Physio Pre ICA Flashcards

1
Q

What does the lower oesophageal sphincter do?

A

It relaxes to accommodate the bolus.
It protects against gastroesophageal reflux.

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2
Q

What does the fundus of the stomach do?

A

It produces HCL, pepsinogen, intrinsic factor, and lipase.

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3
Q

What does the antrum of the stomach do?

A

It produces peptide hormone gastrin and is involved in the mixing and grinding of chyme

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4
Q

What does the parietal cells in the gastric gland secrete?

A

Acid and intrinsic factor.

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5
Q

What does the ECL cells in the gastric gland secrete?

A

Histamine.

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6
Q

What does the chief cells in the gastric gland secrete?

A

Pepsinogen.

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7
Q

After meal stimulation, what is the ionic change that happens in the gastric juice?

A

Increase in chloride and hydrogen ion. (HCL)
Decrease in potassium, sodium, and bicarbonate.

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8
Q

Hydrochloric acid is hypotonic or isotonic?

A

Isotonic.

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9
Q

The tubulo-vesicles of the parietal cell are stimulated by which hormones?

A

Acetylcholine and histamine.

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10
Q

What happens when the tubulo-vesicles fuse into secretory canaliculi?

A

They pump hydrochloric acid out of the cell and into the gastric gland/lumen of the stomach.

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11
Q

What does carbonic anhydrase release during parietal secretion?

A

It releases carbonic acid from water and carbon dioxide.

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12
Q

What happens when the carbonic acid dissociates during parietal secretion?

A

The hydrogen leaves in exchange for potassium.
The bicarbonate leaves, and the urine becomes alkaline because of the bicarbonate.

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13
Q

What does acetylcholine stimulate in motor neurones?

A

The release of pepsinogen from chief cells.
The release of histamine from ECL cells.
The release of HCL from parietal cells.

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14
Q

What does the cholinergic (GRP) stimulate during vagal outflow?

A

The release of gastrin from G cells.

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15
Q

What are the three factors that stimulate gastric secretion?

A

The hormone gastrin, Histamine, and acetylcholine.

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16
Q

From which type of cells is gastrin secreted?

A

Antral G cells.

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17
Q

When gastrin is secreted, how does it stimulate acid secretion?

A

Gastrin stimulates the release of histamine from ECL cells. Histamine stimulates acid secretion.

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18
Q

If the body wants to prevent overstimulation of gastric acid, which hormone does it produce?

A

Somatostatin.

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19
Q

Somatostatin comes from which type of cells?

A

D cells.

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20
Q

Somatostatin blocks which hormone?

A

It blocks the secretion of gastrin.

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21
Q

What happens when low antral pH is low?

A

Somatostatin is released.

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22
Q

What is glycoprotein mucin?

A

It is the most important part of mucus. It is hydrolysed by pepsin.

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23
Q

How is pepsin formed in the gastric juice?

A

Low pH causes the cleavage of pepsinogen into pepsin.

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24
Q

What is the importance of intrinsic factor?

A

It helps absorb vitamin B12.

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25
Q

What does vitamin B12 bind to when ingested?

A

Haptocorin.

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26
Q

What happens when haptocorin is released from vitamin B12?

A

Vitamin B12 bind to intrinsic factor.

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27
Q

What happens when parietal cells stop functioning?

A

Malabsorption of vitamin B12. (also happens in destruction of terminal ileum)

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28
Q

What are the interstitial cells of cajal?

A

They are the pacemaker cells for generation of slow waves.

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29
Q

Gastric emptying is faster for liquid meals or solid meals?

A

Liquid meals.

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30
Q

Why must we chew food?

A

Because some foods have a cellulose membrane.

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31
Q

Chewing muscles are innervated by which nerve?

A

Trigeminal.

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32
Q

What are the three salivary glands?

A

Parotid, sublingual and submandibular

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33
Q

What does the parotid gland do?

A

It is a serous only and is high in amylase.

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34
Q

What does the sublingual and the submandibular glands do?

A

Secrete both mucus and serous.

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35
Q

What does the von ebner gland do?

A

Secrete serous and is high in lipase.

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36
Q

What does the buccal gland do?

A

Secretes mucus only.

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37
Q

Saliva is hypotonic or isotonic?

