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Digestive System > Physiology > Flashcards

Physiology Flashcards

1
Q

Which part of the digestive tract contains striated muscle?

A

Pharynx,
Upper 1⁄2 Oesophagus
External Anal Sphincter

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2
Q

What are the 3 important features for splanchnic circulation?

A

Large blood flow
Large reservoir function
Perfuses a diversity of organs

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3
Q

What percentage of blood is funneled to the liver by the Hepatic portal vein?

A

70% - deoxygenated blood

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4
Q

In which part of the digestive tract is a serosa missing?

A

Oesophagus & Distal rectum

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5
Q

What percentage of blood is coming from the Hepatic artery to the liver?

A

30%

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6
Q

What percentage of the nerve fibres in the Vagus are afferents?

A

75%

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7
Q

Where do motor neuronal cell bodies in the cranial division reside and what do the project via?

A

They reside in the medulla oblongata and project via the Vagus nerve

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8
Q

At what level is the Enteric nervous system present in the hierarchy of neural organization ?

A

Level 1

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9
Q

Fill in the blanks.” Motor neuronal cell bodies in the sacral s.c. project in the _________ to colon , rectum and internal sphincter.”

A

Pelvic nerve

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10
Q

What substance is released by parasympathetic Motor neuronal cell bodies in the sacral s.c. ?

A

Acetylcholine

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11
Q

What substance is released by the sympathetic postganglionic neurone when they synapse on other neurone of the ENS, blood vessels, mucosa and sphincters?

A

Nor-epinephrine

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12
Q

What are the two nerve networks by which the enteric nervous system works by?

A

Submucous plexus- Meissner’s plexus
Myenteric Plexus - Auerbach’s plexus

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13
Q

Where is the Myenteric plexus found?

A

Between the middle circular and outer longitudinal layers.

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14
Q

Where is the submucosal plexus found?

A

Between the submucosa & muscularis propria

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15
Q

What are the types of Neurones found in the Enteric Nervous system?

A

Sensory neurons - respond to stretch , tonicity and chemicals

Motor neurons- Innervate smooth muscles to elicit movement

Secretory neurons - Regulate endocrine and exocrine secretions.

Interneurones- innervate both plexuses

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16
Q

What substances are released that causes excitatory nerves to innervate muscles?

A

Acetylcholine (Ach) and Substance P ( SubP)

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17
Q

What substances are released that causes inhibitory nerves to innervate the muscles?

A

Nitric Oxide (NO) and Vasoactive intestinal polypeptide(VIP)

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18
Q

What is the function of the Submucousal plexus ( Meissner’s plexus)?

A

It has an exocrine & endocrine function

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19
Q

What is the function of the Myenteric plexus?

A

It controls peristalsis and other motor activities

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20
Q

Which substances are involved with Paracrine secretions for the GI tract ?

A

Histamine
Somatostatin

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21
Q

What substances are involved in Neurocrine secretions for the GI tract?

A

Vasoactive intestinal polypeptide(VIP)
Gastrin releasing peptide ( GRP)
Enkephalins

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22
Q

Gastrin, CCK, Secretin , GIP (Glucose- dependent intsulinotropic peptide), motilin and ghrelin are what type of secretory substances?

A

Endocrine secretions

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23
Q

Where is Ghrelin secreted from and what is its function?

A

It is secreted by epithelia in body of stomach and is a hormone that regulates food intake.

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24
Q

What are Neurocrines?

A

These are peptide released from nerve endings in the gut in response to a stimulus.

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25
Q

What stimulates or inhibits the release of endocrines or paracrines?

A

NEUROCRINES (duhh)

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26
Q

What are endocrines?

A

These are hormones released in response to a specific stimulus

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27
Q

What are paracrines?

A

These are substances which acts as local mediators on cells in its immediate environments.

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28
Q

Fill in the blanks. “ Paracrines are release from _______.”

A

Endocrine cells

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29
Q

What are the control centres that help in the regulation of chewing?

A

Brain stem ( medulla oblangata- vagus efferents)
Cerebral Cortex
Hypothalamus
Amygdala

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30
Q

What is the nerve that innervates the muscles of chewing?

A

Trigeminal nerve ( CN V)

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31
Q

What are the processes in the Chewing reflex?

A
  1. Once food is present in the mouth the REFLEX INHIBITION takes place on the muscles of mastication occurs and the lower jaw drops. This happens as there is no action potentials passing through efferent fibres.
  2. STRETCH REFLEX of the jaw muscles, there is a rebound contraction to raise the lower jaw. This allows for ..
  3. CLOSURE OF THE TEETH - Food is compressed against the linings of the mouth and there’s is reflex inhibition of the muscles of mastication occurring again
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32
Q

What are the structures by which swallowing mechanism are triggered by?

A

Afferent impulses from the trigeminal, glossopharyngeal, vagus nerves, hypoglossal nerves , pharynx and facial nerves.

