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Physiology > GIT 2 > Flashcards

GIT 2 Flashcards

1
Q

Immune functions of the Gut

A

Protect against microbial pathogens

Permit immunologic tolerance to both the potentially immunologic dietary substances and normal bacterial flora

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2
Q

Non-immunologic defenses

A

Gastric acid secretion
Intestinal mucin
Peristalsis
Epithelial cell permeability barrier

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3
Q

Roles of GI Tract

A

Digestion and absorption of dietary calories and nutrients
Maintenance of overall fluid and electrolyte balance
Excretion of waste materials
Immune functions
Non immunologic defenses

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4
Q

Secreted by I cells in duodenum and jejunum

Targets pancreas and gallbladder

Inc enzyme secretion
Inc contraction

A

Cholecystokinin

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5
Q

Secreted by K cells in duodenum and jejunum

Targets pancreas

Exocrine: dec fluid absorption
Endocrine: inc insulin release

A

Gastric-Inhibitory Peptide

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6
Q

Secreted by G cells, antrum of stomach

Targets parietal cells in body of stomach

Inc H secretion

A

Gastrin

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7
Q

Secreted by vagal nerve endings

Targets G cells in antrum of stomach

Inc gastrin release

A

Gastrin-Releasing Peptide

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8
Q

Secreted by alpha cells of pancreatic islets of Langerhans

Targets liver

Inc glycogenolysis

A

Glucagon

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9
Q

Secretes endocrine cells in upper GI tract

Targets esophgeal sphincter, stomach, duodenum

Inc smooth muscle contraction

A

Motilin

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10
Q

Secreted by endocrine cells, wide-spread in GI tract

Targets intestinal smooth muscle

Vasoactive stimulation of histamine release

A

Neurotensin

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11
Q

Secreted by endocrine cells in ileum and colon

Targets stomach and pancreas

Dec vagally mediated acid secretion

A

Peptide YY

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12
Q

Secreted by S cells in small intestine

Targets pancreas and stomach

Inc HCO3 and fluid secretion by pancreatic ducts
Dec gastric acid secretion

A

Secretin

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13
Q

Secreted by D cells of stomach and duodenum
D cells of pancreatic islets

Targets stomach, intestines, pancreas

Dec gastrin release
Inc fluid absorption/secretion
Inc smooth muscle contraction

A

Somatostatin

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14
Q

Secreted by enteric neurons

Targets enteric neurons and liver

Neurotransmitter

A

Substance P

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15
Q

Targets small intestines
Pancreas

Dec smooth-muscle relaxation

A

Vasoactive intestinal peptide

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16
Q

Innervation of GI tract:

A

Enteric nervous system
Parasympathetic nervous system
Sympathetic nervous system

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17
Q

Primary neural control of GI function

A

Enteric nervous system

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18
Q

Submucosal plexus

A

Myenteric plexus

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19
Q

Between muscle layers of proximal esophagus to rectum

A

Myenteric Auerbach’s Plexuses

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20
Q

Motor effect

Inc tonic contraction
Inc intensity of rhythmic contraction
Inc velocity of excitatory waves

A

Myenteric Auerbach’s Plexuses

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21
Q

Submucosa of intestines only

Regulates the secretory activities of glandular, endocrine, and epithelial cell

A

Meissner’s Submucosal Plexuses

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22
Q

Parasympathetic NS of GIT

A

Vagus N

Pelvic N

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23
Q

Splenic flexure to anus
Cholinergic (Ach)
Terminates in the enteric plexuses

A

Pelvic Nerves

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24
Q

Stimulated motor and secretory activities

A

Parasympathetic Nervous System

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25
Q

Inhibits motor activity of muscularis externa
Induces contraction of muscularis mucosae
Induces contraction of some sphincters
Inhibits secretory functions of the GI tract
Vasoconstriction of some GI blood vessels

A

Sympathetic NS

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26
Q

Functions of GI Motility

A

Segmental contraction
Propulsive contraction
Allows the stomach and large intestines to act as reservoirs

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27
Q

Segmental contractions

A

Non propulsive

Mixing and churning - digestion and absorption of nutrients

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28
Q

Propagated movement of food in a caudal direction

Results in elimination of nonabsorbed material

A

Propulsive contraction

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29
Q

Electrical and mechanical properties of GIT

A

Rhythmic contraction

Tonic contraction

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30
Q

RMP of GI Smooth Muscle

A

-40 to -80 mV

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31
Q

Slow waves are produced by the

A

interstitial cells of Cajal

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32
Q

AP of GI smooth muscle

A

More prolonged than skeletal

Precise

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33
Q

Modulation of intestinal smooth muscle contraction is dependent on

A

L type Ca2+

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34
Q

Predominant excitatory neurotransmitter

A

Acetylcholine

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35
Q

Inhibitory neurotransmitter

A

VIP

NO

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36
Q

Specialized circular muscles that separate segments of the GI tract

Function as barriers maintaining positive resting pressure that serve to separate two adjacent organs

