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DIGESTIVE SYSTEM > PHYSIOLOGY And Some Schemes Of Endocrine Ca And P Phisiology > Flashcards

PHYSIOLOGY And Some Schemes Of Endocrine Ca And P Phisiology Flashcards

1
Q

Oral mucosa and esophagus present …. Epithelium

A

Stratified squamous non-keratinised

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2
Q

Stomach, intestine and colon present… epithelium

A

Columnar

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3
Q

Gastric glands have… cells

A

Principal and parietal

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4
Q

Duodenal glands of Brunner have…. cells

A

Mucinous

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5
Q

Intestinal crypts of lieberkuhn have… cells

A

Paneth

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6
Q

Salival glands present… cells

A

Acinar

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7
Q

Gastric secretion has the … pH

A

Lowest

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8
Q

Pancreatic secretion and Brunner glands have the … pH

A

Highest

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9
Q

Most of the secreted fluid comes from…

A

Stomach and Small intestine

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10
Q

Serous secretion is characteristic of … glands

A

Parotid, submaxilar and sublingual

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11
Q

Mucinous secretion is characteristic of … glands

A

Submaxilar, sublingual and bucal

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12
Q

Contents of serosa

A

Ptialine, which breaks down starch

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13
Q

Content of the saliva

A

Potassium, bicarbonate, chloride and sodium mainly

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14
Q

Primary secretions coming from the acinous salivary glands move through the duct where it becomes a secondary secretion:

A

Very rich in potassium and bicarbonate

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15
Q

Stimuli for acid secretion by parietal cells

A

Acetylcholine (released by the vagus nerve which innervates parietal cells), Gastrin (produced by G cells in the antrum), histamine (enterocromaffin-like).

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16
Q

Secretory cells in gastric/oxyntic glands

A
  • Mucous or principal cells which produce MUCUS (bicarbonate)
  • Parietal cells, which produce Hcl and intrinsic factor for vitamin B12
  • Chief cells, which produce pepsinogen (for protein breakdown)
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17
Q

Pyloric or tubular glands contain endocrine cells such as…

A
  • G cells, which release gastrin (stimulate Hcl secretion)
  • D cells, which release somatostatin (inhibit Gastrin and Hcl release)
  • Enterochromaffin-like cells (ECL), which release HISTAMINE
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18
Q

CEPHALIC PHASE OF GASTRIC SECRETION

A
  • 30% of total Hcl secretion
  • Stimuli are taste and smell
  • Direct vagal stimulation or indirect (via gastrin) for Hcl release
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19
Q

GASTRIC PHASE OF GASTRIC SECRETION

A
  • 60% of total Hcl secretion
  • Stimuli: gastric distension, presence of peptides
  • Direct or indirect (gastrin) vagal stimulation
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20
Q

INTESTINAL PHASE OF GASTRIC SECRETION

A

-10% of total Hcl secretion
- Mediated by protein digestion products.

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21
Q

Complete this scheme bout neuro-hormonal GI secretion

A
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22
Q
A
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23
Q

Histamine stimulus is…

A

GASTRIN

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24
Q

Histamine action in the stomach:

A

Increase Hcl secretion

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25
Q

Histamine origin

A

ECL cells

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26
Q

Gastrin origin

A

G cells antrum

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27
Q

Gastrin stimulus

A

Distension and proteins

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28
Q

Gastric actions in the stomach

A

Increases: emptying, Hcl secretion, Pepsin (by chief cells), and Histamine (ECL cells)

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29
Q

PARASYMPATHETIC actions in the stomach

A

Emptying, Hcl production by parietal cells, Pepsinogen production by chief cells.

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30
Q

Secretin stimulus

A

Acidity and fat

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31
Q

Secretin action in the stomach

A

Increase secretion of pepsinogen by chief cells

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32
Q

Somatostatin actions in the stomach

A

Decrease emptying and Hcl secretion

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33
Q

Somatostatin stimulus

A

Acidity

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34
Q

Somatostatin origin

A

D cells antrum

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35
Q

Cholecystokinin action in the stomach

A

Decrease emptying, increase Hcl secretion (stimulus is fat and proteins)

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36
Q

Cholecystokinin origin

A

I cells duodenum

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37
Q

Secretion in the duodenum is done by…

A

Brunner Glands

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38
Q

Function of Brunner glands duodenum

A

Secretion of alcalin mucus for protection against Hcl

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39
Q

Brunner glands duodenum stimuli

A
  • touch, distension and irritants
  • PS innervation (X)
  • Secretin (S cells duodenum)
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40
Q

Secretin not only increases pepsinogen secretion but also stimulates…

A

Brunner glands in duodenum (for mucus production)

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41
Q

Inhibition Brunner glands

A

Stress, Sympathetic system (causing stress ulcers)

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42
Q

Secretion along the small inestine is carried out by…

A

Lieberkühn crypts at the base of the intestinal villi

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43
Q

Function of ENTEROCYTES in Lieberkühn crypts of small intestine

A

Secretion of water and electrolytes, absorption of digestion products.

