Zollinger-Ellison Syndrome Non [] cell tumors of the pancrease or duodenum Continually produce [] gastrin [] of the stomach Not controlled by [] regulation If left untreated Diarrehea --\> [] acid causes inactive digestive enzymes Steatorrhea --\> Excess [] in stool Can cause [] which leads to a [] of parietal cells in the [] glands and G cell.

Non beta cell tumors of the pancrease or duodenum Continually produce unregulated gastrin outside of the stomach Not controlled by somatostatin regulation If left untreated Diarrehea --\> increased acid causes inactive digestive enzymes Steatorrhea --\> Excess fat in stool Can cause hypergastinemia which leads to a growth of parietal cells in the Oxynitic glands and G cell.

Cholecystokinin (CCK) Structure is similar to [] Released from []-cells in the [] and jejunum Released in response to [] from peptides, amino acids, fatty acids, acids Stimulates: Gall bladder [] [] of Sphincter of Oddi potent stimulator of [] [] secretion Inhibits [] emptying trophic action of [] pancreas, and mucosa of [] []

Cholecystokinin (CCK) Structure is similar to gastrin Released from I-cells in the duodenum and jejunum Released in response to chemoreception from peptides, amino acids, fatty acids, acids Stimulates: Gall bladder contraction Relaxation of Sphincter of Oddi potent stimulator of pancreatic enzyme secretion Inhibits gastric emptying trophic action of exocrine pancreas, and mucosa of gall bladder

Secretin Chemically homologous to [] Released from []-cells of the duodenum most important stimulus is [] (and [] [] to a lesser extent) Stimulates intestinal []and [] secretion [] secretion from the stomach Inhibits [] [] secretion by parietal cells

Chemically homologous to Glucagon Released from S-cells of the duodenum most important stimulus is acid (and fatty acids to a lesser extent) Stimulates intestinal HCO3- and H2O secretion Pepsinogen secretion from the stomach Inhibits gastric acid secretion by parietal cells

Glucose-Dependent Insulinotropic Peptide (Gastric inhibitory Peptide, GIP) Member of the []/[] family Released from mucosal []-cells of the duodenum and [] [] Released in response to [] [] in the [] lumen Stimulates pancreatic []-cell relese of [] in response to glucose and is the reaosn [] glucose is cleared form blood faster than [] glucose.

Glucose-Dependent Insulinotropic Peptide (Gastric inhibitory Peptide, GIP) Member of the secretin/Glucagon family Released from mucosal K-cells of the duodenum and proximal jejunum Released in response to oral glucose in the duodenal lumen Stimulates pancreatic Beta-cell release of insulin in response to glucose and is the reaosn oral glucose is cleared from blood faster than intravenous glucose.

Motilin: Secreted by crypt []-cells found in the duodenum and Jejunum Relese mechanism is [] Stimulates: [] [] [](interdigestive myoelctric complex) Clears the small intestine of [] in anticipation of the next meal Alakalin pH - [] gastic motor functions Acidic pH - [] gastric motor functions

Secreted by crypt M-cells found in the duodenum and Jejunum Relese mechanism is unknown Stimulates: Migrating myoelectric Complex (interdigestive myoelctric complex) Clears the small intestine of food in anticipation of the next meal Alakalin pH - stimulates gastic motor functions Acidic pH - inhibits gastric motor functions

Pancreatic Polypeptide released from the []-cells of the [] pancreas Released in response to [], [], and [] that are delivered through the [] Acts to inhibit: All [] enzyme release [] secretion

released from the PP-cells of the endocrine pancreas Released in response to proteins, fats, carbohydrates that are delivered through the blood Acts to inhibit: All pancreatic enzyme release HCO3- secretion

Enteroglucagon released from the mucosa of the [] [] and [] released in response to [] (primarily) and [](secondarily) Stimulates [] [] flow Inhibits: [] secretion and [] [] flow rate in order to [] the amount of absorption that can take place. This is done because [] should not be this far into the large intestine.

released from the mucosa of the distal ileum and colon released in response to glucose (primarily) and fat (secondarily) Stimulates hepatic bile flow Inhibits: acid secretion and motility Decreases flow rate in order to increase the amount of absorption that can take place. This is done because glucose should not be this far into the large intestine.