A

GI sphincters

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37
Q

Stimuli proximal to sphincter

A

Sphincteric relaxation

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38
Q

Stimuli distal to sphincter

A

Sphincter contraction

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39
Q

Esophagus

and Anus histology

A

Stratified squamous non keratinized

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40
Q

Stomach
Small and large intestines
Rectum

Histology

A

Simple columnar

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41
Q

Anus histology

A

Stratified squamous non keratinized

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42
Q

Skin histology

A

Straified squamous keratinized

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43
Q 
Absorption
GIT
Stomach
SI
LI
A

Simple columnar

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44
Q

Most common cancer of esophagus

A

Squamous Cel Ca

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45
Q

Metaplasia
SSQ
Simple columnar
Adenocarcinoma

A

Barret’s esophagus

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46
Q

Simple columnar + Glands

A

Adenocarcinoma

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47
Q

Vagal nerve receptors

A

Cholinergic receptor

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48
Q

Located between the circular and longitudinal smooth muscle layers

Responsible for motility

A

Myenteric Auerbach’s Plexus

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49
Q

Cells in the gastric epithelium secreting histamin

A

Enterochromaffin like cells

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50
Q

Released from enteric neurons, mucosal mast cells and specialized EECs called enterochromaffin cells

A

Serotonin

5 hydroxytryptamine

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51
Q

AA precursor of serotonin

A

Tryptophan

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52
Q

Precursor of tryptophan

A

Niacin

53
Q

Triad of pellagra

A

Diarrhea
Dermatitis
Dementia
Death

54
Q

Where is 5HT localized?

A 
Enterochromaffin cells 90%
Platelets: thrombosis
CNS 10%
Dorsal raphe
Ventral raphe
Raphe nuclei
55
Q

Allows GI smooth muscles to perform slow wave contractions and sustained muscle contraction

A

Intersitital cells of Cajal

56
Q

Most common location of GIST

A

Stomach

57
Q

DOC for GIST

A

Imatinib

58
Q

Tumors arising from interstitial cells of Cajal

A

GIST

59
Q

Tumor marker in GIST

A

CD 117 c KIT

60
Q

Main feature of cephalic phase is

A

activation of the GI tract in readiness for the meal

Cognitive and include anticipation or thinking about the consumption of food, olfactory input, visual input (seeing or smelling appetizing food when hungry) and auditory input

61
Q 
Sight, smell, thought of food
Inc parasympathetic outflow
Inc salivary secretion
Inc gastric acid secretion
Inc galbladder contraction

Relaxation of sphincter of oddi

All these responses enhance ability of GI tract to receive and digest incoming food

A

Cephalic phase

62
Q

The only difference of oral phase with cephalic phase is that

A

Food is in contact with the surface of the GI tract

63
Q

Subdivides and mixes food with salivary amylase and lingual lipase and with the glycoprotein mucin which lubricates food for chewing and swallowing (degluttition)

A

Chewing

64
Q

Cleaves internal alpha 1,4 glycosidic linkage

Activity in stomach is limited by

A

Alpha salivary amylase

Acid pH

65
Q

Voluntary behavior and a reflex

To lubricate food
To initiate digestion of starch
To mechanically chop food into smaller pieces

A

Mastication (chewing)

66
Q

Bolus of food in mouth -> mastication inhibited -> stretch reflex of jaw muscles -> rebound contraction

A

Chewing reflex

67
Q

A rigidly ordered sequence of events that propel food from the mouth to the stomach

Initially voluntary, later, a reflex

Swallowing center:
Medulla and lower pons (CN V, IX, X, XII)

A

Degluttition (swallowing)

68
Q

Swallowing center:

A 
Medulla
Lower pons (CN V, IX, X, XII)
69
Q

Elevates the jaw

Closing the mouth

A

Medial pterygoid

70
Q

Lowers the jaw

Open Mouth

A

Lateral pterygoid

71
Q

Chewing problem

A 
Stroke - swallowing (medulla)
ALS
Parkinson’s disease
Myesthenia Gravia
ENT
trauma
Tetanus
72
Q

Movement of bolus through pharynx and UES

A

Pharynx contracts
UES opens
Airway closed
Larynx elevated

Bolus enters esophagus

73
Q

Bolus in mouth

A

Tongue thrust up and back

Nasopharynx is closed

74
Q

Oral phase

A

Voluntary

75
Q

Pharyngeal phase

Esophageal phase

A

Reflex

76
Q

Has primary peristalsis and secondary peristalsis

A

Esophageal reflex

77
Q

18-26 cm hollow muscular tube
Lines with stratified squamous epithelium
No serosa

A

Esophagus

78
Q

Upper 1/3 of esophagus

A

Striated muscle

Voluntary

79
Q

Middle 1/3 of esophagus

A

Striated
Smooth
muscle

80
Q

Lower 1/3 of esophagus

A

Smooth muscle

81
Q

Conduit that moves food from the pharynx to the stomach

A

Esophagus

82
Q

Prevents entry of air

A

UES

83
Q

Prevents the entry of gastric contents

Resting pressure of 20 mmHg

A

LES

84
Q

Reduced LES resting pressure

Can lead to esphagitis

A

GERD

85
Q

Defect in LES relaxation

A

Achalasia

86
Q

A j shaped dilation of the GI tract

A

Stomach

87
Q

Stomach motor fxns:

