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Physiology III > Neuroendocrine Control > Flashcards

Neuroendocrine Control Flashcards

1
Q

what is the ENS also known as?

A

second brain

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2
Q

ENS samples the gut content through…

A

receptors

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3
Q

how do ENS neurons connect to other neurons both inside and outside the ENS?

A

interneurons and afferent neurons

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4
Q

what do efferent ENS neurons innervate?

A

target cells
smooth muscle, secretory, absorptive cells

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5
Q

ENS influences ___ organs and the ___

A

neighboring organs
brain

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6
Q

is the ENS able to still coordinate digestion if it’s severed from the brain?

A

YES
in monogastrics

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7
Q

what is of fundamental significance to control of motility and secretion?

A

detecting nutrients in GI tract

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8
Q

what type of cell senses macronutrients?

A

L cells
has microvilli that make direct contact with nutrient

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9
Q

afferent neurons of the ENS are ___ neurons

A

cholinergic

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10
Q

afferent neurons N receptors in the….

A

mucosa - chemoreceptors and mechanoreceptors
muscle layer - mechanoreceptors

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11
Q

explain what’s going on in this image

A

example of afferent neuron function

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12
Q

a lot of the sensory info from the gut also reaches…

A

brain

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13
Q

which hormones/substances are part of the excitatory process of ENS?

A

ACh
substance P

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14
Q

which hormones/substances are part of the inhibitory process of ENS?

A

VIP
NO
ATP

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15
Q

what do the excitatory efferent neurons do to the ENS?

A

contract longitudinal and sphincter smooth muscles
stim secretion
degranulate enteroendocrine cells

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16
Q

what do the inhibitory efferent neurons do to the ENS?

A

inhibit smooth muscle cells
stim secretion
cause vasodilation

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17
Q

what is the myenteric plexus?

A

N longitudinal and circular smooth muscle layers
control gut movement

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18
Q

what is the submucosal plexus?

A

N glandular epithelium, intestinal endocrine cells, submucosa blood vessels
controls intestinal secretion

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19
Q

myenteric plexus is also known as…

A

Auerbach’s plexus

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20
Q

submucosal plexus is also known as…

A

Meissner’s plexus

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21
Q

the myenteric plexus is mainly concerned with ____, whereas the submucosal plexus is concerned with ___

A

myenteric - gut movement
submucosal - control secretions

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22
Q

what do interneurons do?

A

help integrate extrinsic and intrinsic input
communicates between myenteric and submucosal plexus

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23
Q

enteric interneurons establish ___ patterns by inhibiting effector neurons in altering ___

A

segmentation, segments

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24
Q

interneurons control complex reflex pattern such as…

A

peristalsis and rhythmic segmentation

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25
Q

what is ileus?

A

hypomotility or amotility of GI tract in absence of obstruction

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26
Q

what 3 categories of mechanisms are causes of the pathophysiology of post-op ileus?

A

neurogenic, inflammatory, pharmacologic

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27
Q

what are the pharmacological causes of post-op ileus?

A

opioid peptides administered exogenously DECREASE transit in GI tract through u2 receptors in myenteric plexus, causing hypomotility

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28
Q

what do opioid peptides do in GI normally?

A

modulate motility througb receptors on myenteric and submucosal ganglia
inhibits enteric neuron function

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29
Q

what is the enteric NS modulated by?

A

autonomic NS

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30
Q

the main function of parasympathetic N on enteric system is…

A

promote digestion

motility patterns, net fluid secretion, vasodilation, enteroendocrine cell degranulation

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31
Q

the main function of sympathetic N on enteric system is…

A

inhibit digestion and recover fluid volume

stop motility, increase net fluid absorption, vasoconstriction

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32
Q

what is the dominant extrinsic neural tone on GI tract?

A

parasympathetic

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33
Q

which animals are able to have the ENS operate WITHOUT CNS input?