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33
Q

What happens after the afferent fibres from nerves triggers the swallowing mechanism?

A
  • These impulses are integrated in the nucleus of the tractus solitarius, the nucleus ambiguus and the dorsal motor nucleus of vagus.
  • Then, the efferent fibers pass to the pharyngeal musculature and the tongue via the vagus, trigeminal, facial nerves , hypoglossal nerves and the nerves of the nucleus ambiguous .
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34
Q

What are the structures that make up the Dorsal Vagal Complex?

A

Dorsal motor nerve of Vagus
Nuclei of nucleus ambiguous
Tractus solitarius
Area postrema

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35
Q

Where does the Dorsal Vagal Complex reside?

A

Medulla oblongata

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36
Q

True or False? The Swallowing mechanism has 3 stages and 2 phases.

A

FALSE ! It has 2 STAGES and 3 PHASES

(2 S/ 3 P)

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37
Q

What are the two stages that occur for the swallowing mechanism?

A

Voluntary Stage
Involuntary Stage

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38
Q

What is another name for the Voluntary stage?

A

Buccal phase of Swallowing

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39
Q

What happens during the voluntary stage of the swallowing mechanism?

A
  1. Food is squeezed and rolled posteriorly by the tongue
  2. The tongue is elevated against the palate.
  3. The tongue then retracts and pushes bolus upward and backwards against hard palate towards soft palate and into the oropharynx.
  4. In the soft palate, the mechanical presence of bolus is sensed and the Involuntary stage is initiated.
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40
Q

What are the two phases in the involuntary stage of the swallowing mechanism?

A

Pharyngeal phase
Oesophageal phase

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41
Q

How long is the pharyngeal phase?

A

Less than 1 sec ( <1 sec)

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42
Q

How long is the oesophageal phase?

A

8-10 seconds

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43
Q

What is the normal pH of saliva ?

A

6.8-7 ( may increase to 8 as salivary production increases)

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44
Q

True or False? Duct cells produce the Primary secretion of saliva.

A

FALSE!! Acini cells do this.

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45
Q

What is the main purpose of duct cells in relation to salivary secretion?

A

They modify the secretion into a secondary secretion.

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46
Q

What is the name given to the functional unit of a salivary gland?

A

Salivon

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47
Q

What are the function of the myoepithelial cells which line the acinar cells?

A

Contraction of the myoepithelial cells serve to:
1. Expel formed saliva from the acinus into ducts.

  1. Prevent distention of acini and back flow.
  2. Lower resistance to flow through intercalated ducts
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48
Q

What is the amount of salivary secretions produced each day?

A

1500 ml/day

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49
Q

Which salivary gland produces the most saliva ?

A

Submandibular (70%)

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50
Q

What type of enzyme produced in saliva is used in starch digestion and what type of secretions is it found in?

A

Ptyalin ( alpha- amylase) , it’s found in serous secretions.

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51
Q

Which ions are actively secreted during primary secretions from acini?

A

Chloride Ions

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52
Q

True or False? Primary secretions are described as Hypotonic while Secondary secretions are described as Isotonic .

A

FALSE!!! Primary secretions are ISOTONIC
Secondary secretions of HYPOTONIC

” PI - Private Investigator”
“ SH- Secondary highschool”

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53
Q

What happens to the saliva secretion if there is inhibition of the Na +/ K+ / 2 Cl - co- transporter?

A

The saliva secretion DECREASES by about 65%

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54
Q

What are the main transporters in the duct cells that modify the primary secretion of saliva?

A
  • Basolateral & apical Cl- channels
  • Luminal Cl-/HCO3- exchangers
  • Basolateral Na+/K+ ATPase creates the Na+ gradient
  • Apical Na+ and K+ channel
  • Basolateral Na+/HCO3- must be present to concentrate HCO3-
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55
Q

How else can HCO3 enter lumen from ductal cell?

A

Cystic Fibrosis Transmembrane conductance regulator (CFTR) chloride channel

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56
Q

What is the energy source for the CFTR channel?

A

cAMP

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57
Q

Fill in the blanks. The net result of a Secondary Secretion results in a ____________ in luminal Na+ and Cl - while there is a _________ in luminal K+ and HCO3- .

A

There is a DECREASE in Na + and Cl-
There is an INCREASE in K+ and HCO3 -

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58
Q

What happens during low rates of flow of saliva secretion?

A

The sodium and chloride content decreases while Potassium INCREASES significantly . This is because the duct cells can do its thanggg and work properly to produce the HYPOTONIC secondary secretion.

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59
Q

True or False? At low rates of flow of saliva secretion the saliva is Hypotonic and rich in K+ and HCO3-

A

TRUE!!

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60
Q

What happens to water during Primary secretion of saliva?

A

Water moves DOWN the osmotic gradient causing an Isotonic secretion.

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61
Q

What happens at High Rates of flow for saliva?