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44
Q

Function of GLOBET CELLS in Lieberkühn crypts of small intestine

A

Mucus for pretectiom

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45
Q

Function of Paneth cells in Lieberkühn crypts of small intestine

A

Antimicrobial defense

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46
Q

Function of Stem cells in Lieberkühn crypts of small intestine

A

Renewing of epithelium

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47
Q

…. secrete enzymes such as peptidases, sacarases, maltases, lactases, intestinal lipases in the small inestine

A

Enterocytes

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48
Q

Mechanism of water secretion in Lieberkühn crypts of small inestine

A

Active transport of Cl- and HcO3- with passive diffusion of Na+ (water gets dragged by Na)

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49
Q

La diarrea en la quimio surge porque…

A

Mueren las stem cells at the base of small intestinal crypts

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50
Q

In large intestine there are… but no…

A

Lieberkühn crypts, intestinal villi

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51
Q

In large intestine there are … and …, even though they do not produce digestive enzymes as in small inestine

A

Goblet cells (more than in small intestine), enterocytes

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52
Q

Main function of large intestine

A

Absorption of water, electrolytes and vitamins stimulated by PS SYSTEM

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53
Q

Mucus functions in large intestine

A

Protection and feces cohesion

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54
Q

Secretin hormone function in the pancreas

A

Activates ductal cells to produce HCO3- rich fluid

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55
Q

Cholecystokinin function in the pancreas

A

Activates acinar cells to produce enzymes

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56
Q

Types of cells in the exocrine pancreas

A

Ductal: with a main pancreatic duct (Wirsung)
Acinar: secreting digestive enzymes to pancreatic ducts

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57
Q

Secretin action in the pancreas

A

Increase HCO3 in duct cells

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58
Q

Cholecystokinin action in the pancreas

A

Increase enzymatic secretion in the acinar cells

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59
Q

Parasympathetic action in the pancreas

A

Enzyme secretion by acinar cells, HCO3 secretion by ductal cells

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60
Q

The pancreas has 2 main functions

A

Digestion (acinar cells)
Hydration and alkalinization by ductal cells

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61
Q

Hereditary pancreatitis is usually developed because of…

A

Problems in the trypsin gene

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62
Q

In acinar secretion, …. (zymogen) is released with …
In the small intestine it is converted into … by the … (from duodenal enterocytes).
Finally, … will convert the rest of zymogens in the duodenum.

A

Trypsinogen, trypsin inhibitors, trypsin, enterokinase
Trypsin.

63
Q

Acinar cells produce many regulatory factors such as…

A

Pro-colipase, trypsin inhibitors, monitor peptide.

64
Q

Ductal secretions are… rich

A

Bicarbonate

65
Q

HCO3 from ductal secretions comes from…

A

The production inside the cells with Carbonic anhydrase and the extraction of it from blood

66
Q

Exit of Cl to the lumen in ductal secretion is done thanks to…, and its recycling by…

A

CFTR (the one of cystic fibrosis), Cl/HCO3- PUMP

67
Q

In ductal secretion in the pancreas, the hydrogen ions exit the cell to the to the interstitium via the..

A

Na+/H+ exchanger

68
Q

After pancreatic bicarbonate rich secretion thanks to ductal cells, …. in the lumen reacts with … from the stomach so as to neutralise the pH before pancreatic enzymes (from the acinar cells of the pancreas) become active in the small intestine.

A

HCO3-, Hcl

69
Q

Stimuli for HCO3- secretion in ductal cells

A

Secretin (produced by S cells in the small intestine) and Ach from the PS system.

70
Q
A
71
Q

The gallbladder stores … produced by the liver and then releases it along with pancreatic secretions into the 2nd portion of the duodenum thought the …

A

Bile, Ampulla of Vater

72
Q

Composition of bile

A

Water, bile salts, phospholipids, cholesterol, bile pigments (bilirubin), Na+, HCO3X and other electrolytes

73
Q
A
74
Q

Biliary secretion functions

A

Facilitates the emulsion, solubilization andabsortion of fat
Helps alcalization of the duodenal lumen
Extrection of byproducts by metabolism from the organism.

