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Year 2 Gastrointestinal > Gut physiology > Flashcards

Gut physiology Flashcards

1
Q

What two things control the gut?

A

Neural control and hormonal control

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2
Q

Which two nervous systems control the gut?

A

Autonomic and enteric nervous system

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3
Q

Describe the course of autonomic control of the gut

A

Cell bodies in CNS. The oreganglionic fibres will synapse outside the CNS and release acetyl choline . This post ganglionic fibre will the synapse on the peripheral effector. This neuro-effector junction could be a muscarinic junction or could use noradrenaline or neuropetides depending on the type of ANS system being used.

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4
Q

How does the snoathtetic nervous system reduce gut activity?

A

Reduces blood flow to the gut

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5
Q

where are the sympathetic nerve roots to the gut?

A

T5-T12

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6
Q

The greater splanchnic nerve has what roots?

A

T5-9

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7
Q

The least splanchnic nerve takes fibres form what root?

A

T12

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8
Q

T10 and T11 innervates which embryological gut structures by which nerve?

A

Mid gut by the lesser splanchnic nerve

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9
Q

Do the splanchnic nerves that sympathetically innervates the gut synapse in the sympathetic trunk?

A

No

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10
Q

What do splanchnic nerves synapse with?

A

Prevertebral ganglia eg coeliac, renal , superior mesenteric, inferior mesenteric etc.

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11
Q

Why are the nerve roots of splanchnic nerve roots important?

A

The nerve root dermatomes represent the visceral pain from the organs they supply

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12
Q

Which cranial nerve parasympathetically innervates the gut?

A

Vagus nerve

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13
Q

Other than the vagus nerve how is the gut oarasympathtically innervates?

A

S2-4 pelvic splanchnic nerve

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14
Q

Why does the left vagus nerve innervates anterior gut structures and the right innervates the posterior?

A

90 degree developmental gut rotation

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15
Q

What is the effector transmitter of the parasympathetic nervous system?

A

Acetylcholine

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16
Q

Which peptides are released from post ganglionic parasympathetic fibres?

A

Gastric releasing peptide

Vaso-inhibitors peptide

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17
Q

Where do preganglionic parasympathetic nerves synapse?

A

Walls of viscera

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18
Q

List parasympathetic effectors in the gut

A

Smooth muscles

Endocrine or secretory organs

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19
Q

Where in the gut does the vagus nerve supply?

A

Oesophagus to transverse colon

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20
Q

The pelvic nerve supplies the transverse colon to the anal canal, outline its route (contrast fibre length with sympathetic and give the location of effectors in the cut wall)

A

Long oreganglionic fibres
Myenteric and submucousal plexus is where synapses occur
Effector transmitters are cholinergic or peptides

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21
Q

Does the enteric nervous system operate independently of the ANS..

A

Yes independently but they do have extensive connections between them

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22
Q

Name the two enteric nervous system olexuses

A

Myenteric

Submucousal

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23
Q

Which enteric plexus controls secretions and blood flow?

A

Submucousal ( Meissners)

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24
Q

What is the function of the myenteric plexus?

