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GI > Physiology > Flashcards

Physiology Flashcards

1
Q

What are the layers of the GI wall?

A

Mucosa
Submucosa
Circular & longitudinal smooth muscle
Serosa

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2
Q

What is part of the mucosa?

A

Layer of epithelial cells specialized for absorption and secretion
Highly vascularized
Innermost layer

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3
Q

What is the submucosa consist of?

A

Consists of collagen, elastin, glands, and blood vessels

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4
Q

What is the circular and longitudinal smooth muscle for?

A

Motility for GI tract

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5
Q

Functions of the Mouth

A 
Mostly mechanical digestion
Mastication
Food is broken down into small particles
Chemically digested
Bolus
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6
Q

Enzymes of the Mouth

A

Lingual amylase: carbs

Lingual lipase: lipids

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7
Q

What does lipase require to function appropriately?

A

Co-lipase

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8
Q

How many muscles and CN are used for swallowing?

A

26 muscles

5 CN

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9
Q

What CN are used for swallowing?

A 
5
7
9
10
12
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10
Q

Esophageal Stage of Swallowing

A

Begins with crico-pharyngeal relaxation

Involuntary

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11
Q

What salivary gland matches up with Stenson’s duct?

A

Parotid gland

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12
Q

What salivary glands match up with Wharton’s ducts?

A

Submandibular glands

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13
Q

What salivary glands match up with the sublingual ducts?

A

Sublingual glands

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14
Q

How much saliva does the salivary glands produce a day?

A

1 liter

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15
Q

Functions of Saliva

A

Initial digestion of starches & lipids by salivary enzymes
Dilution & buffering of ingested foods
Lubrication of ingested food to aid its movement

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16
Q

Secretions Produced By:

A

Salivary glands
Gastric mucosal cells
Pancreatic exocrine cells
Liver

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17
Q

Functions of the Stomach

A 
Short-term storage
Absorption
Digestion
Secretion
Chemical/enzymatic digestion
Liquefaction of food
Release slowly into sm. intestine
Pepsin & peptidase to break down proteins
Good environment for enzymes to work in
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18
Q

Functions of the Small Intestine

A

Absorption of nutrients

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19
Q

Function of the Large Intestine

A

Absorption of water

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20
Q

What does gastric juice convert food to?

A

Semiliquid called chyme

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21
Q

4 Parts of the Stomach

A

Cardia
Fundus
Body
Pylorus

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22
Q

What are the 3 phases of digestion?

A

Cephalic phase
Gastric phase
Intestinal phase

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23
Q

Parts of the brain that are part of the cephalic phase

A

Cortex
Amygdala
Hypothalmus
Vagus nerve

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24
Q

Important Hormones of the Gastric Phase

A

HCl

Pepsin

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25
Q

Define Enterogastrone

A

hormones in the GI tract as a group

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26
Q

Define Intestinal Phase

A

Enterogastrone hormones secreted in the duodenum & the lower GI tract

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27
Q

What does stimulation of the vagal nerve fibers cause release of?

A

Pancreatic juice and weak contractions of the gallbladder

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28
Q

What is released during the gastric phase of digestion?

A

Cholecystokinin into the blood stream

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29
Q

What happens when cholecystokinin reaches the pancreas?

A

Induces secretion of enzyme-rich pancreatic juice

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30
Q

What does secretin cause?

A

Copious secretion of bicarbonate-rich pancreatic juice

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31
Q

Gastric mucosal cells secrete what types of gastric juice?

A

HCl: protein digestion
Pepsinogen: protein digestion
Intrinsic factor: absorption of vit. B12

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32
Q

Cell Types of Gastric Mucosa in the Body of the Stomach

A

Parietal cells

Chief cells

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33
Q

What does parietal cells secrete?

A

HCl

Intrinsic factor

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34
Q

What do chief cells secrete?

A

Pepsinogen

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35
Q

Cell Types of Gastric Mucosa in the Antrum of the Stomach

A

G-cells

Mucous neck cells

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36
Q

What do G-cells secrete?

A

Gastrin

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37
Q

What does mucous neck cells secrete?

A

Mucus
HCO3
Pepsinogen

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38
Q

What stimuli releases gastrin?

A

Proteins
Distention of the stomach
Vagal stimulation

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39
Q

When is gastrin-releasing peptide released?

A

Vagal stimulation of the G cells

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40
Q

What does Gastrin promote?

A

H secretion by gastric parietal cells

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41
Q

What does gastrin stimulate?

A

Growth of gastric mucosa

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42
Q

Other Functions of Gastrin Hormone

A

Pepsinogen release
Increase stomach motility
Relax pylori sphincter
Contract LES

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43
Q

How does ACh regulate HCL secretion?

