Lecture 19 Flashcards

1
Q

Four regions of the stomach (in order)
1.
2.
3.
4.
5.
- areas that form the pyloric part)= ________ and ______

A
  1. Cardia
  2. Fundus
  3. Body
  4. Pyloric
    - antrum; pylorus
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2
Q

The muscularis externa in the stomach has 3 layers
1.
2.
3.
- it allows the stomach to _____ (mechanical breakdown) and ____ food

A
  1. oblique muscle
  2. circular muscle
  3. longitudinal muscle
    - churn; mix
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3
Q

Stomach ______: (wrinkles in stomach ______) mucosal folds that allow for gastric __________, enabling it to accommodate varying volumes of ingested food and liquids… _______ the surface area for digestive processes

A

rugae; lining; expansion; increases

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4
Q

Pyloric Sphincter
- located:
- thick ring of ______ muscle that regulates the passage of ______ into the _________

A
  • at the end of the pyloric part of the stomach
  • smooth; chyme; duodenum
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5
Q
  • ________: inner curvature of the stomach
  • ________: outer curvature of the stomach
  • ___________: double layered peritoneal fold that connects the lesser curvature of the stomach to the ________, it helps suspend and support the stomach
A
  • lesser
  • greater
  • lesser omentum; liver
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6
Q
  • pH level within the lumen of the stomach= ______
  • pH level near the epithelial cells that line the walls of the stomach= ______
    -this difference is possible due to the ______ of gastric juices (which contain __________) in the lumen. The epithelial cells have _________ mechanisms to prevent the acidic environment from affecting them directly
A
  • 1.5
  • 7
  • secretion (hydrochloric acid); protective
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7
Q

Three mechanisms that protect the stomach from the harsh acidic and enzymatic environment…
1. _____________: the bicarbonate is a ____ that ________ stomach acid
2. __________: prevent ______ _______ from seeping between them
3. ___________: every ___ to ____ days due to the presence of the _____ cells; rapid replacement

A
  1. Mucous-bicarbonate barrier (mucous coat); base; neutralizes
  2. Epithelial tight junctions; gastric juice
  3. (Damaged) Epithelial cell replacement; 3 to 6; stem
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8
Q
  • in the mucous coat of the stomach, the _________ ion is abundant
  • _______ cells (surface epithelial cells) of the stomach lining is the source of this ion
  • this ion acts as a ______ (____ in this case) neutralizing acid
A
  • bicarbonate
  • mucous
  • buffer; base
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9
Q

Does the stomach have any secretion coming from accessory glands?

A

NO

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10
Q

________: fluid secreted by the stomach glands, composed mainly of _____, _____, & _____

A

gastric juice; water; acid; pepsin

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11
Q

Secretions of different cell types in gastric glands
- parietal cells:
- chief cells:
- G cells:
- Enteroendocrine cells:
- Enterochromaffin cells:

A
  • gastric acid (HCl) & intrinic factor
  • pepsinogen & lipase
  • gastrin
  • hormones
  • histamine
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12
Q
  • _____________: glycoprotein that aids in vitamin _____ absorption by the small intestine
  • produced in the gastric glands by the __________ cells
A
  • intrinsic; B12
  • parietal
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13
Q

Pepsinogen is activated by ______ to become pepsin (active… digests ______)

A

gastric acid (HCl); proteins

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14
Q

The digestion of proteins beings in the _______; which enzyme secreted in the gastric glands digests proteins? __________ which was first ___________ secreted by ________ cells then it underwent transformation with the presence of acid

A

stomach; pepsin; pepsinogen; chief

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15
Q
  • Gastrin is a ________ secreted by ____ cells (mostly in the _____ _______ but can also be found in the __________)
  • amount other functions, it stimulates secretion of ______ by the ______ cells
A
  • hormone; G (pyloric antrum; duodenum)
  • HCl; parietal
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16
Q
  • Cells that are responsible for acid production in the stomach= ___________
  • Specific name of the stomach acid= ________
  • pump crucial for gastric acid production= __________
    -this pump exchanges ______ for ______ ions across the gastric parietal cell membrane
  • ______ used by the proton pump comes from inside the partial cell, ________ ______ (_________) breaks down into __________ ion and ____
A
  • parietal cells
  • hydrochloric acid (HCl)
  • H+/K+ ATPase (=proton pump)
    -H+ for K+
  • H+; carbonic acid (H2CO3); bicarbonate; H+
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17
Q

Parietal cells do _____ create HCL in their cytoplasm (it would _______ the cell)!
- so transporting _____ and ____ separately, allows for the cell to maintain its structural integrity

A
  • NOT; destroy
  • H+; Cl-
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18
Q

What triggers the production of stomach acid?
- Neural: _______ secreted by the _________ nervous system through __________ type 3 receptors
- Hormonal: __________
- Paracrine: __________

A
  • Acetylcholine; parasympathetic; muscarinic
  • gastrin
  • histamine
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19
Q

