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Physiology Renal ABS 2018 > Intro to Gatrointestional Module & Motility > Flashcards

Intro to Gatrointestional Module & Motility Flashcards

1
Q

How can the GI tract work as an “independent” system?

A

It contains its own nervous system, named Enteric Nervous System (myenteric plexus and submucosal)

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2
Q

Why does the GI tract make sounds?

A

borboroygmi, the movement of fluid and gases in and out of the intestines

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3
Q

What are the 4 sphinchter’s are found along the digestive tract? Function?

A

To prevent back flow of food contents ; prevent from spilling out digestive contents

  1. Esophageal (U&L)
  2. Pyloric
  3. Illeocecal
  4. Internal & External
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4
Q

What are the 3 accessory organs of the digestive tract?

A
  1. Liver
  2. Pancreas
  3. Gall Bladder
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5
Q

What are the 3 parts of the small intestines?

A
  1. Duodenum- 1ft
  2. Illeum- 10-12 ft
  3. Jejunum- 10-12ft
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6
Q

What is chyme?

A

term for food that has been mixed with stomach secretions and travels through the rest of digestive tract

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7
Q

What are the 3 parts of the small intestines? Which is highly specialized?

A
  1. Duodenum- 1ft
  2. Illeum- 10-12 ft
  3. Jejunum- 10-12ft
    * Duodenum
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8
Q

What part of the digestive tract do accessory organs feed directly into what structure?

A

The first part of the duodenum

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9
Q

What is the function of the highly specialized dudoenum?

A

receiving and mixing chyme juices from stomach, while also feeding in juices coming from the liver, gall bladder, and pancreas.

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10
Q

What is a special feature of the small intestine? And what other organ in the body is this seen? Function?

A

Villus
in the proximal convoluted tubules of kidneys
to increase surface area of small intestine for reabsporption

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11
Q

What are the one-cell thick lining of small intestine that move food into digestive tract?

A

intestinal epithelial cells are called, enterocytes, reabsorption from lymph and capillary nets

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12
Q

What are the two types of muscle found the small intestine? Function

A
  1. longitudinal
  2. circular muscle
    Function: muscles contracts in two different ways to mix and propel chyme down the digestive tract.
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13
Q

What 2 nerve nets that travel down the digestive tract from esophagus to the anus?

A
  1. Myenteric Plexus
    -MUSCLE; travels between the circular and logitudinal
    when stimulated, depolarizes slow wave, causing contraction that will promote movement of chyme
  2. Submucosal Plexus
    between submucosal and circular muscle, stimulations, causes secretions
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14
Q

What factors affect the function of the enteric nervous system?

A
  2. Hormonal
  3. Chemorectors
  4. Osmoreceptors
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15
Q

What factors affect the function of the enteric nervous system?

A
  1. Extrinsic Nerves
  2. Hormonal
  3. Luminal receptors
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16
Q

Why can the digestive system still function with damage to autonomic nervous system?

A

enteric nervous system, digestion will occur, not as efficiently.

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17
Q

What disease is caused by damage or absence of enteric nervous system in a part of the digestive tract?

A

illeus

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18
Q

What are the 3 structures along the digestive tract capable of voluntary muscle contraction?

A
  1. Mouth-Chewing/ Swallowing
  2. Upper esophagus
  3. External Anal Sphincter
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19
Q

What are the 5 types of cells found in the small intestine?

A
  1. Absorptive
  2. Goblet
  3. Microvaculated
  4. Enteric Endocrine
  5. Stem/ Progenitor
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20
Q

What is the first pass effect?

A

sphlacnic circulations- blood travels from small intestine to the portal vein to the liver before it can go out through systemic circulation

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21
Q

What are the 8 functions of the GI tract?

A

Acronym: Deep Mass

  1. Digestion
  2. Endocrine
  3. Elimination
  4. Protection
  5. Motility
  6. Absorption
  7. Secretion
  8. Storage
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22
Q

Approximately, how much fluid does the small intestine absorbs daily?

A
  • 7-8 liters a day w/o external fluid intake (9-10 with 2L fluid intake)
  • secretes 7-8L/daily
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23
Q

What are 2 significant benefits of digestive secretions?

A
  1. Help lubricate digest
    (HCL & Enzymes)
  2. Buffer the chyme (HCO3)
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24
Q

What is the importance of PH in the digestive system?

