Lecture 27: Absorption Flashcards

1
Q

what is absorption?

A

absorption is the passage of substances from the GI lumen across the lining of the intestine into the interstitial fluid and then into blood or lymph

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2
Q

what are the sites of absorption?

A

Mouth, esophagus, stomach
- minimal absorption of lipid soluble substances

Small intestine
- main site of absorption of 90% of water and sodium and all nutrients

Large intestine
- absorption of 9% of water and sodium

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3
Q

what factors affect absorption?

A
  • motility
  • surface area
  • transport across epithelium
  • removal from interstitial fluid
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4
Q

how does motility affect absorption?

A

Peristalsis
- provides the correct rate of propulsion to allow digestion and absorption

Segmentation
- needed for exposure to products of digestion to absorptive surfaces

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5
Q

how does surface area affect absorption?

A

the rate of absorption is proportional to surface area
- greater surface area = gaster absorption

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6
Q

what adaptations maximise surface area for absorption?

A
  • length of small intestine
  • plicae circulares
  • villi
  • microvilli
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7
Q

what is the problem with transporting molecules across the epithelium? what is the solution?

A
  • the lumen of the intestine is continuous with the outside world as the intestinal epithelium is a barrier

To overcome there there are 2 pathways:
- the paracellular pathway between cells
- transcellular pathway across the membrane through the cytoplasm

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8
Q

what are the features of the paracellular pathways?

A

gaps between cells
- solutes don’t cross cell membrane
- the only barrier is the right junctions binding cells together
- relatively non-selective so small solutes can get through
- is passive so requires a gradient

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9
Q

what are the features of the transcellular pathway?

A
  • solutes must cross two cell membranes
  • cell membranes are lipid bilayers so if it is not lipid soluble it requires a transport protein
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10
Q

how is absorption maximised across the available surface area?

A
  • chemical digestion reduces nutrients into smallest possible unit
  • specific transport proteins absorb what is required and allows active transport against a gradient
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11
Q

how are substances removed from interstitial fluid?

A
  • there is a large blood flow to intestine
  • there is an arrangement of blood vessels and lacteals in the villi
  • they prevent build up in the interstitial fluid
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12
Q

what specific substances are absorbed?

A
  • water
  • sodium
  • carbohydrates
  • proteins
  • lipids
  • bile salts
  • vitamins
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13
Q

how much water is absorbed each day? how much is divided into each region of the GI tract?

A

we drink 1-5L/day

  • salivary secretion - 1.5L/day
  • gastric - 3L/day
  • pancreatic - 1.5L/day
  • biliary - 0.5L/day
  • small intestinal - 1.5L/day

small intestine has 9-10L of water delivered to it everyday

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14
Q

what is osmosis?

A
  • a mechanism for water absorption
  • passive movement of water from lumen into blood
  • osmotic gradient is set up by absorption of salts and nutrients
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15
Q

what are the mechanisms of sodium absorption?

A
  • passive movement via paracellular pathway
  • active transport via the cells
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16
Q

what happens in transcellular absorption of sodium?

A
  • active transport via the cells
  • requires transporters to cross the cell membranes

Mechanisms:
- Na+ transport alone (more detail in another card)
- Na+ transport coupled to monosaccharides
- Na+ transport coupled to amino acids

17
Q

what happens in absorption of sodium alone?

A
  • Na+ moves into cell down its gradient
  • goes from high to low concentration
  • passes through using transport proteins: Na+ channel and Na+/H+ exchanger

To get out the cell it goes from low concentration to high concentration
- so needs active transport using ATP and Na+/K+ ATPase

18
Q

What are the mechanisms of carbohydrate absorption?

A
  • passive absorption
  • active absorption
19
Q

what happens in passive absorption of carbohydrates?

A

involves monosaccharides e.g. glucose, galactose, fructose
- diffuses down concentration gradient via paracellular pathway

20
Q

what happens in active absorption of carbohydrates?

A
  • involves cotransport with Na+ via cellular pathway
  • Na+/K+ ATPase creates driving force for sodium
  • Na+ moves into the cell with a monosaccharide via Na+/glucose cotransporter
  • Monosaccharides passively diffuse out of the cell via monosaccharide carrier
  • Sodium leaves the cell via Na+/K+ ATPase
21
Q

what are the mechanisms of protein digestion?

A
  • passive absorption
  • active absorption
22
Q

what happens in passive absorption of proteins?

A
  • involves amino acids
  • diffuses down concentration gradient via paracellular pathway
23
Q

what happens in absorption of amino acids?

A
  • active absorption
  • involves cotransport with Na+ via cellular pathway
  • Na+/K+ ATPase creates driving force for sodium
  • Na+ moves into the cell with an amino acid via Na+/amino acid cotransporter
  • Amino acids passively diffuse out of the cell via amino acid carrier
  • Sodium leaves the cell via Na+/K+ ATPase
24
Q

what happens in absorption of small peptides?

A
  • active absorption of di and tripeptides
  • involves cotransport with H+ via cellular pathway
    -Na+/K+ ATPase creates a negative membrane potential which is a driving force for H+
  • H+ moves down its electrical gradient and brings a di/tripeptide with it through the H+/peptide cotransporter
  • intracellular cytoplasmic peptidases breaks these down into amino acids
  • Amino acids leave the cell via amino acid carrier
25
Q

how are the products of fat digestions absorbed?

A

In lumen and apical membrane:
- free fatty acids and monoglycerides move by simple diffusion from micelle into cell
- the micelle is not absorbed
- bile salts absorbed in ileum

Intracellular:
- transported to the endoplasmic reticulum
- re-synthesised to triglycerides to maintain gradient for apical diffusion
- secreted from golgi as chylomicrons
- targeted to basolateral membrane

Basolateral membrane:
- exocytosed as chylomicrons
- enters lymph via lacteals of villi

26
Q

how are bile salts absorbed?

A

enterohepatic circulation.
- the bile salts in the micelles are eventually absorbed
- this occurs after fat absorption is completed
- occurs in the ileum via an active transport process using an apical Na+ dependent bile acid cotransporter
- then occurs in the colon via passive absorption where 95% of bile salts are absorbed

27
Q

how are fat soluble vitamins absorbed?

A
  • vitamin A, D, E, K are absorbed with fats
28
Q

how are water soluble vitamins absorbed?

A
  • Na+ dependent absorption
  • e.g. vitamin C
29
Q

how is vitamin B12 absorbed?

A
  • it is a special case
  • it is absorbed in the ileum
  • binds to intrinsic factor produced in the stomach
  • absorbed via a specific transporter for intrinsic factor vitamin b12 in the ileum
30
Q

what is vitamin b12 deficiency called?

A

pernicious anemia

31
Q

what happens to what is not absorbed?

A

Elimination
- expulsion of residues of digestion
- feces are formed in the large intestine
- transferred to rectum via peristaltic waves called mass movement
- elimination from body by defecation reflex