Factors that stimulate the release of gastrin produced by the _______ cells
- the presence of _____ and _____ in the stomach (increase pH)

Direct effects of gastrin on acid gastric secretion
- it stimulates the ______ cells to release _____ upon binding to a surface receptor

Indirect effects of gastrin on acid gastric secretion
- induces _______ release from ___________ cells, which in turn acts as a _________ signal to further stimulate acid secretion by _______ cells in the gastric mucosa

A

G
- AAs; peptides
- parietal; HCl
- histamine; enterochromaffin-like (ECL); paracrine; parietal

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20
Q

Term for the partially digested, semi-fluid mixture of food and digestive fluids in the stomach

A

chyme

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21
Q

Three phases of gastric acid secretion
1. _________:
2. ________:
3. ________:
- in which gastric acid secretion phase does the enterogastric reflex occur= ________

A
  1. Cephalic phase:
  2. Gastric phase
  3. Intestinal phase
    - intestinal phase
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22
Q
  • What stimulates gastric acid secretion during the cephalic phase? ________________
  • cephalic phase effects are mediated by the ____________ NS by the ______ nerve
  • gastric juice is secreted in response to _____ stimulation
A
  • the sight, taste, smell, or thought of food
  • parasympathetic; vagus
  • vagal
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23
Q
  • What triggers the gastric phase of gastric acid production? _____________
  • Three factors that induce gastric acid secretion in the gastric phase
    1. ___________ pH of stomach contents
    2. ____________ of the stomach wall
    3. release of _______ triggered by the presence of ________
A
  • the entry of food into the stomach
    1. increase
    2. distension (stretching)
    3. gastrin; peptides
24
Q

When food enters the stomach, it _______ stomach walls, activating two reflexes:
1. _______ reflex: involves ______ stimulation and the release of __________, contributing to acid secretion
2. ______ reflex: coordinated by ________ nerve plexus, influencing muscular _________ and local responses

A

stretches
1. long; vagal; acetylcholine
2. short; myenteric; contractions

25
Q
  • What triggers the intestinal phase of gastric acid production? the arrival of ______ into the _______ which produces its ________
  • In this phase, what is the purpose of the duodenum sending inhibitory signals to the stomach? to _____ secretion and ______
A
  • chyme; duodenum; distension
  • SLOW; motility
26
Q

_____________ reflex: stretching of the wall of the ___________ results in the ___________ of gastric motility (including peristalsis) and reduced stomach _________ rate

A

Enterogastric; duodenum; inhibition; emptying

27
Q

Hormones that the duodenum releases during the intestinal phase
1.
2.
3.

A
  1. Secretin
  2. Gastric Inhibitory Peptide (GIP)
  3. Cholecystokinin (CCK)
28
Q
  • What triggers the release of secretin by the intestinal cells? __________
  • Primary influence of secretin on gastric function is to _________ gastric acid secretion
A
  • decreased pH
  • DECREASE
29
Q
  • GIP= ____________
  • CCK= ___________
    -major nutritents that stimulate CCK release in duodenum are the arrival of ________ and _______
A
  • Gastric Inhibitory Peptide
  • Cholecystokinin
    -lipids (fatty acids); proteins (amino acids)
30
Q

During which of the three phases of gastric acid production is gastric acid secreted in greater proportion? During the ________ phase

A

GASTRIC

31
Q
  • liver ___________: the structural and function units of the liver
  • ___________ shape in cross section
  • consists of a ___________ surrounded by __________; they also contain ________ (small blood vessels between rows of ___________)
A
  • lobules
  • hexagonal
  • central vein; hepatocytes; sinusoids; hepatocytes
32
Q
  • __________ are liver cells, and they are found in the _________ of the liver, contributing to the structural and functional units of the liver tissue
A
  • hepatocytes; lobules
33
Q

Portal triad refers to a specific anatomical arrangement in the _______, and it is found at each ______ of the hepatic lobules. The portal triad consist of THREE structures…
- a branch of the hepatic _________
- a branch of the hepatic _______
- a _______ ______

A

liver; vertex
- portal vein
- artery
- bile duct

34
Q
  • ___________: the epithelial cells of the _______ duct
  • primary function involves the __________ and _________ of _____
A
  • cholangiocyte; bile
  • modification; transportation; BILE
35
Q
  • _________ cells are in the __________( small blood vessels between hepatocytes)
  • they function as specialized ___________, involved in phagocytosis and immune functions within the _______
A
  • Kupffer; sinusoids
  • macrophages; liver
36
Q
  • ___________ cells: are in the perisinusoidal space (space been the hepatocytes and the sinusoidal endothelial cells)
  • they are the major storage site for ___________
  • upon liver damage: ______________ (scar creation) and _______________
A
  • stellate
  • vitamin A
  • fibrogensis; regeneration
37
Q
  • fibrogensis: the development of _________ tissue
  • fibrosis: refers to the ____________ accumulation of fibrous connective tissue, mainly composed of _______, in an organ or tissue
  • this process occurs in response to ______, inflammation, or chronic damage and can lead to the ________ and stiffening of the affected tissue
  • cells in the hepatic lobule that contribute to this process= _____________
A
  • fibrous
  • excessive; collagen
  • injury; scarring
  • stellate cells
38
Q

