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Gastroenterology > GI tract > Flashcards

GI tract Flashcards

1
Q

What structures make up the gut wall?

A 
Mucosa:epithelium
			lamina propria (loose connective tissue) 	     	muscularis mucosae

Submucosa: connective tissue (containing nerve plexus)

Muscularis: smooth muscle - nerve complex in it

Serosa/Adventita: connective tissue, may have epithelium

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2
Q

How are the 32 teeth subdivided?

A

8 incisors
4 canines
8 premolars
12 molars

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3
Q

What muscle is the largest jaw muscle?

A

Masseter muscle

  • temporalis and massater both used for biting and chewing
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4
Q

What enzymes do salivary glands excrete?

A 
Lingual lipase (fat digestion)
Salivary amylase (carbohydrate digestion
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5
Q

What three salivary glands are there?

A

Parotid

Sublingual

Submandibular

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6
Q

What are the intrinsic muscles of the tongue for?

Extrinsic muscles

A 
Intrinsic muscles 
fine motor control & moving food
Extrinsic muscles 
gross movement of tongue (in, out, up & down)
Assists mechanical digestion
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7
Q

How is the oesophegus divided?

A

method 1.
Cervical- cm
Thoracic -most
Abdominal -cm

method 2. * measurement started by incisors

Upper 1/3 is 24 cm away
Middle is 24-30 cm
Lower 30-40 from incisors

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8
Q

Where does the upper 1/3 of the oesophagus come to?

A

Carina of trachea

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9
Q

What is the function of the Oesophagus?

A

Conduit for food, drink & swallowed secretions from pharynx to stomach

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10
Q

What is the prupose of the oesophagus epithelium?

A
  • Non-keratinising
  • ‘Wear & Tear’ lining (extremes of temp. & texture)
  • Lubrication – Mucus secreting glands (& saliva
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11
Q

How is the upper oesophageal sphincter and lower oesophageal sphincter split?

A

Upper sphincter is a ‘true’ sphincter,

there is a debate whether the bottom one is a sphincter

The ‘Z line’ splits them.
It is where the pale pink mucosa of sqaumous epithelium meets red mucosa of gastric epithelium

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12
Q

What type of muscle controls pristalsis in the Oesophagus?

A

Circular muscle

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13
Q

What is the purpose of the epithelial transition near the gastro-oesophageal junction?

A

…

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14
Q

Why are gastric folds present near the gasto-oesophagul junction?

A

Increase surface of epithelium for more digestion and absorption can occur.

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15
Q

What are the three stages of swallowing?

A

Stage 0: Oral phase
Chewing & saliva prepare bolus
Both oesophageal sphincters constricted
Stage 1: Pharyngeal phase
Pharyngeal musculature guides food bolus towards oesophagus
Both oesophageal sphincters open
Stage 2: Upper oesophageal phase
Upper sphincter closes
Superior circular muscle rings contract & inferior rings dilate
Sequential contractions of longitudinal muscle
Stage 3: Lower oesophageal phase
Lower sphincter closes as food passes through

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16
Q

How is acid reflux from gastro-oesophagul prevented?

A

Diaphragm

Anatomically it lies at an angle to the stomach

17
Q

What are the functions of the stomach?

A

Breaks food into smaller particles (acid & pepsin)
Holds food, releasing it in controlled steady rate into duodenum
Kills parasites & certain bacteria

18
Q

What is found in the Cardia and Pyloric region of the stomach?

A

Mucus only

19
Q

What is found in the body and Fundas of the stomach?

A

Mucus, HCL, Pepsinogen

20
Q

What is found in the antrum of the stomach?

A

Gastrin

21
Q

What two types of stomach contractions are there?

A 
Peristalsis - 20%
Propels chyme towards colon
more powerful as moves from LOS
      to pyloric sphincter
ANS essential
Segmentation - 80%
Weaker.
 Fluid chyme towards Pyloric sphincter
Solid chyme pushed back to body
Stretching activates enteric NS
22
Q

What is a gastric chief cell?

A

Cell in the stomach:

  • Protein-secreting epithelial cell
  • Abundant RER
  • Golgi packaging and modifying for export
  • Masses of apical secretion granules
23
Q

What protein does gastric chief cell secrete?

A

Pepsinogen

  • turns into pepsin by hydrochloric acid activation
24
Q

How is the Parietal cell in the stomach adapted to be secreting HCl?

A 
Many mitochondria (requires lots of ATP)
Cytoplasmic tubulovesicles (contain H+/K+ ATPase)
Internal canaliculi (extend to apical surface)
25
Q

How does the parietal cell secrete HCl?

A

Tubulovesicles fuse with membrane
Microvilli project into canaliculi

  • Na+K+ Pump brings K+ and Na+ out
  • This K+ joins H+/k+ ATPase
  • H+ comes from carbonic anhydrase breakdown
  • Makes Cl- come into cell , when Na+ comes back into cells is makes NaCl which gets secreted too into the lumen
  • This is why stomach is high in HCl and Na+
26
Q

How would inhibition of carbonic anhydrase influence acid secretion in the stomach?

A

Would not have any H+ ions

27
Q

What triggers HCl release?

A

Histamine receptors on parietal cell surfaces

Histamine release

28
Q

What is the hormone gastrin?

A

Secreted by G cells in antrium

Pyloric antrum
Local peptide hormones -gastrin
Stimulate histamine release from
      chromaffin cells (lamina propia)
 = HCl release
  • from antrum region of stomach
29
Q

What is the Cephalic phase?

A

Thought, smell and taste of food starts histamine and gastrin release to activate pariatel cell

  • vagus nerve involvement
30
Q

What is the gastric phase?

A

Food in stomach – stretch- & chemo-receptors

Secretion of acid from

  • vagus nerve involvement
31
Q

What is the intestinal phase?

A

Signal via vagus nerve inhibits secretion of HCl and pepsin

  • Gastric inhibitory peptide
    Cholecystokinin
    Secretin
32
Q

How might you produce a useful drug to decrease acid secretion?

A 
Omeprazole
Ranitidine
\: 
- Block histamine receptor
- Block gastrin receptor
- Hydrogen Potassium Atpase inhibitors
33
Q

Which of the following stimuli would be most likely to
decrease acid secretion in the stomach?

  • Chyme fatty acid content
  • Increased acetylcholine secretion
  • Increased gastrin secretion
  • Protein content of the meal
  • Stomach distension
A

Chyme fatty acid content and protein content of meal

Gastroenterology (10 decks)

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