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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
Q

Name some hormone secreting gut cells

A

Enteroendocrine cells (G, S, D)

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26
Q

Enterochromaffin like cells secrete ..l. And so are like the …. cells of the GI system and help paracrine control of the gut

A

Histamine

Mast

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27
Q

How do gut hormones circulate?

A

Peptides released by endocrine cell in gut.
Enter portal circulation
Systemic circulation
Gut

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28
Q

How do peptides operate in the gut?

A

Diffuse ver short distances

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29
Q

D cells secrete … into the …. of the stomach and the pancreas. They inhibit … cells and inhibits …. release. They are stimulated by H+.

A

Somatostatin
Antrum
G cells
Histamine

30
Q

What do G cells secrete

A

Gastric in response to meals

31
Q

Give an example of neurocrine secretions in the gut?

A

Gastric releasing peptide

32
Q

What are the two broad gastrointestinal hormones?

A

Gastric- includes gastric and CCK

Secretin includes secretin and gastric inhibitory polypeptide

33
Q

I cells in the duodenum and jejunum release?

A

CCK

34
Q

What stimulates CCK release?

A

Fat and proteins

35
Q

What’s the action of ccck?

A

Gall bladder contraction

Pancreatic stimulation

36
Q

What are the secretin GI effects?

A

Increases bicarbonate release from pancreas and gall bladder
Decrease gastric acid secretion

37
Q

S cells in the duodenum that release secretin are stimulated by what?

A

H+. And fatty acids

38
Q

Gastric inhibitory polypeptide increase insulin and decrease gastric acid secretion. They are stimulated by what and where is it released?

A

Sugars amino acids and fatty acids

Cells in duodenum and jejunum

39
Q

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?

A

Appendecitis (central visceral pain with RIF somatic pain as the parietal peritoneum got distended.

40
Q

Visceral stomach pain is where?

A

T5-9 epigastric

41
Q

T10-t11 innervates viscera would give oainwhere?

A

Central

42
Q

Suprapubic pain equates to which viscera?

A

Transverse colon onwards

43
Q

Gall stones may give you what pain?

A

Right upper quadrant - somatic
Shoulder tip
Epigastric

44
Q

Pancreatitis and AAA can guve pain where?

A

Back pain

45
Q

Retrosternal pain related to the gut equates to what viscera?

A

Oesophagus

46
Q

Why do we need gut motility?

A

Move food along
Mix contents
Grind contents

47
Q

Where in the gut is muscle not smooth?

A

Pharynx, upper third of the oesophagus and the external anal sphincter

48
Q

The two muscular layers of the gut are oreintated how?

A

Circular and longtidtudinal

49
Q

Describe two ways of ohasicngut contractions

A 
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
Q

Where is the gut where is the outer longtitudinal layer not complete?

A

Large intestine

51
Q

What is peristalsis?

A

Propelling food in one direction by proximal contraction and distal relaxation

52
Q

How do we mix food?

A

Segmentation where contraction splits contents and lrelaxes to shuttle food back and forth

53
Q

What movement happens in the distal colon?

A

Massmovement kf contents into the rectum controlled by the gastrocolic reflex (need to poo 30 mins post meal)

54
Q

What is a paralytic ileum?

A

Loss of GI CONTRACTILITY (can happen post op)

55
Q

Failure to relax the lower oesophageal sphincter resulting in dysphagia is called what?

A

Achalasia

56
Q

Hirschsprung’s disease will result in a sunctional obstruction in some newborns. What is this condition?

A

Lack of myenteric and submucousal plexus

57
Q

List GI secretions.

A 
Water 
Acid 
Alkali
Enzymes 
Mucous 
Waste products 
Emulsifiers 
Intrinsic factor
58
Q

Where does the gut secret?

A

Saliva
Gastric
Intestinal via liver and pancreas

59
Q

Secretions are about 9L in to gut, but what is the actual amount lost as feeces per day?

A

O.1L/day

60
Q

Stomach acid functions as what?

A

Innate barrier of infection, prepare proteins for digestion and enzyme activation

61
Q

Where does bicarbonate neutralise acid using bicarbonate?

A

Saliva, stomach, duodenum, pancreas and liver via the bile

62
Q

What waste products does the liver secreted

A

Bilirubin and bike salts

63
Q

What is the function of bike salts?

A

Emulsified fat

Packages fat for transport into lymphatics

64
Q

What protects the stomach lining, prtetcts tensmalk intestine against bacteria and harbours bacteria in the large intestine as well as lubricates?

A

Mucous

65
Q

Where do we find digestive enzymes?

A

Saliva, stomach, pancreas and intestine linings

66
Q

What secretes in the gut?

A 
Acini of salivar gkands 
Gastric gkands 
Burners gkands 
Intestinal glands in the crypts 
Acini of exocrine pancreas 
Hepatocytes 
Goblet cells
67
Q

What is movement between cells via tight junctions called?

A

Paracellular

68
Q

What three folding methods help increase surface area fornabsorption?

A

Plica circulares
Villi
Microvili

69
Q

What must the GI TRACT ABSORB.

A 
Carbohydrates 
Proteins
Lipids 
Fat soluble viatamins 
Vitamin B12 
Bile salts 
Ca2+ 
Fe 2+
Electrolytes 
Water
70
Q

Water is abasorbed passively by which mechanisms?

A

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
Q

ENaC channels help form desiccated stool at which part of the gut

A

Colon

Year 2 Gastrointestinal (9 decks)

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