L22 - GI Motility Flashcards

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1
Q

what is swallowing?

A

The passage of food bolus from the oral cavity to the stomach

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2
Q

What does swallowing do?

A
  • protect the airway
  • prevent entry of air into the stomach
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3
Q

What does swallowing involve?

A

Co-ordinated activity of muscles in the oral cavity, pharynx, larynx and oesophagus
(Partly voluntar, reflexive in nature)

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4
Q

What are the 3 different phases of swallowing?

A
  • oral
  • pharyngeal
  • oseophageal
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5
Q

What is the swallowing reflex stimulated by?

A

Food bolus stimulating pressure receptors in the back of the throat and pharynx

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6
Q

What are the steps in the swallowing reflex?

A
  • stimulation of pressure receptors
  • signals swallowing centre in brain
    = nerve impulses
  • involuntary contraction in pharyngeal muscles
    = material into oesophagus
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7
Q

How many muscles does the swallowing reflex involve?

A

25 pairs

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8
Q

What is swallowing a key role of?

A

Oral drug administration
- pathway to digestive system
- convenient route
- wide range of dosage forms
- timing with food

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9
Q

What is the motility in the stomach?

A
  • mixing and churning
  • role in digestion
  • formation of chyme
  • peristalsis
  • gastric emptying
  • depends on viscosity
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10
Q

What is gastric emptying?

A

Exit to the small intestine

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11
Q

How is stomach motility involved in drug administration?

A
  • mixing and dissolution of drugs
  • gastric emptying influences drug absorption
  • drug stability
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12
Q

What is the motility in the SI?

A
  • mixed by segmentation
  • movement by peristalsis
    (Sequential activity in muscle bands)
  • coordinated by the enteric nervous system
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13
Q

What are the steps in peristalsis?

A
  • contraction of circular muscles behind food mass
  • contraction of longitudinal muscles ahead of food mass
  • contraction of circular muscle layers forces food mass forwards
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14
Q

What is the intestinal and colonic motility controlled by?

A

ENS
(Enteric nervous system)

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15
Q

What are the 2 main branching networks in the intestines?

A
  • auerbachs (myenteric) plexus
  • meissners (submucosal) plexus
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16
Q

What are the steps in enteric neurons controlling peristalsis?

A
  • sensory neurons detect food pressure and stretch
  • motor neurons trigger muscle contractions/relaxations
  • influenced by neurotransmitter and autonomic input
    = ensures smooth coordinated and movement through GI
17
Q

What controls the ENS??

A
  • sympathetic nervous system
  • parasympathetic nervous system
  • hormonal control
18
Q

How does the sympathetic nervous system control the ENS?

A
  • fight or flight
  • inhibits ENS
  • dec peristalsis, blood flow, secretion and absorption
19
Q

How does the parasympathetic nervous system?

A
  • rest and digest
  • stimulates ENS
  • inc peristalsis, blood flow, secretion and absorption
20
Q

How does hormonal control control ENS?

A
  • inc by cholecystokinin, gastrin, motilin, serotonin, insulin
  • dec by secretin and glucagon
21
Q

How is intestinal motility involved in drug administration?

A
  • bioavailability - dissolution
  • absorption - transit time
  • distribution
    Migrating motility complex
22
Q

What is within the migrating motility complex?

A
  • recurring motility pattern
  • regulated by electrical activity
  • occurs between feeeding
  • stomach to LI
  • cleansing mechanism
23
Q

How is the migrating motility complex involved in drug administration?

A
  • drug absorption (emptying, motility, timing of administration)
  • controlled release drugs
  • drug efficacy
  • pharmacokinetics (onset of action, half life, bioavailability)
24
Q

What is the motility in the large intestine - segmentation?

A

Haustral shuttling
- localised contraction and relaxation of haustra (segmentation)
- mixing contents
- optimise absorption
- efficient water absorption
- stool formation
- support microbiome

25
Q

What is the motility in the large intestine - mass movement?

A
  • coordinated contraction = contents toward rectum
    (Ascending colon and transverse colon)
  • triggered by gastrocolic reflex
  • role in defaecation
26
Q

What does defaecation do?

A
  • eliminate waste
  • stored in rectum
  • initiated by activation of stretch receptors
  • involuntary and voluntary steps
27
Q

What is constipation?

A
  • weak mass movement
  • inc transit time
  • too much water absorbed
  • causes = lifestyle, medications, neurological issues
28
Q

What is diarrhoea?

A
  • hyperactive mass movement
  • dec transit time
  • too little water absorbed
  • causes = infection, medications, food intolerance
29
Q

What is vomiting?

A
  • expulsion of gastric contents through mouth
  • causes = GI irritation, toxins/drugs, pain/fear/stress, pregnancy, vestibular disturbances
30
Q

What are the sequence of steps in vomiting?

A
  • Signals from body (Stomach, intestines, inner ear, brain)
  • relayed to vomiting center in brainstem (coordinates complex process)
31
Q

What is the vomiting timeline?

A
  • increased salivation
  • relaxation of the lower esophageal sphincter
  • contraction of the diaphragm and abdominal muscles
  • opening of the upper oseophageal sphincter
32
Q

What does increased salivation do in the vomiting timeline?

A
  • protects teeth from stomach acid
  • prepares the body for vomiting
33
Q

What does relaxation of the lower oesophageal sphincter do in the vomiting timeline?

A

Allows stomach contents to move up into oesophagus

34
Q

What does contractionof the diaphragm and abdominal muscles do in the vomiting timeline?

A

Increase pressure in stomach, pushing its contents upwards

35
Q

What does opening of the upper oesophageal sphincter do in the vomiting timeline?

A

Opens, contents expelled through mouth