Green - Bile Secretion And Large Intestine

Question 1

Substance that stimulates bile secretion

Answer 1

Choleretic

Question 2

Reduction or stoppage of bile flow

Answer 2

Cholestasis

Question 3

Transport of bile salts from the liver through the small intestines and blood back to the liver

Answer 3

Enterohepatic circulation

Question 4

Bile acids synthesized by the liver from cholesterol

Answer 4

Primary bile acids

Question 5

Primary bile acids that are modified by bacteria become?

Answer 5

Secondary bile acids

Question 6

Relaxation of the internal anal sphincter when fecal material enters the rectum

Answer 6

Rectosphincteric reflex

Question 7

What collects on the insides of bile salts?

Answer 7

Free fatty acids,

Monoglycerides

Fat-soluble vitamins

Cholesterol

Question 8

What are the contents of bile?

Answer 8

Bile acids

Cholesterol

Phospholipids

Bile pigments

Question 9

Bile’s primary excretory pathway for cholesterol is thru?

Answer 9

Loss of bile salts in feces

Question 10

Metabolite of hemoglobin

Insoluble in water until the liver conjugates it to glucoronic acid

Leaves liver as soluble salt - glucuronide

Not in micelles

Principle bile pigment

Answer 10

Bilirubin

Question 11

Bilirubin is secreted from the liver as ___

Answer 11

The soluble salt bilirubin gluconoride

Question 12

Most common causes of jaundice (x2)

Answer 12

Increased destruction of RBC’s

Obstruction of bile duct/damage to liver cells

Question 13

Predominant electrolyte composition of bile?

Answer 13

Na

Cl

HCO3-

Question 14

A total pool of bile salts must cycle ___ times per meal

Answer 14

2

Question 15

In the terminal ileum, where bile salts are reabsorbed for reuse, what is the transporter that does this?

Answer 15

Apical sodium-dependent bile salt transporter

Question 16

______ bile acids can be absorbed by passive diffusion

Answer 16

Deconjugated

Question 17

Hepatocytes extract bile salts along w/ Na from portal blood via. __________

Answer 17

Sodium-taurocholate cotransporting peptide (NCTP)

Question 18

Defects in BSEP can cause?

Answer 18

Cholestasis

Question 19

What is the bile-independent fraction of biliary secretion?

Answer 19

Volume of secretion of water and electrolytes

Question 20

Bile-dependent fraction of biliary secretion is what?

Answer 20

Quantity of bile salts secreted by liver

Question 21

Bile salts and bile acids are potent ______ of bile secretion

Answer 21

Stimulators

Question 22

Increased secretin levels does what to the contents of the bile?

Answer 22

Increased bicarb

Question 23

How does the gallbladder concentrate the bile?

Answer 23

By actively removing Na, Cl, and HCO3-

This causes water to follow the osmotic gradient

Question 24

Major stimulus for gallbladder contraction?

Answer 24

CCK (released in response to fatty acids and small peptides in duodenum)

[vagal activity also stimulates contraction]

Question 25

What are the actions of CCK on the gallbladder?

Answer 25

Contract smooth muscle

Relax sphincter of oddi

Question 26

80% of gallstones in western societies are formed from?

Answer 26

Cholesterol

Question 27

Pigment gallstones are composed of ?

Answer 27

Calcium bilirubinate

Question 28

How does digestion change after cholecystectomy

Answer 28

Normal digestion and absorption unaffected

Bile constantly released from liver into duodenum

Fats can still be absorbed but high fat diets should be avoided

Question 29

As more bile salts are recirculated to the liver, the rate of new bile acid synthesis _________

Answer 29

Decreases

Question 30

When the ileum is distended the ileocecal sphincter ______

Answer 30

Relaxes

Contents flow into colon

Question 31

When the colon is distended, the ileocecal sphincter _______

Answer 31

Contracts

Reflux into ileum prevented

Question 32

______ propel material into rectum

Answer 32

Mass movements of the distal colon

Question 33

How are suppositories able to be absorbed?

Answer 33

The segmentation contractions of the rectum are more frequent than that of the sigmoid colon. This means that there is retrograde material of fecal matter towards the sigmoid colon

Question 34

When rectum is filled to ____ of capacity, urge to defecate is produced

Answer 34

25%

Question 35

What happens if material enters the rectum, and the rectosphincteric reflex is triggered, but the external anal sphincter maintains its tonic contraction and defecation does not occur?

Answer 35

The internal anal sphincter contracts and the rectum relaxes to accomodate the fecal material w/in it and the urge to defecate subsides

Question 36

Explain Hirschprung’s disease

Answer 36

Hirschprung’s disease, or congenital megacolon, is a disease in which there is lack of enteric nervous system for a section of colon. The enteric nervous system is inhibitory in nature, so this section is tonically contraction. This causes loss of coordinated movement and constriction, leading to build up of material proximal to the area, dilatation of the colon and severe constipation.

Question 37

Increased time of passage or transit of material thru the colon

Answer 37

Constipation

Question 38

What are the two colonic changes in function seen in constipation

Answer 38

Increased storage capacity of the cecum and ascending and transverse colon

Decreased propulsive capacity of the descending and sigmoid colon

Question 39

What are some causes of constipation or decreased frequency of bowel movements?

Answer 39

Old age

Medications

Ignoring urge to defecate

Lack of exercise

Long term use of laxatives