Can hepatocytes undergo replacement, meaning does the liver regenerate after experiencing damage? _______ because of ______ cells

A

YES; stem

39
Q
  • Bile contains ________ (_______) and they play a major role in _____ digestion
  • Bile is produced by __________ in the _____ and secreted into _______ _______ (channels)
A
  • bile acid (bile salts); fat
  • hepatocytes; liver; bile canaliculi
40
Q

The “tubular structure” that connects the bilecanaliculi to the bile duct (or biliary) is the _____________

A

bile ductule (canal of hering)

41
Q

In the Bile duct (biliary)..
- bile is modified by ____________ lining the ducts

A

cholangiocytes

42
Q

_________ is a hormone that STIMULATES the cholangiocytes to secrete ________ and _______ into the bile within the bile duct

A

Secretin; bicarbonate; water

43
Q
  • The __________ duct and ________ duct form the ________ duct
  • the ________ duct and _______ duct form the common bile duct
A
  • right hepatic; left hepatic; common hepatic
  • common hepatic; cystic
44
Q
  • the common hepatic duct: collects ____ from the _____ _______ (bile flows out of ____)
  • the common bile duct: transports the combined bile from the common hepatic duct and the ______ duct (from the _________) to the ________ for digestion
A
  • bile; liver lobules (liver)
  • cystic (gallbladder); duodenum
45
Q
  • the _________ of ________ is located at the confluence of the __________ duct and the __________ duct
  • its the spot where _____ and ______ gets released into the _________
A
  • ampulla of vater; common bile; pancreatic
  • bile; pancreatic; duodenum
46
Q

Which spinster regulates the release of pancreatic juice and bile into the duodenum through the ampulla of water?

A

Sphincter of Oddi (aka hepatopancreatic ampulla)

47
Q
  • In the gallbladder, CCK induces ___________
  • CCK facilitates the _________ of stored bile into the _______ duct
A
  • contraction
  • secretion; cystic
48
Q

CCK causes __________ in the Spincter of Oddi
- this facilitates the secretion of bile and pancreatic juice into the ________

A

relaxation
- duodenum

49
Q
  • pancreatic juice is a ___________ rich fluid containing ________ that digest all categories of foods
  • the ________ portion of the pancreas produces pancreatic juice
  • pancreatic juice is transported from the ________ to the ________ though the ________ duct that will join the common bile duct and finally at the ______________
A
  • bicarbonate; enzymes
  • exocrine
  • pancreas; duodenum; pancreatic; ampulla of vater
50
Q

Two cell types that constitute the exocrine pancreas
1. _________: present in the pancreatic ducts
2. _________: located in the acini or clusters

A
  1. duct cells (ductal cells)
  2. acinar cells
51
Q

Pancreas
- Acinar cells secrete the ________- rich component
- _______ is the hormone that induces this secretion

A
  • enzyme
  • CCK
52
Q

Name of granules found in the acinar cells= ___________
- they contain _______ _______ (_________ or ________)

A

zymogen granules
- inactive enzymes (proenzymes or zymogens)

53
Q

Certain enzymes present in pancreatic juice are in the form of zymogens for ________ measure
- prevents __________ activation and potential damage to __________ tissue by these powerful digestive enzymes
- activation typically occurs in __________, ensuring safe and controlled digestion

A
  • protective
  • premature; pancreatic
  • duodenum
54
Q

Pancreatic duct cells secrete a ________ secretion, rich in _________ ions
- the hormone _________ stimulates this secretion

A
  • watery; bicarbonate
  • secretin
55
Q

Three zymogens that are released by the pancreas to facilitate PROTEIN digestion and names of their corresponding active enzymes
1.
2.
3.

A
  1. trypsinogen–> trypsin
  2. chymotrypsinogen –> chymotrypsin
  3. procarboxypeptidase –> carboxypeptidase
56
Q
  • in which location is pancreatin trypsinogen converted into the active form? ___________
  • trypsinogen is converted into the active form through the action of __________ (enzyme), which is present in the ______ ________ of the _______ mucosa
  • _____________ cleaves trypsinogen to form the active enzyme ________
  • the activation process for the remaining pancreatic zymogens is through _______
A
  • duodenum
  • enteropeptidase; brush border; duodenal
  • enteropeptidase; trypsin
  • trypsin
57
Q

Four other enzymes found in pancreatic juice
1.
2.
3.
4.

A
  1. pancreatic amylase
  2. pancreatic lipase
  3. ribonuclease
  4. deoxyribonuclease