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Physiology Flashcards

1
Q

What are the four functions of the digestive system?

A

Digestion
Secretion
Absorption
Motility

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2
Q

Name the three pairs of salivary glands?

A

Parotid Glands
Salivary Glands
Submandibular Glands

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3
Q

List some functions of the stomach

A

Sterilises food,
Digests protein,
Temporary store of food.

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4
Q

Function of the liver in the gastrointestinal system

A

Production of bile salts for digestion/absorption of fats in small intestine

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5
Q

Function of the gallbladder

A

Stores and concentrates bile

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6
Q

Functions of the pancreas

A

Digestive enzymes for digestion of fats, carbohydrates and proteins

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7
Q

Function of small intestine

A

Final stages of chemical digestion and nutrient absorption

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8
Q

Functions of large intestine

A

Water absorption, bacterial fermentation and formation of faeces

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9
Q

Name the four basic layers of the gut wall

A

Mucosa (epithelium, lamina propria, muscularis mucosae)
Submucosa,
Muscularis externa
Serosa/adventitia

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10
Q

Which parts of the gut tube have glands in the submucosa?

A

Oesophagus and duodenum

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11
Q

What kind of epithelium makes up the mouth, the oesophagus and the anal canal?

A

Stratified squamous

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12
Q

What kind of epithelium makes up the stomach, small and large intestine?

A

Simple columnar epithelium

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13
Q

What are the two layers of muscularis externa in the gut tube?

A

Inner layer of circular muscle,

Outer layer of longitudinal muscle

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14
Q

Where is the myenteric plexus located?

A

The myenteric plexus lies between the two layers of muscularis externa

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15
Q

Where is the submucosal plexus located?

A

Outside the submucosa

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16
Q

What is the autonomic reflex control of the alimentary tract?

A

Long (parasympathetic) and short (ENS reflexes)

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17
Q

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

A

Simulates secretion and motility via the vagus nerve.

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18
Q

What stimulates salivation?

A

The facial (VII) and glossopharyngeal (IX) cranial nerves

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19
Q

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

A

Inhibits secretion and motility via the splanchnic nerve

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20
Q

What parts of the GI tract does the celiac trunk supply?

A

Stomach,
Small intestine,
Pancreas
LIver

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21
Q

What parts of the GI tract does the superior mesenteric artery supply?

A

Small intestine,
Caecum,
Ascending Colon,
Transverse Colon

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22
Q

What parts of the GI tract does the inferior mesenteric artery supply?

A

Descending Colon
Sigmoid Colon
Rectum

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23
Q

What parts of the GI tract does the superior mesenteric vein drain?

A

Small Intestine,
Caecum,
Ascending Colon,
Transverse Colon.

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24
Q

What parts of the GI tract does the inferior mesenteric vein drain?

A

Descending Colon,
Sigmoid Colon,
Rectum

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25
Q

What does the hepatic portal vein drain?

A

Superior mesenteric vein + Splenic vein

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26
Q

What does the hepatic portal vein drain into?

A

Hepatic vein, which then drains into the inferior vena cava.

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27
Q

What two sugars make up lactose?

A

Glucose and Galactose

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28
Q

What two sugars make up sucrose?

A

Glucose and Fructose

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29
Q

What two sugars make up maltose?

A

Glucose and Glucose

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30
Q

What enzyme breaks down alpha 1,4 glycosidic bonds

A

Alpha-amylase

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31
Q

How is glucose/galactose transported across the apical border?

A

Through the SGLT1 glucose symporter (Along with sodium).

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32
Q

How is glucose/galactose transported across the basolateral membrane?

A

Through the GLUT-2 transporter (down its concentration gradient)

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33
Q

How is fructose transported across the apical membrane?

A

Through the GLUT-5 transporter

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34
Q

What enzymes digest proteins to amino acids?

A

Proteases/Peptidases

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35
Q

What does the PepT1 transporter transport?

A

It is an symporter that transports di/tripeptides in along with Hydrogen ions (created by the acid microclimate)

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36
Q

In what form is most fat ingested?

A

Triacylglycerol

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37
Q

What enzyme breaks down fat in the small intestine?