A

ACh released from vagus nerve
Binds receptors on parietal cells
Produces H secretion by parietal cells

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44
Q

What blocks muscarinic receptors on parietal cells?

A

Atropine

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45
Q

How does histamine regulate HCl secretion?

A

Released from mast like cells in gastric mucosa
Binds to H2 receptors on parietal cells
Produces H secretion by parietal cells

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46
Q

What blocks H2 receptors?

A

Cimetidine

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47
Q

How does gastrin regulate HCl secretion?

A

Released into circulation by G cells of stomach antrum
Binds to receptors on parietal cells
Stimulates H+ secretion

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48
Q

Define Segmentation Contractions

A

Circular muscle contracts sending chyme in both directions

Intestine then relaxes allowing chyme to merge back together

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49
Q

Define Peristaltic Contractions

A

Longitudinal muscle contracts propelling chyme along small intestine

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50
Q

How do varies occur?

A

Obstruction of the liver

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51
Q

When does a Mallory-Weise tear occur?

A

Frequent retching

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52
Q

What enzymes are released by the salivary glands?

A

Amylase

Lipase

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53
Q

What enzymes are released by the stomach?

A

Pepsin

Lipase

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54
Q

What enzymes are released by the pancreas?

A 
Amylase
Lipase & co-lipase
Phospholipase
Trypsin
Chymotrypsin
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55
Q

What enzymes are released by the intestines?

A

Enterokinase
Disaccharidases
Peptidases

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56
Q

What does trypsin & chymotrypsin target?

A

Peptides

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57
Q

What does enterokinase activate?

A

Trypsin

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58
Q

What innervates the GI tract?

A

Autonomic nervous system

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59
Q

Parts of the Autonomic Nervous System

A

Extrinsic

Intrinsic

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60
Q

What does the extrinsic autonomic nervous system encompass?

A

Sympathetic

Parasympathetic

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61
Q

What does the intrinsic part of the autonomic nervous system do?

A

Communicates with the extrinsic component

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62
Q

What does the enteric nervous system do?

A

Myenteric plexus

Meissner’s plexus

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63
Q

Where does the parasympathetic nerve supply come from?

A

Vagus nerve

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64
Q

Where does the sympathetic nerve supply come from?

A

Cervical & thoracic sympathetic chain

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65
Q

What does the parasympathetic nervous system do for the GI tract?

A

Motor innervation to the esophageal muscular coat and secretomotor innervation to the glands

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66
Q

What does the sympathetic nervous system do for the GI tract?

A

Regulates blood vessel constriction, esophageal sphincters contractions, relaxation of the muscular wall, and increases in glandular and peristaltic activity

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67
Q

What is a special function of the intrinsic innervations?

A

Can direct all functions of GI in absence of extrinsic innervation

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68
Q

What does intrinsic innervation control?

A

Contractile, secretory, and endocrine functions of the GI tract

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69
Q

Where does the intrinsic part of the ANS receive input from?

A

Parasympathetic & sympathetic nervous systems

Mechanoreceptors & chemoreceptors in the mucosa

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70
Q

Where does the intrinsic ANS send information to?

A

Smooth muscle, secretory, and endocrine cells

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71
Q

4 Functionally Different Cell Types that Compose Glands

A

Mucous cells
Chief cells
Parietal cells
Enteroendocrine cell

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72
Q

What activity does gastrin have on the stomach?

A

Causes gastric glands to increase secretory activity

Stimulates gastric emptying

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73
Q

What activity does gastrin have on the small intestine?

A

Stimulates contraction of intestinal muscle

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74
Q

What activity does gastrin have on the ileocecal valve?

A

Relaxes ileocecal valve

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75
Q

What activity does gastrin have on the large intestine?

A

Stimulates mass movements

76
Q

What activity does serotonin have on the stomach?

A

Causes contraction of the stomach muscle

77
Q

What activity does histamine have on the stomach?

A

Activates parietal cells to release HCl

78
Q

What activity does somatostatin have on the stomach?

A

Inhibits gastric secretion of all products

Inhibits gastric motility and emptying

79
Q

What activity does somatostatin have on the pancreas?

A

Inhibits secretion

80
Q

What activity does somatostatin have on the small intestine?

A

Inhibits GI blood flow

Inhibits intestinal absorption

81
Q

What activity does somatostatin have on the gallbladder?

A

Inhibits contraction and bile release

82
Q

What are the 3 parts of the small intestine?