Histamine synthesized in [] []-[] (ECLs) of the stomach released by [] gland of the mucosa Diffuses to []-[] Receptors on the nearby parietal cells. Stimulates [] [] secretion May be the most potent [] of gastric HCl...but so may gastrin.

synthesized in enterchromaffin-like cells (ECLs) of the stomach released by Oxyntic gland of the mucosa Diffuses to H2-Type Receptors on the nearby parietal cells. Stimulates gastic acid secretion May be the most potent stimulator of gastric HCl...but so may gastrin.

Vasoactive Intestinal Polypeptide Chemically similar to []/[] family released from nerve [] (half life 2-3 minutes) Acts as a [] Mediates relaxation of: [] smooth muscle [] smooth muscle Stimulates intestinal mucosa to release: [] fluid, [] and []. Inhibits gastrin-stimulated [] secretion

Chemically similar to secretin/Glucagon family released from nerve varicosities (half life 2-3 minutes) Acts as a vasodilator Mediates relaxation of: GI smooth muscle Vascular smooth muscle Stimulates intestinal mucosa to release: Pancreatic fluid, HCO3- and H2O. Inhibits gastrin-stimulated gastric acid secretion

Nitric Oxide N-NOS, [] [] [] [], forms NO for release in [] endings released in the [] mucosa and [] [] [] [] visceral smooth muscle and vasuclar smooth muscle []would constrict the LES

N-NOS, or neuronal nitric oxide synthase, forms NO for release in nerve endings released in the GI mucosa and Lower esophageal sphincter Relaxes visceral smooth muscle and vasuclar smooth muscle Ach would constrict the LES

Chewing Reflex: Occurs when a bolus of food touches the lining of the [] Causes [] of the []jaw muscles the jaw [] []stretch reflexes are activated which causes a rebound [].

Occurs when a bolus of food touches the lining of the mouth Causes relaxation of the striated jaw muscles the jaw opens Monosynaptic stretch reflexes are activated which causes a rebound contraction.

Deglutition ([]) May be initiated [] After the oral phase, exclusively [] Swallowing is a reflex triggered by [] [] receptors. this reflex includes a component to inhibit [] and prevent []

Deglutition (swallowing) May be initiated voluntarily After the oral phase, exclusively reflexive Swallowing is a reflex triggered by pharyngeal pressure receptors. this reflex includes a component to inhibit inspiration and prevent aspiration

Buccal Phase of Swallowing initiated by [] receptors in the back of the mouth The tongue lifts the bolus against the [] [] and propells it backwards. Afferent Pressure Receptors V - [] VII - [] IX - [] X - [] Efferents V - [] VII - [] IX - [] X - [] XII - []

initiated by tactile receptors in the back of the mouth The tongue lifts the bolus against the hard palate and propells it backwards. Afferent Pressure Receptors V - Trigeminal Nerve VII - Facial Nerve IX - Glossopharyngeal Nerve X - Vagus Nerve Efferents V - Trigeminal Nerve VII - Facial Nerve IX - Glossopharyngeal Nerve X - Vagus Nerve XII - Hypoglossal Nerve

Pharyngeal Phase of Swallowing [] palate and [] are pulled up and [] [] close to prevent nasal reflex Pharyngeal muscles [] around the bolus Vocal cords [] to close the glottis [] covers the Trachea and respiration is [] UES [] and peristaltic wave begins UES [] once bolus passes by [] [] propels the bolus.

Soft palate and uvula are pulled up and palatopharyngeal folds close to prevent nasal reflex Pharyngeal muscles accomodate around the bolus Vocal cords contract to close the glottis Epiglottis covers the Trachea and respiration is inhibited UES relaxes and peristaltic wave begins UES contracts once bolus passes by Peristaltic stripping propels the bolus.

Esophageal Phase of Swallowing Primary [] occurs respiration resumes after [] of UES Lower Esophageal Sphincter relaxes [] of and prior to the arrival of the [] [] LES is located in the [] region of the stomach LES is made of [] [] muscle.

