Lecture 24: INTRODUCTION AND MOTILITY Flashcards
What are the functions of the GI tract?
To obtain nutrients required fo growth and energy needs. Also replace fluid and salts lost in urine, faeces, breathing and sweating
What must be regulated?
The conditions of the intestinal lumen
Where are receptors found?
In the wall of the GI tract
What do the receptors respond to?
Stretch when food is in the lumen and change in composition
What may change in composition be?
pH, osmolarity, amino acids, sugars and fats
What are the effectors?
Smooth muscle and glands
What do the receptors stimulate?
Smooth muscle contractions and gland secretion
What regulates GI function?
Nervous and hormonal
What does the CNS do?
Coordinate activity over long distances fan modulate activity of the enteric nervous system
What does the parasympathetic nervous system do?
Stimulate motility and secretion
What does the sympathetic nervous system do?
Inhibit motility and secretion
What is the ENS made up of?
Submucosal plexus and myenteric plexus
What does the submucosal plexus do?
Regulate secretion
What does the myenteric plexus do?
Regulate motility
What is the ENS involved in?
Local reflexes (involuntary) such as peristalsis and segmentation
Where is the ENS?
Total self contained in the GI tract
What is the largest endocrine organ in the body?
GI tract
What function does the GI tract have?
Endocrine (blood) and paracrine (localised)
What are critical hormones in the GI tract?
Gastrin, gastric inhibitory peptide (GIP), secretin and cholecystokinin (CCK)
What are the functions of motility in the GI tract?
Movement at a controlled rate, mechanical digestion, mixing and exposure to absorptive surfaces
What does movement at a controlled rate involve?
Propulsion and storage
What does movement at a controlled rate aid?
Chemical digestion and absorption
What does mechanical digestion do?
Increases surface area
What is mechanical digestion essential for?
Chemical digestion
What does mixing aid in?
Chemical digestion
What does exposure to absorptive surfaces aid?
Absorption
What is the basis of GI motility?
Smooth muscle
What are the properties of smooth muscle?
Spontaneously active (contracts without external input)
What is frequency of smooth muscle contraction regulated by?
ENS
What is the frequency of contraction in the stomach?
3/min
What is the frequency of contraction in the duodenum?
12/min
What is the frequency of contraction in the ileum?
9/min
What is the strength of contraction regulated by?
Nervous and hormonal input (CNS)
What is the motility pattern during fasting?
Migrating motor complex
When does the migrating motor complex happen?
4 hours after a meal
When does the migrating motor complex repeat?
Every 2 hours until eat again
What is the purpose of the migrating motor complex?
Housekeeping (remove residual secretions and undigested materials)
What are the motility patterns during feeding?
Storage, propulsion and mixing
Where does storage occur?
Stomach and colon
What does relaxation of smooth muscle allow?
Volume to increase without changing pressure
Where does propulsion occur?
Esophagus, stomach, small and large intestine
What is propulsion known as?
Peristalsis
What happens in peristalsis?
Smooth muscle contracts behind the bolus and pushes it forward
Where does mixing occur?
Stomach, small and large intestine
What is the mixing in the stomach?
Retropulsion
What is the mixing in the small and large intestine?
Segmentation
What happens in segmentation?
Alternate patterns of contraction to push food together and apart (mix it)
What is the purpose of chewing?
To reduce the size of food
What does reducing the size of food do?
Allows injection and mixes food with saliva to allow taste
Is chewing voluntary?
Yes, skeletal muscle of the jaw
What about chewing is involuntary?
Strength, frequency and side
What is swallowing?
Rapid transfer of material from mouth to stomach
How is swallowing initiated?
Voluntarily but proceeds reflexly
Where does storage occur in the stomach?
Fundus and body
Where does mechanical digestion occur in the stomach?
Antrum
Where does mixing occur in the stomach?
Antrum
How is there controlled delivery to the duodenum?
By the pyloric sphincter
What size does the stomach drink to when fasting?
50 ml
What does the migratory motor complex involve?
1 hour of inactivity, 50 min of uncoordinated activity and 10 min of coordinated activity
What happens during feeding (storage)?
Receptive relaxation and gastric accommodation
What is storage under regulation of?
Nervous (vagus nerve - parasympathetic)
Where is peristalsis initiated in the stomach?
The greater curvature and spreads to the antrum
How is peristalsis during the first 60 minutes after eating?
Gentle
How is peristalsis during 60-300 minutes after eating?
Intense
What is retropulsion?
A combination of peristalsis and closure of the pyloric sphincter causing food to collide and mix/break down
What is gastric emptying a result of?
Motility
What does the rate of gastric emptying match?
The digestive capacity of the intestine
What is gastric emptying regulated by?
Feedback from duodenum
What factors affect gastric emptying?
Size of meal -larger means faster emptying and composition of meal
What empties faster?
Fluids faster than solids
What are slow to digest?
Fats so slow gastric emptying
What happens when there is fatty, hypertonic, acidic chyme in the duodenum?
Duodenal entero-endocrine cells secrete enterogastones (secretin and cholycystokinin) and the chemoreceptors and stretch receptors trigger the enterogastric reflex
What happens in the enterogastric reflex?
Short reflex via enteric neurons and long reflex via CNS centres increases sympathetic activity and decreases parasympathetic activity
What is the overall result of fats being in the duodenum?
Decreased contractile force and rate of emptying of the stomach
What is the functions of small intestine motility?
Mixing with secretions from pancreas, biliary system (liver, gall bladder) and intestine, controlled movement and exposure of products of digestion to absorptive surfaces (epithelial cells)
What is the motility pattern of small intestine after a meal?
Segmentation for mixing, exposure to absorptive surfaces and all movement. Limited peristalsis for movement in humans
What does the colon store?
Faeces
What organ of the GI tract has large periods of inactivity?
Large intestine/colon
What does segmentation in the large intestine do?
Exposure to absorptive surfaces and absorption of fluid and salt from faeces
When does mass movement occur?
1-2 times a day following meals
How does mass movement occur?
A peristaltic wave
What does a peristaltic wave do?
Drives faeces into the rectum and initiates defecation