A

Hypotonic.

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38
Q

Which ions are high in saliva?

A

Potassium and Bicarbonate.

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39
Q

What ions are low in saliva?

A

Chloride and Sodium.

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40
Q

What is another name of pancreatic islets?

A

Islets of langerhans.

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41
Q

What are ions that are high in plasma?

A

Chloride and Sodium.

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42
Q

What are ions that are low in plasma?

A

Potassium and Bicarbonate.

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43
Q

Why does tonicity of saliva increase with flow rate?

A

It becomes hypotonic because chloride gets reabsorbed from the saliva and into the duct.

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44
Q

What ions are high and low in the acini?

A

High - Chloride and Sodium.
Low - Potassium and bicarbonate.

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45
Q

What makes the saliva alkaline?

A

Bicarbonate.

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46
Q

What ions are the ducts in the saliva rich in?

A

Potassium and Bicarbonate.

47
Q

What is the function of the constituent mucin?

A

Lubrication.

48
Q

What is the function of the constituent lipase?

A

Fat digestion.

49
Q

What is the function of the constituent amylase?

A

Starch digestion.

50
Q

What is the function of the constituent IgA?

A

Immune protection.

51
Q

What is the function of the constituent growth factor?

A

Wound healing.

52
Q

What is the function of the constituent lysozyme?

A

Antibacterial.

53
Q

What is the propulsive role of the upper oesophageal sphincter?

A

Relaxes to allow food to enter the oesophagus.

54
Q

What is the propulsive role of the lower oesophageal sphincter?

A

Relaxes to allow the bolus to enter the stomach.

55
Q

What is the protective role of the upper oesophageal sphincter?

A

Protects airway from swallowed material.

56
Q

What is the protective role of the lower oesophageal sphincter?

A

Protects oesophagus from acid reflux.

57
Q

Which neurotransmitters stimulate the contraction of circular muscle layer in the oesophageal wall?

A

Acetylcholine and Substance P.

58
Q

Which neurotransmitter relaxes the longitudinal muscle layer in the oesophageal wall?

A

Nitric oxide and maybe VIP.

59
Q

What triggers the relaxation of the lower oesophageal sphincter?

A

Nitric oxide, VIP, CCK, and gastrin.

60
Q

What causes the contraction of the circular muscle layer above the bolus?

A

The production of acetylcholine and substance P.

61
Q

What causes the relaxation of the circular muscle layer below the bolus?

A

Nitric oxide and VIP.

62
Q

What causes the relaxation of longitudinal muscle layer above the bolus?

A

The release of nitric oxide and VIP.

63
Q

What causes the contraction of the longitudinal muscle layer below the bolus?

A

Acetylcholine and substance P.

64
Q

Why is ischemic injury more likely in the mucosa of the gut wall?

A

Because blood flows through the muscularis and submucosal layers before it reaches the mucosa, oxygen content is normally low in the villi

65
Q

What are examples of mediators in the endocrine mechanism of the GIT?

A

CCK, Secretin, Gastrin.

66
Q

What are examples of mediators in the neurocrine mechanism in the GIT?

A

Acetylcholine, VIP, GRP.

67
Q

What are examples of mediators in the paracrine mechanism of the GIT?

A

5HTP, Somatostatin, Histamine.

68
Q

What is the function of the hormone gastrin in the GIT?

A

Stimulates the release of gastric acid pepsinogen from the stomach.

69
Q

What is the function of the hormone CCK in the GIT?

A

Stimulates the release of bile from the gallbladder and pancreatic enzymes from the pancreas. It also helps to slow down gastric emptying.

70
Q

What is the function of the hormone secretin in the GIT?

A

Stimulates the release of bicarbonate from the pancreas and bile from the liver. It also helps to neutralize stomach acid

71
Q

What is the function of the hormone GLP-1 and GIP in the GIT?

A

Stimulates the release of insulin from the pancreas and helps to regulate blood sugar levels. It also slows down gastric emptying and increases satiety.

72
Q

What is the function of the hormone motilin in the GIT?

A

Stimulates the contraction of the muscles in the small intestine, which helps to move food through the digestive system.

73
Q

What is the function of the hormone somatostatin in the GIT?

