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4GHM > L3 upper GI > Flashcards

L3 upper GI Flashcards

1
Q

what are the tissue structures of the GI tract

A

mucosa
submucosa
muscular externa
serosa
mesentery

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2
Q

what are the layers of tissue in the mucosa

A

epithelium
lamina propria
muscularis mucosae

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3
Q

what are the layers of tissue in the muscular externa

A

longitudinal muscle
circular muscle

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4
Q

what are the layers of tissue in the serosa

A

epithelium
connective tissue

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5
Q

main parts of the lips and cheeks

A
  • orbicularis oris (a complex circular muscle that surrounds the orifice of the mouth and forms the majority of the lips) and buccinator muscle
  • vestibule: recess internal to lips and cheeks, external to teeth and gums
  • oral cavity: lies between teeth and gums
  • labial frenulum: median attachment of each lip to the gum
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6
Q

main parts of the palate

A
  • hard palate: palatine bones and palatine processes of the maxillae. slightly corrugated to help create friction against the tongue
  • soft palate: fold formed mostly of skeletal muscle. closes off the nasopharynx during swallowing. UVULA projects downwards from its free edge. anchored by palatoglossal and palatopharyngeal arches
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7
Q

main parts of the tongue

A
  • lingual frenulum: attachment to the floor of the mouth
  • intrinsic muscle: changes shape of the tongue
  • extrinsic muscle: alter the tongue’s position
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8
Q

functions of the tongue

A

repositioning and mixing food during chewing
formation of a bolus
initiation of swallowing, speech, taste

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9
Q

what is the digestion process in the mouth

A

ingestion, mechanical digestion, chemical digestion, propulsion.

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10
Q

what is mastication

A

cheeks and closed lips hold food. teeth and tongue mixes the foos with saliva to soften it
teeth cut and grind solid food
pattern and rhythm of continued jaw movements are controlled mainly by stretch reflexes

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11
Q

saliva functions

A

cleanses the mouth, moistens and dissolves food chemicals, aids in bolus formation, contains enzymes that begin breakdown of starch.

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12
Q

what are the extrinsic salivary glands

A
  1. parotid, 2. submandibular, 3. sublingual
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13
Q

what is parotid gland and its function

A

largest salivary gland, produces 50% of stimulated saliva, secretes amylase. it opens up to the vestibule next to second upper molar

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14
Q

location of parotid gland

A

anterior to ear, external to the master muscle.

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15
Q

location of the submandibular gland

A

medial to the body of the mandible

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16
Q

function of submandibular gland

A

produces 70% of unstimulated saliva, and the ducts open at the base of the lingual frenulum

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17
Q

location of the sublingual gland

A

anterior to the submandibular gland, under the tongue

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18
Q

function of the sublingual gland

A

mainly secretes mucous and lingual lipase. only produces 5% of the saliva. the glands open via the 10-12 ducts into the floor of the mouth

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19
Q

what is mumps

A

inflammation of the parotid glands caused by myxovirus and is common in children.

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20
Q

risk of mumps

A

can cause sterility in males by infection of testes. there is a 24% chance of this occurring.

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21
Q

transmission of mumps

A

saliva

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22
Q

what is sjogrens syndrome

A

an autoimmune condition that commonly affects the salivary and lacrimal glands. is associated with rheumatoid arthritis

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23
Q

symptoms of sjogrens syndrome

A

xerostomia (dry mouth) and xerophthalmia (dry eyes)

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24
Q

diagnosis of sjogrens syndrome

A

biopsy

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25
Q

what is the composition of saliva

A

a slightly acidic solution that is made up of 97-99.5% water. the rest contains:
electrolytes (Na+, K+, Cl-, PO42-, HCO3-)
salivary amylase and lingual lipase
mucin
metabolic wastes (urea and uric acid)
lysozymes, IgA, defenses, cyanide compound that protects against microbes.

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26
Q

role of bacteria in saliva

A

friendly bacteria converts food derived nitrates into nitric acid

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27
Q

uses of saliva in clinic

A

detect and monitor some conditions
- HIV
- oral cancer
- diabetes
- hormones

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28
Q

control of salivation

A

intrinsic glands continuously keep the mouth moist, whereas extrinsic glands produce secretion when 1. ingested food stimulates mechano and chemoreceptors in mouth. salivary nuclei in the brain stem sends impulse along parasympathetic fibers in cranial nerves VII and IX.

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29
Q

what are chemoreceptors (in the mouth) activated by

A

acidic substances

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30
Q

what are mechanoreceptors (in the south) activated by

A

virtually any mechanical stimulus

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31
Q

what increases salivation

A

irritation of lower regions of GI tract (eg by bacteria, spicy food, hyperacidity), especially when accompanied by nausea.

