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Gastrointestinal > Motility Of The GI Tract > Flashcards

Motility Of The GI Tract Flashcards

1
Q

What organs primarily use Tonic contractions?

A

1) Stomach (orad part)
2) lower esophagus
3) ileocecal
4) internal anal sphincters

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2
Q

What is it called when a sub threshold depolarization produces a weak contraction?

A

Basal contractions

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3
Q

What 3 things increase the amplitude of the slow wave?

A

1) stretch
2) Acetylcholine
3) parasympathetics

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4
Q

What 2 things cause cause hyper polarization?

A

Norepinephrine and sympathetics

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5
Q

What plexus controls GI secretions and local blood flow?

A

Submucosal (meissners)

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6
Q

What plexus controls GI movements?

A

Myenteric (Auerbach’s)

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7
Q

Where do slow waves originate from?

A

Interstitial cells of cajal (ICC)

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8
Q

How do slow waves move from pacemaker region to smooth muscle?

A

Gap junctions

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9
Q

Smooth muscle cells respond to slow wave depolarizations with increased what?

A

Permeability of Ca+2 because probability of channels opening increases

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10
Q

What are the 3 phases of swallowing?

A

1) Oral Phase (voluntary)
2) Pharyngeal phase
3) Esophageal phase

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11
Q

Walk through what happens in the pharyngeal phase of swallowing

A

Soft palate is pulled upward –> epiglottis moves –> UES relaxes –> peristaltic wave of contractions is initiated in pharynx –> food is propelled through open UES

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12
Q

Which phase of swallowing takes the longest?

A

Esophageal phase (8-10 seconds)

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13
Q

What 2 things control the esophageal phase of swallowing?

A

Swallowing reflex and the ENS

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14
Q

The involuntary swallowing reflex is controlled by what?

A

The medulla

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15
Q

What is the somatosensory information that signals from the pharynx to the swallowing center in the medulla?

A

Food in the mouth

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16
Q

What 3 nerves can carry afferent info from the pharynx to the medulla in response to food in the mouth?

A

1) Vagus
2) Glossopharyngeal
3) Trigeminal

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17
Q

During the pharyngeal phase of swallowing, the swallowing center inhibits what?

A

The respiratory center

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18
Q

The primary peristaltic wave of the esophageal phase of swallowing is controlled by what?

A

Medulla (swallowing center)

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19
Q

The primary peristaltic wave CANNOT occur after this procedure?

A

Vagotomy

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20
Q

What induces a secondary peristaltic wave?

A
  • if primary contraction fails to empty the esophagus or when gastric contents reflux into the esophagus
  • Induced by distention of the esophagus itself by the retained food
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21
Q

What controls the secondary peristaltic wave?

A

Both the swallowing center and the ENS

22
Q

Can a secondary peristaltic wave occur after Vagotomy?

A

YES

23
Q

What organs primarily use Phasic contractions?

A

1) esophagus
2) Stomach (Antrum/caudad)
3) small intestine
4) all tissues involved in mixing and propulsion

24
Q

Gastroesophageal reflux occurs when intra-abdominal pressure is increased. Give two examples of when this happens.

A

Pregnancy and morbid obesity

25
Q

What neurotransmitter is used by the vagus nerve to relax the lower esophageal sphincter to pass a bolus of food into the stomach?

A

VIP

26
Q

Opening of the LES is mediated by what type of fibers in the vagus nerve?

A

Peptidergic

27
Q

What tests would you order when a patient presents with symptoms that lead you to believe they have Achalasia?

A

manometric recording and barium swallow

28
Q

Receptive relaxation occurs in what region of the stomach?

A

Orad

29
Q

What does receptive relation do to pressure and volume?

A

Decreases pressure and increases volume

30
Q

Receptive relaxation is what kind of reflex?

A

Vagovagal

31
Q

Describe the contractility of the Orad region

A

Little contractility

32
Q

Receptive relaxation of the stomach is controlled by what neurotransmitter of the Vagovagal reflex?

A

VIP

33
Q

Describe the change in contractions from the mid stomach to the pylorus

A

Increase in both force and velocity

34
Q

What is it called when food moves back from pylorus into the stomach?

A

Retropulsion

35
Q

What increases the number of action potentials and the force of contractions? 3 things

A

1) Parasympathetics
2) Gastrin
3) Motilin

36
Q

What 3 things decrease the number of action potentials and force of contractions?

A

1) sympathetics
2) Secretin
3) GIP

37
Q

How long does gastric emptying take?

A

3 hours

38
Q

Whenever there is fat or protein in the food bolus, gastric emptying is decreased by increasing gastric distensibility by what?

A

CCK

39
Q

Acid in the duodenum stimulates what?

A

Secretin release –> inhibit stomach motility via Gastrin inhibition

40
Q

Fats in duodenum stimulate what?

A

CCK and GIP –>inhibit stomach motility

41
Q

How would you treat diabetic gastroparesis?

A

lower blood glucose

42
Q

Large particles of in digested residue remaining in the stomach during FASTING are emptied by what?

A

Migrating myoelectric complexes (MMC)

43
Q

MMC’s are mediated by what hormone?

A

Motilin

44
Q

How does frequency of contraction change as food moves through the small intestine?

A

There is a decrease in the frequency as the bolus moves towards the ileocecal junction

45
Q

What is released from enterochromafin cells in response to a chemical or mechanical stimulation and what does it bind to?

A
  • Serotonin

- IPANs

46
Q

What coordinates the vomiting reflex?

A

Medulla

47
Q

What stimulates the chemical trigger zone in the vomitting reflex?

A

Apomorphine and morphine

48
Q

Major excitatory mediators of the large intestine?

A

ACh and substance P

49
Q

Major inhibitory mediators of large intestine?

A

NO and VIP

50
Q

Distal rectum and anal canal get sympathetic innervation from what?

A

Hypo gastric plexus

51
Q

External and internal anal sphincters get sympathetic innervation from what?

A

Somatic pudendal nerves

Gastrointestinal (9 decks)

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