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M: DS > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

What are the responses of the sympathetic nervous system associated with?

A

Exercise, emotion, excitement

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2
Q

How does the sympathetic nervous system affect the gut function?

A

Inhibits gut function
Predominates at times of activity/stress
Diverting blood to brain and muscles

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3
Q

What are the responses of the parasympathetic nervous system associated with?

A

Rest, repletion, relaxation

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4
Q

How does the parasympathetic nervous system affect the gut function?

A

Promotes gut function
During and after meals
Stimulates secretion and transport in gut tube

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5
Q

What is the enteric nervous system of the gut composed of?

A

Submucosal and myenteric nerve plexus

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6
Q

How many tunics is the gut composed of?

A

4 concentric layers

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7
Q

What are the 4 layers of the gut tube?

A

Mucosa
Submucosa
Muscularis externa
Adventitia/Serosa

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8
Q

What are the three components of the mucosa?

A

Epithelium, lamina propria, muscularis mucosae

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9
Q

What are the functions of the epithelium?

A

Protection (sacrificial layer), secretion, absorption

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10
Q

What are the functions of the lamina propria?

A

Structural support - Mechanical support due to connective tissue
Functional support - Blood vessels and nerves

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11
Q

What is the function of the muscularis mucosae?

A

Muscle of the mucosa

Responsible for movement independent of peristalsis

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12
Q

What are the functions of the submucosa?

A

Structural support - Connective tissue

Functional support - Blood vessels and nerves

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13
Q

What is the structure of the muscularis externa?

A

Usually inner circular and outer longitudinal except stomach

Made up of smooth muscle except for oesophagus

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14
Q

What forms sphincters?

A

Thickenings of inner circular layer

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15
Q

Define adventitia

A

The outermost connective tissue covering of any organ, vessel, or other structure

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16
Q

Define serosa

A

A slippery outer covering for the gut tube. It is two layered, with the outer mesothelium sitting on a bed of connective tissue

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17
Q

What is another name for serosa?

A

Visceral peritoneum

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18
Q

What is ascites?

A

Accumulation of fluid, abdominal swelling, distortion of visceral organs, distended superficial blood vessels.

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19
Q

What diseases can cause ascites?

A

liver disease, heart failure, electrolyte balance

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20
Q

Normally, how much serous fluid do we produce a day?

A

7L

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21
Q

What is peritonitis?

A

Physical damage, chemical irritation, bacterial invasion (complication from surgery) where inflammation interferes with normal function.

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22
Q

What are the three types of salivary glands?

A

Parotid, sublingual, submandibular

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23
Q

How much does the sublingual gland contribute to saliva?

A

5%

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24
Q

What kind of secretion is produced by the sublingual salivary gland?

A

Mixed (serous and mucous)

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25
Q

How much does the submandibular gland contribute to the saliva?

A

70%

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26
Q

What kind of secretion is produced by the submandibular gland?

A

Mixed (serous and mucous)

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27
Q

How much does the parotid gland contribute to the saliva?

A

25%

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28
Q

What kind of secretion is produced by the parotid gland?

A

Serous only

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29
Q

What are the structures found in the submaibular gland?

A

Serous acinus
Mucous acinus
Intercalated duct
Striated duct

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30
Q

What is the appearance of a serous acinus?

A

Dark staining
Granular (due to zymogen granules)
Central circular nuclei
Flat myoepithelial cells around the outside

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31
Q

What is an acinus?

A

A circular group of 5, 8, or 12 cells

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32
Q

What are myoepithelial cells?

A

Modified epithelial cells that are contractile and squeeze contents through the duct

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33
Q

What is the intralobular duct composed of?

A

Intercalated and striated ducts

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34
Q

Describe the appearance of a mucous acinus

A

Pale staining

Mucus granules push nuclei to the periphery. Granules look foamy. Myoepithelial cells also present.

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35
Q

Describe the appearance of striated ducts

A

Many aligned mitochondria Central oval nuclei

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36
Q

What does the high number of mitochondria found in the striated ducts suggest?

A

Very metabolically active, which implies a lot of active transport is happening. Na+ and Cl- move into the cells while K+ and HCO3- move out of the cells.

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37
Q

Describe the appearance of the intercalated duct

A

Fewer, smaller cells
Central nucleus
Short duct so reduced likelihood of capturing in section

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38
Q

What is a serous demilune?

A

Mixed acinus

Mucous cells capped off by serous cells that form a half moon shape.

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39
Q

What does the intralobular duct lead into?

