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GI SYSTEM > Physiology > Flashcards

Physiology Flashcards

1
Q

3 monosaccharides

A

Glucose
Galactose
Fructose

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2
Q

What bond joins monosaccharides

A

Glycosidic bond

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3
Q

What breaks down disaccharides

A

Brush border enzymes

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4
Q

Brush border enzymes are?

And examples

A

On apical membrane of epithelial membrane

Lactase
Sucrase
Maltase

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5
Q

What happens to monosaccharides

A

Products of breakdown and digestion

And absorbed by small intestine (small enough)

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6
Q

3 disaccharides examples

And what each is made up of ?

A

Lactose (glucose and galactose)
Sucrose (glucose and fructose)
Maltose (glucose and glucose)

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7
Q

3 polysaccharides

A

Starch
Cellulose
Glycogen

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8
Q

Starch is what?
2 types?
Made up of?

A

Plant storage form of glucose

Alpha-amylose - glucose in straight chains

Amylopectin - glucose in branched chains

Glucose linked by alpha 1,4 glycosidic bonds

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9
Q

Amylase breaks down what?

Found where? 2

A

Starch

Saliva
Pancreas

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10
Q

Cellulose?
What is it
Made up of?

A

Dietary fibre
Constituent of plant cell walls

Unbranched linear chains of glucose linked by beta 1,4 glycosidic bonds

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11
Q

Cellulase in body?

A

Only in certain bacteria found in large intestine

Not in any vertebrate

We need this bacteria to break down cellulose

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12
Q

Glycogen
What is it
Made up of?
Where?

A

Animal storage of glucose
Made up of glucose linked by 1,4 glycosidic bonds

Excess glucose is stored as glycogen in liver

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13
Q

Glucose blood level

A

5 mmol/L

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14
Q

Microvilli why have it?

A

Increase surface area and increase absorption of nutrients

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15
Q

2 membranes of epithelial cells

A

Apical

Basolateral |_|

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16
Q

2 epithelial cells separated by

A

Tight junction

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17
Q

Transcellular and paracellular means?

A

Transcellular- through cells

Paracellular - through tight junctions- between cells

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18
Q

Vectorial transport?

Needs what?

A

Transport across epithelial cell in one direction
Needs transporter proteins distributed between apical and basolateral membrane

These proteins are placed non randomly

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19
Q

Secondary active transport process means?

A

Moves 2 different molecules across membrane

Opposite ways maybe

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20
Q

What membrane proteins involved in transporting glucose and galactose across epithelial membrane in small I?

A

SGLT1 in apical membrane

GLUT2 in basolateral membrane for sugars
And
Na/KATPase pump

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21
Q

If transport is Na dependant what does it mean too?

A

Water also transported by osmosis in tight junction complex

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22
Q

What membrane proteins are involved in transporting fructose in small intestine epithelial cells?

And is it dependant?

A

GLUT5 in apical membrane

GLUT2 in basolateral membrane

Not dependant not even Na dependant

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23
Q

Amino acids linked by what?

A

Peptide bond

O=C-N-H

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24
Q

Small proteins are called?

A

Di/tri Peptides

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25
Q

What enzymes break down protein and peptides?

A

Pro teases and peptidases

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26
Q

Endopeptidases?

Exopeptidases ?

A

Endopeptidase- acts on interior AA not exterior
Into smaller peptidases

Exopeptidases = act on terminal end AA

  • aminopeptidase - act on amino end
  • carboxypeptidase - act on carboxylate end

Chop off one AA at a time

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27
Q

Proteases example 2

A

Trypsin

Chymotrypsin

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28
Q

How many essential and non essential AA and what means

A 
9 essential (not made by body)
and 11 non essential (made by body)
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29
Q

What membrane proteins used in amino acids transport over small intestine epithelial cells?

A

SAAT1 on apical membrane
NA DEPENDANT on basolateral membrAne (unknown name)

Na/KATPase pump

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30
Q

What membrane proteins used in di/tri peptides transport in small intestine epithelial cells?

4 and what each transport

A

NHE3 in apical membrane - Na(in)/Hion(out)crossover

PepT1 in apical membrane - Hion/peptide(both in)

Na/KATPase in basolateral mamebrane - Kin and Na out
unknown in basolateral membrane - peptide out bottom

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31
Q

What is created from peptide transporting?

