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Phase 1 flashcards > Quick GI/ Liver flashcards > Flashcards

Quick GI/ Liver flashcards

1
Q

oral phase of swallowing

A

tongue presses against hard palate
bolus passes into oropharynx
soft palate lifts to close nasopharynx
voluntary

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2
Q

pharyngeal phase of swallowing

A

tongue seals off oropharynx
nasopharynx closed
epiglottis prevents aspiration by swinging down
pharynx widens and shortens - longitudinal muscles

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3
Q

oesophageal phase of swallowing

A

LES relaxes

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4
Q

what do mucous cells produce?

A

mucin

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5
Q

where is vitamin B12 absorbed?

A

terminal ileum

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6
Q

what do chief cells produce?

A

PEPSINOGEN!

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7
Q

what do these cells produce, and what is the result?:
ECL cells
G cells
D cells

A

ECL
- histamine
- stimulates HCl secretion
G
- gastrin
- stimulates HCl and histamine
D
- inhibits HCl secretion

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8
Q

mucosal protective mechanisms

A

alkaline mucus on luminal surface
tight junctions between epithelial cells
rapid replacement of damaged cells by stem cells in base of gastric pits
feedback loops regulate HCl secretion

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9
Q

causes of peptic ulcers

A

NSAIDS
H Pylori
gastrinoma
chemical irritants e.g alcohol, bile salts

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10
Q

which nerve mediates cephalic phase of digestion?

A

vagus

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11
Q

what mediates gastric phase of digestion

A

vagus
gastrin

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12
Q

volume of empty and full stomach

A

50 ml
1500ml

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13
Q

what increases strength of gastric contractions?

A

gastrin
stomach distension

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14
Q

what decreases strength of gastric contractions?

A

duodenal distension
low duodenal pH
increase in duodenal fat/ osmolarity
an increase in sympathetic stimulation
decrease in parasympathetic stimulation

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15
Q

where are entrogastrones released?

A

duodenum

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16
Q

BMI measurement

A

weight / height2
kg/m2

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17
Q

BMI ranges

A

under 18.5 = underweight
18.5 - 25 = normal
25 - 30 = overweight
30 - 40 = obese
over 40 = morbidly obese

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18
Q

normal BMR

A

24kcal/kg/day

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19
Q

increase BMR

A

male
pregnangy
hyperthyroidism
exercise

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20
Q

decrease BMR

A

female
malnutrition/ starvation
hypothyroidism

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21
Q

how are fat soluble vitamins absorbed?

A

with fat in micelles
ileum

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22
Q

where are water soluble vitamins absorbed?

A

B and C
but not B12

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23
Q

where and how is B12 absorbed?

A

with intrinsic factor in terminal ileum

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24
Q

function of vitamin A

A

cellular growth and differentiation
vision
lymphocyte production

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25
Q

sources of vitamin A

A

liver
dairy
oily fish

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26
Q

function of B12

A

erythrocyte formation
DNA synthesis

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27
Q

source of B12

A

eggs
milk
meat
fish

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28
Q

consequence of B12 deficiency

A

pernicious anaemia

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29
Q

function of vitamin C

A

collagen synthesis
antioxidant

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30
Q

source of vitamin D

A

UV light
fish oils
egg yolk

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31
Q

sources of vitamin E

A

nuts
seeds

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32
Q

symptoms of vitamin E deficiency

A

muscle weakness
retinal degeneration

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33
Q

source of vitamin K

A

bef
liver
leafy green veg

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34
Q

protein digestion

A

small intestines
- protein to polypeptides
SI
- polypeptides to endopeptidases (trypsin, chymotrypsin, elastase) by pancreatic endopeptidases
final digestion
- endopeptidases to amino acids by exopeptidases
- aminopeptidases on luminal membranee of epithelial cells
- also intracellular peptidases

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35
Q

how much water passes through GI tract per day?