A

Pancreatic Lipase

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38
Q

Why can lipase only act on the surface of fat?

A

Lipase is water soluble - cant pass through the fat molecule

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39
Q

What forms the mechanical disruption component of emulsification?

A

Smooth muscle contraction grinding and mixing luminal contents

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40
Q

What forms the emulsifying agent?

A

Bile salts and phospholipids

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41
Q

How is absorption of fat across the enterocytes enhanced?

A

Formation of micelles

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42
Q

How are fatty acids transported across the apical mebrane?

A

Micelles are broken down into free fatty acids and monoglycerides by the acid microclimate and movement in the lumen.

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43
Q

What happens to fatty acids and monglycerides upon entering enterocytes?

A

Enter Smooth endoplasmic reticulum - where they are reformed into triacyleglycerides and coated with an amphiteric protein

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44
Q

What are the fat droplets released as into the lacteals?

A

Chylomicrons

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45
Q

What are the fat-soluble vitamins

A

Vitamins A, D, E, K.

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46
Q

What does vitamin b12 bind to?

A

Intrinsic factor

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47
Q

What does B12 defiency lead to?

A

Pernicious anaemia

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48
Q

Where is Vitamin B 12 stored?

A

In the liver

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49
Q

How is iron transported across the apical membrane?

A

Iron is transported via DMT1

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50
Q

How is iron stored intracellularly?

A

As ferritin - expression is related to iron levels (More ferritin in high iron levels)

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51
Q

How is iron in blood transported?

A

As transferrin

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52
Q

How is chewing controlled?

A

Voluntary innervation - to skeletal muscles of the mouth/jaw

Reflexes - via mechanoreceptors

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53
Q

What makes up saliva?

A

Water, Mucins, Alpha-amylase, Electrolytes, Lysozymes

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54
Q

How is salivary secretion controlled?

A

Via both parasympathetic (Cranial nerves 7 and 10 - watery secretion), and sympathetic control (viscous secretion) - both stimulatory.

Also reflex control via chemi/pressure receptors

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55
Q

What kind of muscle makes up the muscularis externa of the oesophagus?

A

Upper 1/3 is skeletal muscle, Lower 2/3 is smooth muscle.

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56
Q

What stomach cells produce pepsinogens?

A

Chief cells

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57
Q

What stomach cells produce HCl?

A

Parietal cells

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58
Q

What stomach cells produce Intrinsic factor?

A

Parietal cells

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59
Q

What stomach cells produce mucus?

A

Mucous neck cells

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60
Q

What signalling mechanism does gastrin use in parietal cells?

A

PKC (Acts via calcium) - stimulates HCl

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61
Q

What signalling mechanism does ACh use in parietal cells?

A

PKC (Acts via calcium) - stimulates HCl

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62
Q

What signalling mechanism does Histamine use in parietal cells?

A

PKA (Acts via cAMP) - stimulates HCl

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63
Q

What signalling mechanism do Prostaglandins use in parietal cells?

A

PKA (Acts via cAMP) - inhibits HCl

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64
Q

What are the three mechanisms by which gastric acid secretion is controlled?

A

Neurocrine (vagus/local reflexes)
Endocrine (gastrin)
Paracrine (histamine)

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65
Q

What stimulus in the ‘head phase’ of acid secretion stimulates the vagus nerve?

A

Sight, smell or taste of food.

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66
Q

What stimulates gastrin production from G cells?

A

The vagus nerve, along with peptides in the lumen.

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67
Q

What stomach cells produce histamine?

A

ECL cells

enterochromaffin-like

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68
Q

What stimulates histamine release from ECL cells?

A

Gastrin/Ach from vagal stimulation

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69
Q

What stimulus in the ‘head phase’ of acid secretion inhibits the vagus nerve?

A

Stopping eating

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70
Q

What stimulus in the ‘gastric phase’ of acid secretion inhibits acid secretion?

A

Decrease in pH - leading to reduced gastrin production (So that stomach maintains pH)

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71
Q

What does acid in the duodenum do to gastric acid secretion?

A

Reduces gastrin secretion (via secretin and eneterogastric (splanchnic) reflex

72
Q

What does Fat/CHO in the duodenum do to gastric acid secretion?