Due to?

A

Acid microclimate on apical membrane -closer to its surface

Due to H ion transferred out cycle

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32
Q

Triglycerol made up of?

A

Glycerol and 3 stearic acids

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33
Q

Issue with lipase?

A

Water soluble enzyme

Digestion only occurs at surface of fat droplet

So very slow

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34
Q

Lipase from where?

A

Pancreas

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35
Q

Emulsification does what?

A

Speed up digestion process of fat

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36
Q

What is emulsification

And why

A

Diving large droplets into smaller droplets

To increase SA and allow more accessibility for lipase action

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37
Q

Mechanical disruption in stomach does what and how?

A

Large droplets into small droplet

Smooth muscle contraction grinds and mixes lumenal contents

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38
Q

Emulsifying agents example s
Where they found?
What they do?

A

Bile salts
Phospholipids

secreted in bile

Prevents small droplets reforming and aggregating and they are amphiphatic so repel and prevent this

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39
Q

Micelles size

A

4-7 micro m

RBC size

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40
Q

Michelle made up of?

A

Monoglyceride
Fatty acids

Emulsifying agents(bile salt, phospholipids)

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41
Q

What does the Micelle do?

A

Travels to surface (acid microclimate) and releases free FA and monoglyc.
And they diffuse across apical membrane

Unabsorbed ones taken back up and recycled until all absorbed

They breakdown and reform

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42
Q

Is the micelle absorbed?

A

No micelle is too large

They are extra cellular and big

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43
Q

Why we form micelle?

A

Allow travelling through aq solution to cell

Free FA and monoglyc. Can’t do that

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44
Q

Stages in cell once FA and monoglyc. Enter

A
  1. Enter sER and reformed into triglycerol by sER enzymes
  2. These are emulsified by amphiphatic protein to prevent clumping
  3. Triglycerol droplets transported thru vesicles to Golgi apparatus
  4. Exocytosis out of BL membrane
  5. Extra cellular called CHYLOMICRONS
  6. These enter lacteal and transported to lymph system
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45
Q

CHYLOMICRONS

What happens to them and why?

A

Extra cellular fat

ALSO
Contains phospholipids, cholesterol and fat soluble vitamins

Enter lacteal as too large for capillary

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46
Q

Vesicles made from?

A

Formed by sER membrane

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47
Q

Fat soluble vitamins examples

How absorbed ?

A

A D E K

Same process as fat

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48
Q

Water soluble vitamins examples

How is absorbed

A

B GROUP
C
FOLIC ACID

Absorbed By passive diffusion or carrier mediated transport

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49
Q

Vitamin B12

Function? And stored ?
How absorbed
Deficiency is what?

A

Needed for RBC maturation and function and stored in liver as storage

Complex combined with Intrinsic factor absorbed in end of small intestine(ileum) via transporters

Deficiency leads to pernicious anaemia

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50
Q

Minerals for example?

A 
Na 
k 
Mg 
Ca
Fe
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51
Q

How much of eaten iron is absorbed

A

10%

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52
Q

How is iron absorbed

A

Via DMT1 apical transporter in duodenal epithelial cells

-some bond to ferritin to form protein iron complex
And becomes trapped as a storage in cell

-unbound iron transferred out of bL membrane at bottom and bind to transferrin in blood and transported to liver

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53
Q

How is iron blood levels controlled?
Mechanism

Ex ap,e of what happening if hyperaemia and anaemia

A

The binding of iron to ferritin is modulated depending on body irons level

Hyperaemia - increase ferritin and more stored in cell

Anaemia - decrease in ferritin and more released out of cell

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54
Q

How is chewing innervated?

A

Somatic nerves

Voluntary inner sting skeletal muscle of jaw

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55
Q

Chewing seen as a ?

Explain

A

Reflex -
Presence of food and pressure of food against gums detected by mechanoreceptors and inhibit jaw muscles and contract

Cycle

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56
Q

Saliva secreted by what?

A

3 pairs of glands

Parotid
Submandibular
Sublingual

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57
Q

What is in saliva? 5

A 
Water 
Mucins 
Alpha-amylase 
Electrolytes 
Lysozyme
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58
Q

Electrolytes?