A

9L

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36
Q

water from
food and drink
saliva
gastric secretions
bile
pancreatic secretions
intestinal secretions
colonic mucous secretions

A

2L
1.5L
1.5L
0.8L
0.8L
2L
0.2L

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37
Q

where does most water absorption occur?

A

small intestine - 80%
only 1.5L enters large intestine

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38
Q

what percentage of fluid is reabsorbed?

A

98%

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39
Q

how is sodium absorbed?

A

active transport
cotransport with glucose, amino acids
water follows with sodium

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40
Q

how is potassium absorbed?

A

passive diffusion

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41
Q

how is Cl- absorbed

A

exchanged with bicarbonate - active transport

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42
Q

liver embryology

A

foregut
begins forming week 3
hepatocytes derived from endoderm (like all foregut derivatives)
start processing bile at week 12
mesenchymal tissue and Kuppfer cells arise from mesoderm

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43
Q

function of foetal liver

A

haematopoeisis
cells migrate to bone marrow

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44
Q

hepatic diverticulum

A

liver cranially
gallbladder caudally

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45
Q

functional unit of liver

A

lobule
hexagonal
- central vein
- portal triad branches at each corner

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46
Q

is the sinusoid fenestrated?

A

sinusoid is fenestrated

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47
Q

what separates sinusoid and hepatocytes

A

space of Diesse

48
Q

sinusoid lining

A

specialised endothelial cells
Kupffer cells

49
Q

junctions in bile canaliculi

A

tight junctions, gap junctions, desmosomes

50
Q

how is bile pumped towards bile duct?

A

actin filament

51
Q

what does liver store?

A

vitamins
- fat soluble ones
- 3-5 year supply of non-fat soluble B12
minerals
- iron
- copper
glycogen
- 100g
- 12h supply

52
Q

function of copper

A

RBC formation

53
Q

copper transport

A

in plasma bound to ceruloplasmin

54
Q

how much glycogen stored?

A

100g
12 hours supply

55
Q

which types of protein does liver produce?

A

plasma proteins
clotting proteins
complement proteins

56
Q

plasma protein examples

A

albumin, fibrinogen, globulin

57
Q

which clotting factors are not made in liver?

A

3,4,8

58
Q

function of complement proteins

A

innate immunity

59
Q

albumin functions

A

oncotic pressure
transport large hydrophobic molecules

60
Q

xenobiotic

A

foreign chemicals not normally found or produced in the body and cannot be used to produce energy

61
Q

phase 1 reactions

A

transformation of substance from one type to another
oxidation/ hydrolysis reaction
adds -SH or -OH
.g cytochrome p450

62
Q

phase 2 reactions

A

glucuronidation - adds glucuronic acid
conjugation - adds chemical group to substance
excretion (often in bile/urine)

63
Q

UDPGT

A

glucuronyl transferase
- liver enzyme. It changes bilirubin into a form that can be removed from the body through the bile.

64
Q

aim of phase 1 and 2 reactions

A

transform substance to be less toxic
more water soluble so it can be excreted
2 different ways of doing this

65
Q

glucose alanine cycle purpose

A

move proteins from muscles to liver when glycogen is low

66
Q

what can be used to measure liver health?

A

ALT
alanine aminotransferase

67
Q

glucose alanine cycle

A

excess alanine transferred to liver and converted to pyruvate (transamination)
pyruvate is used to produce glucose in gluconeogenesis
glucose enters blood and is used by muscles (glycolysis)
- also removes excess ammonia
glutamate to ammonium by oxidative deamination
dissociates to ammonia
converted to urea for urea cycle

68
Q

urea cycle function

A

remove excess nitrogen
ammonia converted to less toxic urea

69
Q

urea cycle

A

arginine (from diet or protein breakdown) + arginase –> ornithine + urea
ornithine + CO2 + ammonia –> citrulline
citrulline + ammonia –> arginine

70
Q

only product of urea cycle

A

urea

71
Q

why must ammonia be excreted?

