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GI > L11 - Intestines > Flashcards

L11 - Intestines Flashcards

1
Q

Jejunual artery

A

Located in left upper quadrant
Thick intestinal walls
Longer vasa recta (straight arteries)
Less arcades (arterial loops)

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2
Q

Ileal artery

A

Located in lower right quadrant
Thin intestinal walls
Shorter vasa recta
More arcades

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3
Q

Right colic artery

A

Ascending colon

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4
Q

Middle colic artery

A

Transverse colon

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5
Q

Ileocolic artery

A

In the right iliac fossa
Appendix
Terminal ileum and caecum

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6
Q

Marginal artery

A

Sum of all the distal branches of the SMA where they anastamose

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7
Q

Venous drainage of git

A

The IMV joins the splenic vein

Where the SMV and splenic vein meet, forms the portal vein that drains into the IVC

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8
Q

Chyme in intestines

A

Isotonic
Neutral
Digestion nearly complete

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9
Q

Adaptations of the small intestines

A

Villi
Microvilli - brush border
Plicae circulares
Segmentation shuttling - controlled segment contraction

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10
Q

Intestinal epithelia

A

Enterocytes- tall columnar (absorption)
Goblet cells - produces mucus
Enteroendocrine cells - produce hormones

Crypts of Lieberkuhn (gland)
- stem cells

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11
Q

Crypts of Lieberkuhn

A
  • stem cells at base - mature as they migrate to surface - high turnover of epithelial cells
  • Paneth cells at base - prodeuce antimicrobial peptides and protects stem cells
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12
Q

Monosaccharides

A

Only monoasaccharides can be absorbed

  • Glucose - only enters with Na+
  • Galactose
  • Fructose
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13
Q

Fibre

A

Binds to bile salts so they are excreted.

Therefore, more bile salts must be made from bile acids in the liver using cholesterol

Partially digested by bacteria in the colon providing nutrients

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14
Q

Common dietary carbhydrates

A

Starch
Lactose - milk
Sucrose - cane sugar

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15
Q

Amylose

A

Straight chains of glucose

alpha 1-4 glycosidic bonds only

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16
Q

Amylopectin

A

Branched chains of glucose

alpha 1-4 glycosidic bonds and alpha 1-6 glycosidic bonds (branched)

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17
Q

Starch digestion

A

Starch is made of amylose and amylopectin.

Alpha 1-4 glycosidic bonds broken down by salivary and pancreatic amylase producing:

  • maltose in amylose
  • alpha dextrins in amylopectins

Isolmaltase breaks the brnachedalpha 1-6 glycosidic bonds

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18
Q

Maltose

A

glucose + glucose

19
Q

Alpha dextrins

A

Branched sub unit containing 4 glucose

20
Q

Lactose

A

Glucose + galactose

Broken down by lactase

21
Q

Lactose intolerant

A

Not enough lactase when older

Lactose remains in gut drawing water in to the gut causing diarrhoea

Lactose is fermented in the gut producing gas - flatulence and bloating

22
Q

Sucrose

A

Glucose + fructose

Broken down by sucrase

23
Q

Enterocyte Na+/K+ ATPase

A

On the basolateral surface of the enterocyte.

Maintains a low Na+ conc inside the cell establishing a conc gradient

24
Q

Monosaccharide absorption

A

SGLT1 :
On lumenal surface
Absorbs Na+ and glucose/ galcatose into the enterocyte from the lumen

SGLT2 - Transports monosaccharides into the blood from the enterocyte

GLUT5 - Transports fructose from the lumen t the enterocyte via facilitated diffusion

25
Q

Pepsin

A

Pepsinogen released from chief cells

Activated in the stomach at pH 2-3 to pepsin

Pepsin breaks down proteins into oligopeptides which are transported to the small intestines

26
Q

Protein digestion in the small intestines

A

Pancreas releases protease zymogens:

  • trypsinogen
  • chymotrypsinogen
  • proelastase
  • procarboxypeptidase A and B
27
Q

Enterokinase

A

Converts trypsinogen to trypsin

28
Q

Exopeptidases

A

Produce dipeptides or amino acids

Break bonds at the end of polypeptides

  • procarboxypeptidase A and B
29
Q

Endopeptidases

A

Produce shorter polypeptidases

Break bonds in the middle of polypeptidases

  • trypsinogen
  • chymotrypsinogen
  • proelastase
30
Q

Trypsin

A

Trypsinogen is converted to trypsin by enterokinase on epithelial cells

Trypsin activates other zymogens in gut lumen

31
Q

Brush border

A
  • Partially digested polypeptides can be absorbed by the enterocyte via the peptide transporter 1
  • Amino acids are absorbed from the lumen into the enterocyte using an Na+/ amino acid co transporter
  • The dipeptides in the enterocyte are broken down by cytosolic peptidases into amino acids
  • Amino acids are transported out of the cell into the blood
32
Q

Water uptake in large intestines

A

Large intestines contain Na+ channels induced by aldosterone

33
Q

Osmosis

A

Occurs paracellularly via tight junctions and transcellularly

34
Q

Oral rehydration

A

MIxture of glucose and salt for maximum water uptake

35
Q

Water secretion

A

Driven by chloride movement predominantly

  1. Chloride enters the crypt epithelial cell from blood via the NKCC1
  2. cAMP levels increases inside the cell
  3. cAMP activates CFTR so Cl- are secreted into the lumen
  4. Na+ is driven into the lumen via tight junctions
  5. Osmotic gradient is created so water flows into the lumen
36
Q

vit B12 deficiency causes

A

Pernicious anaemia
Hypochlorhydria - inadequate stomach acid
Veganism
Inflammatory disorders of the ileum e.g. Chron’s

37
Q

Irritable bowel syndrome

A 
Abdominal pain 
Bloating
Flatulence
Diarrhoea
Constipation
Rectal urgency
38
Q

Who does IBS affect commonly

A

Females 2:1
Young adults 20 - 40s
People with psychological disorders such as depression and anxiety

39
Q

Coeliac disease

A

Immunological response to the gliadin fraction of gluten

  • Damages mucosa of intestines
  • Absence of intestinal villi
  • Hypertrophy and lengthening of crypts
  • Lymphocyte infiltration of epithelium and lamina propria
  • Impaired digestion and malabsorption
40
Q

Where is gluten found

A

Wheat
Rye
Barley

41
Q

Coeliac synptoms

A

Diarrhoea
Weight loss
Flatulence
Abdominal pain

Anaemia - impaired iron absorption

Neurological symptoms - hypocalcaemia

42
Q

Investigations for coeliac’s

A

Bloods

  • IgA to endomysium
  • tissue transglutaminase

Upper GI endoscopy and biopsy (duodenum)

  • reduced villi
  • mucosal pathology
43
Q

Treatment of coeliac disease

A

Strict gluten free diet

GI (18 decks)

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