Primary peristalsis occurs respiration resumes after contraction of UES Lower Esophageal Sphincter relaxes independent of and prior to the arrival of the peristaltic wave LES is located in the cardiac region of the stomach LES is made of visceral smooth muscle.

GI - pt 2 Hormones etc Flashcards by Bryan Gantner

Zollinger-Ellison Syndrome

Non [] cell tumors of the pancrease or duodenum
- Continually produce [] gastrin [] of the stomach
- Not controlled by [] regulation
If left untreated
- Diarrehea –> [] acid causes inactive digestive enzymes
- Steatorrhea –> Excess [] in stool
Can cause [] which leads to a [] of parietal cells in the [] glands and G cell.

Non beta cell tumors of the pancrease or duodenum
- Continually produce unregulated gastrin outside of the stomach
- Not controlled by somatostatin regulation
If left untreated
- Diarrehea –> increased acid causes inactive digestive enzymes
- Steatorrhea –> Excess fat in stool
Can cause hypergastinemia which leads to a growth of parietal cells in the Oxynitic glands and G cell.

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Cholecystokinin (CCK)

Structure is similar to []
Released from []-cells in the [] and jejunum
Released in response to [] from
- peptides, amino acids, fatty acids, acids
Stimulates:
- Gall bladder []
- [] of Sphincter of Oddi
- potent stimulator of [] [] secretion
- Inhibits [] emptying
- trophic action of [] pancreas, and mucosa of [] []

Cholecystokinin (CCK)

Structure is similar to gastrin
Released from I-cells in the duodenum and jejunum
Released in response to chemoreception from
- peptides, amino acids, fatty acids, acids
Stimulates:
- Gall bladder contraction
- Relaxation of Sphincter of Oddi
- potent stimulator of pancreatic enzyme secretion
- Inhibits gastric emptying
- trophic action of exocrine pancreas, and mucosa of gall bladder

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Secretin

Chemically homologous to []
Released from []-cells of the duodenum
- most important stimulus is [] (and [] [] to a lesser extent)
Stimulates
- intestinal []and [] secretion
- [] secretion from the stomach
Inhibits
- [] [] secretion by parietal cells

Chemically homologous to Glucagon
Released from S-cells of the duodenum
- most important stimulus is acid (and fatty acids to a lesser extent)
Stimulates
- intestinal HCO₃^- and H₂O secretion
- Pepsinogen secretion from the stomach
Inhibits
- gastric acid secretion by parietal cells

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Secretin serves to [] the acid content of the intestine

reduce

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Glucose-Dependent Insulinotropic Peptide (Gastric inhibitory Peptide, GIP)

Member of the []/[] family
Released from mucosal []-cells of the duodenum and [] []
Released in response to [] [] in the [] lumen
Stimulates pancreatic []-cell relese of [] in response to glucose and is the reaosn [] glucose is cleared form blood faster than [] glucose.

Glucose-Dependent Insulinotropic Peptide (Gastric inhibitory Peptide, GIP)

Member of the secretin/Glucagon family
Released from mucosal K-cells of the duodenum and proximal jejunum
Released in response to oral glucose in the duodenal lumen
Stimulates pancreatic Beta-cell release of insulin in response to glucose and is the reaosn oral glucose is cleared from blood faster than intravenous glucose.

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Motilin:

Secreted by crypt []-cells found in the duodenum and Jejunum
Relese mechanism is []
Stimulates:
- [] []
  - Clears the small intestine of [] in anticipation of the next meal
- Alakalin pH - [] gastic motor functions
- Acidic pH - [] gastric motor functions

Secreted by crypt M-cells found in the duodenum and Jejunum
Relese mechanism is unknown
Stimulates:
- Migrating myoelectric Complex (interdigestive myoelctric complex)
  - Clears the small intestine of food in anticipation of the next meal
- Alakalin pH - stimulates gastic motor functions
- Acidic pH - inhibits gastric motor functions

