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Human Form & Function > GI System > Flashcards

GI System Flashcards

1
Q

what are the important factors of the GI in Dentistry?

A
  • Oral cavity is gateway to the digestive tract
  • GI disorders have far reaching
    consequences for systemic heath
  • Many oral conditions linked to GI
    disorders
  • Nutrition is a big part of what we do as
    dentists
  • Many drugs we prescribe have
    implications for the GI system
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2
Q

oral manifestations of GI dysfunction (3)

A

Crohn disease

ulcerative colitis

angular cheilitis

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3
Q

digestive system is essentially a ______ plant

A

processing plant

steps:
receives raw products

break them down
extract the parts that are needed

extrudes the rest

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4
Q

two general parts of digestive system

A

intake and processing

extraction and disposal

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5
Q

gut tube starts at the …

A

esophagus

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6
Q

how many layers in esophagus?

A

4 layers

mucosa, submucosa, muscularis, serosa/advenrtitia

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7
Q

gut tube layers and tissue

A

1) Mucosa:
Epithelium, Lamina
Propria, Muscularis Mucosa

2) Submucosa:
Dense irregular
connective tissue

3) Muscularis:
Mostly smooth
muscle

4) Serosa/Adventitia:
Connective tissue binding
everything together

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8
Q

identify the layers

A
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9
Q

identify the tissues associated with each layer

A
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10
Q

adventitia vs serosa

A

serosa: connective tissue which is covered with mesothelium

adventitia: connective tissue without the lining layer, usually attaches one organ to another

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11
Q

mesothelium

A

simple squamous epithelium
forming internal lining

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12
Q

retroperitoneal organs will have both adventitia and serosa and are where …

A

adventitia where organs are attached to one another, serosa everywhere else

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13
Q

label

A
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14
Q

label

A
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15
Q

salivary glands

A

lubrication
amylase

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16
Q

what happens in the oral cavity (GI System)?

A

chewing: breaks down food into managable pieces, starts forming food into bolus

saliva: softens and lubricates bolus

amylase begins breakdown of starches

swallowing: voluntary muscle introduce bolus into the oropharynx

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17
Q

peristalsis of pharynx

A
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18
Q

label

A
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19
Q

“gatekeeper” in GI system

A

epiglottis

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20
Q

three parts of the pharynx

A

nasopharynx

oropharynx

laryngopharynx

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21
Q

what are the two smooth muscle layers in digestive tract?

A

longitudinal (outer layer)

circular (inner layer)

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22
Q

peristalsis

A

adjacent segments of alimentary tract
organs alternately contract and relax, moving food
along the tract distally

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23
Q

segmentation

A

non adjacent segments of
alimentary tract organs alternatively contract and
relax, moving food forward, then backward. Food
mixing and slow food propulsion occurs.

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24
Q

pharynx is a “____ ___”

A

muscular tube

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25
Q

what is the part of the digestive tract that doesn’t have 4 layers?

A

pharynx

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26
Q

what sections are missing from the pharynx that is present in the rest of GI system?

A

no muscularis mucosa

no submucosa

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27
Q

what are the three histological layers of the pharynx?

A

muscosa (non-keratinized stratified squamous epith)

muscularis externa

adventitia

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28
Q

active swallowing causes the ___ ____ to press against the back of the nasoppharynx, sealing it off

A

soft palate

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29
Q

the ____ blocks off the oral cavity

the _____ moves down to block the trachea

A

tongue
epiglottis

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30
Q

trachealis muscle allows for _____ _____ of trachea

A

partial collapse

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31
Q

the upper _____ _____ opens allowing the food bolus to engage the upper esophagus

A

esophageal sphincter

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32
Q

4 histological layers of the esophagus

A

1-Mucosa (with stratified squamous epithelium)

2-Submucosa

3-Muscularis externa

4-Adventitia

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33
Q

esophageal muscle types:

A

Upper 1/3 is skeletal

Middle 1/3 is mixed smooth and skeletal

Lower 1/3 is all smooth involuntary

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34
Q

esophageal glands are found in the ____ and ____ ____

A

Found in the submucosa and lamina
propria

*Add secretions to aid passage down the
tube

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35
Q

the esophagus meets the stomach at the ____ ____ ____

A

lower esophageal sphincter

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36
Q

esophageal sphincter is composed of ____ (tissue)

A

smooth muscle

*muscularis externa

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37
Q

when the esophageal sphincter dilates, what happens?

