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Physio > GI system > Flashcards

GI system Flashcards

1
Q

alimentary canal is __ to __

A

mouth to anus

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2
Q

accessory canals produce substances secreted into tract such as

A

-salivary glands
-exocrine pancreas
-liver and gall bladder

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2
Q

alimentary canal lumen contents considered __

A

outside body

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3
Q

absorption moves substances from lumen of gut to __

A

blood

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4
Q

mucosa made up of

A

-simple columnar epithelium
-lamina propria
-muscularis mucosa

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4
Q

4 layers of GI tract

A

-mucosa
-submucosa
-muscularis externa
-serosa

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5
Q

mucosa layer aids in the movement of __

A

villi

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6
Q

submucosa layer made up of

A

-CT layer
-blood and lymph vessels
-submucosal plexus

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7
Q

submucosal plexus has projections to

A

-luminal surface cells
-muscularis mucosa
-myenteric plexus

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7
Q

muscularis externa circular muscle-
contraction __ lumen

A

narrows

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8
Q

epithelial layer of GI tract

A

-simple columnar
-goblet cells
-enteroendocrine
-stem cells

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8
Q

muscularis externa longitudinal muscle-
contraction __ tube

A

shortens

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9
Q

muscularis externa contains __ plexus that receives input from __

A

myenteric, autonomic NS

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9
Q

myenteric plexus has projections to

A

-submucosal plexus
-circular
-longitudinal muscle

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9
Q

serosa is __ covering and supports __ in abdominal cavity

A

CT, GI tract

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10
Q

inside villus of GI tract contains

A

-lacteals
-cap. network

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10
Q

increases surface area

A

-circular folds
-villi
-microvilli

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11
Q

control mechanisms in GI system governed by

A

-volume
-luminal contents

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11
Q

enteric nervous system local control of

A

-intestinal secretions
-absorption
-mucosal muscle contraction

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11
Q

endocrine cells in gut are specialized mucosa __ cell __ hormone

A

1, 1

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12
Q

endocrine cells taste __

A

luminal contents

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12
Q

paracrine cells released into __, diffuses to target

A

interstitial fluid

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12
Q

two established gut paracrine factors

A

-histamine
-somatostatin

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13
Q

enteric nervous system controls muscle of __

A

muscularis externa

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13
Q

enteric nervous system when stimulated causes

A
  1. increased gut wall tone
  2. increases rhymic contraction intensity
  3. increase rate of rhythmic contractions
  4. increase conduction velocity
  5. inhibit sphincter contraction
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14
Q

skeletal (voluntary, striated) gut musculature is made up of

A

-mouth
-oropharynx
-upper esophageal sphincter
-upper 1/3 of esophagus
-external anal spincter

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15
Q

enteric nervous system hormones

A

-NE
-ACh
-amines
-NO
-many peptides

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16
Q

smooth (involuntary, unstriated) gut musculature is made up of

A

-lower 2/3 esophagus
-stomach
-small and large intestine
-gallbladder
-biliary and pancreatic ducts

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17
Q

sympathetic made up of post- ganglionic fibers that are usually __

A

inhibitory

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18
Q

parasympathetic made up of pre- ganglionic fibers and are __, depending on final neurotransmitter released

A

stimulatory or inhibitory

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19
Q

what collects all venous outflow from most GI oragns?

A

portal vein

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19
Q

mucus salivary gland

A

tiny buccal glands

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20
Q

smooth muscle controlled by __ factors

A

endocrine and paracrine

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21
Q

mucous saliva __ of surfaces

A

lubrication and protection

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21
Q

all portal outflow goes to __ before entering __

A

liver, vena cava

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21
Q

serous saliva contains __ and contributes to a small amount of __

A

ptyalin, chemical digestion

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22
Q

serous salivary gland

A

parotid

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23
Q

acinar cells are __ in shape and form a unit with a __

A

pyramidal, small central lumen

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24
Q

saliva secretion under __ control

A

neural reflex

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25
Q

mixed salivary gland

A

submandibular and sublingual

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26
Q

mucous cells __ in shape and organized into __

A

columnar, tubules

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27
Q

acinar cells secrete __ saliva

A

isosmotic serous

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28
Q

myoepithlial cells are around the __

A

serous acini

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28
Q

myoepithelial cells __ to move saliva

A

contract

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29
Q

intercalated duct cells move saliva out of __

A

acini

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30
Q

intercalated duct cells prevent __ of saliva into acini

A

backflow

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31
Q

striated ducts are __ epithelial cells that make up __ junctions

A

columnar, tight

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32
Q

striated ducts __ saliva

A

modify

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33
Q

PNS with control of saliva contraction

A

-predominate regulator
-initiates secretion
-sustains high levels
-vasodilation of blood vessles

