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
Which SNS ganglia innervates the following structures? Salivary Glands
Cervical Ganglia
26
Which SNS ganglia innervates the following structures? Esophagus, Pancreas, Liver, Gallbladder, Stomach, Small Intestine, Proximal Colon
Celiac Ganglia
27
Which SNS ganglia innervates the following structures? Distal Colon
Superior Mesenteric Ganglia
28
Which SNS ganglia innervates the following structures? Rectum
Inferior Mesenteric Ganglia
29
The PNS innervation on the GI tract releases _______ and has ______ effects
ACh, excitatory
30
PNS innervation of salivary glands...
CN VII and IX
31
PNS innervation of: Esophagus, Pancreas, Liver, Gallbladder, Stomach, Small Intestine, Proximal Colon
CN X
32
PNS innervation of the distal colon?
sacral n.
33
PNS innervation of the rectum
pelvic n.
34
Describe the mechanism of release of hormones from GI endocrine cells...
GI Cell Chemoreceptors LUMEN → Secretory Granule Stimulation → Peptide release to portal circ. → Gen. Circ.
35
What are the four most important GI hormones?
Gastrin, CCK, Secretin, GIP
36
GIP release is stimulated by what three substances?
Fatty Acids AAs Oral Glucose
37
GIP has what two effects?
↑ Insulin Secretion | ↓ Gastric H+
38
Secretin release is stimulated by what two factors?
H+ in Duodenum | Fatty Acids in Duodenum
39
Secretin release has what three effects?
↑ Pancreatic/Biliary HCO3 ↓ Gastric H+ Inhibit gastrin mediated growth
40
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
CCK
41
CCK release is stimulated by...
small peptides, AAs, FFAs
42
Gastrin release is stimulated by...
Small Peptides & AAs Stomach Distension Vagal Stim. (GRP)
43
Gastrin release has what two effects?
↑ Gastric H+ | Growth of Gastric Mucosa
44
What are the two important GI paracrines?
somatostatin, histamine
45
Somatostatin is released by what cell type and has what effect?
D cells, inhibitis gut hormone release
46
Which GI neurocrine has the following effects? ↑ Secretion, ↑ Smooth Muscle Contraction, Relax sphincters,
ACh (PNS)
47
Which GI neurocrine has the following effects? Sphincter Contraction, Smooth Muscle Relaxation
NE (SNS)
48
Which GI neurocrine has the following effects? Relax Smooth Muscle, ↑ Secretion
Vasoactive Intestinal Peptide (PNS, ENS)
49
GRP has what effect and is released by the____NS
(PNS): ↑ Secretion
50
What is the functional unit of the GI tract smooth muscle?
bundles
51
What allows electrical propagation between GI smooth muscle cells?
low resistance gap junctions
52
What is responsible for the basic electrical rhythm/slow wave of GI visceral smooth muscle?
Δ Ca2+ & K+ conductance
53
What cells are responsible for generating the BER?
Interstitial Cells of Cajal (Myenteric Plexus)
54
What effect does ACh from the PNS have on visceral smooth muscle contraction? What about NE from SNS?
↑ BER Amplitude, ↑ Spike Potentials, ↑ VSMC Tension Opposite for NE
55
Does ANS input have any influence on BER frequency?
no
56
The _______ is a housekeeping cycle of motor activity from stomach to ileum, regulated by _______
Migrating motor complex motilin
57
The MMC has what effect?
remove undigested material from stomach
58
The MMC causes intense, slow peristaltic contractions at ___ min. intervals ____ hours post-prandial
90 min. interval 2 hours post-prandial
59
This is autonomic & endocrine reflexes due to anticipation of eating & initial food contact
Cephalic phase
60
The cephalic phase prepares the GI tract via ______ resulting in...
via PNS Efferents | ↑ secretion of Saliva, Gastric Acid, Gastrin, Pancreatic Enzymes
61
What inhibits PNS secretion of saliva? (3)
Dehydration, fear, sleep
62
What stimulates PNS secretion of saliva? (4)
conditioning food nausea smell
63
What drug blocks release of ACh on acinar/ductal M receptors, leading to blocking of salivary release?
atropine
64
Saliva is released by what two cell types?
acinar cells, ductal cells
65
What three channels are present on the salivary ductal cell's apical membrane?
NHE, Cl-/bicarb exchange, H+/K+ exchange
66
what channel is present on the basolateral membrane of the ductal cell?
sodium-potassium ATPase
67
Ductal cells draw in ___ and ____ without water movement. This makes saliva______
sodium, chloride saliva becomes hypotonic
68
are ductal cells permeable to water?
no
69
Are acinar cells permeable to water? What effect does this have on salivary tonicity?
yes, isotonic saliva
70
What are 4 components of saliva?
Mucus: lubricant Alpha-amylase: CHO digestion Lingual lipase: TG digestion Contains IgA, Kallikrein (↑ bradykinin → ↑ salivary gland blood flow
71
High salivary secretion rates result in what changes to saliva?
isotonic saliva & ↑ pH due to ↑ HCO3-
72
In ductal cells, while sodium and chloride are reabsorbed, what two substanes are secreted, leading to what?
K+ and HCO3- leads to more alkaline saliva
73
What brain center is stim. by taste, smell, tactile stimulation in mouth
Medulla Salivary Center (PNS)
74
PNS ACh and VIP have what three effects on salivation?
Saliva, amylase & mucus secretion Vasodilation & Salivary Duct Dilation
75
Which phase of swallowing? Bolus formed during mastication, voluntarily pushed by tongue to back of pharynx
oral phase
76
The oral phase causes what neuro signaling?
Somatosensory Receptor Stim. → involuntary swallowing reflex in medulla
77
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
Pharyngeal Phase
78
The pharyngeal phase of swallowing is ______ controlled and ______ is inhibited throughout
Reflexively controlled, breathing inhibited
79
Which phase of swallowing? Peristalsis → food to LES (primary swallow) LES relaxes for 5-10 seconds, contracts when bolus passes into stomach
Esophageal phase
80
What mediates the relaxation of LES during the esophageal phase of swallowing?
VIP
81
The esophageal phase of swallowing is mediated by...
medulla swallowing center
82
Secondary swallow is mediated by ____ and occures when...
ENS mediated: incomplete swallow or gastric regurgitation
83
What condition has the following features? Failed LES Relaxation During Swallowing Food accumulation in esophagus → dilation
Achalasia
84
What is the etiology of achalasia?
degeneration of myenteric plexus, defective NO/VIP release
85
Reflux esophagitis is a result of _____ and can result in _______
loss of LES tone acid reflux