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32
Q

what produced thick, mucin rich saliva

A

sympathetic stimulation

33
Q

what does dehydration cause (in terms of salivation)

A

inhibition, due to reduced filtration at capillary beds

34
Q

what is the oesophagus

A

a straight course through thorns from the pharynx to the stomach. it pierces the diaphragm

35
Q

what are the layers of the oesophagus

A
  1. mucosa
  2. submucosa
  3. adventitia
  4. muscularis
36
Q

what is the mucosa in the oesophagus

A

stratified squamous epithelium

37
Q

what is the submucosa in the oesophagus

A

glands secrete mucus

38
Q

what is the muscularis of the oesophagus (3)

A

proximal third is skeletal, middle is a mixture, inferior is smooth

39
Q

adventitia of the oesophagus is instead of what

A

serosa

40
Q

what is the adventitia of the oesophagus

A

a fibrous connective tissue

41
Q

difference between adventitia and serosa

A

adventitia: dense connective tissue, retroperitoneal, mouth, pharynx, esophagus, pylorus of stomach, distal duodenum, saddening and descending colon, anal canal

serosa: connective tissue covered in mesothelium, intraperitoneal, most of stomach, duodenum, caecum, sigmoid and transverse colon, rectum

42
Q

pharynx job and lining

A

allows passage of food, fluids, and air. histology similar to oral cavity, lining of epithelium is stratified squamous

43
Q

what are the skeletal muscle layers of pharynx

A

inner longitudinal, outer pharyngeal constrictors

44
Q

what is deglutition

A

swallowing

45
Q

what is involved in deglutition

A

tongue, soft palate, pharynx, oesophagus, 22 muscle groups

46
Q

two phases of deglutition

A
  1. buccal phase: voluntary contraction of tongue
  2. pharyngeal-esophageal phase: involuntary
47
Q

what is hiatus hernia

A

part of the stomach squeezes up into the chest through an opening (“hiatus”) in the diaphragm.

48
Q

causes of hiatus hernia

A

weak diaphragm, increased intrabdominal pressure, associated with obesity

49
Q

what does hiatus hernia cause

A

acid reflux

50
Q

anatomy of stomach

A
  • cardiac region
  • fundus (top arc)
  • body (mid portion)
  • pyloric region (lower arc)
  • greater curvature (big, longer curve)
  • lesser curvature (opposite to greater)
  • omen (mesenteries from stomach curvatures)
  • ANS nerve supply
  • blood supply
51
Q

what is the cardiac region of the stomach

A

surrounds cardiac orifice

52
Q

what is the fundus of the stomach

A
  • bulges higher than cardia
  • dome shaped beneath the diaphragm
53
Q

what is the pyloric region of the stomach

A
  • pylorus, which is the gate keeper
  • is funnel shaped, and has a pyloric sphincter
54
Q

what is the omenta of the stomach

A
  • mesenteries from the stomach curvature
  • contains lesser and greater omentum.
  • lesser: from liver to less curvature
  • greater: drapes from greater curvature and contains fat deposits
55
Q

what is the ANS nerve supply of the stomach

A
  • sympathetic via splanchnic nerves and celiac plexus
  • parasympathetic via vagus nerve (10)
56
Q

what is the blood supply of the stomach

A
  • celiac trunk
  • veins of the hepatic portal system
57
Q

what are the digestive processes

A
  • physical digestion
  • denaturation of proteins
  • enzymatic digestion of proteins by pepsin
  • secretes intrinsic factor required for absorption of vitamin B12
  • delivers chyme to small intestine
58
Q

functions of mucus in stomach

A
  • mucus forms gel-like layer to protect mucosa from gastric juice.
  • mucus traps layer of bicarbonate rich fluid beneath it.
59
Q

gastric secretion

A

stomach lining is dotted with deep gastric pits that lead to tubular gastric glands that produce gastric juice. the stomach secretes 2.5L of juice, that contains pepsinogen (chief cells) and HCl (parietal cells)

60
Q

what is the pH of the stomach

A

1-2 in lumen and 6-7 above the mucosa

61
Q

what is the microscopic anatomy of the stomach

A

contains mucosa which are columns that contain mucous cells

62
Q

what are produced by the mucous cells

A

alkaline layer of protective mucus, which traps bicarbonate-rich fluid beneath it.

63
Q

what does chief cell produce?

A

pepsinogen (inactive enzyme) and lipase

64
Q

what does parietal cell produce?

A

HCl and intrinsic factors

65
Q

what is the pH level of the protective mucus layer in the stomach

A

~7

66
Q

how often does the stomach lining get renewed?

A

3-6 days

67
Q

what does the enteroendocrine cells release?

A

paracrine (serotonin and histamine) and hormones (somatostatin and gastrin)

68
Q

what is gastritis

A

inflammation caused by anything that breaches mucosal barrier

69
Q

what is a peptic/ gastric ulcer

A

erosion of the stomach wall

70
Q

most gastritis are caused by

A

H. pylori bacteria

71
Q

how do bacteria cause gastritis

A

burrows through mucus and destroys it

72
Q

how much gastric juice is released per day?

A

3 litres

73
Q

what are the phases of stimulatory and inhibitory secretion of gastrin

A

1) cephalic (reflex): few minutes prior to food entry
2) gastric: 3-4 hours after food enters stomach
3) intestinal: brief stimulatory as partially digested food enters duodenum and inhibitory effects after.

74
Q

what are the neural (vagus) and hormonal (gastrin) mechanisms

A

1) vagus fires, all secretory and motility up.
2) gastrin increases motility, HCl and pepsinogen
3) Secretin from small intestine reduces HCl production
4) Gastric inhibitory polypeptide released from duodenum and jejunum.
5) enteroglucagon from colon decreases motility.

75
Q

what is the gastric contractile activity

A
  • peristalsis waves move towards pylorus at rate of 3 per min.
  • the rhythm (basic electrical rhythm (BER)) is initiated by pacemaker cells
  • most vigorous at the pylorus
76
Q

how is chyme delivered

A

3ml spurts to duodenum or forced backwards to stomach, causing pyloric sphincter to contract. this helps to mix chyme more

77
Q

what is emesis

A

vomiting

78
Q

causes of emesis

A

spicy food, excess alcohol, bacterial toxins, drugs

4GHM (8 decks)

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