A

Duodenum
Jejunum
Ileum

83
Q

Function of the Small Intestine

A

Primary site for digestion and absorption of nutrients

84
Q

What ducts empty into the duodenum?

A

Bile duct

Pancreatic duct

85
Q

Where does the liver receive blood from?

A

Hepatic portal vein

Hepatic artery

86
Q

What type of vascular resistance occurs in the liver?

A

Low vascular resistance

87
Q

What happens to the liver circulation when someone has cirrhosis?

A

Vascular resistance increases

Blood flow decreases

88
Q

Hepatic Functions

A 
Carbohydrate metabolism
Lipid metabolism
Protein metabolism
Removal of drugs and hormones
Excretion/secretion of bilirubin
Synthesis of bile salts
Storage of some compounds (glucose)
Phagocytosis
Aids in synthesis of active vitamin D
Urea formation from ammonium
89
Q

Carbohydrate metabolism in the liver

A

Maintaining a normal blood glucose

Storage of glycogen

90
Q

Why do alcohol abusers frequently have hypoglycemia?

A

Alcohol suppresses citrate cycle and impairs gluconeogenesis from amino acids

91
Q

Why do patients with cirrhosis have hyperglycemia after a carbohydrate rich meal?

A 
Liver insufficiency
Decrease of glucose utilization
Hyperglycemia
Hyperinsulemia
Down-regulation of insulin receptors
Insulin resistence
92
Q

Steps in Carbohydrate Breakdown

A

Disaccharides

Monosaccharides

93
Q

Steps in Protein Breakdown

A

Peptides

Amino acids

94
Q

Steps in Lipid Breakdown

A

Diglycerides

Monoglycerides & fatty acids

95
Q

Where does most of our cholesterol come from?

A

Liver

96
Q

Fat Metabolism in the Liver

A

Oxidation of fatty acids to supply energy
Synthesis of large quantities of cholesterol, phospholipids, and lipoproteins
Inactivation of steroids & excretion from the body

97
Q

Disorders of Protein Metabolism

A

Ammonia detoxification disorder and failure of urea formation
Hyperammonemia
Hepatic coma

98
Q

Ammonia Detoxification Disorder & Failure of Urea Formation

A

Ammonia comes from bacterial degradation of nitrogen substances in intestines, from intestinal mucosa during glutamine degradation, from degradation of amino acids in kidneys and muscles

99
Q

Hyperammonemia SE

A

Mental changes: disorientation, sleeping disorders, chaotic speech, personality changes
Motor changes: increased muscle reactivity, hyperreflexia, tremor

100
Q

Types of Hepatic Coma

A

Endogenous

Exogenous

101
Q

Endogenous Hepatic Coma

A

Viral hepatitis and poisoning

Hepatic cell disintegration

102
Q

Exogenous Hepatic Coma

A

Final status of chronic cirrhosis

103
Q

Basics of Bile Secretion

A

Necessary for digestion and absorption of lipids
Mixture of bile salts, bile pigments, and cholesterol
Bile salts emulsify lipids

104
Q

Bile Secretion and Recycling

A

Produced and secreted by liver
Stored in gallbladder
Ejected into sm. intestine
After lipid absorption, bile salts are recirculated to liver
Extraction of bile salts from portal blood

105
Q

Formation of Bilirubin

A 
Formed from hemoglobin
Hemoglobin phagocytosed
Iron release bound to transferrin
Remainder of heme group covered to biliverdin
Biliverdin reduced to bilirubin
Bilirubin attached to albumin
Secretion of bilirubin into bile
106
Q

Processing Bilirubin by Hepatocytes

A

Albumin removed as unconjugated bilirubin passes through liver
Bilirubin conjugated

107
Q

Secretion of Conjugated Bilirubin into Bile

A

Hepatocytes transport conjugated bilirubin into bile clinical
Conjugated bilirubin enters duodenum

108
Q

Role of Small Intestine in Bile Metabolism

A

Bile & bile salts increase growth of intestinal bacteria
Intestinal bacteria metabolize conjugated bile to urobilirubin
Urobilirubin reabsorbed into blood

109
Q

What happens to the bile when the duodenal orifice is closed?

A

Bile is stored and concentrated in the gallbladder

110
Q

How much bile does the liver produce in a day?

A

500-1000 mL

111
Q

Composition of Bile

A 
Water
Bile Salts
Bile pigment
Cholesterol
Inorganic salts
Fatty acids
Lecithin
Fat
Alkaline phosphatase
112
Q

What are the ways people become jaundice?