A

Na+ Cl - content INCREASES
Less time for secretion of K+
HCO3 - remains relatively high ( due to salivary agaonist.

SALIVA APPROACHES ISOTONICITY , rich in NaCl.

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62
Q

True or False, At both high and low rates of flow of salivary secretion the HCO3 content is high?

A

TRUE!!

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63
Q

True or False? The primary secretion of saliva produced is isotonic and has the same Na+, K+, Cl–, and HCO3– concentrations as plasma.

A

TRUE!!

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64
Q

In what type of salivary ducts does modification of secretions occur?

A

In LARGER(striated) duct NOT intercalated ducts

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65
Q

What is the name of the hormone that increases Sodium reabsorption and increases Potassium content of saliva?

A

Aldosterone

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66
Q

What are some of the enzymes contained in saliva?

A

Pytalin ( alpha amylase)
Muramidase
Lingual lipase

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67
Q

Which enzyme is responsible for fat digestion?

A

Lingual lipase

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68
Q

Which enzyme is a lysozyme that lyses an acid for some bacteria ex staphylococcus?

A

Muramidase - lyses muramic acid

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69
Q

Fill in the blanks. “ Relaxation of the Lower oesophageal sphincter is ______”

A

Neurally mediated

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70
Q

What is the term given to when food enters the stomach, the fundus and upper portion of the body relax and accommodate the food with little if any increase in pressure?

A

Receptive Relaxation

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71
Q

What is the relative constant Intragastric pressure ?

A

5 mmHg

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72
Q

What is the normal frequency for slow waves of the stomach?

A

Every 3-4 mins

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73
Q

What is the normal duration for slow waves in the stomach?

A

12-20 seconds

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74
Q

What is the name given to the pacemaker cells found in the Stomach?

A

Intestinal Cells of Cajal (ICC)

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75
Q

Where are the pacemaker cells of the stomach normally located?

A

At the junction of the fundus and body

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76
Q

True or False? Slow waves initiate contraction ONLY when the plateau potential exceeds threshold.

A

TRUE!!

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77
Q

Where are spike potentials normally seen in the stomach?

A

Pyloric antrum

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78
Q

Which diseases can arise as a result of a Gastrectomy?

A

Iron deficiency anaemia
Vitamin B 12 deficiency ( Megaloblastic anaemia)

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79
Q

What are symptoms that will occur after a patient has a gastrectomy?

A

“Dumping Syndrome” - tachycardia, sweating, nausea . This will occur because of Rapid gastric emptying.

Hypoglycemia
Hypovolemia
Hypotension

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80
Q

What parts of the stomach is classified to be apart of the Proximal Motor Unit?

A

Cardia, Fundus & Body

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81
Q

What parts of the stomach is classified to be apart of the Distal Motor Unit?

A

Body, Antrum, Pylorus & “ Antral Pump”

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82
Q

True or False? The Distal Motor Unit of stomach can be known as the Receptacle or Reservoir for incoming food.

A

FALSE!! The proximal unit is known as this because it accommodates ingested materials.

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83
Q

By what structure is the Distal Motor unit innervated by?

A

Vagal Excitatory Ach fibres

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84
Q

Fill in the blanks. “ ___________ set the frequency of slow waves.”

A

Pacemaker cells

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85
Q

What structure is known as the main regulator for intragastric pressure?

A

Proximal Motor Unit

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86
Q

Fill in the blanks. “ __________ determine the duration and strength of phasic contractions of the antral pump.

A

Gastric slow waves

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87
Q

Where does Gastric Filling occur?

A

In the Proximal Motor Unit

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88
Q

What is the term given to the constant stretch of Smooth muscles resulting in a decreased tension?

A

Adaptive Relaxation

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89
Q

What is Laplace’s Law?

A

The pressure is proportional to tension over the radius.

P = 2T/R

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90
Q

What is Retropulsion?

A

This occurs when food lying in the core of the stomach ( which is greater then 7mm in diameter) is forced back into the stomach.

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91
Q

The grinding and mixing of food is termed as?

A

Trituration

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92
Q

Which phase of Gastric Secretions can be classified as Neuro-humorally mediated?

A

Gastric phase

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93
Q

True or False? The Cephalic phase of the stomach is neurally regulated while the Intestinal phase is Humorally regulated.

A

TRUE!!

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94
Q

What is the average amount of Gastric Juice produced per day?

A

2-2.5 L

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95
Q

What is the normal pH of Gastric Juice?

A

1-2

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96
Q

What are some substances contained in Gastric Juices?

A

Pepsins I & II ( Endopeptidaes)
Mucus
Gastric lipases
Intrinsic Factor
Gelatinase
Water
H+ ions

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97
Q

What type of cells are found in Gastric (Oxyntic) Glands?

A

Surface epithelial cells
Mucous neck cells
Peptic ( Chief cells)
Parietal cells ( Oxyntic cells)

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98
Q

What substance are produced by peptic/chief cells?