A

allow things into the stomach, then contracts the keep stomach contents in the stomach

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38
Q

stomach contents, including acid, enter the esophagus causing
irritation/inflammation

A

GERD

gastro-esophageal reflux disease

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39
Q

acidic fluid plus bolus =

A

chime

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40
Q

at the esophageal/stomach junctions, the epithelium changes from stratified squamous to …

A

simple columnar

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41
Q

lipase is secreted to break down ____ in the stomach

A

lipids

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42
Q

pepsin is secreted to break down ____ in the stomach

A

proteins

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43
Q

amylase breaks down _____ in the stomach/oral cavity

A

carbohydrates

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44
Q

what are the four main parts of the stomach

A

1) Cardia – the pathway into the stomach

2) Fundus – upper curvature

3) Body – main, largest region of the stomach

4) Pyloris – where stomach joins small
intestine

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45
Q

parasympatheitic nervous system will make muscularis externa do what?

A

contract when food is present in the stomach

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46
Q

stomach regions and there characteristics

A

Cardia: pits are shorter than glands (connect with lamina propria)

Body/Fundus: relatively long
glands, but pits are more defined
than in cardia

Pyloris: longer pits and shorter
glands

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47
Q

gastric gland vs pit

A
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48
Q

stomach cells are their secretants

A
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49
Q

gastric glands contain ____ and ____ cells

A

parietal and chief cells

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50
Q

parietal vs chief cells

A

Parietal cells – produce and secrete gastric acid and intrinsic factor

  • Chief cells – produce and secrete pepsin and lipase
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51
Q

pyloric glands are primarily _____ glands

A

mucous

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52
Q

where are G cells found?

A

pyloric glands

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53
Q

what do G cells secrete?

A

gastrin

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54
Q

Stem cells are found in the ____ of the gland (in isthmus between pits and glands)

A

Stem cells are found in the TOP of the gland (in isthmus between pits and glands)

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55
Q

what does the mucous in the stomach lining do?

A

protects the tissues from acids and enzymes

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56
Q

Surface mucous cells are more _______in shape and secrete
______

A

Surface mucous cells are more “columnar” in shape and secrete
“bicarbonate”

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57
Q

surface mucous cells secrete _____ and ____

A

bicarbonate and mucous

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58
Q

Mucous neck cells are more _____ in shape, have apical granules,
but fewer of them.

A

Mucous neck cells are more “round” in shape, have apical granules,
but fewer of them.

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59
Q

parietal cells secrete…

A

gastrin, acetylcholine, histamine, and gastric intrinsic factor (GIF)

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60
Q

gastric intrinsic factor for _____ absorption

A

B12

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61
Q

loss of gastric intrinsic factor leads to…

A

pernicious anemia (B12 not absorbed)

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62
Q

chief cells secrete…

A

pepsinogen (pepsin)

gastric lipase

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63
Q

where are chief cells found?

A

bottom of the gastric glands

64
Q

G cells are part of the _____

A

DNES

diffuse neuroendocrine system

65
Q

in the stomach, DNES cells secrete 4 main things:

A

1 - Gastrin and Histamine: triggers
HCl secretion by parietal cells

2 – Ghrelin: peptide hormone –
signals hunger to the brain

3 – Serotonin: neurotransmitter -
Produces psychotropic effects from
eating etc.

66
Q

what cells are the messengers to the rest of
the body signaling what is in the stomach and
how much is there?

A

G cells

67
Q

what controls parietal cell acid production

A

Gastrin Releasing Peptide (GRP)

68
Q

three phases of the gastric secretion control

A
  1. cephalic phase
  2. gastric phase
  3. intestinal phase
69
Q

what phase?

A

cephalic phase

70
Q

what phase?

A

gastric phase

71
Q

what phase?

A

intestinal phase

72
Q

label

A
73
Q
A
74
Q

three segments of the small intestine

A

duodenum
jejunum
ileum

75
Q

duodenum is the site of…

A

most chemical digestion

Bile from Gall Bladder – fat digestion

Bicarbonate and digestive enzymes from
Pancreas – fat, protein, carb digestion

Mucous produced by Brunner’s Glands

76
Q

bile is ____ digestion

A

bile

77
Q

bicarbonate and digestive enzymes from pancreas digest (3)

A

fat
protein
carbohydrates

78
Q

jejunum absorbs the digested things from the…

A

duodenum

79
Q

ileum absorbs ____-____ ____

A

bile-lipid micelles

and anything not absorbed in the jejunum

80
Q

peyer’s patches?

A

ileum?