A

monogastric animals

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34
Q

what type of innervation is done by vagus nerve?

A

parasympathetic

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35
Q

what GI does vagus nerve N?

A

abdominal viscera and pharyngeal mucosa

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36
Q

___ increases gut blood flow, motility, and glandular secretions

A

ACh

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37
Q

what type of N does splanchnic nerve supply?

A

sympathetic

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38
Q

splanchnic afferents carry info about…

A

distension of gut wall, noxious chemicals, inflammation

39
Q

splanchnic efferents tend to be ___ in nature

A

inhibitory

40
Q

____ decreases motility and glandular secretions

A

norepinephrine

41
Q

are GI endocrine cells concentrated into glands?

A

NO

42
Q

list the main GI hormones

A

gastrin
CCK
secretin
GIP
motilin
somatostatin

43
Q

gastrin is released by what type of cells, and where?

A

G cells
in pyloric antrum and duodenum

44
Q

gastrin release stimuli

A

food anticipation, stomach distension, protein/peptides in stomach

45
Q

gastrin inhibition is done via…

A

HCl, somatostatin, secretin, GIP

46
Q

gastrin 4 main functions

A
  1. stim K/H ATPase in parietal cells
  2. stim release of histamines from enterochromaffin-like cells to stim cAMP mediated insertion of K/H ATPase pumps into apical membrane of parietal cells
  3. gastric motility
  4. pancreas acinar cells
47
Q

how are K/H ATPase pumps added to the apical membrane of parietal cells?

A

gastrin causes release of histamine -> stim cAMP -> pump insertion

48
Q

somatostatin is released by what type of cell, and from where?

A

D cells - stomach
delta cells - endocrine pancreas
hypothalamus

49
Q

somatostatin release stimuli

A

very low pH in antrum
CCK

50
Q

somatostatin function

A

direct and indirect inhibition of gastric acid secretion

51
Q

explain the direct inhibition of gastric acid secretion done by somatostatin

A

inhibits adenylyl cyclase of parietal cells, which antagonizes stim effects on histamine

52
Q

explain the indirect inhibition of gastric acid secretion done by somatostatin

A

inhibit G cells, ECL cells, parietal cells

53
Q

how is somatostatin release blocked during the cephalic and gastric phase?

A

vagal stim

54
Q

how is somatostatin stimulated for release during the intestinal phase and between meals?

A

low pH in stomach and CCK

55
Q

which cells does somatostatin inhibit?

A

G cells
ECL cells

56
Q

secretin is released by which cell, where?

A

S cells in duodenum

57
Q

secretin release stimuli

A

fat and acid entry into duodenum

58
Q

secretin 2 functions

A
  1. pH regulation - promotes pancreatic and biliary bicarb secretion as well as bicarb release in duodenum epithelium cells
  2. reduce gastric acid secretion - block G cells
59
Q

CCK is released by what cell, where?

A

I cells
duodenal and jejunal mucosa
neurons in ileum and colon

60
Q

CCK release stimuli

A

fa/aa/peptide presence in chyme entering duodenum

61
Q

CCK inhibition

A

somatostatin

62
Q

CCK functions

A
  1. enzyme secretion from pancreas
  2. gallbladder contract to release bile
  3. activate D cells for somatostatin release
63
Q

GIP is released from which cell, where?

A

K cells
duodenal and jejunal mucosa

64
Q

GIP release stimuli

A

gls and fa in chyme entering duodenum

65
Q

glc injected into blood ___ followed by increased GIP activity

A

IS NOT

66
Q

injection of glc into SI results in ___ efficient disposal of glc

A

more

67
Q

GIP functions

A

inhibit parietal secretion
increase insulin release from endocrine pancreas

68
Q

motilin is released by which cell, where?