A

Pepsinogens ( inactive)
Gastric lipase

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99
Q

Fill in te blanks. “ Pepsinogens are split by ______ to form active forms - pepsin I (Ph2) and pepsin II (pH3)

A

Hyrdrochloric Acid ( Hcl)

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100
Q

What substance is produced by Oxyntic cells?

A

Hcl & Intrinsic factor

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101
Q

What type of cells are found throughout the base of Gastric glands and what substance do they produce?

A

Enterochromaffin - like cells( ECL)

They produce histamine in response to gastrin

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102
Q

What is the name of the structure that produces GI hormones ?

A

Amine Precursor Uptake & Decarboxylation (APUD) system - found in base of gastric glands also.

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103
Q

What type of cells are found in the pyloric glands present in the antrum?

A

G- cells
D- cells

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104
Q

True or False? G - cells produce Gastrin while D- Cells produce Somatostatin.

A

TRUE!!

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105
Q

What is the name of the cells in the stomach that produces mucous?

A

Mucous neck cells & Surface epithelial cells

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106
Q

What type of cells produce bicarbonate ?

A

Surface epithelial cells

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107
Q

What is the name given to the structure that stabilises the mucous - bicarbonate ( HCO3) layer in Stomach?

A

Trefoil peptides

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108
Q

Where are parietal cells and chief cells found in the stomach?

A

In the fundus and body of stomach

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109
Q

What is the main component of gastric juice?

A

Gastric acid

110
Q

What is the pH of Gastric acid?

A

0.87

111
Q

At rest , where are proton pumps located?

A

They are sequestered within the parietal cell in a series of membrane compartments known as TUBULOVESICLES.

112
Q

What happens to the tubulovesicles when the parietal cells become active?

A

These vesicles fuse with invaginations of the apical membrane known as canaliculi, thereby amplifying the apical membrane area and positioning the proton pumps to begin acid secretion

113
Q

True or False? Hcl is secreted into the tubulovesicles via proton pumps during the active phase of parietal cell.

A

FALSE!! Hcl is secreted into the caniculli during the active phase of the parietal cells.

114
Q

True or False? In the active Parietal cell, There is a paucity (little) of tubulovesicles , long microvilli and numerous mitochondria.

A

TRUE!!

115
Q

What are the characteristics of a non- secreting parietal cell?

A

Many tubulovesicles present
Caniculli are internalized
Devoid of microvilli

116
Q

What are the main receptors found on the parietal cell and to what substances do they bind with?

A

CCK-B ——-> Gastrin
H2 ————> Histamine
M3 ———–> Acetylcholine

117
Q

What happens when Gastrin & Acetylcholine binds to its respective receptors on the parietal cell?

A

They promote secretion by elevating cytosolic free calcium concentrations ( Ca 2+)

GA –>C

118
Q

What happens when Histamine binds to its respective receptor on the parietal cell?

A

Histamine promotes secretion by increasing intracellular cyclic adenosine 3′,5′- monophosphate (cAMP)

119
Q

What are sources of H+ ions for the parietal cells?

A
  1. Cytochrome Oxidase system - pumps H+ in caniculli.
  2. Dissociation of water
  3. Dissociation of carbonic acid
120
Q

What is the name of the enzyme that aids in the formation of carbonic acid?

A

Carbonic anhydrase

121
Q

What are sources of bicarbonate (HCO3 )?

A

1) Hydroxyl (OH) when buffered by carbonic acid will produce bicarbonate.

2) Splitting of Carbonic Acid

122
Q

True or False? Chloride Drift is a passive process.

A

FALSE!! It is an active process ( energy dependent ) because Cl- moves down its electrochemical gradient through channels in the apical membrane.

123
Q

Which phase of the regulation of Gastric secretion is the shortest phase?

A

Cephalic phase - 30% of secretions

124
Q

Which phase of the regulation of Gastric secretion is the longest phase?

A

Intestinal phase - 4hrs

125
Q

Which phase gives the basal secretion of 1-5 mEq/hr ( about 10%)

A

Interdigestive Phase

126
Q

Which phase of Regulation of Gastric secretion is done through direct vagal stimulation?

A

Cephalic phase

127
Q

What are the stimuli that will activate the Cephalic phase?

A

Thought of food
Smell
Taste
Chewing
Swallowing

128
Q

Direct Vagal stimulation during the cephalic phase produces what substances that will initiate a secretory response?

A

Gastrin-releasing peptide (GRP) and Acetylcholine

129
Q

What is the stimuli that will activate the Gastric Phase?

A

1)Gastric Distention - the physical presence of the meal distends the stomach and activates stretch receptors.

2) Products of protein digestion.

130
Q

What is the response to stimuli in the Gastric phase of the Stomach?

A

1) Increase release of gastrin
2) It provokes a “vago-vagal” reflex
3) Local intramural reflexes that further amplify secretion during the gastric phase.

131
Q

What is the stimuli that will activate the Intestinal Phase?