A

Digestion in stomach occurs under very acidic (PH 1-1.2) conditions , but needs to be neutralized to a (PH of 7) before it gets to jejenum for digestive enzymes to work properly

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25
Q

What are the 5 ways GI tract can be regulated?

A
  1. Enteric Nervous System
  2. Lumenal Chemo-, mechano-, and osmo- receptors
  3. PNS- Pro(mainly transverse colon, pelvic nerves to anus)
  4. SNS- Slow/Stop(post-ganglionic, adrenergic fibers from celiac, superior & inferior messenteries, hypogastric plexuses)
  5. CNS- (senses, anticipatory response)
  6. Hormones
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26
Q

How much of digestion happens pre-duodenally?

A

only 25-30% digestion occurs pre-duodenally by mouth& stomach enzymes

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27
Q

How much of digestion happens post-duodenally?

A

70-75% of the digestion occurs post-duodenally by pancreatic enzymes

28
Q

What is motility?

A

how we move things down our digestive tract

29
Q

What is the interdigestive state?

A

the period of digestion occuring 3-4 hours after finishing a meal that utilizes a special type of motility

30
Q

What is the special type of motility active int he digestive state? Why is it neccessary?

A

MMC- Migrating Myoelectric Complex

sweep bacteria & undigested material from stomach to colon bc its harmful to the stomach and intestines

31
Q

What are the 4 features of the MMC?

A
  1. begins 3-4 hours after eating
  2. Performs housekeeping movements (sweeps undigested materials & bacteria to the colon)
  3. Active mid stomach-terminal illeum
  4. Has 4 phases (enitre cycle last 75-120 minutes)
32
Q

What is the most important phase of the MMC? Why?

A

Phase 3, only occurs when your not eating

33
Q

What is the significance of phase 3?

A

Motilin stimulates very specific contractions—-series of wave-like pulses that sweep the bacteria & undigested material into colon

34
Q

What are two types of propulsion in the esophagus? Function? Control?

A
  1. Primary esophageal peristalisis
    - oral contraction around the bolus
    - Swallowing center in the medulla- VN-PNS
  2. Secondary esophageal peristalisis
    - occurs when bolus is stuck
    - ENS senses problem
35
Q

How can a fever contribute to diarrhea?

A

Fevers contribute diarrhea because it increases the metabolism, increasing sips syncitium , increasing slow waves of the digestive tract, causes the chyme to move distally throughout the digestive tract with minimal fluid reabsorption, i.e watery diarrhea

36
Q

How do the vagal nerves affect motility into the GI tract?

A

vagal nerves stimulate by secreting hormones that cause an increase in digestion, while also extended stomach to accommodate food

37
Q

Why can you get an urge to defecate soon after eating?

A

mass movement of feces into descending colon filling rectum, stimulates rectalsphincteric reflex, i.e. urge to defecate

38
Q

What is acalasia? Clinical Presentation? Treatment? Problems with treatment?

A

small muscle disorder caused by absence of ens resulting in lower esophageal sphincter to stay contract, food backs
CP: Painful to eat, food back-up, anorexia
Treatment: Surgery
Problems w/treatment: Gird
Treatment: H2 receptor antagonist+ proton pump inhibitor to reduce acid in the stomach

39
Q

Why do you feel full faster when you have a vagatomy?

A

A vagatomy prevents the stomach from being extended when food enters, therefore the intraluminal pressure makes you feel full faster

40
Q

What is the concept of bariatric surgery?

A

reduce the ability to accommodate the food in the stomach..

41
Q

What affects gastric emptying?

A

constituents in the food, easy entry and exit digestive tract based on whether the duodenal

42
Q

What affects gastric emptying?

A

constituents in the food, easy entry and exit digestive tract depends on whether the duodenal has to prepare….

43
Q

What affects gastric emptying?

A

constituents in the food, easy entry and exit digestive tract depends on whether the duodenal has to prepare via bile….

44
Q

Why do we have/secrete bile?

A

bile emulsifies fat, meaning mixes with the fat and coats it like a micelle taxi so it can be absorbed by cells/dudoenum

45
Q

Why are fats not readily absorbed in the duodenum?

A

the duodenum has absorptive mucosa with crypts and villi specializing in mucous secretion and water reabsorption and repelling fats.

long time to digest fat

46
Q

What cells in the digestive tract contain pacemaker cells?

