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
Q

what is an ulcer

A

erosion of the mucosal layer with leads to inflammation and damage to underlying tissue

26
Q

what are the main causes of gastric ulcers

A
  • H pylori infection most common
  • NSAID use (2nd most common)
  • smoking, caffeine etc can contribute
27
Q

how can gastric ulcers be managed

A
  • explanation and reassurance
  • drug therapy (control of acid production)
  • eradication of H pylori