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Pancreatic Polypeptide

released from the []-cells of the [] pancreas
Released in response to [], [], and [] that are delivered through the []
Acts to inhibit:
- All [] enzyme release
- [] secretion

released from the PP-cells of the endocrine pancreas
Released in response to proteins, fats, carbohydrates that are delivered through the blood
Acts to inhibit:
- All pancreatic enzyme release
- HCO₃^- secretion

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Enteroglucagon

released from the mucosa of the [] [] and []
released in response to [] (primarily) and
Stimulates [] [] flow
Inhibits:
- [] secretion and []
- [] flow rate in order to [] the amount of absorption that can take place.
- This is done because [] should not be this far into the large intestine.

released from the mucosa of the distal ileum and colon
released in response to glucose (primarily) and fat (secondarily)
Stimulates hepatic bile flow
Inhibits:
- acid secretion and motility
- Decreases flow rate in order to increase the amount of absorption that can take place.
- This is done because glucose should not be this far into the large intestine.

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Histamine

synthesized in [] []-[] (ECLs) of the stomach
released by [] gland of the mucosa
Diffuses to []-[] Receptors on the nearby parietal cells.
Stimulates [] [] secretion
May be the most potent [] of gastric HCl…but so may gastrin.

synthesized in enterchromaffin-like cells (ECLs) of the stomach
released by Oxyntic gland of the mucosa
Diffuses to H₂-Type Receptors on the nearby parietal cells.
Stimulates gastic acid secretion
May be the most potent stimulator of gastric HCl…but so may gastrin.

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Vasoactive Intestinal Polypeptide

Chemically similar to []/[] family
released from nerve [] (half life 2-3 minutes)
Acts as a []
Mediates relaxation of:
- [] smooth muscle
- [] smooth muscle
Stimulates intestinal mucosa to release:
- [] fluid, [] and [].
Inhibits gastrin-stimulated [] secretion

Chemically similar to secretin/Glucagon family
released from nerve varicosities (half life 2-3 minutes)
Acts as a vasodilator
Mediates relaxation of:
- GI smooth muscle
- Vascular smooth muscle
Stimulates intestinal mucosa to release:
- Pancreatic fluid, HCO₃^- and H₂O.
Inhibits gastrin-stimulated gastric acid secretion

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Nitric Oxide

N-NOS, [] [] [] [], forms NO for release in [] endings
released in the [] mucosa and [] [] []
[] visceral smooth muscle and vasuclar smooth muscle
- []would constrict the LES

N-NOS, or neuronal nitric oxide synthase, forms NO for release in nerve endings
released in the GI mucosa and Lower esophageal sphincter
Relaxes visceral smooth muscle and vasuclar smooth muscle
- Ach would constrict the LES

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The muscles that are involved in jaw closing:

Masseter (most important)

Medial Ptergoid

Temporalis Muscles

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The muscles that are involved in the jaw opening:

Lateral pterygoid

Digastric Muscles

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Mouth mastication is innervated by the []

Trigeminal Nerve (V)

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Chewing Reflex:

Occurs when a bolus of food touches the lining of the []
Causes [] of the []jaw muscles
the jaw []
[]stretch reflexes are activated which causes a rebound [].

Occurs when a bolus of food touches the lining of the mouth
Causes relaxation of the striated jaw muscles
the jaw opens
Monosynaptic stretch reflexes are activated which causes a rebound contraction.

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Chewing rhythm is generated by [] stimuli to the [] center from the [] receptors. This caues a cycle of about [] duration.

Chewing rhythm is generated by afferent stimuli to the chewing center from the pressure receptors. This caues a cycle of about 1 second duration.

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Deglutition ([])

May be initiated []
After the oral phase, exclusively []
Swallowing is a reflex triggered by [] [] receptors.
- this reflex includes a component to inhibit [] and prevent []

Deglutition (swallowing)

May be initiated voluntarily
After the oral phase, exclusively reflexive
Swallowing is a reflex triggered by pharyngeal pressure receptors.
- this reflex includes a component to inhibit inspiration and prevent aspiration

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What are the 3 phases of swallowing?