A

interstitial cells of cajal(ICC)

47
Q

What is the basic electrical rhythm of the digestive tract?

A

resting membrane potential of the intestinal tract that are in the form of slow waves (unhilations)

48
Q

What is the resting membrane potential in GI tract or at this ICC?

A

-40 mv

depolarize above this for action potential to be generated–i.e contractions can occur

49
Q

What is a special feature of ICC cells that facilitate this slow wave?

A

K-dependent- sip synctium causes the wave-like form seen in digestive tract and is a largely metabolically dependent event

50
Q

What are action potentials of the GI tract called?

A

spike potentials

51
Q

How do the amount of waves/per min differ based on what part of the digestive tube your in?

A

the waves in different parts of the digestive have specific movements
stomach-3/per min(stomach squeezes a little chyme at a time as food is broken down)
small intestine-8-12/per min
( a lot of movement is happening in the small intestine

52
Q

How does the sip synctium affected by metabolism?

A

-Increase in metabolism, increase in sip syncitium, i.e increase amt slow waves/per min

53
Q

What is the mechanistic pathway of stimulating contractions of the GI tract? 5 (steps)

A
  1. Factors causing depolarization
  2. Depolarize above -40 mv
  3. Action Potential
  4. Mobilize Ca 2+ into smooth muscle cell
  5. Ca 2+ binds calmodulin
  6. Cross bridge formation
  7. Contraction
54
Q

What are the 5 factors that cause depolarization?

A
  1. stretch receptors
  2. Ach
  3. Gastrin
  4. Serotonin
  5. Substance P (tachykinin)
55
Q

What are 4 factors that cause hyperpolarization? (i.e. relaxation)

A
  1. NO
  2. NE
  3. Vasoactive intestinal peptide (VIP)
56
Q

What hare two types of motility found in the gut?

A
  1. Peristalsis

2. Segmentation

57
Q

What is peristalsis? NS Control?

A

more vagally controlled
-signal behind bolus (cholinergic motor neuron or tachykinin)— depolarization slow wave —stimulating circular muscle contraction behind the bolus + simultaneous hyperpolarization of VIP motor neuron to relax circular muscle in the area in front of bolus—-allowing bolus to push through/travel down digestive tract.

58
Q

What is segmentation? NS control? Two types of movement ?

A

-Intrinsic Enteric nerve
depolarization of the slow wave around chyme– causes contraction of circular muscle —-result of the formation of these pockets (mixing occurs) —followed by a period of relaxation
Two movements:
1. Mixing
2. Propulsion-segmentation
*more dominant along the intestinal tract

59
Q

What mediates gall bladder contraction?

A

Anticipatory Vagal stimulation will stimulate bile production in liver, little bit of bile release via relaxation of the sphincter of oddi…
CCK and Vagal stimulation contractions gall bladder stimulating bile release into duodenum

60
Q

What are 2 contractions that occur in the colon?

A
  1. Segmental Propulsion
    - taneia coli contracts (3 longitudinal bands of muscle that run through colon) @ accoridion pleats—- pleats into pouches called haustrae (stays for long time)
  2. Mass movements (PNS & Gastrin)
    - peristaltic contractions (mass movement defecation)—haustre relax—-pushing chyme distally throughout the tract—when it reaches descending colon becomes feces—-feel urge to defecation reflex
61
Q

What is the main purpose of segmental propulsion in the colon?

A
  • slow, for reabsorption purposes
  • designed for storage of and dehydration of chyme to feces
  • major type; occurring majority of the day
62
Q

What reflex is most active in babies? function

A

gastrocolic reflex is super active in babies, occurs when

food is in the stomach causes defecation…(feces close to your rectum, eating in close proximity to each other)

63
Q

What is the rectosphinteric reflex?

A

reflex resulting from mass movement contractions of feces into the rectum as it fills, causing feeling of urge to defecate

64
Q

What are 4 that affect GI motility

A
  1. Constipation
  2. Diarrhea
  3. IBD
  4. Congenital disorders
65
Q

What is the hirschsprung’s disease? Treatment

A

congenital disorder caused by loss of ENS in the lower digestive tract where you cant relax internal sphincter
Symptoms:
Pain
Feces will back up
Dilation of digestive tract (mega-colon)
Treatment: cut out lower part of digestive tract and re-anastomose

Physiology Renal ABS 2018 (5 decks)

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