Lecture 3: Gastrointestinal Motility Flashcards
Name the three things that motility accomplishes
Grinding, mixing, breakdown of fragments and ingested food
Contractile tissue of GIT is composed of:
Smooth muscle
Striated muscle in pharynx, upper 1/3 of esophagus, external anal sphincter
What type of smooth muscle allows for very smooth muscle contractions?
Unitary smooth muscle
Unitary smooth muscles cells are __________ coupled via __________
Electrically; gap junctions
Circular muscle decreases ________ of that segment
Diameter
Longitudinal muscle decreases ________ of that segment
Length
Periodic contractions followed by relaxation
Phasic contractions
What type of contractions maintain a constant level of contraction or tone without regular relaxation?
Tonic contractions
Where do phasic contractions take place?
Esophagus, gastric antrum, SI
Where do tonic contractions take place?
Upper region of stomach, lower esophageal region, ileocecal and internal anal sphincters
T/F: Slow waves always bring membrane potential to threshold
False
T/F: Slow waves are always present
True
T/F: APs are always present
False
What happens when a slow wave causes an AP?
Contraction
What determines direction and velocity of contractions?
Slow waves
What is the frequency of slow waves in the stomach?
3 per minute
What is the frequency of slow waves in the duodenum?
12 per minute
T/F: Frequency of slow waves is not influenced by neural or hormonal input
True
What ion causes the depolarizing phase and maintenance of the plateau of slow waves?
Calcium
What ion is responsible for repolarization of slow waves?
Potassium
Name the 3 phases of swallowing
Oral phase
Pharyngeal phase
Esophageal phase
Oral phase, voluntary or involuntary?
Voluntary at first then becomes involuntary
Name the phase of swallowing:
Tongue forces bolus toward pharynx, lots of receptors, then involuntary swallowing takes over
Oral phase
Name the phase of swallowing:
Involuntary, propel bolus from mouth through pharynx to esophagus in 4 steps
Pharyngeal phase
Name the phase of swallowing:
Controlled by swallowing reflex AND enteric nervous system
Propels bolus through esophagus to stomach
After bolus enters esophagus, swallowing reflex closes sphincter
Esophageal phase
In pharyngeal phase, what pulls up so that food cannot move into nasopharynx?
Soft palate
In pharyngeal phase, what moves to cover the opening to the larynx?
Epiglottis
In pharyngeal phase, when the larynx moves up against the epiglottis, what is covered?
Trachea
In pharyngeal phase, what relaxes so food can pass from pharynx to esophagus?
Upper esophageal sphincter
In pharyngeal phase, what propels the bolus through the sphincter?
Peristaltic wave
What is the esophageal phase controlled by?
Swallowing reflex and enteric nervous system
In the esophageal phase, after the bolus enters the esophagus, what reflex closes the sphincter?
Swallowing
In the esophageal phase, what pushes the bolus down?
Primary peristaltic wave
In the esophageal phase, what happens if the esophagus is still distended (food still in it) after the primary peristaltic wave?
Secondary peristaltic wave
Why is esophageal motility needed?
To propel bolus from pharynx into the stomach
What is the action of the primary peristaltic contraction?
Creates high pressure area behind bolus
What opens as the peristaltic wave and bolus reach it?
Lower esophageal sphincter
What is the lower esophageal sphincter mediated by?
Vagus nerve and VIP
Why is the bolus allowed to move into the stomach?
Lower pressure than in esophagus
What difference is there between the upper and lower esophagus?
Pressure difference
Where in the esophagus is pressure lower?
Upper
What are the three muscle layers of the stomach?
Outer longitudinal
Inner circular
Inner oblique
What region of the stomach is thin walled?
Orad
What region of the stomach is thick walled for stronger contractions?
Caudad
The orad stomach relaxes due to
Relaxation of lower esophageal sphincter
What does relaxation of the orad stomach do to pressure and volume of the stomach?