A

Minerals in body that have charge
Balances amount of water in body

Maintains ph/tonicity

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59
Q

Lysozyme?

A

Natural occurring enzyme in saliva which kills bacteria by cleaving polysaccharide component of bacterial cell walls
Bacteriocidal

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60
Q

Water and mucins role in saliva?

A

Water - softens and moistens dilutes substances

Mucins- viscous solution, lubricant function

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61
Q

Salivary glands made up of?
Types of secretions?
3 types of acini

A

Acini and ducts
2 types of secretions - serous and mucous

ACINI
Mixed
Serous
Mucous

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62
Q

What nerves innervate and action on salivary glands?

A

Para and symp.
Both stimulatory

No inhibitory

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63
Q

Parasympathetic innervation of salivary glands?

A 
Cranial nerves (facial) and (glossopharyngeal)
Stimulates watery saliva secretion

REST/DIGEST

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64
Q

Sympathetic innervation of salivary glands?

A

Non-watery, viscous and sticky saliva

Controlled by separate adrenoreceptors
Alpha1 -high mucous content
beta2-high amylase content

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65
Q

What is saliva release like?

A

Reflex control

Presence of food in mouth detected by chemoreceptors and pressure receptors and activate saliva

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66
Q

Role of upper and lower oesophageal sphincter?

A

Regulate movement of material in and out of oesophagus

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67
Q

When is it Adventitia?

A

She outside peritoneal cavity

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68
Q

Where are submucosal glands found only?

A

Oesophageas

And duodenum

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69
Q

Muscularis externa made up of?

A

Inner circular and outer longitudinal

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70
Q

Receptive relaxation of stomach means?

A

Relaxation of thin elastic stomach muscle of fundus and body initiated by relaxation of LOS and entry of bonus into stomach

Done by vagus nerve

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71
Q

As stomach vol increases what happens to its pressure ?

A

No change

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72
Q

Functions of stomach?5

A 
Temporary storage 
Dissolve food and initiate digestion 
Control delivery into small I- no dumping syndrome 
Produces IF
Sterilises eaten food by acid
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73
Q

Without stomach we won’t be able to?

A

Eat large amounts of food and process it gradually !

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74
Q

Pyloric sphincter role?

A

Prevents against dumping syndrome

Controls what enters duodenum

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75
Q

Muscles externa layers of stomach?

A

Longitudinal OUT
Circular
Oblique IN

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76
Q

Why oblique muscle extra in stomach?

A

For more powerful contraction and breakdown of food

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77
Q

Rugae of stomach?

A

Innermost folds of wall

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78
Q

Luminal surface of stomach?

A

Most inner surface of stomach lined by epithelium = gastric glands and their cells

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79
Q

Fundus is like?

A

Thin and stretchy and elastic

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80
Q

3 cells inside gastric glands? And what each secrete

A 
Mucous neck cells (secrete mucus)
Parietal cells (secrete HCl)
Chief cells (secrete pepsinogens)
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81
Q

Gastric pits?

A

Open into gastric glands

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82
Q

Where is myenteric and submucosal plexus found?

A

Myenteric - between circular and longitudinal muscle layers

Submucosal - between circular and submucosal layer

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83
Q

Function of antrum of stomach

A

Where all the mixing and grinding occurs

And gastrin secreted by g cells

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84
Q

Proton pump?

A

H ion out and k in

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85
Q

Carbonic anhydrase does what?

A

Enzyme that catalysts co2 and water forming carbonic acid

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86
Q

Regulation of proton pump by what?

Explain each

A

Stimulatory hormones
Gastrin - endocrine from g cells
Histamine -paracrine
Acetylcholine -neural(parasympathetic.)

Inhibitory hormones
Prostaglandins

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87
Q

What phases control and involve gastric HCl secretions?

A

Cephalic phase -in head thinking/seeing about food
Gastric phase-food in stomach
Intestinal phase - food in intestine

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88
Q

Cephalic phase

A

Sight smell and taste of food triggers vagus nerve

Which acts on g cells and releases gastrin and triggers ACh

Local gastrin and ACh prescience then act on ecl cells and release histamine

All acting on parietal cells to increase acid released

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89
Q

Role of cephalic phase though?

A

Protective measure to prep stomach before food enters

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90
Q

Gastric phase?