A

Too much production of bilirubin
Conjugation of bilirubin
Obstruction of path to the duodenum

113
Q

Obstructive Jaundice

A

Bile prevented from flowing out of biliary duct
Conjugated bilirubin builds up in biliary duct
Conjugated bilirubin is returned to blood
Unconjugated bilirubin normal or decreased

114
Q

Formation and Secretion of Bile

A 
Detoxification of various substances
Synthesis of plasma proteins
Coagulation
Blood reservoir
Immunity
Vitamins
Relation to blood formation
115
Q

Function of the Gallbladder

A

Blind pouch that stores bile

116
Q

Ducts of the Gallbladder

A

Hepatic duct
Cystic duct
Common bile duct

117
Q

What duct joins the common duct?

A

Pancreatic duct

118
Q

Why is the pancreatic duct pressure greater than the common bile duct pressure?

A

Reflux of bile into the pancreas will give the patient severe pancreatitis

119
Q

Innervation of the Pancreas

A

Sympathetic: splanchnic nerves
Parasympathetic: vagus

120
Q

Exocrine Glands in the Pancreas

A

Secrete essential digestive enzymes through pancreatic duct into duodenum

121
Q

Endocrine Gland of the Pancreas

A

Islets of Langerhans

122
Q

Four Major Cell Types in the Islets of Langerhans

A

Alpha: glucagon
Beta: insulin
Delta: somatostatin
F cells: pancreatic polypeptide

123
Q

What does the pancreatic polypeptide do?

A

Secretes insulin and glucagon into the blood stream

124
Q

What do the exocrine pancreas enzymes digest?

A

Carbohydrates
Proteins
Fats

125
Q

Major Stimulants of Bicarbonate Secretion

A

Secretin
Cholecystokinin
Gastrin
Acetylcholine

126
Q

Major Inhibitors of Bicarbonate Secretion

A

Atropine
Somatostatin
Pancreatic polypeptide
Glucagon

127
Q

Amylase from the Pancreas

A

Only enzyme to be released in active form

Hydrolyzes starch & glycogen to glucose, maltose, maltotriose, and dextrins

128
Q

Function of Lipase from the Pancreas

A

Emulsify and hydrolyze fat in the presence of bile salts

129
Q

How much of the islet cell mass must be removed before diabetes will become clinically apparent?

A

80%

130
Q

Most Important Stimulant of Acinar Cells

A

CCK

131
Q

Major Stimulant of Ductal Cells

A

Secretin

132
Q

What is secretin secreted in response to?

A

H+ in intestine

133
Q

Big Adipose Secretions

A

Resistin
Adiponectin
Leptin

134
Q

Where is the pain when posterior ulcers erode?

A

Back pain

135
Q

Where is the pain when anterior ulcers perforate?

A

Peritonitis

136
Q

Why is the third portion most vulnerable to traumatic rupture?

A

It’s fixed

137
Q

How do GI peptides regulate functions of the GI tract?

A

Contraction and relaxation of smooth muscle wall & sphincters
Secretion of enzymes for digestion
Secretion of fluid & electrolytes
Regulate secretion of other GI peptides

138
Q

What activity does intestinal gastrin have on the stomach?

A

Stimulates gastric glands and motility

139
Q

What activity does secretin have on the stomach?

A

Inhibits gastric gland secretion and gastric motility during gastric phase of secretion

140
Q

What activity does secretin have on the pancreas?

A

Increases output of pancreatic juice rich in bicarbonate ions
Potentiates CCK’s action

141
Q

What activity does secretin have on the liver?

A

Increases bile output

142
Q

What activity does cholecystokinin (CCK) have on the liver/pancreas?

A

Potentiates secretin’s actions on these organs

143
Q

What activity does cholecystokinin (CCK) have on the pancreas?

A

Increases output of enzyme-rich pancreatic juice

144
Q

What activity does cholecystokinin (CCK) have on the gallbladder?

A

Stimulates organ to contract and expel stored bile

145
Q

What activity does cholecystokinin (CCK) have on the hepatopancreatic sphincter of Oddi?

A

Relaxes sphincter to allow entry of bile and pancreatic juice into duodenum

146
Q

What activity does vasoactive intestinal peptide (VIP) have on the duodenum?

A

Stimulates buffer secretion

Dilates intestinal capillaries

147
Q

What activity does vasoactive intestinal peptide (VIP) have on the stomach?

A

Inhibits HCl production

148
Q

What activity does vasoactive intestinal peptide (VIP) have on the small intestine?

A

Relaxes intestinal smooth muscle

149
Q

What activity does motilin have on the proximal duodenum?

A

Stimulates migrating motility complex

150
Q

How does digestion occur in the small intestine?