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33
Q

as flow rate of saliva increases this happens

A

-less time for ductal modification
-saliva resembles plasma
-more basic

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34
Q

reflex activation of PNS stimulates saliva production by

A

-taste and tactile stimuli on tongue
-smell of food
-ingestion of irritating foods
-nausea

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34
Q

SNS in saliva productions has a __ role

A

minor

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35
Q

saliva production inhibited by

A

-fear
-sleep
-fatigue
-dehydration

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36
Q

unstimulated salivation production percent by gland

A

-69% submand.
-26% parotid
-5% sublingual

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36
Q

stimulated salivation production percent by gland

A

-69% parotid
-26% submand.
-5% sublingual

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37
Q

most common causes of xerostomia

A

-polypharmacy
-anxiety and depression
-insufficient hydration
-head and neck radiation
-sjogren syndrome

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37
Q

saliva production stimulated by

A

-autonomic
-thinking/ seeing/ smelling food
-conditioned salivation
-chewing
-nausea

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38
Q

management of zerostomia

A

-avoid spicy foods
-alochol- free toothpastes and rinses
-oral moisturizers
-sialogogues

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38
Q

sjogren syndrome destruction of __

A

mucous membranes and glands

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38
Q

consequences of xerostomia

A

-caries
-halitosis
-impaired senses of tastes
-heart burn

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39
Q

3 deglutition stages

A
  1. voluntary
  2. pharyngeal
  3. esophageal
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40
Q

voluntary stage initiates __

A

swallowing reflex

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41
Q

voluntary stage bolus of food moved into __ by tongue

A

pharynx

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42
Q

voluntary stage stimulates __ receptor area

A

epithelial swallowing

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43
Q

pharyngeal stage has a __ reflex

A

invountary

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44
Q

pharyngeal stage mediated by swallowing center in the __

A

brainstem

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44
Q

pharyngeal stage __ closes off trachea

A

epiglottis

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45
Q

pharyngeal stage __ pulled upward and closes off __

A

soft palate, nasopharynx

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46
Q

pharyngeal stage __ relaxes

A

upper esophageal sphincter

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46
Q

esophageal stages coordinated muscle contraction move bolus through __ into __

A

esophagus, stomach

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47
Q

primary peristalsis is a continuation of peristalic wave intiated during __

A

pharyngeal phase

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48
Q

3 functions of sphincters and peristalsis

A
  1. food from pharynx to stomach
  2. prevent air intake
  3. prevent reflux
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49
Q

secondary peistalsis activated by __ from retained food in esophagus

A

esophageal distension

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50
Q

esophagus outflow by somatic nerves that regulate __

A

striated muscle directly

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51
Q

esophageal outflow autonomic nerves regulate __

A

smooth muscle

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52
Q

in the esophagus the autonomic nerves regulates smooth muscle via __

A

enteric nervous or directly

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53
Q

primary peristalsis wave of __ in front of bolus

A

relaxation

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53
Q

primary peristalsis wave of __ behind of bolus

A

contraction

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54
Q

secondary peristalsis clears bolus not wholly expelled by __

A

primary wave

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54
Q

secondary peristalsis removes any gastric contents that reflux back into the __

A

lower esophagus

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55
Q

upper and lower esophageal sphincters __ between swallows

A

closed

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56
Q

upper and lower esophageal sphincters have __ properties

A

tonic contractile

57
Q

top of the stomach is the __

A

fundus

57
Q

upper and esophageal sphincters relaxes during __ and lower relaxes as __ approaches

A

swallow, peristaltic wave

58
Q

GERD treated by inhibiting __

A

gastric acid secretion

58
Q

upper portion of the stomach called __and lower __

A

orad portion, caudad portion

59
Q

antrum of the stomach secretes __

A

mucus, pepsinogen , gastrin

59
Q

antrum of the stomach controls __

A

mixing and grinding

59
Q

the lower esophageal sphincter prevents __

A

reflux

59
Q

pyloric sphincter controls __

A

emptying

59
Q

peristalsis contributes to __ production

A

chyme

60
Q

body os the stomach secretes __

A

mucus, pepsinogen, HCl

60
Q

receptive relaxation reduces pressure which increases preventing __ and premature __

A

gastric reflux, gastric emptying

60
Q

receptive relaxation accommodates the __ of the meal

A

volume

61
Q

peristalsis causes trituration which mixes ingested nutrients with gastric secretions to __

A

breakdown particles and increase SA for digestion

62
Q

main functions of the stomach

A

-temp. storage of food
-produces chyme
-deliver chyme to duodenum

63
Q

pyloric sphincter empties __ kcal/hr into small intestine (do not overload)

A

200

64
Q

migrating motility complex (MMC) sweep ingested solids that cannot __ through intestinal tract