Buccal Phase

Pharyngeal Phase

Esophageal Phase

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Buccal Phase of Swallowing

initiated by [] receptors in the back of the mouth
The tongue lifts the bolus against the [] [] and propells it backwards.
Afferent Pressure Receptors
- V - []
- VII - []
- IX - []
- X - []
Efferents
- V - []
- VII - []
- IX - []
- X - []
- XII - []

initiated by tactile receptors in the back of the mouth
The tongue lifts the bolus against the hard palate and propells it backwards.
Afferent Pressure Receptors
- V - Trigeminal Nerve
- VII - Facial Nerve
- IX - Glossopharyngeal Nerve
- X - Vagus Nerve
Efferents
- V - Trigeminal Nerve
- VII - Facial Nerve
- IX - Glossopharyngeal Nerve
- X - Vagus Nerve
- XII - Hypoglossal Nerve

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Pharyngeal Phase of Swallowing

[] palate and [] are pulled up and [] [] close to prevent nasal reflex
Pharyngeal muscles [] around the bolus
Vocal cords [] to close the glottis
[] covers the Trachea and respiration is []
UES [] and peristaltic wave begins
UES [] once bolus passes by
[] [] propels the bolus.

Soft palate and uvula are pulled up and palatopharyngeal folds close to prevent nasal reflex
Pharyngeal muscles accomodate around the bolus
Vocal cords contract to close the glottis
Epiglottis covers the Trachea and respiration is inhibited
UES relaxes and peristaltic wave begins
UES contracts once bolus passes by
Peristaltic stripping propels the bolus.

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Esophageal Phase of Swallowing

Primary [] occurs
respiration resumes after [] of UES
Lower Esophageal Sphincter relaxes [] of and prior to the arrival of the [] []
LES is located in the [] region of the stomach
LES is made of [] [] muscle.

Primary peristalsis occurs
respiration resumes after contraction of UES
Lower Esophageal Sphincter relaxes independent of and prior to the arrival of the peristaltic wave
LES is located in the cardiac region of the stomach
LES is made of visceral smooth muscle.

The upper esophageal sphincter is made of [] [] muscle and is normally [].

The lower esophageal sphincter is made of [] [] muscle and is normally [] (a lot of times due to the low energy [] state)

The upper esophageal sphincter is made of striated skeletal muscle and is normally relaxed.

The lower esophageal sphincter is made of visceral smooth muscle and is normally constricted (a lot of times due to the low energy latch state)

[] [] occurs when a bolus gets stuck in the esophagus. It does not involve a [] phase of swallowing.

Secondary peristalsis occurs when a bolus gets stuck in the esophagus. It does not involve a pharyngeal phase of swallowing.

Dysphagia

Difficulty in [], usually caused by LES not maintaining complete []
- Can lead to [] and []

Difficulty in swallowing, usually caused by LES not maintaining complete closure
- Can lead to esophagitis and heartburn

Achalasia * Occurs when the LES does not [], usually due to problems with the myenteric plexus * [] [] neurotransmitter seems to be impaired, which causes the malfunction in LES. * food accumulates in the esophagus and causes [] []. * Treated by [] [] of the LES * Can cause [] in venous return --\> [] in blood pressure

* Occurs when the LES does not **relax**, usually due to problems with the myenteric plexus * **Nitric Oxide** neurotransmitter seems to be impaired, which causes the malfunction in LES. * food accumulates in the esophagus and causes **secondary peristalsis**. * Treated by **balloon stretching** of the LES * Can cause **decrease** in venous return --\> **decrease** in blood pressure

Stomach Motor functions: * Internal [] layer of smooth muscle helps [] out stomach during emptying * Extrinsic innervation from [] nerve and [] Ganglia (= [] innervation) * Gastric receptors - like []receptors that generate feelings of [].

* Internal **oblique** layer of smooth muscle helps **wring** out stomach during emptying * Extrinsic innervation from **Vagus** nerve and **Celiac** Ganglia (= **sympathetic** innervation) * Gastric receptors - like **pain** receptors that generate feelings of **satiation**.