A

Hydrolysis then absorption

151
Q

Causes of Malabsorption of Nutrients

A

Anything that interferes with delivery of bile or pancreatic juice
Damaged intestinal mucosa
Diarrhea

152
Q

Functions of the Small Intestine

A

Electrolyte absorption

Water absorption

153
Q

Electrolyte Absorption in the Small Intestine

A

Along whole length
Iron & calcium in duodenum
Sodium coupled with absorption of glucose & amino acid
Ionic iron stored in mucosal cells with ferritin
Potassium diffuses with osmotic gradients
Calcium absorption is regulated by vitamin D and PTH

154
Q

Water Absorption in the Small Intestine

A

95% absorbed via osmosis
Net osmosis occurs when gradient is created via transport of solutes
Water uptake coupled with solute uptake

155
Q

How does the intestinal lining increase absorptive surface area?

A

Villi

Microvilli

156
Q

Define Villi

A

Finger-like projections of the mucosa

157
Q

Define Microvilli

A

Tiny projections on luminal membrane of each intestinal cell

158
Q

When do the final stages of chemical digestion occur?

A

Just prior to absorption of amino acids, glucose and fatty acids

159
Q

What does carbohydrates have to be broken down to, to be absorbed?

A

Monosaccharides

160
Q

What does protein have to be broken down to, to be absorbed?

A

Small peptides

Amino acids

161
Q

What does fat have to be broken down to, to be absorbed?

A

Monoglycerides

Free fatty acids

162
Q

Path of Absorption of Carbohydrate Digestion

A

Glucose/galactose co-transport with sodium ions

Fructose via facilitate diffusion

163
Q

Path of Absorption of Protein Digestion

A

Co-transport with sodium ions

164
Q

Path of Absorptions of Fat Digestion

A

Diffusion

Combine with proteins (chylomicrons)

165
Q

Path of Absorption of Nucleic Acid Digestion

A

Active transport via membrane carriers

166
Q

Emptying at the Ileocecal Valve

A

Fluidity of contents promotes emptying
Pressure & chemical irritation relax sphincter and excite peristalsis
Pressure or chemical irritation in cecum inhibits peristalsis of ileum and excites sphincter

167
Q

Functions of the Large Intestine

A

Reabsorb water
Compact material into feces
Absorb vitamins
Store fecal matter

168
Q

Physiology of the Ascending Colon

A

Processing chyme delivered from the terminal ileum

169
Q

Physiology of the Transverse Colon

A

Storage and dehydration of feces
Primary site for removal of water & electrolytes
Storage of feces

170
Q

Physiology of the Descending Colon

A

Conduit between transverse and sigmoid colon

171
Q

Physiology of the Rectosigmoid Region

A

Maintains fecal continence

172
Q

Types of Motions of the Colon

A

Haustrations- mixing movements

Mass movements- propulsive movements

173
Q

Define Haustrations (Mixing Movements)

A

Ring-like contractions divide colon into pockets

174
Q

When does net forward propulsion occur?

A

When sequential migration of hausfrau occurs the length of the bowel

175
Q

Define Mass Movements (Propulsive Movements)

A

Starts in middle of transverse colon and precede by relaxation of the circular muscle and the downstream disappearance of austral contractions

176
Q

What movements are inhibited during massive movements?

A

Haustral contractions

177
Q

Physiology of the Large Intestine in Regards to Reabsorption

A 
Water
Vitamins K, biotin, B5
Organic wastes- urobilinogens & sterobilinogens
Bile salts
Toxins
178
Q

Define Crypts

A

Tubular glands responsible for mucus secretion

179
Q

What happens when crypts are occluded?

A

Diverticulitis

180
Q

What is the last portion of the digestive tract?

A

Rectum

181
Q

Where does the rectum terminate?

A

Anal canal

182
Q

Rectum Function

A

Storage of feces

183
Q

Define Feces

A

Particles of waste matter that is left over after the body has processed and absorbed nourishment from foods

184
Q

What does feces contain?

A 
Water
Dietary fiber
Inorganic salts
Dead cells
Bacteria
Anything the body cannot or will not absorb
185
Q

What type of sensory receptors does the rectum have?

A

Pain
Temperature
Touch

186
Q

What structures maintain fecal continence?

A

Contraction of internal anal sphincter and puborectalis muscle

187
Q

How does a bowel movement exit the anus?

A

Rectum fills with feces
Contraction of muscles increase intra-abdominal pressure
Increases intra-rectal pressure
Sphincter relax
Feces enter canal
Peristaltic waves push feces out
Relaxation of internal/external anal sphincters allows feces to exit

GI (20 decks)

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