Histo Phys-Stomach Flashcards

1
Q

What histological region of the stomach is responsible for secreting acid?

A

Oxyntic gland area

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2
Q

How many muscle layers are in the wall of the stomach?

A

Some say 3, really they are all intertwined to form a thick muscularis externa

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3
Q

Identify the region of the stomach shown below

A

Gastric rugae. These folds are mostly unfolded when the stomach is completely full.

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4
Q

Surface epithelium of the stomach

A

Single layer of columnar epithelium

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5
Q

What cells are present as you move down the gastric pits?

A

1) Mucous surface cells 2) Mucous neck cells 3) Parietal cells (secrete acid) 4) Peptic cells (Chief cells that secrete peptic enzymes) 5) Enteroendocrine cells

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6
Q

What cells are indicated below?

A

Parietal cells. Note that they are located within the epithelium and have a pale pink stain.

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7
Q

Identify the cells indicated below

A

Top: Chief cell. Bottom: Parietal cell

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8
Q

How do you tell the difference between mucous surface cells and chief cells?

A

The surface mucous cells will have the nucleus all the way at the base and its cytoplasm will be more pale.

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9
Q

Role of HCl secreted by parietal cells

A

Kill bacteria, denature protein, convert pepsinogen to pepsin

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10
Q

Role of ion secretion in stomach

A

Protection of mucosa (Na, K, Cl, HCO3)

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11
Q

Role of chief cells in stomach

A

Secrete pepsinogens after vagal impulse

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12
Q

Role of mucous secretion in the stomach

A

Protection of surface epithelium

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13
Q

Role of intrinsic factor secretion in the stomach

A

Absorption of vitamin B12 complex in the ileum

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14
Q

Role of water secretion in the stomach

A

Dissolving and dilution of ingested material

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15
Q

By what mechanism is acid secreted from the parietal cell?

A

Secretagogue binds receptor -> cAMP activation or inactivation -> protein kinase turned on or off -> H+/K+ ATPase turned on to pump out H+ or turned off

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16
Q

What happens to the actual morphology of the parietal cell when they begin to actively secrete ions?

A

Expansion of canaliculi. Note the many channels surrounding the mitochondria in the image below.

17
Q

Ions secreted by parietal cells? Ions secreted by mucous cells?

A

Parietal: H+, Cl-, K+. Mucous cells: Na+, Cl-, HCO3-X

18
Q

What structure is indicated below?

A

Surface mucous cells in the stomach. Note the elongated cells with mucus secretory granules localized apically.

19
Q

How does mucous help protect the gastric epithelium?

A

Trefoil factors family (TFF) help ulcers heal by promoting migration of epithelium across injured areas. Mucous also contains bicarbonate (prevents acidic damage).

20
Q

Cells that secrete gastrin

A

G-cells (endocrine) secrete the activating factor out the basilar aspect

21
Q

Cells that secrete somatostatin

A

D-cells (paracrine) secrete the inhibitory factor

22
Q

Function of ghrelin

A

Increase HCl and appetite

23
Q

What is the role of the ECL cell in acid secretion?

A

Different molecules bind receptors and increase or decrease secretion of histamine (which increases acid secretion by local parietal cells).

24
Q

4 phases of gastric secretion

A

1) Interdigestive (basal state) 2) Cephalic (sight, smell and taste) 3) Gastric (food in stomach) 4) Intestinal (food in intestine)

25
Q

3 different ways we can activate parietal cells

A

1) Enteric nervous system activates G-cells, gastrin activates parietal cells 2) Direct activation by vagus nerve 3) Vagal activation of ECL cells that secrete histamine and activate parietal cells

26
Q

2 different ways we can inhibit parietal cells

A

1) D cell activation, somatostatin inhibits parietal cells and ECL cells 2) Secretin release to inhibit parietal cells

27
Q

Metabolic effects from prolonged vomiting

A

*

28
Q

Drugs used to decrease gastric acidity?

A

H2 antagonists, anticholinergics and PPIs