Decreases pressure
Increases volume
What reflex is involved in the relaxation of the stomach?
Vasovagal
For the vasovagal reflex, what is carried on the vagal nerve?
Both afferent and efferent limbs
Name the three components of gastric motility
Relaxation of orad region
Contractions
Gastric emptying
What is the purpose of contractions in gastric motility?
Reduce bolus size and mix with gastric secretion
What do gastric secretion consist of?
HCl and Pepsin
Describe the path of the contraction waves of gastric motility (begin and move towards where)
Begin in middle of body
Move distally along caudal stomach towards pylorus
When waves are propelled back and further decrease particle size, what is this called?
Retropulsion
For slow waves, neural input and hormones can’t alter frequency, but can alter
Contraction strength
Force of contractions can be increased via
PSNS, gastrin, motilin
Force of contractions can be decreased via
SNS, secretin, GIP
Migrating myoelectric complexes are mediated by
Motilin
What causes migrating myoelectric complexes to occur, and how often?
During fasting state at about 90 minute intervals
What does gastric emptying consist of?
Chyme entering small intestines
How often do slow waves occur in duodenum?
12 per minute
How often do slow waves occur in ileum?
9 per minute
What coordinates segmentation and peristaltic contractions in the SI?
Enteric nervous system
Parasympathetic innervates the SI via what
Vagus nerve
Sympathetic innervates SI via
Celiac and superior mesenteric ganglia
Parasympathetic innervations will do what to contraction strength?
Increase
Sympathetic innervations will do what to contraction strength?
Decrease
What muscle do segmental contractions occur in? (SI)
Circular muscle
What is the purpose of segmental contraction?
Mix chyme expose to pancreatic enzymes
Describe movement of segmental contractions
Back and forth movement to mix, but NO forward movement
T/F: Segmental contractions contain forward movement
False
What kind of contraction propels chyme toward LI?
Peristaltic contractions
What kind of muscle involved in peristaltic contractions?
Circular and longitudinal
Where does the contraction occur in relation to the bolus?
Contraction behind bolus, relaxed in front of bolus
What kind of cells sense the bolus?
Enterochromaffin cells
What triggers the peristaltic reflex for moving chyme?
Bolus sensed by enterochromaffin cells
Explain the course of events that trigger the vomiting reflex
Information from vestibular system
Back of throat
GIT and chemoreceptor trigger zone in 4th ventricle?
Vomiting center in medulla
Vomiting reflex
Explain the events of the vomiting reflex
Reverse peristalsis in SI
Relaxation of stomach and pylorus
Increased abdominal pressure
Movement of larynx up, relaxation of lower esophageal sphincter, closure of glottis
Forceful expulsion
During retching, what remains closed
Upper esophageal sphincter
During retching, what remains open
Lower esophageal sphincter
What opens to allow contents from SI into cecum?
Ileocecal sphincter
Describe the course of contents through colon
Ascending, transverse, descending, sigmoid colon to rectum and anal canal in ruminants in pigs
What do ruminants and pigs have that horses, cats, and dogs don’t?
Sigmoid colon
Segmentation contraction occurs in which parts of LI?
Cecum and proximal colon
Segmentation contractions in cecum and proximal colon are associated with what?
Haustra
Define haustra
Saclike segments
Do dogs, rats, carnivores, ruminants have haustra?
No
Do guinea pigs, rabbits, pigs, humans, monkeys, horses have haustra?
Yes
The mass movements in the LI have what goal?
Move contents over long distances
How often do mass movements in the LI occur?
1-3 times a day
External anal sphincter is _______ contracted until defecation
Tonically
What contracts to create pressure on the external anal sphincter?
Smooth muscle
Retosphincteric reflex
When internal anal sphincter relaxes when rectum fills
Gastrocolic reflex
Distention of stomach increases motility of colon
Gastrocolic reflex is afferent where and efferent where?
Afferent in stomach
Efferent in colon