oesophagus and stomach Flashcards
gastric gland: recall the structure and function of a typical gastric gland and its constituent cells (including mucous cells, parietal cells, chief cells, enteroendocrine cells and epithelial stem cells)
function of gastric pits
lead to multiple gastric glands which house functional secretory cells of stomach
what is present in gastric pits
mixture of cells responsible for secreting gastric juice
what is present in gastric juice
cocktail of HCl, enzymes, enzyme zymogens
3 other things cells in glands secrete
mucous, paracrine signalling molecules, hormones
fuction of mucous cells
secrete bicarbonate-rich mucosa to protect stomach lining
additional function of mucus lining
protect stomach lining from active lipase and protease (may interfere with bilayer and transmembrane proteins)
function of parietal cells
secrete HCl into stomach
normal state of parietal cells
quiescent (sleeping) state until activated; cytoplasmic tubulovesicles which contain H+/K+ ATPase; internal canaliculi which extend to apical surface (appear like empty reservoirs)
what happens when parietal cells are activated
tubovesicles in cytoplasm fuse with small invaginations on apical surface, making complicated canalicular surface, which has a high SA for HCl secretion
what is present in high abundance in parietal cells
mitochondria for membrane transport
3 functions of HCl
kill ingested pathogens, activate protease zymogens, alter protein structure to help digestion
what is intrinsic factor
glycoprotein essential for absorption of vitamin B12, secreted by parietal cells
what does intrinsic factor deficiency lead to
pernicious anaemia
function and structure of chief cells
produce protease zymogen (pepsinogen) and a lipase (gastric lipase); abundant rough ER; Golgi packaging and modifying for export
what activates pepsinogen to pepsin
HCl in gastric lumen
why is pepsinogen secreted as a precursor
prevent it auto digesting chief cells
function of pepsin
break dietary proteins into smaller peptide chains, autocatalysis back into pepsinogen
function of gastric lipase
digest fat by removing fattu acid from triglyceride molecule
what type of cells are G cells, and where in gastric pits are they located
enteroendocrine cells, bottom of gastric pits
function of G cells
release gastrin hormone into bloodstream
3 stimuli for secretion of gastrin hormone
vagus nerve stimulation, presence of peptides in stomach, stomach distension
function of gastrin in stomach
stimulates gastric secretion and motility, leading to stronger contractions and the opening of pyloric sphincter to move food into duodenum
function of gastrin in pancreas and gallbladder
increases secretion of pancreatic juice and bile
what type of cell are enterochromaffin-like cells (ECL), and where are they located in the gastric glands
neuroendocrine cell deep in gastric gland, in vicinity of parietal cells
function of enterochromaffin-like cells (ECL)
secrete histamine from chromaffin cells (lamina propia), stimulating secretion of acid from parietal cells
what type of cell are D-cells
enteroendocrine cells
function of D-cells
secrete somatostatin, having an inhibitory effect on gastrointestinal function
function of D-cells in gastric gland
inhibits ECL production of histamine and parietal cell activity, inhibiting HCl secretion
function of gastric stem cells
pluripotent so capable of differentiating into all cells of stomach under influence of different factors
2 exocrine cells of stomach
parietal, chief
production of HCl in parietal cells
CO2 diffuses in down gradient → combined with water in presence of carbonic anyhdrase → forms carbonic acid → dissociates into bicarbonate and H+ → exchange of bicarbonate for Cl- interstitial space → Cl- move down gradient into stomach lumen via Cl- channels → Na+/K+ exchanger in basolateral membrane and Cl- channels in apical membrane allow H+ to be pumped into lumen → K+ pumped into cell in exchange for H+ → K+ re-enters lumen → secreted H+ combines with Cl- to form HCl
what do chief cells store pepsinogen in
masses of apical secretion granules until stimulated to exocytose
three phases of stomach activity
cephalic (stimulatory), gastric (stimulatory), intestinal (inhibitory)
afferents of cephalic phase
sight, smell, taste, thought of food
efferents of cephalic phase
vagus nerve produces acetylcholine which stimulates histamine, switching on HCl production (stimulate secretion from mucous, chief, parietal and G-cells via submucosal plexus)
effects of cephalic phase
small secretion for a few minutes
afferents of gastric phase
distension of stomach and chemoreception of nutrients and reduced pH which stimulate local nerves
efferents of gastric phase
vagus nerve stimulate secretion from mucous, chief, parietal and G-cells via submucosal plexus and increase motility via myenteric plexus, releasing more mucus, acid and pepsin
effect of gastric phase
3-4 hours gastric activity (secretion of acid, enzymes and hormones) and mechanical digestion
afferents of intestinal phase
duodenal stretch and chemodetection of reduced pH, duodenal distension and chemical constituents
efferents of intestinal phase
enterogastrine reflex: I-cells secrete cholecystokinin (CCK) and S-cells secrete secretin into blood, decreasing parietal cells secretion and inhibiting gastric motility and emptying; stretch receptors input into enteric nervous system, reducing stomach activation; gastric inhibitory peptide also released
effect of intestinal phase
gastric emptying slows fown allowing downstream organs to deal with current contents
how does reduced intrinsic factor lead to pernicious anaemia
unable to absorb adequate vitamin B12, which limits erythropoiesis
intestinal phase (excitatory component)
dependent on protein concentration of duodenum - if protein concentration high, stomach hasn’t effectively broken down proteins, so gastrin secretion to stimulate acid secretion
what to drugs interfere with to decrease acid secretion
acetylcholine, histamine, gastrin; target acid producing machinery in parietal cells (e.g. carbonic anhydrase)
what does omeprazole inhibit
H+/K+ exchange
how does ranitidine work
histamine antagonist