81
Q

organs that contribute to digestion (4)

A

liver
bile duct
gallbladder
pancreas

82
Q

liver, gallbladder, and bile duct produce ___ for ___ digestion

A

bile
fat digestion

83
Q

pancreas makes ____ and ________ to digest (3)

A

bicarbonate and digestive enzymes

fat, protein, carbohydrate digestion

84
Q

small intestine has an extremely large surface area due to ..(4)

A

length (22 ft)

plica circulares (circular folds - absorb area 3X)

villi (absorb area 10X)

microvilli (absorb area15-40X)

85
Q

plica circulares

A

circular or semilunar folds in the lining of small intestine

86
Q

plica circulares consist of … (2 layers)

A

mucosa

submucosa

87
Q

plica circulares is most pronounced in…

A

jejunum

88
Q

villi are …

A

dense covering of fingerlike projections

89
Q

internal tissue of villi

A

lamina propria

with microvasculature, lacteals and lymphatics –
absorb fats

90
Q

external tissue of villi

A

columnar epithelium

91
Q

where are microvilli found?

A

apical ends of villi in the small intestine

92
Q

microvilli increase absorption by

A

15-40 X

93
Q

brush border is…

A

closely packed microvilli

94
Q

____ glands secrete an alkaline fluid composed of mucin

A

Brunner

*in duodenum

95
Q

what does the the alkaline fluid (mucin) do? (secreted by Brunner’s gland in the duodenum)

A

this exerts a physiologic anti-acid function by coating the duodenal epithelium, protecting it from the acid chyme of the stomach

96
Q
A

Brunner’s Gland

97
Q

circular folds in the jejunum force ____ to spiral through the lumen

A

chyme

*this slows it down for nutrient absorption

98
Q

what feature of the jejunum help slow the speed at which chyme travels?

A

plica circulares (circular folds)

99
Q

Ileum has ____ patches

A

Peyer’s Patches

100
Q

what are Peyer’s patches?

A

in the ileum

Lymphoid tissue seen as thickened patches in the ileum (storage unit for immune cells)

101
Q
A

Peyer’s patches in the Ileum

102
Q

what do the Peyer’s patches store in the ileum?

A

immune cells

103
Q

MALT stands for

A

Mucosal Associated Lymphatic Tissue

104
Q

how doe Peyer’s patches recognize antigens in the lumen?

A
  1. M cells
  2. endocytosis of antigens (bring them to lymphocytes and dendritic cells)
  3. immune response (AB production)
  4. MALT (lymphoid tissue)
105
Q

MALT is _____ tissue found in carious _____ ______ sites

A

lymphoid tissue

submucosal membrane

106
Q

MALT contains what four cells

A

T cells, B cells, Plasma cells, and Macrophages

plus M cells

107
Q

the epithelium of the small intestine is ….

A

simple columnar with microvilli projections

108
Q

enterocytes are…

A

absorptive columnar cells in the mucosa of small intestine

109
Q

goblet cells are…

A

mucous-producing cells in the mucosa of small intestine

110
Q

enteroendocrine cells are…

A

local and systemic signals relating to digestion and transit

in mucosa of small intestine

111
Q

paneth cells are…

A

antimicrobial molecule secreting cells that regulate immune response

in mucosa of small intestine

112
Q

whare are four cells in the mucosa of small intestine?

A

enterocytes
goblet cells
enteroendocrine cells
paneth cells

113
Q

5 steps of lipid absorption

A
114
Q

5 steps (in words): lipid absorption

A
  1. Bile acids emulsify fats to micelles (liquid droplets)
  2. Gastric lipase digests lipids to produce glycerol, FA (fatty acid) and monoglycerides
  3. These are packaged as micelles and diffuse across the cell membrane entering the cell
  4. Resynthesized in SER to triglycerides (glycerol plus 3 fatty acids) then pass through the RER, Golgi - eventually packaged into chylomicrons (lipid and protein)
  5. Chylomicrons enter the lymphatic system and are
    transported throughout the body
115
Q

Because of Lipid entry into the lymph circulation, fats
end up in the tissues, bypassing the liver, unlike
_____ and _____

A

carbohydrates and proteins

116
Q

enterocytes secrete

A

disaccharidase & amino
peptidases

117
Q

disaccharides and dipeptides are digesting into

A

monosaccharides and amino acids

118
Q

amino acids are absorbed via

A

active co-transport with sodium

119
Q

carbohydrates are absorbed via __ with __ or __

A

active co-transport

with sodium (glucose, galactose)
or direct diffusion
(fructose)

