LAB 3 Flashcards by Clint Eastwood

Chemical digestion of proteins happens through ____

Pepsin, in an acidic pH

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What is Pepsinogen produced by?

Chief cells of the stomach wall

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If proteins are not completely digested in the stomach, what will happen?

Moves to the duodenum (alkaline environment - inactivates pepsin)

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If food is not digested in the stomach, it moves to the duodenum where pepsin is inactivated, what will it be digested by?

Trypsin from the pancreas (tripsinogen -> trypsin)

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Chemical digestion of carbohydrates begins where?

In the mouth by AMYLASE* from the salivary glands

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After chewing, and swallowing, amylase can ______

Continue digestion of carbs (depending on the pH of the stomach)

NOT if it’s TOO ACIDIC, (4-4.5 = amylase deactivated)

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If the amylase is deactivated, where will carbohydrate digestion end?

It will end in the stomach

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When carbs move to the duodenum after amylase in the salivary glands are deactivated, what will happen?

Carbohydrates move to the duodenum and amylase from the pancreas will continue digestion - finish digestion in the upper portion of small intestine and duodenum

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Fat digestion occurs where?

In the duodenum

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What is bile’s function?

Emulsification of fats to increase surface area for lipase to work

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Where is lipase produced?

In pancreas (and in small amounts, the salivary glands)

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Where does the pancreatic ducts open into?

The Duodenum

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What does bile do?

It divides the fats from large globus to small globus so lipase works more efficiently

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Where is the stomach located?

Upper left abdominal cavity

-> Epigastric area of abdominal cavity above where ribs connect

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Fundus function:

Storage of gas, if we didn’t have the fundus we would belch all the time

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What is the significance of stomach fundus for chiropractic care?

Gastric air bubbles on X-ray to identify the left side of the body if missing the marker

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What is a gastric air bubble?

Radiolucent spot on Lf side of film

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Gastroesophageal/esophageogastric junction aka

Cardia area

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What does Gastroesophageal/esophageogastric junction aka cardia area prevent?

The stomach contents from moving from the stomach to the esophagus (irritates esophageal mucus)

Prevented by the lower esophageal sphincter

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What is the lower esophageal sphincter?

Portion of the stomach goes into the lower portion of the stomach: The lower esophageal sphincter isn’t always strong enough - HEARTBURN

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What is heartburn?

Irritation of the esophageal mucus by the stomach contents -> dangerous

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What can frequent irritation of lower esophageal sphincter result in? (Heartburn)

BARRETT ESOPHAGUS

What is BARRETT ESOPHAGUS?

Metaplasia (change of cell type from normal to abnormal) of the distal 2 cm of the esophageal mucosa

Will you see changes to the mucosa with BARRETT ESOPHAGUS?

Yes they will be obvious, PRECANCEROUS status (20 x’s increase in probability) one of the factors that promotes esophageal cancer

Line that separates the gastric and esophageal mucosa =

Z Line (GERD) Gastro Esophageal Reflux Disease

What causes GERD?

Nothing prevents the stomach contents through the esophagus - once into the pharyngeal cavity, can inhale stomach content

What are the 2 reasons that GERD is bad (inhaling stomach content)?

1) . Strangulation - Death of the patient - common death in chronic alcoholics (vomiting while sleeping, inhaling contents) 2) . Aspiration Pneumonia

What is “Aspiration Pneumonia” associated with GERD?

Infectious inflammation of lung tissue and in the stomach aggressive content (enzymes) = chemical damage to respiratory tract

What is the treatment and problems with Aspiration pneumonia associated with GERD

You have to take care of chemical burns - people have trouble sleeping in certain positions due to the contents moving into the esophagus (Have to sleep upright/sitting) - Gravity eliminates moving of food up into esophagus (PNEUMONIA + HEART BURN)

What are the problems that can occur within the stomach body?

Lesser curvature and greater curvature

Why is the lesser curvature significant in the stomach?

It is the favorite place of the peptic ulcer and stomach cancer **

What is the “Antrum” in the stomach associated with?

“Cave” - Cells and Infection

What is the Pylorus of the stomach?

Contains the pyloric canal (communicates the stomach acidic environment with duodenal basic environment)

What is contained in the pyloric sphincter?

Smooth much cells that are composed of lumen

What is the pyloric reflex?

The more acidic the environment of the stomach, the more narrow the pyloric canal (to prevent moving too much acidity into the duodenum)

If you get full after eating too much, what should you drink?

Something basic to raise the pH to open the pyloric canal more and allow more food to move from stomach to duodenum

What is significant about the beginning of duodenum?

Duodenal bulb = horizontal and very short

What is the beginning of duodenum (bulb) infected by?

Moving of stomach content - chemical affects - acidic environment bombards the wall and predisposes the duodenal wall to peptic ulcer which changes the mucosa

What is the most common place of the peptic ulcer?

Beginning of the duodenum - You will find scar tissue on the wall even without pain

How does the body protect the duodenal bulb?

THrough the pyloric reflex - The more acidic the stomach, the more narrow the canal, small portion of chyme allowed out at a time: The more basic the stomach, the more opened the canal (not dangerous)

What are on the inner surface of the stomach?

Foldings called rugae, allow for the stomach to distend (allow for more surface area/contact for the food on the stomach wall)

Epithelial cells of the stomach are covered by _____

TALL COLUMNAR EPITHELIAL cells WITHOUT goblet cells **

Duodenum and other portions of the intestines and lungs contain -

Goblet mucus producing cells (which produce mucus)

What do Goblet cells do?

Protect the lungs and trachea - bronchial tree

What would happen if Goblet cells are found in the stomach?

They are unacceptable in stomach, and it indicates sickness

What sickness is it called when mucosal cells are in the stomach?

Intestinal Metaplasia (part of CHRONIC GASTRITIS) - intestinal cells in the stomach = precancerous situation

Stomach mucus cells are different than goblet how?

Don’t have the same shape as a goblet cell - forms mucus by forming submucosal glands with multiple of the same cells - mucus goes out and covers the stomach wall to protect it

What do parietal cells produce?

HCl

What is the physiological reason for stomach acidity?

1) Activation of enzyme pepsinogen to pepsin 2) Stomach acidity maintains the pepsin in active state (pepsin can be in active and inactive forms based on spatial configuration)

What does active Pepsin require?

Acidic environment, when stomach environment becomes basic, spatial configuration changes, inactivating pepsin

What happens if the stomach is not acidic enough?

Leads to improper digestion of the proteins -> drink a lot of sour stuff (Sour fluid promotes acidic environment thus promotes activation of pepsin)

What is someone with weak acidic stomach environment subscribed?

0.5 % HCl solution

What is Stomach acidity’s other major purpose (immune)?

Killing bacteria that gets in (prevent from bacterial contamination - prevents replication and growth of bacteria)

What is a natural barrier from infection?

Stomach’s acidic environment