A

When food inside stomach Still triggering more HCl

By distension of stomach triggering vagus nerve

Peptides in stomach triggering g cells

Local gastrin and ACh presence triggering ECL cells

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91
Q

Submucosal glands release what in duodenum

A

Secretin and GIP and CCK

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92
Q

What triggers response to reduce acid in duodenum in intestinal phase

A

Acid in duodenum and Fat/CHO in duodenum

93
Q

Pepsinogen is

A

Pepsin in inactive form

94
Q

What activates and deactivates chief cells to release pepsinogen?

A

Acidic environment in stomach activates pepsin and deactivated by neutral pH

95
Q

What regulates pepsin secretion

A

Same as HCL secretion

Gastrin
Histamine
ACh
All increase pepsin secretion

96
Q

How is mucus secreted into stomach and creates what?

A

Mucus secreted by neck cells onto surface of stomach lumen

Creates thick layer coat slidy surface for harmful surface

97
Q

Mucus thick layer coat in stomach lumen effect?

A

Rich in bicarbonate which creates neutral ph at surface of stomach lumen
Deactivates pepsin and neutralises acid near surface

Protects against gastric acid corrosion and pepsin digestion

98
Q

Intrinsic factor produced by

A

Parietal cells

99
Q

Gastric motility

A

Persistaltic waves from body into antrum to move food

100
Q

How is antrum mixing brought about?

A

Contraction of pyloric sphincter where food hits and is recycled and continues to mix as forced back up

101
Q

Peristaltic rhythm generated by what in stomach?

A

By pacemaker cells in longitudinal muscle layer

102
Q

BER ?

A

Basic electrical rhythm

Each part of gut has its own BER

103
Q

How is peristaltic waves conducted in stomach?

A

By slow waves through gap junction along longitudal muscle layer

Longitudinal muscle cells connected by tight junction

Need above threshold to induce AP and later on a contraction

104
Q

What two things trigger increase contraction and what one thing decreases contraction in stomach?

A

Gastrin hormone increases contraction

Dissensions of stomach wall increases contraction

Fat AA or acid in duodenum inhibits contraction

105
Q

Why do we need to neutralise acid in duodenum

A

Due to digestive enzymes needing a optimum neural pH

106
Q

How neutralisation of acid in duodenum occurs

A

Bicarbonate HCO3 secreted from brunners glands cells SUBMUCOSAL glands

Neutralises acid

107
Q

Accessory pancreatic duct for?

A

In case other is blocked

Variable in people

108
Q

Common bile duct from where?

A

GB

109
Q

Two types of cells in pancreas that enters pancreatic duct?

A

Acinar - enzyme secrete

Duct cell- secrete bicarbonate

110
Q

Zymogens?

Where

A

Enzymes stored in inactive forms

How it’s stored in acinar cells

111
Q

How is inactive zymogen activated in small I?

A

Inactive enzyme from pancreas trypsinogen goes to small I

Enterokinase enzyme on surface of apical membrane of duodenum epithelial cells converts trypsinogen to trypsin

Trypsinogen then converts all zymogens into active enzyme forms in small I

112
Q

Why stored as zymogens in pancreas?

A

To prevent pancreas autodigesting

113
Q

Nucleases -?
Elastase-?
Phospholipases?
Lipases?

A

Nucleases -hydrolyses DNA and rna

Elastase -collegan digestion

Phospholipases- phospholipids to FA

Lipases - triglycerides to FA and monoglyc.

114
Q

What controls zymogen secretion

A

CCK
Released in reposted to FAt/AA in duodenum

And stimulates zymogen release
For digestion

115
Q

How many lobes of liver

A

4 lobes

Right and left

Caudate -
quadrate-

116
Q

Porta of liver and where

A

On inferior surface and where entry/exit of vessels into/out liver

117
Q

What enters liver?

And leaves liver

A

Portal vein
Hepatic artery

Hepatic vein

118
Q

What joins to form common bile duct

A

Common hepatic duct and cystic duct

119
Q

What separates left and right lobes of liver

3 ligaments of liver

A

Falciform ligament and end with round ligament at bottom

And coronary ligament on top surface

120
Q

Round ligament remnants of?

