GIT - Lecture 4 Flashcards
What is the form of activity in the distal stomach?
peristalsis
Where does peristalsis start and end in the stomach?
starts: midpoint
ends: pylorus
Is there peristalsis in the proximal stomach?
no
What does propagated wave of contraction result from?
a series of local enteric reflexes in response to local distension
What does the amplitude of contraction in the distal part of the stomach due to?
the magnitude of stimulus (stretch and ACh)
The higher the magnitude of stimulus, the ___ the amplitude of contraction.
greater
What influences the frequency (direction + velocity) of peristalsis?
electrical characteristics of smooth muscle
If you take a recording pipette and you put it on one of the muscle cells in the proximal part of the stomach where there’s no peristalsis, what would you see?
you would measure a constant resting potential
What is the resting potential of the proximal part of the stomach?
-55 mV
If you take a recording pipette and you put it on one of the muscle cells in the distal part of the stomach where there is peristalsis, what would you see?
rhythmic waves of partial depolarization
What is the amplitude of the partial waves of depolarization in the distal stomach?
10 to 15 mV
What is the basic electrical rhythm of the stomach?
ongoing wave of partial depolarization
How long does basic electrical rhythm last?
1-4 seconds
How does the basic electrical rhythm occur?
at regular intervals
How often does the basic electrical rhythm occur? How many per second?
every 20 seconds, 3 per second in the stomach
What is the rhythm at the midline of the stomach?
occurs synchronously along the circumference of the stomach
What is the rhythm a bit lower of the midline of the stomach?
occurs with a delay more distally in the stomach
Basic electrical rhythm of the distal stomach is synchronous ___ and migrates down the ___ axis.
circumferentially, longitudinal
Does the BES cause muscle contraction?
no
Why doesn’t the BER cause muscle contraction?
because it doesn’t cross the firing potential
Where are the second electrical signals found after BER depolarization?
at the peak of the BER depolarization (the spikes)
What causes muscle contraction of the BER?
the second electrical signal at the spikes
What do spikes produce?
muscle contraction
When do the “spikes” occur?
at peak of depolarization in the BER
What determines the number of spikes?
the magnitude of the stimulus
What determines the amplitude of the muscle contraction?
the number of spikes
If spikes are on all the BER peaks, what will the rate of stomach contraction be?
3x/minute
What is the maximum frequency of muscle contraction?
3x/minute
The BER (slow waves) are detectable in which kinds of muscle?
longitudinal and circular
What is the origin of BER (slow waves)?
non-neuronal, not ENS pacemakers
Do BER (slow waves) need contractions to be initiated?
no, they are constantly present
What kind of cells are the ICC?
non-neuronal, non-muscular
Where are ICC located?
between the smooth muscle layers and the enteric plexuses
What directions do the ICC extend in?
circumferential and longitudinal directions
What can act as an intermediary between the neurons and the smooth muscle?
ICC
What functions as the pacemakers for the spontaneous basic electrical rhythm of the gastrointestinal tract?
ICC
What are the 3 different functions of the ICC?
a) origin and propagation of BER
b) communication between nerves and muscle
c) coordinating groups of muscle cells
What 2 things depolarize the muscle and therefore result in spikes?
ACh and stretch
Why are the spikes “phase-locked”?
because they always occur at the same time (peaks)
How are cells propagated during spikes?
via gap junctions
What are contractions associated with?
spikes
What is the maximal frequency of contractions limited by?
frequency of BER
How do the contractions vary in the stomach?
closer to the midline they are weaker whereas as you move further from the midline more distally, they become stronger
What happens to the band of contraction and the contractions as the bolus approaches the pyloric sphincter?
band of contraction: wider
contractions: stronger
What 2 parts of the stomach contract synchronously to close the pyloric sphincter?
the antrum and pyloric sphincter
What is antral systole
when the antrum and the pyloric sphincter contract to close the pyloric sphinctor
When is the pyloric sphincter open and closed?
open: at rest
closed: by antral peristalsis
How can the pyloric sphincter act as a barrier?
since the lumen is very narrow, it serves as a filter
What is the length of the pyloric sphincter?
1-2 mm
What are the 2 functions of the distal stomach?
a) mixing
b) propulsion
How much of the contents of the stomach are going to be able to get past the pyloric sphincter before it closes?
very little
Mixing is achieved as a result of what 2 events?
- antal systole
- the early closure of the pyloric sphincter
As the wave of contraction passes over the antrum, some of the chyme is discharged into the ___, but most of it is squirted back into the body as high velocity.
duodenum
What kind of flow results in effective mixing?
retropulsive flow
What leads to gastric emptying?
propulsion
What causes the gastric emptying of liquids?
the difference in pressure between proximal stomach and duodenum
Which has a higher pressure, the proximal stomach or the duodenum?
proximal stomach
Why is the pressure difference between the duodenum and the proximal stomach small?
because of receptive relaxation
What would be the effect on the difference in pressures of the duodenum and proximal stomach if there was a vagotomy to the proximal stomach?
it would be small
What would be the effect on the change in liquid emptying if there was a vagotomy to the distal stomach?
not much change
Where in the proximal stomach is the meal stored in?
the fundic resevoir
What does the distal stomach function as during gastric emptying of solids?
antral pump
What is the formula for pump?
frequency x stroke volume
What does stroke volume depend on?
chyme fluidity and amplitude of contraction
What controls the amplitude of contraction?
distention
What determines the amplitude of contraction of the peristaltic wave? (3)
a) stretch of muscle
b) local ENS reflex
c) vago-vagal reflex
What would happen to emptying of solids if you cut vagi to distal stomach?
it would be sluggish/slow
Factors in the ___ also control (slow) rate of gastric emptying/atral peristalsis.
duodenum
What are the 4 factors in the duodenum that can slow the rate of gastric emptying?
- distention
- ph < 3
- osmolarity
- chemical composition
What are the levels of chemical composition that affect the rate of gastric emptying?
fat»_space; protein»_space; carbs
Gastric factors ___ motility, duodenal factors ___ motility.
increase, decrease