Antral Pyloric Systole * BER increases in [] at the antrum starts to cause [] which lead to muscle contraction during feeding * mixes [] with gastric secretions * mixing is due to [] * Regulates the [] of the stomach

* BER increases in a**mplitude** at the antrum and starts to cause **action potentials** which lead to muscle contraction during feeding * mixes **chyme** with gastric secretions * mixing is due to **retropulsion** * Regulates the **emptying** of the stomach

Gastric Emptying * Rate is slowed by * [] volume of meal * high [] pressure * high [] and [] concentration

* Rate is slowed by * **Small** volume of meal * high **osmotic** pressure * high **fat and protein** concentration

Mechanism of Gastric Emptying: * 2 Rules * Greater stomach [] = greater emptying * Greater energy []= less emptying * fat\>protein\>carbs

* 2 Rules * Greater stomach **volume** = greater emptying * Greater energy **density** = less emptying * fat\>protein\>carbs

What 3 things decrease Gastric motility?

Gastric Inhibitory Peptide (GIP) Cholecystokinin (CCK) Sympathetic Nervous System (SNS

Gastric motility is increased by... * []- increases release of [] from G-cells * [] [] [] from vagovagal reflexes

* **distention** - increases release of **gastrin** from G-cells * **Parasympathetic Nervous System (PNS)** from vagovagal reflexes

What are the 3 phases of Digestion?

Cephalic Phase Gastric Phase Intestinal Phase

Cephalic digestion is controlled via the [] comprised of [] input and [] l input. Basically...its controlled [] the shoulders.

Cephalic digestion is controlled via the **vagus** comprised of **hypothalamic** input and **cortical** input. Basically...its controlled "**above"** the shoulders.

Gastric digestion * Involves [] reflexes like distenstion leading to increased motility. * Stimuli comes from the [] * neural stimuli is [] * hormonal stimuli is []

* Involves **vago-vagal** reflexes like distenstion leading to increased motility. * Stimuli comes from the **stomach** * neural stimuli is **distention** * hormonal stimuli is **gastrin.**

Intestinal Digestion: * Inhibits stomach [] and stomach activity * Controlled by: * [] pH * osmolarity [] gastric emptying * [] * Gastric [] Peptide

* Inhibits stomach **motility** and stomach activity * Controlled by: * **duodenal** pH * osmolarity **decrease** gastric emptying * **Secretin** * Gastric **Inhibitory** Peptide

[] is a protective reflex providing a mechanism to empty gastric and dueodenal contents.

Emesis

Retching: * Reverse [] * LES [], but UES remains [] * Product of [] [] dominant signals

* Reverse **peristalsis** * LES **relaxes**, but UES remains **closed** * Product of **peripheral afferent** dominant signals

Central Afferents and Vomitting: * [] [] [] (CTZ) is though to reside in the area postrema in the medulla * [] []or the Nucleus Tractus Solitarius (NTS) * Anti-[] suppress both CTZ and NTS * Projectile vomitting is can be indicitive of []damage

* **Chemoreceptor Trigger Zone** (CTZ) is though to reside in the area postrema in the medulla * **Vomitting Center** or the Nucleus Tractus Solitarius (NTS) * Anti-**emetic** suppress both CTZ and NTS * Projectile vomitting is can be indicitive of **NTS** damage

Vomitting leads to a loss of [] and possibly metabolic []

Vomitting leads to a loss of **H⁺** and possibly metabolic **Alkalosis**

Gall Bladder Motility * [] acids and [] acids in dueodenum casue release of [] * CCK initiates [] of the Gall bladder and [] of the Sphincter of Oddi

* **Fatty** acids and **amino** acids in dueodenum casue release of **CCK** * CCK initiates **contractions** of the Gall bladder and **relaxation** of the Sphincter of Oddi

[] in the intestines helps "crush" food, mix chyme, and increase opportunity for food to contact enterocytes.

**Segmentation** in the intestines helps "crush" food, mix chyme, and increase opportunity for food to contact enterocytes.

3 types of GastroIntestinal Reflexes:...