A

Decreases it (Via GIP release acting on Gastrin secretion)

73
Q

What converts pepsinogen to pepsin?

A

Acid hydrolysis (low PH in stomach)

74
Q

What feedback mechanism does pepsin act on pepsinogen?

A

Positive feedback - stimulating its own production

75
Q

What role does mucus have in the stomach?

A

Protects mucosal surface from injury

Protects against gastric acid corrosion and pepsin digestion

76
Q

What is required for vitamin b12 absorption?

A

Intrinsic Factor

77
Q

What is the difference between serosa and adventitia?

A

Serosa - inside peritoneal cavity.

Adventitia - outside peritoneal cavity (oesophagus and rectum)

78
Q

What kind of epithelium line the oesophagus?

A

Stratified squamous (non-keratinised)

79
Q

What is the function of the upper oesophageal sphincter?

A

Prevention of food reflux

80
Q

What is the third muscular layer of the stomach?

A

Oblique layer

81
Q

What is the upper portion of the stomach called?

A

Fundus (Storage funtion)

82
Q

What is the lower portion of the stomach called?

A

Antrum (Mixing/Grinding function)

83
Q

What controls entry into the duodenum?

A

Pyloric Sphincter

84
Q

What name is given to the invaginations of the luminal surface of the stomach?

A

Gastric pits

85
Q

What type of epithelium makes up the stomach?

A

Simple Columnar

86
Q

What stimuli in the ‘gastric phase’ of acid secretion promote acid secretion?

A

Distension of stomach
Peptides in lumen
Gastrin/ACh - Activate ECL cells to produce histamine

87
Q

What stimulus in the ‘intestinal phase’ of acid secretion inhibits acid secretion?

A

Acid in duodenum

Fat/CHO in duodenum

88
Q

What hormones, produced from duodenal mucosa, act to prevent further acid buildup in duodenum?

A

Secretin, cholecystokinin (CCK), GIP

89
Q

How do secretin and CCK act to prevent acid buildup in the duodenum?

A

Inhibit gastric acid secretion

Inhibit gastric emptying (inhibit motility/contract pyloric sphincter)

90
Q

What is the only essential function of the stomach? (ie not compensated)

A

Intrinsic Factor

91
Q

Which part of the GI tract absorbs the Intrinsic factor/B12 complex?

92
Q

What name is given to gastric content entering the duodenum?

93
Q

What produces peristaltic waves?

A

Peristaltic rhythm (produced by pacemaker cells)

Slow waves (spontaneous depol/repolarisation) - Basic Electrical Rhythm

94
Q

What does gastrin do to peristaltic contraction?

A

Increases it

95
Q

What does fat/acid/amino acid/hypertonicity in the duodenum do to motility?

A

Inhibits it

96
Q

What substance is secreted from Brunner’s gland cells to neutralise acid?

A

Bicarbonate (HCO3)

97
Q

What controls release of duodenal bicarbonate (HCO3)?

A

-Long (vagal) and short (ENS)
reflexes
-Secretin release from S cells (also releases HCO3 from pancreas/liver)

98
Q

What feedback mechanism exists for secretin release in the presence of acid neutralisation?

A

Negative feedback control - secretin release inhibited upon neutralisation

99
Q

What is produced in the endocrine portion of the pancreas?

A

Insulin, Glucagon and Somatostatin

100
Q

What is produced in the exocrine portion of the pancreas?

A

Secretion of bicarbonate by duct cells

Secretion of digestive enzymes by acinar cells

101
Q

What is the name for the common passage of the common bile duct and main pancreatic duct into the duodenum?

A

Sphincter of Oddi

102
Q

What are digestive enzymes stored as in pancreatic acinar cells?

A

Inactive zymogen granules (prevents autodigestion)

103
Q

What converts trypsinogen to trypsin?

A

Enterokinase

104
Q

What is the function of trypsin?

A

Converts other zymogens to active forms

105
Q

List some categories of pancreatic enzymes

A

Proteases, Nucleases, Elastases, Phospholipases, Lipases, α-Amylase

106
Q

What stimulates zymogen secretion from the pancreas?

