GI Theme 2 Flashcards
what is involved in chemical digestion in the mouth
a-amylase
- starch digestion at pH 7
-when bolus & enzyme hit pH 2.5 gastric juices hydrolysis will cease
lingual lipase
-breakdown of triglycerides into fatty acids and glycerol
what is involved in mechanical digestion int eh mouth
breaks into pieces
mixes with saliva
what are the function of the stomach
storage
digestion
protection
how does the stomach have a protective fucntion
acids destroys bacteria and other pathogens (HCl)
outline mechanical digestion in the stomach
gentle mixing waves
more vigorous waves
intense waves near the pylorus
with each wave a small amount of chyme enters the duodenum
outline protein digestion in the stomach
HCl denatures protein molecules
HCl transforms pepsinogen into pepsin that breaks peptide bonds between certain amino acids
outline fat digestion in the stomach
gastric lipase splits the triglycerides in milk fat
most effective at pH6 to 6
what is the cytoplasmic pH of the parietal cells
7.2
which cells secrete mucus and bicarbonate
mucus cells in the neck of gastric glands
how does gastric mucous & bicarbonate provide protection
creates a barrier protecting stomach from autodigestion
mucus-physical barrier
bicarbonate- chemical barrier
how are GI secretions regulated
Long cephalic reflexes
- CNS (feeds forward & emotional reflexes)
Short reflexes
-ENS (motility & secretion: enzymes and hormones)
what is the enteric ns
subdivision of the peripheral ns controlling GI system
capable of autonomous functions
can recieve from the autonomic ns
how are gastric secretions and motility regulated
CNS & ENS
- cephalic phase
- gastric phase
- intestinal phase
what happens in the cephalic phase
“stomach getting ready”
- cerebral cortex stimulates parasympathetic ns
- vagus n increases stomach muscle and glandular activity
what happens in the gastric phase
“stomach working”
- nervous control keeps stomach active
- endocrine influences over stomach activity
what is the function of D-cells
decrease stomach acid production
what happens in the intestinal phase
“stomach emptying”
- intestinal activity increased (duodenum)
- distension, fatty acids or sugar signal medulla
- hormonal influences
what is the role of the sympathetic nervous system in the intestinal phase
slow stomach activity
what does secretin do in the intestinal phase
decerases stomach secretions
what does cholecystokinin (CCK) do in the intestinal phase
decreases stomach emptying
what does gastric inhibitory peptides(GIP) do in the intestinal phase
decrease stomach secretions, motility and emptying
what do D cells secrete, what does this do & what is its stimulus
somatostatin
inhibits acid
acid in stomach
what do G cells secrete, what does this do & what is its stimulus
gastrin
stimulates acid secretion
acetlycholine, peptides
what do chief cells secrete, what does this do & what is its stimulus
pepsinogen & gastric lipase
protein digestion
ActChl, secretin, acid
what do mucous cells secrete, what does this do & what is its stimulus
mucus & bicarbonate
physical barrier & chem protection
irritation & secreted with mucus
what do parietal cells secrete, what does this do & what is its stimulus
gastric acid & Intrinsic factor
activates pepsin, denatures protein, kills bacteria & vit B12 absorption (IF)
ActChl, gastrin, histamine
what do enterochromaffin like cells secrete, what does this do & what is its stimulus
histamine
stimulates acid secretion
ActChl, gastrin
stimulates acid secretion
what nutrients does the stomach absorb
water esp if cold
electrolytes
drugs (aspirin & alcohol)
why would the palatal and lingual tooth surfaces be at risk of erosion
patient suffering from reflux (gastric goes through oesophagus into oral cavity)
which patients may be more at risk of aspiration of stomach contents when under GA
hiatus hernia
non fasted
pregnant
which drugs can cause a dry mouth
chelates and complexes
protein pump inhibitors (omeprazole)
which drugs can cause a chalky taste
antacids
which drug can cause staining of tongue, erythema multiforme & swelling and pain of salivary gland
H2 receptor antagonists - ranitidine
what is the approx length of the SI
6 meters
what is the approx length of the duodenum and jejunum
2.5m
what is the approx length of ileum
3.5m
what is the function of the small intestine
mechanical digestion- weak peristalsis
chemical digestion
absorption of nutrients across intestinal enterocyte
how long does chyme stay in the small intestine
3 to 5 hrs
what is meant by segmentation in the SI
local mixing of chyme with intestinal juices
sloshing back and forth
what paracrine hormones are involved in the regulating the small intestine
secretin
GIP
GLP-1
CCK
what does secretin do
regulates water homeostasis & secretions in the stomach pancreas and liver
located in S cells of duodenum (intestinal glands
what is GIP produced by
k cells of duodenal and jejunal mucosa
what is GLP-1 produced by
intestinal enteroendodrine L-cells and some ENS and brainstem neurones
what does CCK do in the SI
stimulates release of digestive enzymes and bile from the pancreas and gall bladder
hunger suppressant
produced by enteroendocrine duodenal cells
how does chemical digestion occur in the small intestine
pancreatic juice
what cells produce pancreatic juice
acinar
how does pancreatic juice enter duodenum
pancreatic duct
what does pancreatic juice contain
proteases
lipases
amylase
sodium bicarbonate to neutralise chyme
which hormones regulate pancreatic juice secretion
CCK- enzyme rich
secretin- bicarbonate rich
what are incretins
hormones that stimulate decrease of blood glucose levels
when are incretins released
at the beginning of intestinal phase of digestion
GIP & GLP
how do incretins cause a decrease a blood glucose levels
stimulate insulin release from pancreatic b cells
inhibit glucagon release from pancreatic a-cells
what hormone regulates bile
CCK
which hormone stimulates goblet cells
VIP
which enzymes break down carbs in the small intestine
sucrase-isomaltase
- sucrose = glucose + fructose
lactase
-lactose= glucose + galactose
how may lactose intolerance occur
damage to intestinal mucosa(age, drug treatment or chemotherapy)
where are the enzymes that break down carbs located
apical membrane of SI
where are peptidases found
brush border
how & where are food proteins hydrolysed for peptidases to act upon
pepsin - stomach
pancreatic proteases- duodenum onwards
what do enterokinases do
partially hydrolyse pancreatic zygomen proteases to release the active enzyme
do brush border hyrolases act on lipids or nucleic acids
no
why are tight junctions important for the function of polarised cells
keep extracellular fluids surrounding apical and basolateral membranes separate & prevent diffusion of membrane proteins and glycolipids between fucntional domains
what are the consequences of tight junctions
prevent passage of molecules and ions between cells
must enter by active transport
peristaltic waves cause aid mechanical digestion in the large intestine, outline how
haustral churning
gastroilial reflex
gastrocolic reflex
what happens the the haustral churning part of mechanical digestion in the LI
relaxed pouches filled from below muscular contractions (elevator)
what happens the the gastroilial reflex part of mechanical digestion in the LI
when stomach full gastrin hormone relaxes ileocal sphincter so small intestine will empty and make room
what happens the the gastrocolic reflex part of mechanical digestion in the LI
when stomach fills a strong perostaltic wave moves contents if transverse colon into rectum
are enzymes involved in chemical digestion in theLI
no, only mucus is secreted