75
Q
A
76
Q

What happens in the cephalic phase of biliary secretion?

A
  1. Relaxation of the Oddi Sphincter (X)
  2. Bile to the duodenum before the chyme
77
Q

Action of CCK (I cells duodenum) in the intestinal phase of biliary secretion

A

CHOLAGOGUE ACTION: contracts the gallbladder and increases the passage of bile to the duodenum

78
Q

Action of secretin (S cells duodenum) in the intestinal phase of biliary secretion

A

CHOLETERIC ACTION: it increases the production of bile by the hepatocytes and of luid from ductal cells

79
Q

Gallbladder is essential (T/F)

A

False: it is not essential. without it there is not bile concentration and the flux of bile is constant although it also increases with meals

80
Q

Cholecystokinin and Acetylcholine of the PS NERVOUS SYSTEM cause…

A

Contraction of the gallbladder and relaxation of the sphincter of Oddi.

81
Q

Stimuli for biliary secretion

A
82
Q

Secondary bile acids in the intestine suffer…. so as to become bile salts

A

CONJUGATION

83
Q

Main characteristic of bile salts that allow them to carry out fragmentation and emulsification as well as solubilisation and absorption

A

They are amphipatic

84
Q

Free and already used bile salts diffuse into the blood and enter …

A

Portal circulation

85
Q

… of bile acids are recycled, losing only… through the feces.

A

95%, 5%

86
Q
A
87
Q

Hepatic structure

A
88
Q

Anatomical unit of the liver

A

Hepatic lobule

89
Q

Functional unit of the liver

A

Hepatic acinus

90
Q

Hepatic zones

A

ZONE 1: peripheral or porto-portal
ZONE 2: intermediate
ZONE 3: peri-central

91
Q

Hepatic sinusoids have …. endothelium and have/do not have basement membrane

A

Fenestrated, do not have

92
Q

In the space of disse we find … cells

A

HEPATIC STELLATE CELLS

93
Q

Flow per minute reaching the liver
1. Portal vein:
2. Hepatic artery:
3. Total approx:

A
  1. 1L (75%)
  2. 300 ml (25%)
  3. 1.3L=27% of cardiac output
94
Q

When do we consider there is considerable portal hypertension?

A

If the gradient is greater than 10mmHg (from portal vein to hepatic veins)

95
Q

Main cause of liver hypertension

A

Liver CIRRHOSIS

96
Q

Portal hypertension is usually due to LIVER CIRRHOSIS (increased fibrosis). There is resistance to portal hepatic flow and the flow finds collateral venous systems, which cause problems such as:

A
  • ESOPHAGEAL VARICES
  • SPLENOMEGALY
  • ASCITES
  • HYPERPLENISM (sequester platelets)
97
Q

Main cell responsible for liver regeneration

A

Mature hepatocyte

98
Q

Molecules involved in priming phase of liver regeneration

A

INFLAMMATORY CYTOKINES: TNFa, IL6

99
Q

Molecules involved in proliferation phase of liver regeneration

A

GROWTH FACTORS: EGF, HGF

100
Q

Molecules involved in termination phase of liver regeneration

A

TRANSFORMING GROWTH FACTOR: TGFb

101
Q

Hepatic venous blood after liver passage is sterile because … cells purifícate bacterial products

A

KUPFFER CELLS

102
Q

Kupfer cells enter the … through the … in response to chemokines and damage signals.

A

space of Disse
fenestrae of sinusoidal endothelium

103
Q

Which proteins does the liver store?

A

A, D and B12

104
Q

Hepatocytes contain large amounts of … (lo que te falta a ti)

A

FERRITIN

105
Q

Liver is also responsible for protein production of the…

A

COAGULATION CASCADE

• Fibrinogen, prothrombin, Factor V (acceleratingglobulin), Factor VII, Factor IX, Factor X
• Some depend on vitamin K for their hepaticproduction: “1972” (Factor 10, 9, 7 and protromin -factor 2-)

106
Q

Gluconeogenesis is increased in zone … of the liver

A

1 (peripheral, porto-portal)

107
Q

GLYCOLISIS is increased in zone… of the liver

A

3 (peri-central)

108
Q
A
109
Q

Jaundice can be cause due to…

A

LIVER- BILIARY DISEASES (problem in excretion of conjugated bilirubin to bile duct) or HEMOLYSIS (increased unconjugated bilirubin production)