A

1) Protein digestion products in duodenum.
2) Distention

132
Q

What is the response to stimuli in the Intestinal phase?

A

1) Increase amino acids in blood
2) Intestinal endocrine cell

133
Q

What stimulates the release of Histamine from ECL cells?

A

Gastrin

134
Q

True or False? PGE2 INHIBITS acid secretion.

A

TRUE!!

135
Q

Which phase of regulation of gastric secretions is mainly an inhibitory phase to acid secretion ?

A

Intestinal Phase

136
Q

True or False? Histamine is a hormone.

A

FALSE!! Histamine is NOT a hormone, its a paracrine secretion.

137
Q

What cells produces Secretin?

A

S- cells

138
Q

Which enzyme produced by the Exocrine pancreas is always produced in the active form?

A

Anti-Trypsin

139
Q

True or False? In relation to the Exocrine pancreas - In humans, HCO3- and Cl- are secreted into the cell lumen.

A

TRUE!!

140
Q

In the exocrine pancreas, what is the name of the substance that activates opening of CFTR channels in response to Secretin stimulation?

A

cAMP

141
Q

True or False? The cystic fibrosis transmembrane conductance regulator (CFTR ) is present in acinar cells but not duct cells.

A

FALSE!! In humans it is present in DUCT cells not acinar cells.

142
Q

Fill in the blanks. “ In the exocrine pancreas , the rate of HCO3- secretion is dependent on __________.”

A

Dependent on the availability of luminal Cl-

143
Q

Fill in the blanks. “ In the exocrine pancreas, the availability of luminal Cl- is dependent on _______.”

A

The opening of the apical Cl- CFTR channels.

144
Q

What is the Two-component theory ?

A
  • Acini secrete low volume of Na+ & Cl-
  • Duct cells secrete large volume of Na+ & HCO3-
145
Q

At low secretion rates of pancreatic juice , what happens?

A

At low rates of secretion, the Cl− concentration of the juice is therefore relatively high due to low secretion of HCO3- by duct cells or high substitution of ions . This results in a Na + & Cl - solution.

146
Q

What is the name of the substance found in saliva which chelates iron and thus prevents the multiplication of organisms that require it for growth?

A

Lactoferrin

” Ferrin —> ferrous —> has to do with iron duhh”

147
Q

What is the optimum pH of salivary amylase and at what pH does it become denatured?

A

Optimum pH -7
Becomes denatured at a pH of 4 .

148
Q

What happens to the carbohydrate digestion if salivary amylase is absent?

A

There is no defect in carbohydrate digestion because the pancreatic enzyme is secreted in amounts sufficient to digest all the starch present.

149
Q

True or False? Lipid lipase is the enzyme found in saliva which plays a role in the hydrolysis of dietary lipid.

A

FALSE!! LINGUAL lipase does this !!

Ntn don’t name lipid lipase lol

150
Q

What is the embryological origin of Salivary glands?

A

Ectoderm

151
Q

Fill in the blanks. “The intercalated ducts are lined by ______ cells while striated ducts are lined by _______ cells.”

A
  • Intercalated ducts- Myoepithelial cells

Striated ducts- Columnar cells

152
Q

What happens as saliva traverses the striated duct?

A

Sodium (Na+) is actively reabsorbed from the juice, and potassium (K+) is transported into it.

153
Q

Fill in the blanks. In the salivary gland, the parasympathetic preganglionic fibers are delivered by ______________ to the _______________.

A

Delivered by the Facial & Glossopharyngeal nerves to the Autonomic ganglion.

154
Q

Where does the sympathetic preganglionic nerves of the salivary gland originate from?

A

Cervical ganglion

155
Q

What happens to the Osmolality of salivary secretion as the secretory rate of the salivon is increased?

A

The osmolality of saliva also increases as secretory rate increases

156
Q

True or False? In Primary secretions of the saliva , the levels of Na+ , K+, Cl- and probably HCO3- are similar to that of plasma.

A

TRUE!!

157
Q

Fill in the blanks. Saliva is _________ at all rates of secretion.

A

Hypo-osmotic

158
Q

True or False? HCO3 remains high in low secretory rates of saliva but remains low in high secretory rates of saliva.

A

FALSE!! It remains high in both high and low secretory rates of saliva.

159
Q

What is the Primary ion secreted by the acini cells?

A

Cl-

160
Q

What is the name of the drug that inhibits the Na+/H+ exchanger in Cell 2 of the acinar cell of the salivary gland?

A

Amiloride

161
Q

What is the name of the drug that inhibits the secretory mechanism for Cl− in the acinar cell of the salivary gland?

A

Ouabain

162
Q

What is the gastric mucosa divided into?

A

Oxyntic gland area (secretes acid) and the pyloric gland area ( gastrin secreting)

163
Q

In the resting parietal cell, where is the H+ /k+ ATP-ase pump found?