A

Cholecystokinin (CCK)

Released in response to fat/amino acids in duodenum

107
Q

What are the four lobes of the liver?

A

Right, Left, Caudate, Quadrate

108
Q

Where does entry/exit of blood vessels, lymphatic vessels, ducts and nerves happen in the liver?

A

Porta hepaticus (on inferior surface)

109
Q

What ligament separates the right and left lobes of the liver?

A

Falciform ligament

110
Q

What ligament attaches the liver to the underside of the diaphragm?

A

Coronary ligament

111
Q

What is the bare area of the liver?

A

Where it attaches to the diaphragm

Elsewhere covered by capsule and visceral peritoneum

112
Q

How do the connective tissue septa divide the liver?

A

Into hexagonal lobules

113
Q

What makes up the components of the portal triad (located at the corner of each lobule)?

A

Hepatic portal vein, hepatic artery, hepatic duct.

114
Q

What is the central vein within each lobule?

A

Hepatic veins

115
Q

What radiates out from the central veins in the liver?

A

Hepatic cords (made of hepatocytes)

116
Q

What exists within the spaces between hepatic cords?

A

Hepatic sinusoids (blood channels)

117
Q

How is bile taken from the hepatocytes in the lobules to the hepatic duct?

A

Through bile canaliculi

118
Q

List functions of hepatocytes

A

Bile synthesis
Nutrient storage (Glycogen, Fats, Vits, Cu, Fe)
Nutrient interconversion
Detoxification

119
Q

What blood vessel carries O2-depleted, nutrient-rich blood to the liver?

A

Hepatic Portal Vein

120
Q

What blood vessel carries O2-rich, nutrient-depleted blood to the liver?

A

Hepatic Artery

121
Q

List components of bile

A 
Bile Acids
Lecithin
Cholesterol
Bile pigments (bilirubin)
Toxic Metals
Bicarbonate
122
Q

How is bilirubin produced?

A

Extracted from blood by hepatocytes and secreted into bile (breakdown product of haemoglobin)

123
Q

What happens to bile acids prior to secretion?

A

Conjugation (w glycine/taurine) - ^ solubility

124
Q

What are the three layers of the gallbladder wall?

A

Mucosae (Folded rugae)
Muscularis (Smooth muscle)
Serosa

125
Q

What duct leaves the gallbladder to become part of the common bile duct?

A

Cystic duct

126
Q

What is the function of the sphincter of oddi?

A

Controls release of bile and pancreatic juice into duodenum

127
Q

What are the functions of the gallbladder?

A

Stores AND concentrates bile

128
Q

What hormone controls Gallbladder contraction/Bile secretion?

A

Cholecystokinin (CCK)

129
Q

What hormone controls both sphincter of Oddi relaxation and pancreatic enzyme secretion?

A

Cholecystokinin (CCK)

130
Q

What is the overall action of secretin?

A

Neutralisation

131
Q

What is the shortest part of the small intestine?

132
Q

What is the function of the duodenum?

A

Gastric acid neutralisation, digestion, iron absorption

133
Q

What is the function of the jejunum?

A

Nutrient absorption (95%)

134
Q

What is the function of the ileum?

A

NaCl/H20 absorption (chyme dehydration)

135
Q

How is the absorptive surface area enhanced in the small intestine?

A

Folds, Villi, Microvilli

136
Q

Where do undifferentiated small intestinal cells exist?

A

Crypts of Leiberkuhn

137
Q

What is the name of the lymph vessel projections in villi?

138
Q

Where is the main area of absorption in a villus?

A

Top third area

139
Q

Where is the main area of secretion in a villus?

A

Crypts of Leiberkuhn (secrete water and Cl)

140
Q

What is the primary route for water uptake in the small intestines?

A

Following sodium-glucose transport.

141
Q

Why is water secretion in the small intestine important?

A
  • Maintains lumenal contents in liquid state
  • Promotes mixing of nutrients with digestive enzymes
  • Aids nutrient presentation to absorbing surface
  • Dilutes and washes away potentially injurious substances
142
Q

How does chlorine get into enterocytes basolaterally?

A

Through a sodium-potassium-chloride co-transporter

143
Q

How does chlorine leave enterocytes on the apical surface?

