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Medical Phys II > Normal GI > Flashcards

Normal GI Flashcards

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USMLE® Step 1 flashcards
1
Q

What is segmentation?

A

using smooth muscle to squeeze apart food particles and mix them with surrounding material

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2
Q

Where does segmentation take place?

A

Small intestine

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3
Q

What type of digestion is segmentation?

A

Mechanical

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4
Q

What are the two types of nerve plexuses in the GI tract?

A

Short (enteric)

Long (CNS involvement)

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5
Q

What are the three layers of the mucosa?

A

Epithelium
Lamina propria
Muscularis mucosae

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6
Q

What is found in the submucosa?

A

Blood vessels, lymph, nerves

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7
Q

What does the submucosa do?

A

Allows GI tract to expand

Differentiates parts of the small intestine

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8
Q

What is the makeup of the muscularis layer?

A

2 layers

Inner circular, outer longitudinal

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9
Q

What are the four layers of the alimentary canal?

A

Mucosa
Submucosa
Muscularis
Serosa or Adventitia

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10
Q

What determine if a layer will be covered by serosa or adventitia?

A

Esophagus, rectal canal, parts of retroperitoneal are covered by adventitia- rest of structures by serosa

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11
Q

What are the two major intrinsic plexuses?

A

Submucosal nerve plexus

Myenteric nerve plexus

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12
Q

What do salivary glands do?

A

Clean mouth, taste, moisten food, chemical breakdown of starch (most are extrinsic)

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13
Q

What are intrinsic salivary glands?

A

Buccal

Keep mouth moist

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14
Q

How are extrinsic salivary glands described?

A

Paired, compound, tubuloalveolar glands

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15
Q

What are the three extrinsic salivary glands?

A

Parotid glands
Submandibular glands
Sublingual glands

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16
Q

What are the two phases of deglutition?

A

Buccal phase

Pharyngeal-esophageal phase

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17
Q

Where is the swallowing center located?

A

Medulla and pons

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18
Q

What cell types if mainly found in the stomach in gastric pits?

A

Goblet cells

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19
Q

What layer of the mucosa is scant in the stomach?

A

Lamina

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20
Q

What type cell in the gastric gland cells produce intrinsic factor?

A

Parietal cells

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21
Q

What do chief cells produce?

A

Pepsin

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22
Q

What extra layer is added to the muscularis in the stomach?

A

Inner oblique layer

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23
Q

What is the only enzymatic digestion that occurs in the stomach?

A

Protein degradation

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24
Q

What is rennin

A

Digests casein in infants

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25
Q

What is pepsin?

A

Protein digesting enzyme

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26
Q

What does protein degradation denature?

A

HCl

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27
Q

What does gastrin do?

A

Stimtulates secretion of enzymes, HCl & other hormones

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28
Q

What are the three phases of gastric secretion?

A

Cephalic (reflex)
Gastric
Intestinal

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29
Q

What triggers the cephalic phase in gastric secretion?

A

Aroma, taste, sight or thought of food

Conditioned reflex

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30
Q

What does the cephalic phase of gastric secretion do?

A

Prepares stomach for digestion

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31
Q

What happens during the gastric phase of gastric secretion?

A

Distention- stimulates stretch receptors
Causes impulses to medulla along vagus
Gastrin stimulates HCl production

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32
Q

When does the intestinal phase of gastric secretion starts?

A

When food enters small intestine

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33
Q

What is the excitatory subphase of intestinal secretion?

A

Presence of acidic chyme in small intestine causes intestine to release gastrin- stimulates gastric glands to produce even more HCl

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34
Q

What are the two subphases of the intestinal phase?

A

Excitatory subphase

Inhibitory subphase

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35
Q

What sets peristalic wave rate in the stomach?

A

Pacemaker cells

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36
Q

How much chyme enters the small intestine at a time?

A

3 ml

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37
Q

What are the three surface area modifications in the small intestine?

A

Plicae circularis
Villi
Microvilli

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38
Q

What do the plicae circularis do/ where are they found?

A

Slow chyme and mix with digestive juices
Cork-screwed shaped
Found in duodenum

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39
Q

What do the villi look like?

A

Finger like projections

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40
Q

What is found in villli?

A

Lamina propria
Capillary bed
lacteal (lymph cell for fat)

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41
Q

What is microvilli?

A 
Brush border (+ their enzymes) 
Increases surface area
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42
Q

Where are paneth cells found?

A

interstinal crypts

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43
Q

What do Paneth cells do?

A

Secrete lysozyme

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44
Q

What does bile do?

A

Emulsifies fats- facilitates digestion (makes fat water soluble)

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45
Q

What works with the gallbladder to produce and store bile

A

Liver

46
Q

What are the three vessels at the portal triad?

A

hepatic arteriole
portal venule
bile duct
(there will also be lymph)

47
Q

What is the main function of the hepatocytes?

A

Form bile

48
Q

What do hepatocytes do with glucose?

A

Store and release it

49
Q

What other things does the liver store?

A

Fat-soluble vitamins

Amino acids

50
Q

what are the cells that are macrophages in liver sinusoids?

A

Kupffer’s Cells

51
Q

How is bilirubin formed?

A

From heme; happens in liver

52
Q

What happens to the bilirubin in the small intestine?

A

Converted in small intestine to urobilinogen- brown pigment

53
Q

what do bile salts do?

A

Emulsify fats in small intestine (reabsorbed in ilium for resection)

54
Q

What layer of the alimentary canal is areolar tissues covered with mesothelium?