A

Umbilical vein that exists in free edge of falciform ligament

121
Q

Bare area of liver

A

Small area on diaphragmatic surface surrounded by coronary ligament

With no connective tissue covering it

122
Q

How do vessels and ducts follow through liver

A

Follow septa throughout liver -

Network of connective tissue

123
Q

Septa divides liver into what

A

Hexagonal lobules

124
Q

Portal trains where?

A

Corners of hexagonal lobules

Hepatic portal vein
Hepatic artery
Hepatic duct

125
Q

What forms hepatic veins

And drains into what

A

Central veins joining

Then draining into Ivc

126
Q

Hepatic cords made up of?

A

Hepatocytes

127
Q

Bile canaliculus?

A

Lie between cells within each cord

Where bile runs out from centre and to bile duct

128
Q

Hepatic sinusoids?

A

Open channels between cords - blood channels

Where processing can happen

129
Q

What type of blood in hepatic portal vein?

A

Oxygen low
High nutrients
Blood

130
Q

Hepatic artery blood type

A

Oxygen rich
Lack of nutrients
Blood

131
Q

What is occurring at sinusoids

A

Mixing of high oxygen and low nutrient blood
With
Low oxygen and high nutrient blood

132
Q

Sinusoids interact with what?

A

With hepatocytes where processing occurs

133
Q

Hepatocytes functions ? 4

A

Bile synthesis

Nutrient storage (glycogen, fat, B12, iron)

Nutrient inter conversion for requirements

Detoxification - is accident,y ingested toxic stuff - dump into bile for release out of other end

134
Q

Function of liver ?

A

Production and secretion of bile

135
Q

6 components of bile

A 
Bile acids 
Lecithin
Cholesterol
Bile pigments 
Toxic stuff
Bicarbonate released by liver duct cells

But both can’t look too beautifull

136
Q

Lecithin ?

A

Fat essential for cells and breaks fat dietary down

137
Q

Bile pigments such as?

What is it? For?

A

Bilirubin

Yellow substance forms after RBC breaks down and travels to liver

Breakdown product

Reason why poo is brown and pee is yellow - excreted out

138
Q

Bile acids how made?

And used?

A

Bile acid made from cholesterol by hepatocytes

Bile acid is unsoluble then combines with glycine/taurine to form bile salt = soluble

Secreted into bile duct and into small I

139
Q

What happens to bile salts?

Reabsorped where?

A

Recycled via enterhepatic circulation

Some 5% lost in faeces and rest is recycled via portal vein

Reabsorbed in ileum area

140
Q

Function of gall bladders?

And how does it do it?

A

Concentrates bile by absorbing water and Na+

141
Q

What does sphincter of oddi do?

A

Controls release of bile and pancreatic juice into duodenum

142
Q

CCK affect on oddi and gallbladder and pancreas?

A

Relaxes oddi

Contracts gallbladder and bile secretion triggered

Triggers acinar cells in pancreas to realease enzymes

143
Q

What occurring in each segment of small I?

A

Duodenum- gastric acid neutralisation and digestion and iron absorption

Jejunum- nutrient absorption

Ileum- nacl absorption and dehydration of chyme, absorbs left overs(B12, bile acids)

144
Q

Why called small intestine?

A

Smaller diameter

145
Q

Plicae?

A

Numerous folds of mucous membrane on small I wall

146
Q

Why have plicae?

A

Increases SA helps mixing and gets nutrients closer contact to epithelial cells

147
Q

What are crypts?

A

Invagination of epithelium around villi and lined with younger epithelial cells
Stem cells are here

148
Q

What it means when they say epithelial cells have short life span?

A

Mucousal surface constantly shredding and renewing the epithelial cells
Turnover rapid

Like an elevator from crypt to villus top and down death

149
Q

Where are crypts found?

A

Small I

150
Q

2 cells found on villi in small I?

A

Goblet - give mucous layer acid microclimate

Absorptive

151
Q

Where does laminate propria lie?

A

Epithelium on LP

Provides support and nutrients to it

152
Q

Epithelium type in small I

A

Simple columnar epithelium

153
Q

Type of epithelium in stomach?

A

Simple columnar epithelium

154
Q

Villus does what?

Crypt cell does what?

A

Villus absorbs

Crypt cell secretes Cl and water

155
Q

Water absorption needs what?

Water secretion needs what?

A

Absorption Na gradient

Secretion Cl gradient

156
Q

What does small I do with water?

