Neural and hormonal control of gastrointestinal function Flashcards

1
Q

What is responsible for local control of gut function?

A

Enteric nervous system via interstitial cells of Cajal

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2
Q

What is the role of the enteric nervous system?

A
  • regulate contractile activity and secretion of water and salt (mm to cm distances)
  • contains basic elements required for complex motor programs (sensory neurons, interneurons, and motor neurons)
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3
Q

What is responsible for long-distance control of the gut?

A

endocrine system; signals to brain, gallbladder, pancreas

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4
Q

What is the function of the gut endocrine system?

A
  • secretion of enzymes and solvents into interstitial lumen
  • regulation of appetite
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5
Q

The myenteric plexus resides

A

between the longitudinal external smooth muscle and the inner circular smooth muscle

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6
Q

The submucosal plexus resides

A

between the inner circular smooth muscle and the mucosa

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7
Q

The submucosal plexus is involved in

A

control of water and electrolyte secretion

target for many bacterial toxins that produce diarrhoea

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8
Q

The myenteric plexus is involved in

A

main control system of ENS

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9
Q

Enterochromaffin cells contain

A

5-HT (serotonin)

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10
Q

What is the general structure of enteroendocrine cells?

A
  • contain one or more different hormones
    • eg: serotonin (EC), CCK, secretin, somatostatin, glucagon-like peptides 1 & 2, pancreatic polypeptides, gastrin
  • span epithelium:
    • apical layer protrudes into gut lumen
    • basolateral surface secretes hormones into interstitial cell space to be taken up by blood vessels (to the liver and body)
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11
Q

What is released by enterochromaffin-like (ECL) cells?

A

histamine; involved in acid secretion in the stomach

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12
Q

What modulates the enteric nervous system function?

A
  • vago-vagal reflex pathways
  • intestino-intestinal reflexes
  • CNS control relating to anticipation, mood, activity
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13
Q

What is the vago-vagal reflex pathway?

A
  • coordinate movements in the upper GI
    • vagus pathway for control of swallowing
    • vagus regulation of acid secretion in stomach, coordination of contractions in stomach and duodenum
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14
Q

What are the intestino-intestinal reflexes?

A
  • some mediated by vagus to brain, others via dorsal root ganglia and SC
  • intestinofugal/viscerofugal neurons projecting into gut
    • cell bodies in gut wall
    • synapse w/pre-vertebral sympathetic ganglia
      • produce reflex inhibition of proxima regions when distal regions are distended, reducing overall flow in the system
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15
Q

Sphincter function is directly regulated by

A

SNS innervation

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16
Q

What interactions control gut function?

A
  • GI hormones excite enteric neurons and extrinsic sensory neurons (paracrine) that feed back to the brain
  • muscle contraction generated feeds back to the extrinsic circuit and endocrine system
  • vagal and sympathetic input modulates ENS circuits
  • ICC act as pacemakers of the muscle
    • largely independent of neural activity
    • neural activity superimposes a level of excitation or inhibition that modulates contraction; not directly stimulating contraction
17
Q

The cephalic phase of secretion is triggered by

A

sight, smell, taste, thought of food

18
Q

Activation of the cephalic phase of secretion causes

A
  • increased salivation
  • increased gastric acid secretion
  • increased secretion of pepsin in the stomach
  • relaxation of gastric corpus and fundus (main storage components of the stomach)
19
Q

Cephalic phase of secretion operates by

A

vagus nerve (no somatic innervation of the gut)

20
Q

The cephalic phase contributes what percent of acid secretion in the stomach?

21
Q

D cells secrete

A

Somatostatin

22
Q

Somatostatin

A

inhibits ECL cells from releasing histamine and tf decreases acid release from parietal cells

23
Q

G cells secrete

24
Q

G cells are present

A

in the duodenum and gastric antrum

25
What regulates acid secretion from parietal cells?
* vagus nerve activates ENS neurons in intestinal wall to release **ACh:** * activate M3 muscarinic ACh receptors on parietal cells to **release acid** * activate ECL cells to secrete **histamine** --\> activates parietal cells to **release acid** * activate **G cells** to release **gastrin** to **release acid** * activate D-cells to release **somatostatin** --\> inhibits ECL cells, G cells, and parietal cells to **decrease acid release**
26
Gastrin and somatostatin act on parietal cells via
portal vein and liver
27
Swallowing is controlled by
vagus nerve
28
Primary peristalsis is regulated by
vagus nerve and swallowing mechanism via perstaltic mechanism in the brain stem (motor pattern generated by the brain)
29
Secondary peristalsis is regulated by
ENS
30
Distension of the stomach causes
* further relaxation of the stomach * initial feeling of being full * activation of enteric and vago-vagal reflexes * leads to increased acid and pepsin secretion * stimulates pacemaker activity of ICC cells in antrum to mash food against the pylorus
31
What is the role of the antrum in digestion?
* food and acid entering antrum triggers reflex inhibition of acid secretion in the corpus * ICC potentials propogate from corpus to pylorus, mashing food against the closed sphincter * acid, protease, and mechanical activity separates food * forms a layer of fat that floats to the fundus of the stomach (fat is tf the last thing to exit the stomach)
32