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Gastrointestinal / General Surgery > Physiology 3 > Flashcards

Physiology 3 Flashcards

1
Q

What are the different parts of the large intestine?

A

Caecum and appendix
Colon
Rectum
Anal canal and anus

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2
Q

What are the different parts of the colon?

A

Ascending
Transverse
Descending
Sigmoid

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3
Q

What are the sack-like bulges in the large intestine, caused by contraction of the circular muscle?

A

Haustra

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4
Q

What is the appendix?

A

Blind ended tube with extensive lymphoid tissue connected to the distal caecum via the appendiceal orifice (obstruction –> appendicitis)

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5
Q

Which substances are absorbed in the large intestine?

A

Na+, Cl- and water

Short chain fatty acids (from any carbs not absorbed in small intestine)

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6
Q

Which substances are secreted in the large intestine?

A

K+, HCO3 and mucus

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7
Q

Which features of the colon increase the surface area?

A

Colonic folds
Crypts
Microvilli

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8
Q

Which cells are responsible for ion and water absorption in the colon?

A

Colonocytes –> surface epithelial cells

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9
Q

Which cells mediate ion secretion?

A

Crypt cells

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10
Q

Which cells are responsible for secretion of much into the colon?

A

Goblet cells

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11
Q

Which ion may be lost significantly in the faeces in secretory diarrhoea?

A

K+

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12
Q

What is the effect of aldosterone on the colon?

A

Na+ absorption

K+ secretion

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13
Q

Which pattern of motility is responsible for non-propulsive segmentation in the colon?

A

Haustration

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14
Q

What are the main functions of the liver?

A
  • Carbohydrate, fat and protein metabolism
  • Deactivation/activation of some hormones
  • Storage
  • Synthesis of proteins
  • Protection
  • Detoxification
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15
Q

Which substances are stored in the liver?

A 
Fat soluble vitamins (A, D, E and K)
Water soluble vitamin B12
Iron
Copper
Glycogen
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16
Q

What happens to bile between meals?

A

Stored and concentrated in gall bladder

17
Q

What happens to bile during a meal?

A

Gall bladder contraction and sphincter of Oddi opens (due to CCK)
Bile spurts into duodenum via cystic and common bile ducts

18
Q

How do the bile juices get to the ducts?

A

Secreted from hepatocytes –> canaliculi –> biliary ductules and ducts

19
Q

What does the primary binary juice contain?

A 
Primary bile acids
Water and electrolytes
Lipids and phospholipids
Cholesterol
IgA
Bilirubin
Metabolic wastes and conjugated drug metabolites
20
Q

What happens if there is too much cholesterol in the bile juices?

A

May precipitate into micro crystals that aggregate into gall stones –> cholelithiasis

21
Q

What is bilirubin?

A

Breakdown product of the porphyrin component of haemoglobin

22
Q

What is the best treatment for symptomatic gall stones?

A

Laproscopic cholecystectomy

23
Q

Which treatment may be suitable for patient with small/medium sized radiolucent stones and unimpaired gall bladder function?

A

Ursodeoxycholic acid –> dissolves them

SE: diarrhoea

24
Q

What happens to most of the bile salts entering the duodenum?

A

Reabsorbed in the terminal ileum

–> enterohepatic recycling

25
Q

How does hepatic encephalopathy occur?

A

Severe hepatic failure –>
Failure of detoxification of ammonia to urea (via urea cycle) –>
Blood ammonia levels rise and exert toxic effect on CNS

26
Q

What are the clinical features of hepatic encephalopathy?

A

Incoordination
Drowsiness
Coma
Death due to cerebral oedema

27
Q

What are the treatment options for hepatic encephalopathy and hw do they work?

A

Lactulose
–> ammonia converted to ammonium which is not absorbed
Antibiotics –> suppress gut flora so inhibit ammonia production

28
Q

What is the process of water absorption from the lumen of intestines into the blood stream?

A

Passive process driven by transport of solutes (mainly Na+)

29
Q

What is the normal role of CFTR?

A

Normally little secretion of Cl- occurs because apical CFTR is either closed of not present

30
Q

Give some examples of factors that indirectly activate CFTR leading to secretion?

A

Enterotoxins from e.g. cholera, E.coli, C.diff
Hormones/neurotransmitters e.g. VIP, ACh, bradykinin, 5-HT
Immune cell products e.g. PGs, histamine
Some laxatives e.g. bile salts

31
Q

What is the overall effect of increased secretion via CFTR?

A

Secretory diarrhoea

32
Q

What are some of the net effects of diarrhoea?

A

Dehydration –> Na+ and water loss
Metabolic acidosis –> HCO3 loss
Hypokalaemia –> K+ loss

33
Q

What are the main mechanisms of development of diarrhoea?

A

Impaired absorption of NaCl e.g. congenital, inflammation, infection, excess bile
Non-absorbable solutes in lumen e.g. lactase deficiency
Hypermotility
Excessive secretion

34
Q

Which membrane transporter is exploited in Oral Rehydration Solution and how does it work?

A

SGLT1

Absorption of Na+ and glucose –> accompanying absorption of water

Gastrointestinal / General Surgery (4 decks)

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