A

Interlobular ducts in connective tissue septa and then eventually into the submandibular duct

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40
Q

What is saliva composed of?

A

99% water with an assortment of ions, buffers, metabolites, enzymes

41
Q

What are the three main functions of saliva?

A

Lubrication
Protection
Digestion

42
Q

What provides lubrication in the saliva? What is another function of this substance?

A

Carbohydrate-rich glycoproteins(mucins), which also aid in protection via bacterial adhesion

43
Q

What substances in the salivary glands aid in protection?

A

Bicarbonate ions
Lysozyme
Lactoferrin
Immunoglobulin A

44
Q

What does the saliva need to protect from?

A

Bacterial adhesion and secretions

Acidic vomit

45
Q

How do bicarbonate ions in the saliva aid in protection?

A

Counteracts acidity of the bacterial secretions and vomit

46
Q

What reflex is associated with bicarbonate ions in the saliva?

A

We get an influx of saliva into the mouth when vomiting

47
Q

How do lysozymes in the saliva aid in protection?

A

Break down bacterial cell walls

48
Q

How does lactoferrin in the saliva aid in protection?

A

Fights iron-dependent bacteria

49
Q

How does IgA in the saliva aid in protection?

A

Generic protection against bacteria and viruses

50
Q

What substances in the saliva aid in digestion?

A

Amylase
Lipase
Kallikrein

51
Q

How does amylase in the saliva aid in digestion? What is the active range pH of amylase?

A

Breaks down sugars

Active range pH: 4-11

52
Q

How does lipase in the saliva aid in digestion? What is the optimal pH?

A

Breaks down fat

Optimal pH: 4.0 so more active in the stomach

53
Q

What is the function of kallikrein?

A

Increases blood flow and supply to the salivary glands to help sustain demand for metabolism.

54
Q

What kind of nervous stimulation do the salivary glands receive?

A

Each salivary gland receives both parasympathetic and sympathetic stimulation

55
Q

What increases the stimulation of salivary glands?

A

Sight and thought of food (prep, presentation, smell, taste, chewing), nausea

56
Q

What decreases the stimulation of salivary glands?

A

Fatigue, sleep, fear, dehydration, exercise

57
Q

How does the parasympathetic nervous system affect the salivary glands?

A
  • Accelerates secretion, resulting in the production of large amounts of watery saliva
  • Myoepithelial cells contract
  • Increased blood flow sustains demand for metabolism
58
Q

How does the sympathetic nervous system affect the salivary glands?

A
  • Secretion of a small volume of viscous containing high enzyme concentrations
  • Reduced volume produces the sensation of dry mouth.
  • Blood vessels are constricted which restricts blood flow and secretion
59
Q

How does meth amphetamine lead to bad teeth?

A

It causes destruction of salivary glands, which leads to loss of protective function and bad teeth

60
Q

What is xerostomia?

61
Q

What are the causes of xerostomia?

A
  • Mumps (virus which preferentially targets the parotid glands)
  • Salivary duct calculi (stones)
  • Salivary gland tumours (usually benign)
  • Sjogren’s syndrome (autoimmune)
  • Medications
62
Q

What is another name for hypersalivation?

A

Water brash

63
Q

What conditions is hypersalivation associated with?

A

Peptic ulceration
Inflammatory bowel disease
Medications
Toxins (organophosphates, arsenic)

64
Q

How is the submucosa packed in the oes? Why?

A

Loosely packed to allow expansion and contraction as needed when bolus travels through

65
Q

What is the function of the oesophagus?

A

Rapid transport (peristalsis) of food bolus tot he stomach.

66
Q

Describe the structure of the oes

A

Straight tube 25 cm long. Thick muscular walls with a protective lining. Collapsed outline with folds of submucosa when empty. These are stretched out flat as food descends the stomach.

67
Q

Describe the epithelium of the oes.

A

Thick sacrificial stratified squamous epithelium (6-8 layers), non-keratinised in humans (a small number of keratohyalin granules present, but do not undergo true cornification). Transitions into simple cuboidal/columnar as approaches stomach.

68
Q

Describe the muscularis mucosae of the oes.

A

Absent/rare near upper oes but developed near stomach. Longitudinal smooth muscle and elastic network (discontinuous in places). Permits independent movement and folding of the mucosa, aiding digestion and absorption.

69
Q

Are glands present in the oes?

70
Q

Describe the muscularis externa of the oes.