A

Inhibits the release of several other gastrointestinal hormones, including gastrin, CCK, secretin, and GIP.

74
Q

What is the function of the hormone ghrelin in the GIT?

A

Stimulates appetite and helps to regulate energy balance.

75
Q

What is the function of the hormone PYY in the GIT?

A

Inhibits appetite and helps to regulate blood sugar levels

76
Q

Pancreatic and biliary secretion are stimulated by what in the duodenal response?

A

Secretin.

77
Q

Why add bicarbonate into the lumen of the duodenum?

A

To neutralize gastric acid.

78
Q

What does CCK stimulate the secretion of in the liver?

A

The secretion of bile.

79
Q

The bicarbonate then leaves out the luminal side of the pancreatic ductal cell in exchange for what?

A

Chloride.

80
Q

The hydrogen ion leaves the pancreatic ductal cell into the bloodstream in exchange for what?

A

Sodium.

81
Q

Where does the pancreatic ductal cell get bicarbonate from?

A

Production of carbonic acid from CO2 and H2O, in the presence of ATP carbonic anhydrase produces carbonic acid, which then dissociates.

82
Q

Why is pancreatic juice alkaline?

A

Because of bicarbonate secretion and chloride absorption.

83
Q

What ions are in high concentrations in pancreatic juice?

A

Bicarbonate and Sodium.

84
Q

Why is secretin secreted into the duodenal mucosa by S cells?

A

Secretin is stimulated by the low pH, it triggers the release of bicarbonate from the pancreatic ducts.

85
Q

Which produces more secretin, meal or IV?

A

Meal.

86
Q

If you combine secretin with CCK, what will happen?

A

A dramatic increase in secretin production.

87
Q

Does CCK stimulate the release of secretin?

A

No.

88
Q

If you combine acetylcholine with bicarbonate, what will happen?

A

A dramatic increase in bicarbonate.

89
Q

What is the release of CCK stimulated by?

A

Amino acids, fatty acids, little polypeptide.

90
Q

What causes relaxation of sphincter of Oddi?

A

VIP and NO.

91
Q

What does the pancreatic ganglia produce to stimulate acinar cell secretion?

A

GRP, Ach, VIP.

92
Q

Which hormones are responsible for the incretin effect?

A

GIP & GLP-1.

93
Q

When are GIP & GLP-1 released?

A

When the glucose levels are high. This prevents hypoglycaemia.

94
Q

Which hormone increases the volume of bile?

A

Secretin.

95
Q

What keeps the cholesterol soluble?

A

Lecithin, bile salts, and high pH.

96
Q

Where does bile salts reabsorption happen?

A

Ileum.

97
Q

What is absorbed in ileum?

A

Vitamin B12.

98
Q

CCK stimulates what?

A

Gall bladder contraction and sphincter of oddi relaxation.

99
Q

What hormones are secreted in the upper small intestine?

A

Bicarbonate, CCK, and secretin.

100
Q

Where would digestion and absorption normally occur in the small intestine?

A

In the upper small intestine.

101
Q

What can be absorbed in the upper small intestine?

A

Calcium and iron.

102
Q

At which phase would peristalsis occur in the small intestine?

A

The interdigestive phase.

103
Q

At which phase would segmentation occur in the small intestine?

A

The digestive phase.

104
Q

Which hormones are absorbed in the distal small intestine?

A

Vitamin B12 and Bile salts.

105
Q

What would the distal small intestine secrete?

A

PYY and GLP.

106
Q

Which hormone stimulates the migrating motor complex?

A

Motilin.

107
Q

Which hormones contribute to motilin suppression?

A

CCK and GIP.

108
Q

What stimulates the muscularis mucosae?

A

The submucosal plexus.

109
Q

What do the crypts of luberkuhn secrete?

A

Chloride and bicarbonate.

110
Q

Where would digestion and absorption occur in the intestinal villi?

A

At the tip of the villi.

111
Q

Where would secretion occur in the intestinal villi?

A

At the base of the villi.

112
Q

What stimulates brunner’s glands secretion?

A

Secretin and VIP.

113
Q

What is SGLT-1 responsible for?

A

Active transport of glucose and galactose into the cells.

114
Q

What is sodium enhanced by?

A

Aldosterone.