1. Enteric Nervous System moediate dwith the Gut wall 2. Prevertebral Ganglia - Sympathetic NS Reflexes 3. Brain Stem (PNS) mediated reflexes

Enteric NS within the gut wall Reflex: * [] Gastrointestinal reflex * Mechanisms to control [], [] * Inhibited by over [] of the intestines * Inhibits [] activity for protection

* **Fastest** Gastrointestinal reflex * Mechanisms to control **mixing**, **peristalsis** * Inhibited by over **distention** of the intestines * Inhibits **contractile** activity for protection

Prevertebral Ganglia - Sympathetic NS reflexes to the Gut * [] Fast * Examples: * GastoIleal Reflex * distention of the stomch [] the [] of the ileum & [] of Ileaocecal Sphincter * GastroCholic Reflex * Distention of stomach causes and [] in the motility of the Colon...clears [] from the large intestine * Colonoileal Reflex * distention of the colon causes [] of ileum emptying.

* **MODESTLY** Fast * Examples: * GastoIleal Reflex * distention of the stomch **increases** the **motility** of the ileum & **relaxtion** of Ileaocecal Sphincter * GastroCholic Reflex * Distention of stomach causes and **increase** in the motility of the Colon...clears **chyme** from the large intestine * Colonoileal Reflex * distention of the colon causes **inhibition** of ileum emptying.

Brain Stem reflexes in the Gut * [] gut reflex * Has to travel al the way to the brain stem and wait for []response to the gut * Examples: * regulation of [] motor activity * regulation of [] activity * [] reflexes * [] reflexes

* **Slowest** gut reflex * Has to travel al the way to the brain stem and wait for **PNS** response to the gut * Examples: * regulation of **gastric** motor activity * regulation of **secretory** activity * **Pain** reflexes * **Defecation** reflexes

Villi Movements * Muscularis mucosa contracts irregularly at about []/[] * contraction thought to aid [] flow

* Muscularis mucosa contracts irregularly at about **3/min** * contraction thought to aid **lymph** flow

List the 6 sections of the colon.

Ascending Transverse Descending Sigmoid Rectum Anus

Colonic Innervation: * Vagus Nerve (PNS) - [] the transverse colon * Pelvic Nerve (PNS) - [] the transverse colon * [] and [] Mesenteric Ganglia (SNS) * Hypogastric Ganglia (SNS) for [] and [] * [] Nerve (voluntary) - External Anal Sphincter

* Vagus Nerve (PNS) - **above** the transverse colon * Pelvic Nerve (PNS) - **below** the transverse colon * **Superior** and **Inferior** Mesenteric Ganglia (SNS) * Hypogastric Ganglia (SNS) for **Rectum** and **anus** * **Pudendal** Nerve (voluntary) - External Anal Sphincter

Defecation: 1. [] [] causes filling of rectum 2. Rectal distention causes [] reflex relaxtion of [] 3. Reflex [] of EAS, through [] Nerve 4. Voluntary action is necessary to [] EAS 5. If one ignores defecation urge, feces are moved back into [] and [] passes

1. **Mass movement** causes filling of rectum 2. Rectal distention causes **autonomic** reflex relaxtion of **IAS** 3. Reflex **contraction** of EAS, through **pudendal** Nerve 4. Voluntary action is necessary to **relax** EAS 5. If one ignores defecation urge, feces are moved back into **colon** and **anxiety** passes

* Interal Anal Sphincter * [] [] muscle * Always [], normally [] * External Anal Sphincter * [] muscle innervated by the [] Nerve * Voluntary and [] control, normally [] * Angle between the rectum and anus is maintained by the [] Muscle

* Interal Anal Sphincter * **circular smooth** muscle * Always **toned**, normally **closed** * External Anal Sphincter * **Striated** muscle innervated by the **Pudendal** Nerve * Voluntary and **reflex** control, normally **relaxed** * Angle between the rectum and anus is maintained by the **Puborectalis** Muscle

Haustrations * Bulging of [] muscle in the colon * SM [] to squeeze fecal material and propel the matter towards next haustra * 1-3 times/day we have a [] [] - which is a slow long lasting peristaltic contraction

* Bulging of **smooth** muscle in the colon * SM **contracts** to squeeze fecal material and propel the matter towards next haustra * 1-3 times/day we have a **Mass movement** - which is a slow long lasting peristaltic contraction