A
  • Two thick coats, inner and outer, not always regularly circular and longitudinal, respectively (inner = many spiral and oblique bundles, outer = also irregularly arranged in many places)
71
Q

Describe the type of muscles found in the different thirds of the oes.

A

Top: Mostly skeletal muscle
Middle: Mixed skeletal and smooth
Bottom: Mostly smooth muscle

72
Q

Describe the sphincters of the oes.

A

Upper and lower, Physiological rather than anatomical. No obvious muscle thickening. Some increase in inner muscle coat in lower sphincter area. Tonal contraction.

73
Q

What is the outer covering of the oes?

A

Adventitia, except for the 1-2 cm between the diaphragm and the stomach, which is retroperitoneal (anterior and lateral surfaces covered by serosa and peritoneum)

74
Q

What nervous system supplies the oes? What does it control?

A

Autonomic nervous system

Coordinates movements involved in swallowing

75
Q

What are oesophageal varices?

A

Dilated blood vessels. Associated with hypertension in the liver, caused by blockage. Can lead to back flow of blood into dilated vessels. Leads to very weak veins that get overfilled. Dangerous because they can haemorrhage quite easily. Can lead to increased blood loss.

76
Q

List the gastro-oesophageal diseases

A 
Achalasia
Neurological disorders, neuromuscular disorders, extreme old age
Gastro-oesophageal disease
Reflux oesophagitis
Barrett's oesophagus
77
Q

What happens in achalasia?

A

Aperistalsis of the oes with a failure of the lower oesophageal sphincter to relax on swallowing

78
Q

What is gastro-oesophageal reflux disease?

A

When gastric juices reflux back into oes. Normally we have the lower oesophageal sphincter to prevent this from happening but it is not foolproof.

79
Q

What occurs in Barrett’s oesophagus?

A

Stratified squamous epithelium becomes more glandular (stomach-like) epithelium. This is neoplasia

80
Q

What is chronic oesophagitis?

A

Inflammation of oes in some regions due to chronic exposure to acids. Stratifies squamous epithelium protects us from physical abrasion, not chemical attacks. Regions of ulceration can form, where the stratified epithelium has been digested away.

81
Q

What is aprecursor to oedophageal cancer?

A

Barrett’s oes

82
Q

What are the functions of the stomach?

A

Secretion, sterilisation, digestion, and some absorption

83
Q

What is the capacity of the stomach?

84
Q

What are the 4 key regions of the stomach?

A

Cardia
Fundus
Body
Pylorus

85
Q

What is secreted by the cardiac glands? Why?

A

Mucus only. Buffer zone because we don’t want acid near oes.

86
Q

What is secreted by the parietal glands?

A

HCl, intrinsic factor, pepsinogen, somatostatin

87
Q

What are the rugae?

A

Transient folds that are prominent when the stomach is empty and less prominent when the stomach is full.

88
Q

What is secreted by pyloric glands?

A

Pepsinogen
Mucus
Gastrin
Somatostatin

89
Q

Why is there not much acidic activity at the pylorus?

A

Don’t want the duodenum to deal with strong acids

90
Q

What are the 6 types of cells found in the stomach?

A

1) Simple columnar mucous cells of surface and pits
2) Mucous neck cells of gastric glands
3) Undifferentiated stem cells
4) Parietal cells
5) Chief cells
6) Enteroendocrine cells

91
Q

What is another name for parietal?

92
Q

What is the function of the simple columnar mucous cells? What is the appearance?

A

Insoluble, alkaline/neutral glycoproteins forms a protective mucous bicarbonate barrier sheet above the epithelium. Mucous granule is at the apex and elongated nucleus.

93
Q

What are prostaglandins?

A

Derivatives of fatty acids which have hormone-like activity. Stimulates production of mucus and phospholipids.

94
Q

What are the functions of the prostaglandins?

A

Increases mucus layer

Increases phospholipids in membrane

95
Q

What is another name for mucus layer of the simple columnar mucous cells?

96
Q

How does helicobacter pylori affect simple columnar mucous cells of the stomach?

A

Destroys the mucus layer.

  • Contains urease that converts urea in the blood to ammonia, which attacks mucus coat and degrades it.
  • Toxins secreted by the bacteria also damage epithelium and release ulcerogens (platelet activating factor) which cause ulcers
97
Q

What do mucous neck cells secrete?

A

Soluble, acidic glycoproteins secreted when food is present.

98
Q

What is the appearance of the mucous neck cells?

A

Expanded apex. Basal nucleus. Mucous granules are less densely packed.

M: DS (29 decks)

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