A

be digested out of stomach

65
Q

MMC occurs during __

A

fasting

66
Q

gastric receptive relaxation initiated by __ of gastric or duodenal wall

A

stretch

67
Q

gastric receptive relaxation initiated by __ in duodenum

A

protein or fat

68
Q

gastric receptive relaxation contains __ reflexes

A

END (short) and vago- vagal (long)

69
Q

gastric receptive relaxation caused by __ from __

A

inhibitory signals, ENS

70
Q

in peristalsis pacemaker cells go through spontaneous phases of __

A

depolarizations and repolarizations (slow waves)

70
Q

factors that decrease force of antral contractions (decrease gastric emptying)

A

-contents of duodenum

70
Q

gastric peristalsis is generated by __ cells in GI smooth muscle

A

pacemaker

71
Q

rate of gastric emptying is __

A

highly variable

71
Q

rate of gastric emptying influenced by

A

-solid vs. liquid
-nutrient content
-forced gastric contractions

71
Q

on average-
- 50% of stomach contents emptied __ hours
- Total emptying of the stomach __ hours
- Total emptying of the small intestine __ hours
- Transit through the colon __ hours

A

2.5-3
4-5
3-5
8-15

71
Q

factors that increase force of antral contractions (increase gastric emptying)

A

-gastrin
-distension of stomach

71
Q

enterogastrones are these hromones secrete by duodenum in response to chyme

A
  1. CCK (fat, protein)
  2. secretin (acid)
  3. GIP (carbohydrate)
71
Q

MMC occurs every __

A

90 minutes

72
Q

MMC has intervals of __ contravtions

A

strong propulsive

72
Q

MMC continues until meal is __

A

ingested

73
Q

MMC intrinsic to __ and involves the hormone __

A

ENS, motilin

74
Q

exocrine gland produces __

A

gastric juice

74
Q

2 process of GI secretion

A

-exocrine
-endocrine

75
Q

function of intrinsic factor

A

vit. B12 absorption

75
Q

the exocrine parietal cells produce __

A

HCl and intrinsic factor

76
Q

function of HCl

A

-activate pepsinogen
-sterilize meal

77
Q

exocrine chiefs cells produce __

A

pepsinogen

78
Q

pepsinogen function

A

protein digestion

79
Q

exocrine surafce mucous cells produce __

A

-mucus, HCO3-
-trefoil factors

80
Q

mucus, HCO3- and trefoil factors function

A

gastroprotection

81
Q

paracrine ECL cells produce __

A

histamine

82
Q

histamine function

A

regulates gastric secretion

83
Q

feeding pattern stimulated by __ hormones and inhibited by __ hormones

A

-CCK, gastrin, insulin, serotonin
-secretin and glucagon

83
Q

ileum secretes

A

-PYY
-HCO3-

84
Q

duodenum secretes

A

-CCK
-secretin
-Gip
-HCO3-

84
Q

secretion in the small intestine occurs in the __

A

duodenum and ileum

85
Q

segmentation is mixing which __ fats and adjusts __

A

emulsifies, pH

85
Q

absorption of __ decreases down the small intestine

A

ions, nutrients, and H2O

85
Q

intraluminal and surface digestion __ down the small intestine

A

decreases

85
Q

feeding pattern BER __ waves in small intestine

A

slow

86
Q

longest to shortest feeding pattern intake

A

fats> proteins> carbs

86
Q

__ absorbed in the duodenum

A

Fe

86
Q

__ absorbed in the ileum

A

-bile acids
-vit. B12

86
Q

motility in the duodenum occurs through

A

-MMC
-segmentation
-peristalsis

87
Q

feeding pattern contains __ cells of cajal

A

interstitial

88
Q

feeding pattern stimuli

A

-distension of duodenum
-nutrient content of chyme
-gastroenteric reflex

89
Q

segmentation exposes __ to __

A

mucosa to chyme

89
Q

peristalsis spreads __ across __ as it enters from stomach

A

chyme, mucosal surface

90
Q

peristalsis can occur __ in the small intestine

A

anywhere

91
Q

rate of substance across intestinal epithelium is influenced by

A

-surface area
-motility

92
Q

factors influencing digestion

A

-motility
-large surface area
-appropriate pH
-hydrolytic enzyme
-emulsifying fats

93
Q

factors influencing absorption

A

-large surface area
-specialized cells
-specific transport mechanisms
-energy
-blood or lymph flow