A

Serosa

55
Q

What layer of the alimentary canal is fibrous connective tissue that blends with surrounding structure? What does it cover

A

Adventitia

Esophagus, rectal canal, parts of retroperitoneal

56
Q

What does the submucosal nerve plexus control?

A

Glands and secretions of submucosa

57
Q

What does the myenteric nerve plexus control?

A

Muscles of muscularis

58
Q

What is found in saliva?

A

Salivary amylas, lysozyme, IgA, metabolic wastes, mucin

59
Q

Does any absorption take place in the mouth, pharynx or esophagus?

A

No

60
Q

What enables chemical digestions in the mouth?

A

salivary amylase

61
Q

What are the four types of gastric gland cells?

A

Mucous neck cells
Parietal cells
Chief cells
Enteroendocrine cells

62
Q

What is the purpose of the inhibitory subphase of the intestinal phase?

A

Protects small intestine from acidic chyme
Inhibition of gastric gland secretion
Pyloric sphincter tightens

63
Q

In the small intestines, what type (histology) cells are in the mucosa layer?

A

Simple columnar cells

64
Q

What type of cells are found in the mucosa in the small intestine?

A

Absorptive cells
goblet cells
enteroendocrine cells
T cells

65
Q

What are most enzymes in the small intestine associated with?

A

Brush border

66
Q

What emulsifies fats and facilitates digestion?

A

Bile

67
Q

What is in the center of each liver lobule?

A

Central vein, blood travels here over hepatocytes through sinusoids

68
Q

What is bile released into for transport to the triad?

A

Canaliculi

69
Q

What does the liver store?

A

Glucose, fat-soluble vitamins, amino acids

70
Q

What are macrophages that live in liver sinusoids?

A

Kupffer’s Cells

71
Q

What do Kuppfer’s Cells do?

A

Remove bacteria and worn RBCs

72
Q

What is bilirubin converted to in the small intestine

A

Urobilinogen (brown pigment)

73
Q

What does cholecystokinin cause?

A

The gallbladder to contract and stimulate secretion of pancreatic enzymes

74
Q

What does secretin trigger?

A

The liver to make more bile

pancreatic production of bicarbonate

75
Q

What are the endocrine islands in the pancreas?

A

Islets of Langerhans

76
Q

What are the exocrine portion of the pancreas?

A

Acinar tissue

77
Q

What is produced in the Islets of Langerhans?

A

Insulin
Glucagon
Somatostatin

78
Q

What is produced in the acinar tissue?

A

Enzymes

Bicarbonate ions

79
Q

What are these:
Trysinogen
Procarboxypeptidase
Chymotripsinogen

A

Proteases produced by the pancreas.

Turn into active form when they reach the small intestine

80
Q

What produces gas and acidity in the large intestine?

A

Ferment undigestible carbs

81
Q

What vitamins are synthesized in the large intestine?

A

B complex and K vitamins

82
Q

What are the two types of the propulsions that happen in the large intestine?

A

Haustral contraction

Mass movements

83
Q

What is absorbed in the large intestine

A

Mainly water

ions, vitamins

84
Q

What is enzymatic hydrolysis?

A

“split with water”

catabolic process where complex molecules are broken into simple molecules

85
Q

What are the three type of carbohydrate monomoers

A

Glucose
Galactose
Fructose

86
Q

Where does carbohydrate digestion occurs?

A

Mouth and small intestine

87
Q

How does fructose cross barriers to get reabsorbed?

A

Facilitated diffusion

88
Q

What is the only type of nutrient that is digested in the stomach?

A

Protein

89
Q

These are all _____ enzymes
Trypsin
Chymotrypsin
Carboxypeptidase

A

pancreatic

90
Q

These are all ____ enzymes
Aminopeptidase
Carboxypeptidase
Dipeptidase

A

Brush border

91
Q

What cleaves between tyrosine and phenylalanine?

A

Pepsin

92
Q

What digests casein (infants only)?

A

Rennin

93
Q

What hydrolyzes aa one at a time from the C terminus?

A

Carboxypeptidase

94
Q

What do these two enzymes do:
aminopeptidase
Dipeptidase

A

Liberate final aa products

95
Q

What does lipase do?

A

Produces two free fatty acid and monoglyceride

96
Q

Where are bile salts absorbed?

A

Ileum of small intestine

97
Q

What is the main form of absorption

A

Active transport

98
Q

In transepithelial transport, uptake occurs on the ____ side, exocytose occurs on the ____ side

A

Apical

Basal

99
Q

Whole proteins are only absorbed in ____

A

infants

100
Q

What is a collection of fatty elements and bile salts?

A

Micelle

101
Q

Where do micelles break apart in order to be absorbed?

A

Near apical surface then lipid diffuse into epithelial cell

102
Q

What is produced in the cytoplasm of epithelium cell when triglycerides combine with phospholipids and cholesterol

A

Chylomicrons

103
Q

What hydrolyzes triglycerides in capillaries?

A

Lipoprotein lipase

104
Q

Does fat go through the liver?

A

No, enter lymph system via lacteals

105
Q

How are fat soluble vitamins absorbed?

A

Incorporated into micelles

106
Q

Where is iron and calcium absorption limited to?

A

Duodenum

107
Q

How is sodium absorbed?

A

Coupled to cotransport of glucose and amino acids

108
Q

What are chloride ions actively transported in exchange for?

A

Bicarbonate

109
Q

How are potassium ions reabsorbed?

A

Vita simple diffusion (osmotic gradients)

110
Q

Where is iron actively transported into?

A

Mucosa cells

111
Q

What is calcium locally regulated by?

A

Vitamin D

112
Q

What is water uptake coupled to?

A

Sodium uptake

Medical Phys II (16 decks)

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