A

Storage
Formation of chyme
Emptying gastric contents into duodenum

88
Q

Storage in the stomach happens in the

A

proximal part

89
Q

Expulsion of gastric and duodenal contents from the GI tract through the mouth

A

Vomiting

90
Q

Vomiting center

A

Medulla

91
Q

Vomiting is preceded by

A

Retching

92
Q

Small intestine functions

A

To mix chyme with digestive secretions
To bring chyme into contact with the absorptive surface of the microvilli
To propel chyme toward the colon

93
Q

Types of SI movement

A

Segmentation

Peristalsis

94
Q

Most frequent SI movement
Closely spaced contractions of the circular muscle layer
Effectively mixes chyme with digestive secretions

A

Segmentation

95
Q

Progressive contraction of successive secretions of circular smooth muscle
Orthograde direction
Involves only a short length of SI

A

Peristalsis

96
Q

The respiratory center in the medulla is inhibited during this phase of swallowing

A

Pharyngeal

97
Q

Produces mainly serous secretions

Largest

A

Parotid gland

98
Q

Secretes mainly mucus

A

Sublingual

99
Q

Produces a mixed secretion

A

Submandibular gland

100
Q

Salivary gland that profuce entirely serous ptyalin rich secretion

A

Parotid

101
Q

Most common benign salivary gland tumor

A

Pleomorphic adenoma

102
Q

Most common malignant salivary gland tumor

A

Mucoepidermoid tumor

103
Q

Bursts of intense electrical and contractile activity separated by long quiescent periods

Occurs in the fasting state

From the stomach to the terminal ileum

Repeats every 75-90 mins

Stronger than contractions in the fed state

Housekeeper of small intestine

A

Migrating myoelectric complex

104
Q

Cystadenoma lymphomatosum

Limited to parotid gland

A

Warthin’s tumor

105
Q

Composition of saliva

A 
Low osmolarity
High K
Concentration and organic constituents including enzymes (amylase, lipase)
Mucin
Growth factors
106
Q

A tubular structure 1.5m in length

The longitudinal muscle layer is concentrated into 3 bands called

A

Large intestine

Taenia coli

107
Q

Absorb of fluids and electrolytes and converts the liquid content of ileocecal materials to solid and semi-solid food

Absorb the short chain-fatty acids formed by the catabolism of dietary carbohydrates that are not absorbed in the SI

Serve as reservoir

A

Large intestine

108
Q

Salivary secretion is always

A

Hypotonic

Na, K, HCO3, Ca, Mg, and Cl

109
Q 
Dry mouth (xerostomia)
Dry eyes (xeropthalmia)
Causes by impaired salivary secretion
Congenital or autoimmune process 
Keratoconjunctivitis sicca
A

Sjogren’s

110
Q

Types of movement in large intestine

A

Segmentation/Haustration

Mass movement

111
Q

Haustra
Cecum and proximal part of colon
Circular muscle contractions churn the luminal contents and move them in an orad direction
Facilitates absorption of salts and water by the mucosal epithelium

A

Segmentation/Haustration

112
Q

1-3x a day
Propulsive movement
Sweeps feces toward the rectum

A

Mass movement

113
Q

Length of esophagus in UGI Endoscopy

A

40cm

114
Q

Start of esophagus

A

C6

Cricoid cartilage

115
Q

Where does esophagus end?

A

Esophageal opening of diaphragm

T10

116
Q

Distention of one part of the colon causes a relaxation in other parts of the colon

A

Colonocolonic reflex

117
Q

An increase in the motility of proximal and distal colon and the frequency of mass movements after a meal

A

Gastrocolic reflex

118
Q

Most common location of cancer in esophagus

A

Middle 1/3

SCC

119
Q

If in the lower 1/3 of esophagus

A

Adenocarcinoma associated with Barett’s esophagus

120
Q

Presence of acid in duodenum cause release of

A

Secretin

121
Q

Other name of CCK

A

Pancreozymin

122
Q

Effect of CCK on gallbladder

and sphincter of Oddi

A

GB contraction

Sphincter of Oddi relaxation

123
Q

Storage and secretion of GB

Capacity of GB

A

500 ml

30 ml

124
Q

Produced by duodenum S cells

Secretion of HCO3

A

Secretin

125
Q

Promotes secretion of pancreatic juice

A

Secretin

126
Q

K cells of small intestine produce

A

Glucoinsulinotropic peptide

GIP

127
Q

Targets beta cells of pancreas

Stimulates insulin secretion

A

Glucoinsulinotropic Peptide

128
Q

Regulatory petide released from EEC cells in the gut wall in response to presence of luminal carbohydrate and lipids

A

Glucagon like peptide 1

Drug: agonist exenatide type 2 DM

Physiology (23 decks)

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