93
Q

digestive enzymes in small intestine require a __ pH to function

A

neutral

94
Q

the small intestine has a very high __

A

reserve capacity

95
Q

2 sites for digestion of protein and carbohydrate

A
  1. intraluminal
  2. mucosal surface
96
Q

intraluminal __ completed in lumen

A

fat digestion

96
Q

factors that affect small intestine pH

A

-H+ from stomach
-bile HCO3-
-pancreatic HCO3-

97
Q

salivary amylase inactivated by __

A

gastric acid juice

98
Q

starch and glycogen digestion by __

A

pancreatic amylase

99
Q

brush border hydrolases produce the __

A

monosaccarides

99
Q

protein digestion in stomach begins by __

A

pepsin

100
Q

pepsin important for __ digestion

A

collagen

101
Q

pepsin inactivated by __ in small intestine

A

basic pH

102
Q

80-90% small intestine-
small peptides and amino acids produced by

A

-trypsin
-chymotrypsin
-carboxypeptidases
-elastase

102
Q

in small intestine brushed border __ produce amino acids

A

peptidases

103
Q

peptide transport 1 (PEPT1)-
-__ substrate availability
-can be used for __

A

-broad
-drug delivery

104
Q

most abundant dietary fats

A

triglycerides

105
Q

digestion of fat requires emulsification of

A

-bile salts
-lecithin

105
Q

digestion breakdown begins in __ by __

A

stomach, lingual lipase (<10%)

106
Q

> 90% of fat digestion occurs in the __ by __

A

small intestine, pancreatic lipase

107
Q

digestion of cholesterol esters by __

A

pancreatic cholesterol ester hydrolase

108
Q

digestion of phospholipids by __

A

pancreatic phospholipase A2

109
Q

TG and pther hydrophobic substances packaged into __

A

chylomicrons

109
Q

FA and MG cross apical membrane via __

A

simple diffusion

110
Q

chylomicrons secreted across __ via __

A

BL membrane, exocytosis

111
Q

chylomicrons enter lymphatic vessels via __ and are transported to __

A

lacteals, systemic veins

112
Q

surface cells absorb __

A

Na+, Cl-, H2O

113
Q

amylase breaks down __ to __

A

polysaccrides to disaccrides

113
Q

surface cells are __ intestinal epithelial cells and crypt cells are __ intestinal epithelial cells

A

mature, immature

114
Q

crypt cells found in deep spaces between __

A

circular folds

115
Q

crypt cells produced by __ mature and migrate to __

A

stem cells, surface

116
Q

crypt cells normally balance between __

A

absorption and secretion

117
Q

crypt cells secrete __

A

Na+, Cl-, H2O

118
Q

surface cells prandial state (absorption)

A

-electrogenic
-anions and H2O flow

119
Q

surface cells post- prandial (absorption)

A

-electroneutral
-H2O flows

119
Q

crypt cells secretion

A

-electrogenic
-Na+ and H2O follows

120
Q

cholera and E. coli infection both produce __ that increase __

A

enterotoxins, cAMP

121
Q

cAMP activated Cl- secretion via CFTR into gut lumen and causes __

A

massive diarrhea

121
Q

what does not affect sodium- glucose cotransport?

A

enterotoxins

122
Q

vit. B12 (cobalamin) absorption in stomach binds to __ protein to stabilize it in acidic environment

A

R- binding

122
Q

vit. B12 absorption in ileum intrinsic factors binds to __ and taken into cells via receptor mediated __

A

IFCR, endocytosis

122
Q

vit. B12 in stomach intrinsic factor secreted by gastric parietal cells cannot interact with B12 at __

A

low pH

123
Q

vit. B12 absorption in duodenum binds to __

A

intrinsic factor (pH neutral)

123
Q

vit. B12 absorption inside cells complex cross BL via __

A

exocytosis

123
Q

vit. B12 absorption inside cells __ degraded and binds to __

A

intrinsic factor, TCII

123
Q

vit. B12 absorption in duodenum __ digest R- binding protein

A

proteases

124
Q

absorption of water soluble vitamins cotransport with __ and completed in __

A

Na+, upper small intestine

125
Q

other actively absorbed substances

A

-Ca2+
-PO4-
-Mg2+
-Fe2+
-bile salts

126
Q

maldigestion due to __

A

-pancreatic “insufficiency”
-liver disease
-biliary obstruction

127
Q

malabsorption due to __

A

-achlorhydria
-short bowel
-mucosal disease
-lactose intolerance

128
Q

pressure and chemical irritation __

A

relax sphincter and excite peristalsis

129
Q

fluidity of contents promotes __

A

emptying

130
Q

pressure or chemical irritation in cecum __

A

inhibits peristalsis of ileum and excites sphincter

131
Q

absorbing colon is the __ 1/2

A

proximal

132
Q

absorbing colon absorbs __ from chyme to form solid feces

A

water and electrolytes

133
Q

storage colon is __ 1/2

A

distal

134
Q
A
135
Q
A
136
Q
A
137
Q
A

Physio (34 decks)

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