A

M cells
duodenal and jejunal mucosa

69
Q

motilin release stimuli

A

increasing pH in duodenum
spontaneous release into circulation during interdigestive phase

70
Q

motilin functions

A

increase gastric emptying
increase somatostatin release from pancreas

71
Q

erythromycin is a motilin receptor ___

A

agonsit

72
Q

erythromycin function

A

enhances gastric emptying and intradigestive migratory motor complex

73
Q

erythromycin side effects

A

D, abdomen pain, V

74
Q

the endocrine system helps coordinate functions of the ___ and ___

A

stomach and SI

75
Q

how do endocrine control systems affect salivary glands during cephalic phase?

A

parasympathetic stim of acinar and duct cells

76
Q

how do endocrine control systems affect gastric secretions during cephalic phase?

A

parasympathetic stim
ENS (Ach) stim G cells and parietal cells
G cells release gastrin into blood
gastrin finds receptors on parietal and chief cells

77
Q

how do endocrine control systems affect pancreatic secretions during cephalic phase?

A

ENS/ACh stim acinar and duct cells

78
Q

how do endocrine control systems affect salivary glands during gastric phase?

A

parasympathetic stim

79
Q

how do endocrine control systems affect gastric secretions/motility during gastric phase?

A

stomach is distended, so stretch receptors are stim
G cells (gastrin) stim and parietal cells are stim (more H+ into apical membrane)
elevate gastrin levels, since HCl secreted

*low pH will be perceived by G cells to cause inhibition when pH<2

histamine is also produced, stim HCl production and gastrin

80
Q

how do endocrine control systems affect pancreatic secretions during gastric phase?

A

ENS stim acinar and duct cells
gastrin acts on CCK receptors

81
Q

after meal ingestion, the process of ___ starts

A

gastric emptying

82
Q

arrival of nutrients into the duodenum triggers ___ feedback on emptying and ___ secretion of digestive enzymes

A

negative feedback
stim secretions

83
Q

how do endocrine control systems affect salivary glands during intestinal phase?

A

cease activity

84
Q

how do endocrine control systems affect gastric secretion/motility during intestinal phase?

A

duodenal distension and fat/protein in duodenum trigger CCK secretion, causing stomach to relax
CCK also stim D cells to release somatostatin

85
Q

how do endocrine control systems affect pancreatic secretions during intestinal phase?

A

ENS/ACh stim acinar AND duct cells
CCK/secretin stim acinar and duct cells

86
Q

during the intestinal phase, gastric secretions ___ due to neural and humoral control

A

decrease

87
Q

how does neural control inhibit gastric secretions during intestinal phase?

A

removes stimuli from stomach (pH and stretch)

88
Q

how does humoral control inhibit gastric secretions during intestinal phase?

A

somatostatin synthesized/released from D cells
D cells activated by gastrin and CCK
SOMATOSTATIN INHIBITS PARIETAL AND ECL CELL ACTIVITY

89
Q

how does endocrine control system affect secretions into GI tract during the interdigestive phase (stomach and SI empty)?

A

NO distension stimulus
reduced gastrin release
somatostatin inhibits gastric and pancreatic secretions, CCK release
motilin stim contraction of gut smooth muscle and interdigestive motility complex, mass movements

90
Q

what is gastrinoma?

A

rare neuroendocrine tumor
malignant transformation of somatostatin-secretind delta cells of endocrine pancreas into gastrin-producing cells

91
Q

what effect does gastrinoma have?

A

gastrin stim secretion of gastric acid
hypergastrinemia

92
Q

hypergastrinemia due to gastrinoma can lead to…

A

esophageal/gastroduodenal ulcers
enzymatic digestion in SI hampered due to increased acid delivery
antral hypertrophy delays gastric emptying
indigestion can cause weight loss/anorexia
D due to maldigestion

93
Q

treatment options for gastinoma

A

block H/K pump to improve stomach and duodenum conditions (heal ulcers)
somatostatin use to suppress gastrin secretions
surgery to remove tumor

Physiology III (18 decks)

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