A

Motility

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25
Name some hormone secreting gut cells
Enteroendocrine cells (G, S, D)
26
Enterochromaffin like cells secrete ..l. And so are like the .... cells of the GI system and help paracrine control of the gut
Histamine | Mast
27
How do gut hormones circulate?
Peptides released by endocrine cell in gut. Enter portal circulation Systemic circulation Gut
28
How do peptides operate in the gut?
Diffuse ver short distances
29
D cells secrete ... into the .... of the stomach and the pancreas. They inhibit ... cells and inhibits .... release. They are stimulated by H+.
Somatostatin Antrum G cells Histamine
30
What do G cells secrete
Gastric in response to meals
31
Give an example of neurocrine secretions in the gut?
Gastric releasing peptide
32
What are the two broad gastrointestinal hormones?
Gastric- includes gastric and CCK | Secretin includes secretin and gastric inhibitory polypeptide
33
I cells in the duodenum and jejunum release?
CCK
34
What stimulates CCK release?
Fat and proteins
35
What's the action of ccck?
Gall bladder contraction | Pancreatic stimulation
36
What are the secretin GI effects?
Increases bicarbonate release from pancreas and gall bladder Decrease gastric acid secretion
37
S cells in the duodenum that release secretin are stimulated by what?
H+. And fatty acids
38
Gastric inhibitory polypeptide increase insulin and decrease gastric acid secretion. They are stimulated by what and where is it released?
Sugars amino acids and fatty acids Cells in duodenum and jejunum
39
22 year old women with central abdominal pain for twelve hours. Been unwell and off food and now pain has moved to RIF with rebound pain. What's the most likely differential?
Appendecitis (central visceral pain with RIF somatic pain as the parietal peritoneum got distended.
40
Visceral stomach pain is where?
T5-9 epigastric
41
T10-t11 innervates viscera would give oainwhere?
Central
42
Suprapubic pain equates to which viscera?
Transverse colon onwards
43
Gall stones may give you what pain?
Right upper quadrant - somatic Shoulder tip Epigastric
44
Pancreatitis and AAA can guve pain where?
Back pain
45
Retrosternal pain related to the gut equates to what viscera?
Oesophagus
46
Why do we need gut motility?
Move food along Mix contents Grind contents
47
Where in the gut is muscle not smooth?
Pharynx, upper third of the oesophagus and the external anal sphincter
48
The two muscular layers of the gut are oreintated how?
Circular and longtidtudinal
49
Describe two ways of ohasicngut contractions
``` Periodic contraction used for propulsion and mixing Tonic contraction (a constant state of contraction) seen in upper stomach, ileocaecal valve and the internal anal sphincter. ```
50
Where is the gut where is the outer longtitudinal layer not complete?
Large intestine
51
What is peristalsis?
Propelling food in one direction by proximal contraction and distal relaxation
52
How do we mix food?
Segmentation where contraction splits contents and lrelaxes to shuttle food back and forth
53
What movement happens in the distal colon?
Massmovement kf contents into the rectum controlled by the gastrocolic reflex (need to poo 30 mins post meal)
54
What is a paralytic ileum?
Loss of GI CONTRACTILITY (can happen post op)
55
Failure to relax the lower oesophageal sphincter resulting in dysphagia is called what?
Achalasia
56
Hirschsprung's disease will result in a sunctional obstruction in some newborns. What is this condition?
Lack of myenteric and submucousal plexus
57
List GI secretions.
``` Water Acid Alkali Enzymes Mucous Waste products Emulsifiers Intrinsic factor ```
58
Where does the gut secret?
Saliva Gastric Intestinal via liver and pancreas
59
Secretions are about 9L in to gut, but what is the actual amount lost as feeces per day?
O.1L/day
60
Stomach acid functions as what?
Innate barrier of infection, prepare proteins for digestion and enzyme activation
61
Where does bicarbonate neutralise acid using bicarbonate?
Saliva, stomach, duodenum, pancreas and liver via the bile
62
What waste products does the liver secreted
Bilirubin and bike salts
63
What is the function of bike salts?
Emulsified fat | Packages fat for transport into lymphatics
64
What protects the stomach lining, prtetcts tensmalk intestine against bacteria and harbours bacteria in the large intestine as well as lubricates?
Mucous
65
Where do we find digestive enzymes?
Saliva, stomach, pancreas and intestine linings
66
What secretes in the gut?
``` Acini of salivar gkands Gastric gkands Burners gkands Intestinal glands in the crypts Acini of exocrine pancreas Hepatocytes Goblet cells ```
67
What is movement between cells via tight junctions called?
Paracellular
68
What three folding methods help increase surface area fornabsorption?
Plica circulares Villi Microvili
69
What must the GI TRACT ABSORB.
``` Carbohydrates Proteins Lipids Fat soluble viatamins Vitamin B12 Bile salts Ca2+ Fe 2+ Electrolytes Water ```
70
Water is abasorbed passively by which mechanisms?
After a meal water will followndoium which is being contransported with nutrients Between meals the Na and Cl exchangers who'll allow water to follow
71
ENaC channels help form desiccated stool at which part of the gut
Colon

Year 2 Gastrointestinal (9 decks)

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