110
Q

…. is absorbed by the liver and converted into …

A

Indirect/unconjugated, direct or conjugated

111
Q

Conjugated bilirubin is excreted through the … until it reaches the intestines

A

Bile duct

112
Q

Conjugated bilirubin is transformed into … by intestinal microbiome

A

UROBILINOGEN

113
Q

UROBILINOGEN is transformed into … and excreted through the feces

A

STERCOBILINOGEN AND STERCOBILIN

114
Q

UROBILINOGEN is converted into … in the kidneys and excreted through urine

A

Urobilin

115
Q

18% of UROBILINOGEN is reabsorbed by the intestinal walls, entering the … and being recycled (it returns to liver)

A

ENTEROHEPATIC CIRCULATION

116
Q

The liver transforms … into … by a process known an, it is then excrete through urine

A

NH3, UREA, UREA CYCLE

117
Q

Bilirubin detoxification scheme

A
118
Q

Ammonia detoxification scheme

A
119
Q

CALCIUM AND PHOSPHORUS FUNCTIONS

A
120
Q

PROTAGONISTS IN PHOSPHO-CALCIUM METABOLISM

A
121
Q

REGULATION OF PTH RELEASE

A
122
Q

PTH ACTIONS AND VIT D ACTIVATION

A
123
Q

EFFECTS OF PTH ON BONE

A
124
Q

EFFECTS OF PTH ON KIDNEY

A
125
Q

SYNTHESIS AND EFFECTS OF VIT D

A
126
Q

INTESTINAL CALCIUM REABSORPTION

A
127
Q

HORMONAL RESPONSE TO HYPOCALCEMIA

A
128
Q

When the lower esophageal sphincter does not work properly, it is called…

A

ACHALASIA

129
Q

Migrating motor complex is..

A

Small wave of contraction during fasting in small intestine which cleans dead cells, bacteria…

Carried out by MOTILIN

130
Q

Liver lymphatics, lumber lymphatics and intestinal lymphatics are connected by…

A

CISTERNA CHYLI

131
Q

The main absorption of water is done in…

A

COLON

132
Q

Absorption of vitamins and minerals is done mainly in the….

A

Small intestine

133
Q

Calcium and iron are mainly absorbed in the…

A

Duodenum

134
Q

Fats and vitamins are mainly absorbed in the…

A

Jejunum and ileum

135
Q

Vitamin B12 and bile salts are mainly absorbed in the…

A

Terminal ileum

136
Q

…. is found in saliva and protects vitB12 from gastric digestion

A

HAPTOCORRIN

137
Q

Vit B12 binds… and travels to Terminal Ileum

A

Intrinsic Factor

138
Q

VitB12+Intrinsic factor enters enterocytes through…

A

CUBILIN RECEPTOR

139
Q

Deficiency of Intrinsic Factor, CUBILIN receptor, achlorydria or resection of terminal ileum causes…

A

PERNICIOUS OR MEGALOBLASTIC ANEMIA (huge erythrocytes)

140
Q

Treatment for pernicious/megaloblastic anemia

A

Give patients liver extracts (main place of storage for VitB12)

141
Q

Before entering the liver, Fe3+ in transformed into Fe2+ by…

A

Duodenal cytochrome B

142
Q

Fe2+ enters the hepatocytes by…

A

DMT-1 TRANSPORTER

143
Q

Iron can be stored in the hepatocytes in the form of…

A

FERRITIN

144
Q

Iron exits the hepatocytes by…

A

FERROPORTIN

145
Q

Fe2+ is transformed into Fe3+ before entering the blood by …

A

HEPHAESTIN

146
Q

Fe3+ joins … in blood and is transported either to the liver or to the bone marrow.

A

PLASMA TRANSFERIN

147
Q

…. inhibits ferroportin

A

HEPCIDIN

148
Q

Calcium absorption can be transcellular active by…

A

TRPV5

149
Q

Calcium is sent to blood thanks to Calcium Binding Protein known as…

A

CALBINDIN

150
Q

CALBINDIN (calcium binding protein) is increased by…

A

VITAMIN D

151
Q

Microbiome is mostly rich in…

A

COLON

152
Q

Microbiome produce vitamin…

A

K

153
Q

Firmicutes like Clostridium or Lactobacillus are predominant in the…

A

SMALL INTESTINE

154
Q

Bacterioides are predominant in the …

A

COLON

DIGESTIVE SYSTEM (5 decks)

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