A

Through CFTR (mutated in CF)

144
Q

What are the two types of intestinal movement?

A
  • Segmentation

- Peristalsis

145
Q

What takes place in segmentation?

A

Contraction followed by relaxation of short intestinal segments.

146
Q

How is segmentation initiated?

A

Depolorisation of pacemaker cells in longitudinal muscle

147
Q

What determines strength of contraction in segmentation?

A

Action potential frequency

148
Q

What determines frequency in segmentation?

A

Basic Electrical Rhythm (BER)

149
Q

What happens to BER as you move down the intestine?

A

It decreases (as does strength of contraction).

150
Q

What does parasymp stimulation do to segmentation?

A

Increases contraction.

151
Q

What does sympathetic stimulation do to segmentation?

A

Decreases contraction.

152
Q

What is the function of peristalsis?

A

Clearance of undigested food

Limit bacterial colonisation of small intestine

153
Q

How is peristalsis controlled?

A

Migrating Motility Complex (MMC) - initiated by motilin hormone
(Mediated by neurones in myenteric plexus)

154
Q

If an area of intestinal smooth muscle is distended, what happens to the muscle on the oral side of the bolus?

A

It contracts.

Protective to avoid obstruction

155
Q

What term refers to reflex ileocaecal sphincter contraction in response to colon distension?

A

Gastroileal reflex (prevents backflux)

156
Q

What are the four parts of the colon?

A

Ascending, Transverse, Descending, Sigmoid

157
Q

What name is given to the incomplete bands of longitudinal muscle overlying the colon?

A

Teniae coli

158
Q

What do the crypts in large intestine have a large number of?

A

Goblet cells

159
Q

What is the epithelium of the anal canal?

A

Stratified squamous epithelium

160
Q

Is the internal anal sphincter under smooth or skeletal muscle control?

A

Smooth muscle

161
Q

Is the external anal sphincter under smooth or skeletal muscle control?

A

Skeletal muscle (Voluntary control)

162
Q

What is the function of the colon?

A

Osmotic absorption of water (through active transport of sodium)

(No important role in nutrient absorption)

163
Q

What causes the defaecation reflex?

A

Distension of the rectal wall activating mechanoreceptors.

Process under parasympathetic control

164
Q

How is voluntary delay of defaecation achieved?

A

Descending neural pathways.

165
Q

List some enterotoxigenic bacteria?

A

Vibrio cholerae, E.Coli

166
Q

What is the pathogenesis of enterotoxigenic bacteria?

A

Maximally turn on chloride secretion -> ^^H20 secretion

167
Q

What is used to treat diarrhoea?

A

Sodium/Glucose solution

Oral rehydration therapy

168
Q

In what ways does the small intestine maintain a barrier against pathogens?

A
  • Immune sampling
  • Monitoring presence of pathogens
  • Translocation of bacteria
  • Gut Associated Lymphoid Tissue (GALT)
169
Q

What pancreatic enzyme is used to breakdown fat?

A

Pancreatic lipase

170
Q

What pancreatic enzyme is used to breakdown carbohydrates?

A

Pancreatic amylase

171
Q

What are the neuronal components that trigger nausea and vomiting?

A

Sympathetic and Vagal Components

Vomiting Centre

Chemoreceptor Trigger Zone (CTZ)

172
Q

What are the functions of the liver?

A

Clotting factors
Bile acids
Carbohydrates -(Gluconeogenesis, Glycogenolysis, Glycogenesis)
Proteins -(Albumin synthesis)
Lipids - (Cholesterol synthesis, Lipoprotein and TG synthesis)
Hormones -(Angiotensinogen, insulin like growth factor)

173
Q

What is the detoxification function of the liver?

A

Urea production from ammonia
Detoxification of drugs
Bilirubin metabolism
Breakdown of insulin and hormones

174
Q

What is the contribution of the liver to immune function?

A

Combating infections
Clearing the blood of particles and infections, including bacteria
Neutralizing and destroying all drugs and toxins

175
Q

What is included in the storage function of the liver?

A

Stores glycogen
Stores Vitamin A, D, B12 and K
Stores copper and iron

Alimentary (4 decks)

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