A

In the membranes of the tubulovesicles

164
Q

Fill in the blanks. “In Gastric filling, ______________ underlie the peristaltic contractions .”

A

Basic Electrical Rhythm (BER) or Gastric Slow Waves

165
Q

What are the two types of Primary Bile acids formed by the hepatocytes?

A

Cholic acid
Chenodeoxycholic acid

166
Q

What are the two types of Secondary bile acids formed by the hepatocytes?

A

Deoxycholic acid ( soluble)
Lithocholic acid( insoluble)

167
Q

Fill in the blanks. “Mixing waves are achieved by ______ while propulsive waves are achieved by ______.”

A

Mixing waves- Segmentation

Propulsive waves- Peristalsis

168
Q

What are prolonged contractions that isolate segments and fosters absorption?

A

Tonic contractions

169
Q

Where does Slow waves or BER NOT occur ?

A

In the oesophagus & Proximal stomach

170
Q

How are slow waves conducted ?

A

Aborally
They are slow oscillatory waves .

171
Q

Fill in the blanks. “ BER or Slow waves are initiated by _______.”

A

Interstitial cells of Cajal

172
Q

What is the rate of slow waves in the duodenum?

A

12 waves per minute

173
Q

What is the rate of slow waves in the Terminal Ileum?

A

8 waves per minute

174
Q

What is the rate of slow waves in the Stomach?

A

3-4 waves per minute

175
Q

True or False? The BER or slow waves decreases in colon.

A

FALSE!! It increases in the colon

176
Q

True or False? Slow waves DO NOT initiate muscle contractions.

A

TRUE!! - They coordinate contractions

177
Q

True or False? Epinephrine DECREASES the intensity of spike potentials when body is under stress.

A

TRUE!!

178
Q

In the small intestine, Depolarization occurs due to what?

A

Ca2+ influx via L- type channels

179
Q

In the small intestine, Repolarization occurs due to what?

A

K+ efflux & inactivation of Ca2+ channels

180
Q

Fill in the blanks. “ A plateu phase occurs by a balance between _____ &_______.”

A

Calcium (Ca2+ )INFLUX &
Potassium (K+)EFFLUX

181
Q

What substances can increase the intensity of Spike potentials?

A
  • Acetylcholine
  • Gastrin
  • CCK
182
Q

What does it mean when no spikes or action potential appears at the crest of the slow waves for the small intestine?

A

Contractions are absent

183
Q

True or False? “When Action potentials are present, small amplitudes of contractions occur with each slow wave.”

A

FALSE!! When action potentials (spikes) are present, LARGE amplitudes of contractions occur with each slow wave.”

184
Q

When is Peristalsis initiated in the small intestines?

A

It is initiated by the stretching of the gut wall.

185
Q

In Peristalsis of the Intestines, what substance is released by local stretch receptors?

A

5-HT (Serotonin )

186
Q

Fill in the blanks. “ Cholinergic neurons via a _________ direction activate enteric neurons to release _____ &_______ that causes smooth muscle contraction .”

A

Cholinergic neurons via a RETROGRADE direction activate enteric neurons to release SUBSTANCE P & ACETYLCHOLINE that causes smooth muscle CONTRACTION .”

187
Q

Fill in the blanks. “ Cholinergic neurons via a _________ direction activate enteric neurons to release _____ &_______ to cause relaxation ahead of the stimulus .”

A

Cholinergic neurons via a ANTEROGRADE direction activate enteric neurons to release NITRIC OXIDE (NO) & VASOACTIVE INTESTINAL PEPTIDE (VIP) to cause RELAXATION ahead of the stimulus .”

188
Q

True or False? Peristalsis is weaker than Segmentation contractions.

A

FALSE!! Segmentation Contractions are weak jelly backs.

189
Q

When does Segmentation contraction occurs?

A

It occurs when a contraction is not coordinated with activity above and below the content .

190
Q

What is the function of Peristalsis in the colon ?

A

It propels contents from Caecum towards rectum intermittently .

191
Q

What is the Extrinsic innervation of the small intestines?

A

Extrinsic innervation is supplied by the vagus nerve and by nerve fibers from the celiac and superior mesenteric ganglia (parasympathetic)

192
Q

Contractions in the small intestines occur for what duration?

A

Multiple intervals of 5 seconds

193
Q

Who first discovered the Law of the Intestines?

A

Bayliss and Starling

194
Q

What is the Law of the Intestines ( Peristaltic reflex) ?

A

Peristalsis occurs when the stimulation of the gut produces excitation above and relaxation below in orderly sequence.

  • Contents of the gut move the material in an aboral direction and if they occur sequentially, they can propel a bolus the entire length of the gut in a short time.
195
Q

During what phase of the slow waves does Spike potential activity occurs in the small intestine?

A

They occur only during the DEPOLARIZATION PHASE of the slow wave

196
Q

True or False? In the small intestines , slow wave frequency sets the maximum frequency of contractions at any one site.

A

TRUE!!

