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GI II > Phys review > Flashcards

Phys review Flashcards

1
Q

mucosa layers

A

epithelium
lamina propria
muscularis mucosa

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2
Q

lamina propria

A

layer of CT which contains glands, hormone-containing cells, lymph nodes, and capillaries

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3
Q

submucosa

A

a layer of CT that contains glands, large vessels, and lymphatics
outermost region has Meissner’s plexus

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4
Q

Meissner’s plexus

A

in submucosa

part of ENS and involved in secretory activity

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5
Q

musclarisexterna

A

inner layer of circular mm
outer layer of longitudinal mm
myenteric nn plexus btwn layers

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6
Q

serosa

A

outermost layer of GI tract
consists of CT and layer of epi
w/in this layer autonomic nn run and synpase of target cells and ENS plexuses

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7
Q

NE

A

sympathetic
decreases motility and secretion
increases constriction of sphincter

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8
Q

ACh

A

increased motility and secretions

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9
Q

VIP

A

decreased constriction of sphincter

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10
Q

GRP

A

increases gastrin

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11
Q

secretin

A

from S cells lining duodenum
stimulated by acid entering duodenum
inhibits stomach motility and secretion
stimulates HCO3 secretion from pancreas

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12
Q

CCK

A

from cells lining duodenum
stimulated by fat and aa entering duodenum
inhibits emptying
stimulates pancreatic enzyme secretion
causing contraction of gallbladder and relaxation of sphincter

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13
Q

GIP

A

from duodenum
stimualted by fat, CHO, aa
inhibits stomach motility and secretion

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14
Q

events of swallowing

A 
relaxation of UES
primary peristalitic wave
relaxation of LES via VIP
relaxation of proximal stomach
if primary perstaltic wave not sufficient local distention will initiate a second
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15
Q

achalasia

A

LES fails to relax due to abnormalities of ENS
primary pertalsis in esophgeal body poor
pressure wave is weak and resting pressure in LES is high

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16
Q

sclerederma

A

may present w/reflux due to inadequate LES tone

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17
Q

stimulation of gastric motility

A

parasympathetics ( Ach and gastin)

local distension

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18
Q

inhibition of gastric motility

A

low pH inhibits relase of gastrin

feedback from duodenal overload (neuronal and hormonal)

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19
Q

stomach emptying rate

A

liquids > CHO > proteins > fat

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20
Q

what will slow gastric emptying

A

CCK
GIP
Secretin
all by increasing pyloric constriction

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21
Q

ileocecal sphincter

A

usually closed
distention of ileum relaxes it
distention of colon constricts it

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22
Q

haustrations

A

bulges along colon due to segmental contractions

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23
Q

mass movements

A

of colon
propulsive
more prolonged then peristaltic movements of small intestine

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24
Q

MMC

A 
migrating myoenteric complex
propulsive movement initiated during fasting which begins in stomach
repeats every 90-120 min during fasting
correlated w/high levels of motilin
prevents back flow of bacteria
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25
Q

defecation

A

reflex involving CNS

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26
Q

parotid secretions

A

entirely serous

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27
Q

submandibular and sublingual secretions

A

mixed serous and mucous

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28
Q

salivary secretions

A

under parasympathetic control

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29
Q

saliva production

A

initial formation in acinus via indirect Cl pump (powered by Na/K ATPase)
initially fluid is isotonic, then NaCl reabsorbed so final solution is hypotonic

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30
Q

composition of salivary secretions

A 
low in Na and Cl
high in K and HCO3 
pH =8
alpha-amylase
mucus, glycoproteins
immunoglobulins and lysozymes
low tonicity
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31
Q

gastric secretions

A

epi cells covering gastric mucosa secrete highly viscous alkaline fluid
pH = 1

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32
Q

NSAIDS

A

decrease secretion of mucin and bicarb

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33
Q

parietal cells

A

HCL

IF

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34
Q

Chief cells

A

pepsinogen is converted to pepsin by HCL
pepsin is active only in acid pH
pepsin digests proteins to peptides

35
Q

mucus neck cells

A

mucus and bicarb

36
Q

ionic composistion of gastric secretions

A

high in H, K, Cl
low in Na
greater secretion rate higher H and lower Na

37
Q

stimulation of acid secretion

A 
Ach
histamine (locally released)
gastrin
distention of stomach 
these also stimulate chief cells
38
Q

inhibition of acid secretion

A

pH of stomach decreases to 2.0

negative feed back

39
Q

cellular mechanism of acid secretion

A
  • parietal cells extracts CO2 from aa
    -in cell carbonic anhydrase convertes water and CO2 to H and HCO3
    -H pumped across apical membrane creating gradient for HCO3 to flow down across the basal membrane
    Cl diffuses across apical membrane
    vv blood leaves alkaline
40
Q

pancreatic secretions

A

acini and ducts similar to salivary glands

primarily under influence of secretin and CCK

41
Q

stimulation of pancreatic secretions

A

cholinergic nn to pancreas stimulate secretion of both enzymes and aqueous components
stretch receptors in stomach

42
Q

inhibition of pancreatic secretions

A

sympathetics

43
Q

enzymatic components of pancreatic secretions

A

trypsin inhibitors present in pancreatic secretions prevent activation of proteases in pancreas

44
Q

pancreatic amylases

A

secreted as active enzymes
hydrolyze alpha 1,4 glucoside linkage of CHO -> alpha limited dextrins, maltotriose (trisaccharide), and maltose (disaccharide)
CANNOT hydrolyze beta linkages of cellulose

45
Q

pancreatic lipases

A

secreted as active enzymes
needs colipase to be effective
digest into 2 FFAs and one monoglyceride

