physiology of the stomach 2 Flashcards

1
Q

what coordinates contraction and relaxation of the muscle in stomach wall

A

the myenteric plexus which receives input from ANS

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2
Q

does parasympathetic stimulation increase or decrease motility

A

increases

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3
Q

does sympathetic stimulation increase or decrease motility

A

decrease

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4
Q

what does the muscularis allow

A

food to be churned - particularly in antrum where muscle wall is thicker

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5
Q

what does food mix with to produce

A

mixes with gastric juice to produce chyme

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6
Q

where does chyme travel to

A

chyme passes through pyloric sphincter to duodenum

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7
Q

what breaks down protein in the stomach

A

pepsin

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8
Q

how is pepsin produced and activated

A

it is converted from pepsinogen by HCl
only active in acid environment

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9
Q

what does gastric lipase do

A

breaks down fat at a higher pH

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10
Q

what does gastric pepsin do

A

initiate protein digestion in the stomach

hydrolyses proteins to polypeptides and amino acids which stimulate acid production

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11
Q

when does pepsin become activated/deactivated

A

it is inactivated at high ph (6+) but can be reactivated upon re-acidification

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12
Q

when does salivary amylase act on carbohydrate

A

if pH is around 6 (mouth), so its far less active in acidic environment of stomach

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13
Q

what determines the force of contraction and amount of gastric emptying

A

neuronal and hormonal input to the antral smooth muscle

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14
Q

what increases antral contraction

A

distension of stomach
increased gastrin levels

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15
Q

what influences rate of gastric emptying

A

physical and chemical nature of stomach/intestine content

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16
Q

what does stomach emptying involve

A
  • contraction of lower oesophageal sphincter
  • contraction of gastric muscularis
  • relaxation of pyloric sphincter
17
Q

what inhibits gastric emptying

A

called the enterogastric reflex

  • the distension of the duodenum
  • presence of fat
  • increased HCl
18
Q

what does the enterogastric reflex prevent

A

too much chyme entering the duodenum all at once and aids digestion/absorption

19
Q

what are the implications of the enterogastric reflex on oral drug absorption

A

high fat meal delays entry to the duodenum

20
Q

what happens if you eat a larger meal

A

a longer digestive phase

21
Q

what is the effect of high fat content

A

fat in duodenum causes fundus to relax, lowering intragastric pressure

increases feeling of fullness for longer than low fat meal of same energy content, influences intake at next meal

22
Q

what is absorbed from stomach

A
  • water
  • electrolytes
  • alcohol
  • some drugs
23
Q

when does absorption properly start

A

when contents reach small intestine where food is acted upon by products of pancreas, liver, gallbladder

24
Q

what is the major source of variability in gastric absorption of drugs

A

the presence of food in the stomach

25
what is an ulcer
erosion of the mucosal layer with leads to inflammation and damage to underlying tissue
26
what are the main causes of gastric ulcers
- H pylori infection most common - NSAID use (2nd most common) - smoking, caffeine etc can contribute
27
how can gastric ulcers be managed
- explanation and reassurance - drug therapy (control of acid production) - eradication of H pylori