197
Q

Fill in the blanks. “ Digestion is assisted by ______ & _________”

A

Hcl & Bile

198
Q

What is Digestion?

A

It is the orderly process that involves the chemical breakdown of food by enzymes.

199
Q

Where are the main enzyme secretions that aid in digestion from?

A
  • Glandular cells in the mouth
  • Chief cells of stomach
  • Exocrine pancreas
  • Apical membrane of the enterocytes
200
Q

What is Absorption ?

A

It is the process by which molecules are transported into the epithelial cells of the GI tract , then to the blood and lymph draining that region of the GI tract.

201
Q

Where is. the main Absorptive area of the GIT?

A

Duodenum & Jejunm

202
Q

What is Luminal (Cavital) Digestion?

A

Luminal Digestion involves enzymes secreted by salivary glands, stomach & pancreas.

203
Q

What is Membrane Digestion ?

A

This is significant digestion due to hydrolysis by enzymes (synthesized by epithelial cells ) at the intestinal brush border.

204
Q

What is the optimum pH of Ptyalin?

A

6.7

205
Q

What are the chief dietary forms of Carbohydrates ?

A
  • Polysaccharides
  • Disaccharides
  • Monosaccharides
206
Q

What are examples of Polysaccharides?

A
  • Starches
  • Glycogen
  • Cellulose ( Beta-1,4 links)
207
Q

What are examples of Disaccharides?

A

Sucrose (25%)
Lactose (5%)

208
Q

What are examples of Monosaccharides?

A

Glucose
Fructose

209
Q

What are the two polysaccharides that are found in starch?

A

Amylopetin (80-90%)
Amylose ( alpha 1,4-links)

210
Q

Which enzyme catalyses the hydrolysis of Alpha - 1,4 links of Starch?

A

Ptyalin ( alpha -1,4 amylase)

211
Q

What branches of a Starch compound cannot be hydrolysed by the Alpha - amylases?

A
  • Alpha-1,6 branching links
  • Spare terminal –1,4 links
  • Spare alpha–1,4 links next to branching points
212
Q

What are the products formed when Alpha amylase cannot hydrolase specific parts of the Starch molecule?

A

Oligosaccharides
- Maltose
- Maltotriose
- Alpha - limit dextrins

213
Q

Where are microvilli found in the small intestines?

A

On the apical surface of columnar epithelial cells.

214
Q

What are the function of Paneth cells?

A

These cells secrete several agents that destroy bacteria (lysozymes and defensins) or produce inflammatory responses (tumor necrosis factor-α [TNF-α]).

215
Q

What is the cell turn-over time for epithelial cells in the GIT ?

A

3 to 6 days

216
Q

What is Contact digestion?

A

Contact digestion connotes activity by exogenous enzymes that become adsorbed on the epithelial surface.

217
Q

What is an example of a membrane- bound enzyme?

A

Oligosaccharidases

218
Q

True or False? The half-life of membrane-bound enzymes is shorter than that of the epithelial cells.

A

TRUE!!

219
Q

Where is Vitamin B12 and Bile salts mainly absorbed?

A

In the Terminal Ileum

220
Q

What is the major form of carbohydrate in the diet?

A

Amylopectin (plant-starch)

221
Q

Fill in the blanks. “ _______ &_______ are dimers of Glucose.

A

Maltose & Trehalose

222
Q

What is the name of the substance that activates salivary & pancreatic amylase?

A

Chloride (Cl - )

223
Q

Where does Hydrolysis of Amylase occurs?

A
  • In the lumen
  • Surface epithelial cells
224
Q

What is the name of the enzyme that hydrolyses the products of amylase along with other dietary sugars?

A

Brush border carbohydrases

225
Q

What are the brush border enzymes?

A

M- Maltase
I -Isomaltase
L- Lactase
T- Trehalase
S- Sucrase

226
Q

Fill in the blanks. “ In the stomach , Before Ptyalin is inactivated , 30-40% of Starch is hydrolysed to form _____ & 2% is hydrolysed to form _______.”

A

30-40% - Hydrolysed to form Maltose

2% - Hydrolysed to Isomaltose

227
Q

What is the function of the Brush border enzymes in the Small intestines?

A

They split disaccharides & trisaccharides into MONOSACCHARIDES

228
Q

What are the ONLY products of Sugar digestion?

A

Glucose
Galactose
Fructose

229
Q

What is the rate-limiting step in sugar assimilation?

A

The absorption of free hexoses following hydrolysis

230
Q

Which Carbohydrates are not digested in the Small intestines?

A

Cellulose & Hemicellulose

231
Q

By what process is Fructose absorbed in the blood stream?

A

Facilitated Diffusion

232
Q

What is the name of the transporter in which Fructose enters the enterocyte?

A

GLUT-5

233
Q

Where is the GLUT-5 transporter located?

A

On the apical surface of the enterocyte

234
Q

What is the name of the transporter in which Fructose enters the bloodstream?