120
Q

Water absorption in small intestine

A
  • Sodium comes in with co-transporters and is
    pumped out of the lumen of the intestines
  • This creates a high sodium concentration in the
    intercellular space
  • Water diffuses from the lumen into the intercellular
    space and eventually into capillary blood
121
Q

the vessels responsible for absorption are located in the…

A

lamina propria in the center of each villus

122
Q

blood vessels for ____ and _____

lacteals for _____

A

blood vessels for proteins and carbohydrates

lacteals for lipids

123
Q

diarrhea is caused by…

A

an imbalance in the physiologic
mechanisms of the GI tract,
resulting in impaired absorption
and excessive secretion

124
Q

____ million children die yealry from diarrhea

A

1.6 mil

125
Q

one of the main functions of the GI tract is to reabsorb ____

A

water

126
Q

types of diarrhea

A
127
Q

paneth cells are…

A

Paneth Cells are secretory epithelial cells located
at the ends of intestinal crypts

128
Q

Crypts of Lieberkuhn

A

intestinal crypts

129
Q

what cells are intestinal crypts

A

paneth cells

130
Q

function of paneth cells in the intestinal crypts

A

secretion of antibacterial proteins into the crypt lumen, thereby providing protection for the stem cells which line the crypt walls

131
Q

Enteroendocrine cells are

A

distributed throughout the small
intestine. They regulate digestion by responding to certain
chemical signals and environmental cues

They help the GI Tract keep track of what is where so it can
respond appropriately.

132
Q

secretin…

A

stimulates HCO3 and H2O secretion by the pancreas
and bile ducts. It inhibits H+ production by the parietal cells in stomach.

133
Q

CCK (cholecystokinin)…

A

stimulates pancreatic acinar cell secretion and smooth muscle contraction by the gall
bladder. Signals immediate satiety to the brain.

134
Q

GIP (gastric inhibitory peptide, glucose dependent insulinotropic hormone)…

A

stimulates insulin secretion by beta cells in
pancreas

134
Q
A
135
Q

Peptide YY…

A

signals long term satiety to the brain

136
Q

Muscularis mucosa (intestinal motility)

A

produce local movements of villi and plica
circulae in order to gently mix/expel
contents in the intestinal crypts.

137
Q

submucosal plexus (intestinal motility)

A

submucosal plexus is a collection of
parasympathetic nerve fibers which
regulate contraction

138
Q

muscularis externa (intestinal motility)

A

-Primary source of intestinal motility

-Same circular/longitudinal bands as
upper tract

-The myenteric plexus (Aeurbach’s
plexus) – collection of both sympathetic and
parasympathetic nerve fibers as well as
sensory nerves that regulate GI function

139
Q

large intestine consists of

A

cecum
colon
rectum
anal canal

140
Q

functions of the large intestine

A

1- absorb water, electrolytes, little nutrients
2- secrete bicarbonate and mucous
3- store indigestible material as feces

141
Q

The large intestine is ___ meters long

A

1.5 meters

142
Q

colon layers

A
143
Q

in the colon, the mucosa lacks ____

A

villi

144
Q

what penetrates the mucosa in the colon?

A

tubular intestinal glands

145
Q

what cells are in the mucosa of the colon?

A

goblet cells
absorptive cells (colonocytes)

146
Q

the colon has active fluid absorption that ______ the feces

A

dehydrates

147
Q

tubular intestinal glands are ____ (epithelium_

A

simple columnar

148
Q

The outer layer of colon has three extra longitudinal
bands called the

A

taeniae coli

149
Q

In the colon, the taeniae can produce a
‘___ ____’ designed to empty whole
sections of the colon

A

mass movement

150
Q

what is the transitional zone between mucosa of the GI tract and the external skin, which sort of wraps around and “tucks in.”

A

anal canal junction

151
Q

what tissue is in the external anal sphincter?

A

skeletal muscle

152
Q

when swallowing and it “goes down the wrong tube”, which of the following has occurred:
a. upper esophageal sphincter relaxed and let food enter trachea
b. lower esophageal sphincter relaxed and let food enter trachea
c. epiglottis action delayed or incomplete, allowing food to enter the trachea
d. esophageal glands are not working and the esophagus inadequately lubricated to receive food bolus

A

c. epiglottis action delayed or incomplete, allowing food to enter the trachea

153
Q

the pharynx differ histologically from the rest of the GI tract by this feature:
a. has both circular and longitudinal muscle fibers in the muscularis ecterna
b. does not have muscularis mucosa or a submucosa
c. is covered by an adventitia layer not a serosa layer
d. contains Auerbach’s plexis of nerves in muscularis external to control motility

A

b. does not have muscularis mucosa or a submucosa

154
Q

question #3-7 from mal

A

Human Form & Function (36 decks)

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