46
Q

cholesterol esterase

A

hydrolyzes cholesterol esters to yield cholesterol and FAs

47
Q

pancreatic proteases

A

secreted as zymogens
trypsinogen activated by enterokinase to trypsin
chymotrypsinogen activated by trypsin to chymotrypsin
procarboxypeptidase activated by trypsin to carboxypeptidase

48
Q

enterokinase

A

secreted by lining of small intestines, not a BBE

49
Q

fluid and electrolyte components of pancreatic secretions

A

aqueous components from epi cells lining ducts
fluid is isotonic
HCO3 and Cl concentration vary reciprocally: high flow high bicarb and low Cl
HCO3 active transport into lumen
Cl via ClCh (broken in CF)

50
Q

primary bile acids

A

known as cholic acid and chenodeoxycholic acid

synthesized by liver from chlesterol

51
Q

conjugated bile

A 
conjugated with glycine
water soluble 
ionized at neutral pH 
aka bile salts
secreted by liver
52
Q

secondary bile acids

A

formed by deconjugation and dehydroxylation of primary bile salts by intestinal bacteria -> deoxycholic acid and lithocholic acid

53
Q

lithocholic acid

A

hepatotoxic

excreted

54
Q

micelle formation

A

when bile salts become concentrated

water soluble spheres with a lipid soluble materials in aqueous medium of bile fluid and small intestines

55
Q

micelle function

A

vital for digestion, transport, and absorption of fluid soluble substances from duodenum to distal ileum
in distal ileum bile salts actively reabsorbed and recycled

56
Q

stercobilin

A

produced from metabolism of bilirubin by intestinal bacteria
brown color of stool

57
Q

control of bile secretion and gallbladder contraction

A

secretin causes secretion of HCO3 and fluid
secretion of bile from liver due to concentration gradient
CCK causes gallbladder contraction and sphincter relaxation

58
Q

small intestine

A

most prominent feature is villi
surface of epi have microvilli
water and electrolyte reabsorption greatest at villus tip
water and electrolyte secretion from bottom of crypts of lieberkuhn

59
Q

crypt secretion

A

Na-K-Cl transporter in basolateral membrane (Na down its gradient)
elevated Cl and neg intracellular potential drives Cl thru apical membrane
luminal Cl pulls water, Na and other ions

60
Q

Cholera toxin

A

activates apical ClCh increasing water and electrolyte secretion
countered by glucose solution

61
Q

triglycerides in stomach

A

fatty material pulverized to decrease size and increase surface area

62
Q

triglycerides in small intestines

A

bile micelles emulsify fat and pnacreatic lipase digest it

63
Q

triglyceride general

A

micelles and pancreatic lipases required for digestion

end products are 2-monoglycerides and fatty

64
Q

CHO mouth

A

salivary amylase begins digestion and conitnues in stomach

65
Q

CHO small intestines

A

pancreatic amylase required
hydrolysis of starch mostly in duodenum
BBE

66
Q

BBE for CHO

A

splitting of tri, di, and oligosaccharides
alpha-dextrinase, isomaltase, maltase
highest activity in jejunum
necessary b/c disaccharides cannot be absorbed

67
Q

alpha-dextrinase

A

aka alpha-glucoamylase

cleaves terminal alpha 1.4 bonds -> free glucose

68
Q

lactase

A

hydrolyzes lactose -> glucose and galactose

69
Q

sucrase

A

sucrose -> glucose and fructose

70
Q

maltase

A

maltose and maltortirose -> glucose

71
Q

proteins stomach

A

pepsin begins digestion, but not essential

72
Q

proteins small intestines

A

digestion continues w/pancreatic proteases (trypsin, chymotrypsin, elastase, caboxypeptidases
digestion completed by BBE dipeptidase, tripeptidases and aminopeptidases -> aa, dipeptides and tripeptides

73
Q

carbohydrate absoption

A

luminal membrane: glucose and galactose are actively absorbed linked to Na
fructose absorbed independently by facilitated diffusion
basal membrane: monosacchardies are absorbed passively via facilitated diffusion

74
Q

protein absoption

A

luminal membrane: aa transported by secondary active transport linked to Na, small peptides by Na-H antiporter
basal membrane: simple diffusion and protein mediated transport

75
Q

lipid absorption

A

micelles diffuse across BB- rate limiting step

in mucosal cells triglycerides resynthesized to form chylomicrons which leave via lymphatics

76
Q

electrolytes duodenum

A

hypertonic fluid enters becoming isotonic
most divalent ions and water soluble vitamins begins here and continues thru small intestines
igested Fe and Ca form insoluble salts
acid environment of stomach dissolves them and allows them to be absorbed in duodenum
Fe2+ only can be absorbed in duodenum

77
Q

electrolytes jejunum

A

net absorption of water and electrolytes

identical to cells lining nephron proximal tubule

78
Q

ileum electroyltes

A

reabsorption of water, Na, Cl, K, continues with secretion of HCO3
distal ileum biel alts and IF w/B12 absorbed

79
Q

colon and electrolyes

A

no digestive enzymes or proteins transporters
only limited resorption of water NaCl
target for aldosterone to increase resorption of Na, water, and secretion of K

80
Q

secretory diarrhea

A

oversecretion of fluid and electrolytes

cholera toxins

81
Q

malabsorptive diarrhea

A

improper absoprtion of nutrients -> osmotic effect

celiac disease and lactose intolerance

82
Q

executive disease

A

mucosal destruction causes output of purulent bloody stool

83
Q

hyperactivity of intestines

A

accelerated movement water cannot be reabsorbed

IBD

GI II (2 decks)

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