A

Absorbs it - villus

Secretes it - crypt

157
Q

How is water secreted out in small I?

A

Secretes out by passive diffusion

Using Cl channel called CFTR as a driver to push water out

158
Q

Why is water secretion important in digestion? 4

A

Maintains lumenal contents in liquid state

Promotes mixing of nutrients with enzymes

Dilutes and washes away any injurious substances

Helps absorption and promotes it

159
Q

What is cftr?

A

Cl channel to drive water secretion

160
Q

What protein activates and opens cftr?

A

Protein kinase A

161
Q

Two types of intestinal movements

A

Segmentation

Peristalsis

162
Q

Can segmentation and peristalsis occur at same time?

A

No either or

163
Q

Segmentation intestinal movement describe

Allows what

When occurs

A

Back and forth contraction and relaxation
Of short intestinal segments
Relaxed areas contract then relax

Allows for thorough mixing of contents

During a meal or aftermath

164
Q

Difference between segmentation and peristalsis what are they contracting

A

Segmentation - contract circular muscles

Peristalsis-Contract Longitudinal muscles

165
Q

Small I how does it contract

A

Like stomach and has pacemaker cells in longitudinal muscle layer

BER. Is subthreshold and needs input to fire AP

166
Q

What determines strength of contraction of small I muscle ?

A

Action potential frequency

167
Q

BER what happens as you go down intestine

A

Decreases

168
Q

Effect of parasympathetic and sympathetic nervation on small I contraction

A

Para. - increase contraction

Symp. - decrease contraction

169
Q

What nerves innervate small I muscles contraction? 3

A

Parasympathetic
Sympathetic
ENTERIC NERVOUS SYSTEM

170
Q

When does peristalsis in small I occur

A

After absorption of nutrients

Between meals

171
Q

When does segmentation occur in small I

A

While during a meal while absorbing

172
Q

Migrating motility complex is what?

A

Pattern of peristaltic activity travelling down small I

During periods between meals

As one MMC ends another begins

173
Q

What cessation of mmc

A

Arrival of food in stomach initiates segmentation

174
Q

Role of MMC?

Why is it good? Important?

A

To clean out small I and sweep left overs out and undigested material out and transfer to large I

This tops bacteria colonisation in small I

175
Q

What triggers start of MMC?

A

Motilin hormone

Motilin is high means

Nutrients absorbed is low

176
Q

Law of intestine - how is bolus always moved

A

Into area of relaxation towards colon

177
Q

Gastricileal reflex is what ?

Explainnsteps

A
  1. Gastric emptying into small I
  2. Triggers segmentation activity in ileum
  3. Opening of ileocaecal sphincter
  4. Entry of chyme into large I
  5. Distension of colon wall as fills
  6. Reflex contraction of sphincter to prevent backflow into small I
178
Q

Gastroileal reflex is what type of reflex?

A

Long

From gastric to large I !!!

179
Q

Colon parts 4

A

Ascending
Transverse
Descending
Sigmoid

180
Q

What is the muscles layers like in colon?

A

Circular is complete and longitudinal is incomplete

181
Q

Teniae coli?

What happens when these contract?

A

3 Bands along length of colon -strips of longitudinal muscle

When they contract they form haustra pouches

182
Q

Caecum function?

A

Appendix is projection from it

No function

183
Q

Villi in large intestine?

A

No villi

Just straight deeper crypts with lots of goblet cells

184
Q

Why lots of goblet cells in large I?

A

Mucus creates flat slimy,slippery surface for solid faeces to slide out

185
Q

What is rectum?

A

Straight muscular tube between sigmoid and anus

186
Q

Epithelium of rectum?

A

Simple columnar epithelium

187
Q

Which Muscalaris is thicker anus or rectum?

A

Rectum is less thicker than anus

188
Q

Flow from rectum out from body?

A 
Rectum 
Anal canal
Internal anal sphincter 
External anal sphincter 
Anus
189
Q

Internal anal sphincter difference with external anal sphincter?

A 
Internal = smooth muscle we can’t control it 
External = skeletal muscle we can control it
190
Q

Epithelium change in anus

A

Simple columnar to

Stratified squamous epithelium (cheeks of bum)

191
Q

What happens with water in large I?

