible for the basic electrical rhythm/slow wave of GI visceral smooth muscle?

A

Δ Ca2+ & K+ conductance

53
Q

What cells are responsible for generating the BER?

A

Interstitial Cells of Cajal (Myenteric Plexus)

54
Q

What effect does ACh from the PNS have on visceral smooth muscle contraction? What about NE from SNS?

A

↑ BER Amplitude, ↑ Spike Potentials, ↑ VSMC Tension

Opposite for NE

55
Q

Does ANS input have any influence on BER frequency?

A

no

56
Q

The _______ is a housekeeping cycle of motor activity from stomach to ileum, regulated by _______

A

Migrating motor complex

motilin

57
Q

The MMC has what effect?

A

remove undigested material from stomach

58
Q

The MMC causes intense, slow peristaltic contractions at ___ min. intervals ____ hours post-prandial

A

90 min. interval

2 hours post-prandial

59
Q

This is autonomic & endocrine reflexes due to anticipation of eating & initial food contact

A

Cephalic phase

60
Q

The cephalic phase prepares the GI tract via ______ resulting in…

A

via PNS Efferents

↑ secretion of Saliva, Gastric Acid, Gastrin, Pancreatic Enzymes

61
Q

What inhibits PNS secretion of saliva? (3)

A

Dehydration, fear, sleep

62
Q

What stimulates PNS secretion of saliva? (4)

A

conditioning
food
nausea
smell

63
Q

What drug blocks release of ACh on acinar/ductal M receptors, leading to blocking of salivary release?

A

atropine

64
Q

Saliva is released by what two cell types?

A

acinar cells, ductal cells

65
Q

What three channels are present on the salivary ductal cell’s apical membrane?

A

NHE, Cl-/bicarb exchange, H+/K+ exchange

66
Q

what channel is present on the basolateral membrane of the ductal cell?

A

sodium-potassium ATPase

67
Q

Ductal cells draw in ___ and ____ without water movement. This makes saliva______

A

sodium, chloride

saliva becomes hypotonic

68
Q

are ductal cells permeable to water?

A

no

69
Q

Are acinar cells permeable to water? What effect does this have on salivary tonicity?

A

yes, isotonic saliva

70
Q

What are 4 components of saliva?

A

Mucus: lubricant

Alpha-amylase: CHO digestion

Lingual lipase: TG digestion

Contains IgA, Kallikrein (↑ bradykinin → ↑ salivary gland blood flow

71
Q

High salivary secretion rates result in what changes to saliva?

A

isotonic saliva & ↑ pH due to ↑ HCO3-

72
Q

In ductal cells, while sodium and chloride are reabsorbed, what two substanes are secreted, leading to what?

A

K+ and HCO3-

leads to more alkaline saliva

73
Q

What brain center is stim. by taste, smell, tactile stimulation in mouth

A

Medulla Salivary Center (PNS)

74
Q

PNS ACh and VIP have what three effects on salivation?

A

Saliva, amylase & mucus secretion

Vasodilation & Salivary Duct Dilation

75
Q

Which phase of swallowing?

Bolus formed during mastication, voluntarily pushed by tongue to back of pharynx

A

oral phase

76
Q

The oral phase causes what neuro signaling?

A

Somatosensory Receptor Stim. → involuntary swallowing reflex in medulla

77
Q

Which phase of swallowing?

Soft palate pulled upward

Epiglottis covers laryngeal opening

larynx moves upward/seals epiglottis

UES reflexively inhibited

Peristaltic wave → food through UES to esophagus

A

Pharyngeal Phase

78
Q

The pharyngeal phase of swallowing is ______ controlled and ______ is inhibited throughout

A

Reflexively controlled, breathing inhibited

79
Q

Which phase of swallowing?

Peristalsis → food to LES (primary swallow)

LES relaxes for 5-10 seconds, contracts when bolus passes into stomach

A

Esophageal phase

80
Q

What mediates the relaxation of LES during the esophageal phase of swallowing?

A

VIP

81
Q

The esophageal phase of swallowing is mediated by…

A

medulla swallowing center

82
Q

Secondary swallow is mediated by ____ and occures when…

A

ENS mediated: incomplete swallow or gastric regurgitation

83
Q

What condition has the following features?

Failed LES Relaxation During Swallowing

Food accumulation in esophagus → dilation

A

Achalasia

84
Q

What is the etiology of achalasia?

A

degeneration of myenteric plexus, defective NO/VIP release

85
Q

Reflux esophagitis is a result of _____ and can result in _______

A

loss of LES tone

acid reflux

Physiology II (28 decks)

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