Lecture 10 : the Colonic Phase Flashcards

1
Q

What is the main function of the large intestine?

A
  • absorb a small amount of water
    (last area that can absorb water)
  • store the waste product of meal

Major role of colonic epithelium is to absorb/secrete electrolytes and water rather than nutrients.

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2
Q

What separates the ileum from the cecum and prevents reflux from the cecum into the ileum?

A

Ileocecal valve guarding the small intestine to prevent contents from being send back

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3
Q

What is the main regulator of colonic function?

A

NEURAL

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4
Q

What activates the local Reflexes?

Via which nervous system?

What do these reflexes stimulate?

A
  1. Passage of bolus of fecal material (stretch)
  2. Enteric NS
  3. short bursts of Cl- and 5-HT and Ach
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5
Q

What are the 2 LONG Reflex Arcs?

What activates them?

A
  1. Gastrocolic Reflex
    - activated by DISTENSION of stomach
    - stimulated by vagus (Ach and 5-HT)
  • why we poop after eating*
    2. Orthocolic Reflex:
  • rising from bed
  • promotes morning poop
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6
Q

What cells secrete Peptide YY?

What is the signal to secrete peptide YY?

What is its function?

A
  1. Entereendocrine cells
  2. LIPID (should have been absorbed way before the colon)
  3. Decreases gastric emptying and GASTRIC MOTILITY (slow things down)
  • also reduces fluid secretion
  • reduces propulsion of chyme to give more time for DIGESTION & absorption
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7
Q

What are the 3 layers of non-overlapping longitudinal muscles in the Colon Called?

What are the colonic segments called?

A

Taeniae coli

Haustra

  • mix and circulate contents via SEGMENTAL contractions

(no propulsive movement unless there is a stimulus to move the fecal material)

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8
Q

Propulsion of bolus is MORE vigorous in the colon as opposed to the small intestine.

True or False

A

FALSE

  • propulsion is less vigorous in the colon
  • Contents are moved back and forward between haustra – maximizes their contact time with epithelium.
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9
Q

How do the following affect Colon motility

  1. Parasympathetic Innervation
    - What does Vagus control?
    - What do Pelvic nerves control?
  2. Sympathetic
A
  1. Parasympathetic Innervation
    = enhance motility

Vagus (via intramural plexi) - controls haustrations in the cecum, ascending and transverse colons;

Pelvic nerves from sacral spine to intramural plexi – controls descending and sigmoid colons, rectum, and anal canal.

  1. Sympathetic
    = reduce motility
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10
Q

What histological feature is present in the small intestine that is NOT present in the colon?

What glands are present in both?

A

NO villi in the colon!
- no large scale absorption in the colon since most absorption has occurred in the small intestine

Glands of Lieberkuhn (also in the small intestine)
-tubular glands enriched with GOBLET CELLS

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11
Q

What is the only unique nutrient absorbed by the Colon?

How are they absorbed on the luminal side of the colon?

What drives this absorption?

A
  1. Short- Chain Fatty Acids (SCFA) - butyrate
  2. Na-Dependent!
    - via Sodium Monocarboxylate Transporters (SMCT)
    - symporters
  3. gradient established by Na-K ATPase
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12
Q

What produces Short Chain fatty acids?

A

Colonic Bacteria

(not digestion!)

-in individuals who take antibiotics long term the BUTYRATE/ short chain fatty acids are destroyed

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13
Q

What are 3 structures/transporters unique to the COLON?

A
  1. Short-chain fatty acids
  2. Sodium Monocarboxylate Transporters (SMCTs)
  3. ENaC
    - epithelial sodium channel

ONLY IN THE COLON!!!

SGLT1 and SMCT’s both depend on sodium to transport their individual nutrients

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14
Q

How is Na absorbed in the DISTAL colon?

last mechanism to prevent the loss of water

A

ENaC

  • channel is opened by NT’s or hormones
  • transported into blood via Na-K ATPase
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15
Q

What does ENac prevent?

How is this changed in patients with Bowel inflammation?

A

Loss of Water in the stool

  • reduced ENaC in patients with bowel inflammation
    = diarrheal symptoms
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16
Q

What are the negatives of broad-spectrum antibiotics?

A

Disrupts colonic microflora
(symbiosis between bacteria and cells of colon)

  • may cause overgrowth of pathogenic bacteria in GI

= intestinal and systemic infections!

17
Q

How can severe intestinal infections caused by bacteria be cured?

What causes this serious infection?

What bacteria does this predispose people to?

A
  1. Fecal Transplant

(also for infants with kwashiorkor)

  1. Antibiotics
  2. C. Difficile

Fecal transplant:
It involves diluting stool with a liquid, like salt water - pumping it into the intestinal tract via an enema, a colonoscope or a tube run through the nose into the stomach or small intestine.

18
Q

Where does the colon terminate?

What type of muscle does the colon lack?

What are two important sphincters?

Which is voluntary?

A
  1. Rectosigmoid junction
  2. Circular
  3. Internal Anal (thick circular muscle)

External Anal
- striated muscle wrapped around canal

  • innervated by pudendal nerves, thus VOLUNTARY
19
Q

Where is most striated muscle found?

A

Pharynx, upper 1/3 of esophagus, and rectum

20
Q

What produces mass movement of feces?

What relaxes the internal anal sphincter?

What is tonically contracted because it is under voluntary control?

A

High amplitude propagating contractions
- rectum fills with fecal material

  1. Filling of rectum
    - releases VIP and NO
  2. External Anal Sphincter
21
Q

What is the cause of colon cancer, the 2nd most prevalent cancer in males?

What is the initial sign of cancer?

A
  1. Rapid turnover of the colonic epithelium and exposure to bacterially synthesized or environmental toxins
  2. Polyps are the initial sign of cancer
    - Colon cancer mortality can be reduced substantially by early detection and removal of polyps.
22
Q

What is the major issue of Hischprung’s disease in regards to the colon?

What alleviates the symptoms?

A
  1. segment of the colon is permanently contracted

–causing obstruction (usually diagnosed in infants).

  1. ENTERIC NVS does NOT develop properly
  2. Surgical excision of affected segment alleviates the symptoms