A

Absorption of water by Na gradient

Dehydrates chyme to form solid faecal pellets

192
Q

Why does bacteria colonise in large I

A

Due to long residence in colon

193
Q

Role of bacteria in large I?

Outcome of it?

A

Fermentation/breakdown of undigested carbohydrates/undigested material

To form bio products -

Short chain FA for energy
Vit K for blood clotting
Gas - nitrogen/CO2 farts

194
Q

Mass movement contraction ?

A

Material entering rectal wall from colon

A wave of contraction

195
Q

What triggers defaecation reflex?

A

Distension of rectal wall sensed by mechanoreceptors increase urge to defaecate

196
Q

Defaecation reflex innervation explain?

A

Parasympathetic only via pelvic splanchnic nerves

No sympathetic influence

197
Q

Defaecation reflex steps explain

A

Contraction of rectum and distension of wall

Relaxation of internal and contraction of external sphincter

Increased peristaltic activity in colon to push more into rectum to increase urge

Pressure increases on external sphincter and relaxes under voluntary control

Expulsion of faeces

198
Q

What is constipation

A

Find it hard to poo don’t go to toilet often

No absorption of toxins from faecal material too

Distension of rectum for too long

199
Q

What is diarrhoea

A

Faeces too liquid

Leads to dehydration as losing too much fluid

200
Q

Causes of Diarrhea?

Explain mechanism

A

Bacteria e.g. - e.coli, cholera

Produce protein toxins that turn on crypt cells on MAX so secrete lots of water and CL

And so water swamps the lumen

Infected crypt cells essentially

201
Q

Treatment of diarrhoea?

A

Oral rehydration therapy

Salt and sugar solution Na/glucose

This Will drive water absorption and rehydration in villi cells

202
Q

GAHS score? TELLS U WHAT

A

glasgow alcoholic hepatitis

-preducts mortality in patients with alcoholc hepatitis

203
Q

end stage liver disease?

A

cirrhosis with low albumin, prolonged prothrombin time, raised bilirubin, ascites, encephalopathy

204
Q

prothrombin time?

A

test to see how long takes blood to clot

205
Q

cholecystitis?

A

inflamed gall bladder

206
Q

alcohol withdrawal from when?

A

24hrs onwards

207
Q

features of alcohol withdrawal?

A 
sweating
hypertension 
nausea 
weakness 
vomiting 
anxiety
208
Q

ascites caused by?

A

portal hypertension

low serum albumin - causing low plasma pressure

209
Q

what reduces risk of further bleeding?

A

beta-blocker

210
Q

hellers myotmy?

A

cut muscles of LOS - allowing food to pass into stomach

211
Q

how to diagnose toxic megacolon?

A

transverse colon distended over 5cm and patient is systemically unwell

212
Q

pSc associated with more In IBD?

A

UC

213
Q

IS TRYPSIN released by pancreatic cells?

A

NO

released as trypsinogen
and covnerted to trypsin in duodenum by enzyme

214
Q

cellulase in a vertebrate?

A

does not exist - no vertebrate has cellulase in them

215
Q

stomach dimension does what to gastric secretion?

A

increases it

216
Q

what stimulates bicarbonate from brunners glands?

A

secretin

217
Q

pepsin requires what environment to work?

A

acidic environment

218
Q

cck does what?

A

cause gb to contract and relaxing of sphincter of oddi

219
Q

conjoint tendon formed by?

A

internal oblique and transversus abdomnis

220
Q

direct hernia?

A

weakness of abdominal wall

221
Q

inguinal canal posterior wall formed by

A

posterior wall- transversals fascia

anterior wall - external oblique

222
Q

encephalopathy caused by lack of what vitamin?

A

B1

223
Q

MAIN REASON FOR ASCITES?

A

PORTAL HYPERTENSION

224
Q

treatment of ascites?

A

sodium restriction

fluid retention

225
Q

side effects of opioids?

A

constipation

226
Q

how does pancreatitis affect glucose levels?

A

HYPERGLYCEMIA

227
Q

SIDE EFFECT OF PPI?

A

C DIFF infection risk

228
Q

what level of neutrophils in ascites indicate Ab needed in SBP?

A

more than 250 cells per mm3

229
Q

when does it hint to be churns disease?

A

when affects stuff along the whole git - mouth to anus

GI SYSTEM (4 decks)

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