A

GLUT - 2

235
Q

Where is the GLUT-2 transporter located?

A

On the basolateral membrane of the enterocyte

236
Q

What is the name of the transporter in which Glucose and Galactose enters the bloodstream?

A

GLUT -2

237
Q

How is Glucose and Galactose absorbed into the enterocyte?

A

Via a Na+-dependent carrier system (SGLT-1)

238
Q

By what process is Glucose and Galactose transported into the Interstitium?

A

Facilitated diffusion via GLUT -2 transporter.

239
Q

By what process is Fructose transported into the Interstitium?

A

Facilitated diffusion via GLUT -2 transporter.

240
Q

True or False? The GLUT-5 transporter is Na+ dependent.

A

FALSE !! It is Na+ INDEPENDENT.

241
Q

True or False? Carbohydrates remaining in the intestinal lumen decreases the osmotic pressure of the luminal contents because of defects in digestion and absorption.

A

FALSE!! Carbohydrates remaining in the intestinal lumen INCREASES the osmotic pressure of the luminal contents because of defects in digestion and absorption

242
Q

What is the name of the condition given to individuals who have an Intolerance of sucrose and isomaltose and is mostly found in children?

A

Sucrose intolerance due to congenital sucrase-isomaltase deficiency (CSID)

243
Q

What is the most common congenital disaccharidase deficiency?

A

Lactase deficiency

244
Q

In persons who are Glucose and Galactose intolerant , what transporter is absent?

A

These patients the SGLT-1 transporter is ABSENT.

245
Q

How can one survive if they are glucose and galactose intolerant?

A

The patients thrive and show no symptoms when they are fed FRUCTOSE, this is because GLUT-5 transporter is present.

246
Q

True or False? SGLT -1 transporter has a greater affinity for Galactose than glucose.

A

TRUE!!

  • SGLT has L & T in its name and so does gaLacTose so it loves it more. The word Glucose doesn’t have T in it.
247
Q

When is Active transport of Glucose & Galactose inhibited?

A

When there is a FALL in the luminal Na+ to LESS than 90 mMol/L.

248
Q

What is the name of the substance that activates Trysinogen to Trypsin?

A

Enterokinase

249
Q

What is the name of the transporter that transports short - chain amino acids ( glycine,alanine, serine, proline) INTO the cell along with H+?

A

Proton-dependent amino acid transporters—PAT proteins

250
Q

Which part of the small intestine has a greater capacity to absorb di-peptides and tri-peptides?

A

Proximal Intestines

251
Q

Which part of the small intestine has a greater capacity to absorb single amino acids?

A

Distal intestines

252
Q

True or False? In Protein Digestion , tetrapeptides, pentapeptides, and hexapeptides are poorly absorbed.

A

TRUE!!

253
Q

Fill in the blanks. “ Di -peptides and Tri-peptides are transported into enterocytes via _______.”

A

Peptide transporter (Pep T1) that requires H+

254
Q

True or False? In protein digestion, transport systems have a higher affinity for L-isomers?

A

TRUE!!

255
Q

Fill in the blanks. “ Glycine prefers ______ groups while cysteine prefers _______.”

A

Glycine prefers Imino groups

Cysteine prefers Basic groups

256
Q

What is the name of the transporter in which H+/peptide co- transporter (PEPT1) is functionally coupled with ?

A

Na+/H+ exchanger, NHE3, in the same membrane.

257
Q

What is the name of the enzyme that hydrolyzes the peptides in the enterocytes?

A

Cytoplasmic peptidases

258
Q

What is Cystinuria ?

A

This is a congenital defect in the transport of basic amino acids and results in Kidney stones.

259
Q

What is Hartnup diseases?

A

This is a Congenital defect in the mechanism that transports neutral amino acids. Ex. Loss of trytophan , Deficiciency of vitamin b complex- Niacinimide (Pellagra)

260
Q

What are examples of the Neutral amino acids?

A

Valine, Alanine, Cystine

261
Q

Arginine and lysine are what type of amino acids?

A

Basic amino acids

262
Q

What are examples of acidic amino acids?

A

Glutamic acid, Aspartic acid

263
Q

Where is Pepsin I found?

A

In the body of the stomach

264
Q

Where is Pepsin II found ?

A

In the Antrum of the stomach

265
Q

What are examples of Endopeptidases?

A

Trypsin,
Chymotrypsin,
Elastase

266
Q

What are examples of Exopeptidases?

A

Carboxypeptidase, Aminopeptidase, Dipeptidase

267
Q

Bile flows towards periphery _____________ to flow of blood.

A

Countercurrent

268
Q

What’s the benefit of the countercurrent flow?

A
  • improves liver’s efficiency in extracting substances
  • minimizes concentration difference between substances in blood & bile
269
Q

Hepatocytes remove substances from the blood and secrete them into biliary canaliculi. T or F?

A

True

270
Q
A

Digestive System (16 decks)

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