A

neurotoxic - crosses bbb
would require lots of water to excrete - dehydration
very water soluble

72
Q

lipid metabolism

A

lipids + bile salts –> micelles
micelles constantly break and reform
lipids + pancreatic lipase –> glycerol and fatty acids
fatty acids absorbed by enterocytes and link to form triglycerides
triglycerides combine with proteins to form chylomicrons in Golgi
chylomicrons enter lacteal and are transported away from intestine to liver
VLDL transport lipids from liver into blood to adipose tissue
triglycerides diffuse into adipocytes for storage

73
Q

where are LDLs made?

A

plasma
cholesterol delivery to all body cells

74
Q

where are HDLs made?

A

liver
removes excess cholesterol from blood and tissues via excretion in bile

75
Q

where are VLDLs made?

A

hepatocytes
triglyceride delivery from liver to adipocytes

76
Q

fatty acid beta oxidation

A

catabolism of fatty acids to produce energy
in mitochondria of hepatocytes
each cycle shortens fatty acid chains by 2 carbons, continues until only 2 carbons remain
if odd number of chains, e.g 3C, cannot be oxidised further
leads to production of CO2 and ATP via Krebs
2 carbons removed as acetyl CoA is 2C
dduring every round, 2 carbons are cleaved to form acetyl CoA

77
Q

what is in bile

A

bile salts
phospholipids
bicarbonate
cholesterol
bile pigments e.g bilirubin

78
Q

how is bile concentrated in gallbladder?

A

microvillous epithelial cells
rugae

79
Q

bilirubin metabolism

A

haem converted to biliverdin and Fe2+ by haem oxygenase
biliverdin to unconjugated bilirubin by biliverdin reductase
unconjugated bilirubin transported to liver by albumin
in the liver, unconjugated bilirubin is converted to conjugated bilirubin by glucuronyl transferase (glucuronidation by UDPGT)
conjugated bilirubin enters duodenum in bile
conjugated bilirubin is converted to urobilinogen by colonic bacteria
some urobilinogen is reabsorbed into blood, to liver, to urobilin
urobilin is recycles to bile or excreted by kidneys - yellow urine
most is oxidised to stercobilin by bacteria for excretion - brown faeces

80
Q

what carries out glucuronidation?

A

UDPGT

81
Q

pancreatic embryology

A

originates as 2 buds
dorsal bud
- neck, body, tail, part of head
ventral bud
- ucinate process, part of head
dorsal and ventral buds undergo clockwise rotation
pancreas sits in C shape of duodenum
exocrine and endocrine cells - endoderm, foregut derivative
mesenchymal tissue - mesoderm
insulin secretion at week 20

82
Q

pancreatic histology

A

lobulated connective tissue that stains dark
lighter stained circular cells that lack lumen are islets of langerhans (endocrine)

83
Q

how are beta cells stained?

A

blue by aldehyde fuchsin

84
Q

where are delta cells and what do they produce?

A

in pancreas
somatostatin

85
Q

other hormones produced by pancreas

A

pancreatic polypeptide
vasoactive intestinal polypeptide
substance p
serotonin

86
Q

function of islets

A

endocrine

87
Q

function of tissues surrounding islets

A

exocrine

88
Q

terminal secretory units

A

acini
pyramidal cells arranged in a circle without visibe lumen

89
Q

pancreatic secretion pathway

A

acini, interlobular ducts, pancreatic ducts, pancreatic sphincter, sphincter of Oddi

90
Q

lining oof pancreatic ducts

A

simple columnar epithelia

91
Q

exocrine pancreas

A

acini of pancreas –> digestive enzymes as zymogens
released via pancreatic duct to duodenum
acini are exocrine to duodenum (enzymes)

92
Q

endocrine pancreas

A

islets of langerhans produce insulin, glucagon, somatostatin
to regulate glucose
islets are endocrine to blood (hormones)

93
Q

is most pancreas endocrine or exocrine?

A

exocrine

94
Q

what activates zymogens?

A

enterokinase on brush border

95
Q

pancreatic juice

A

amylase - starch to maltose
lipase - triglycerides to fatty acids
endopeptidase - peptides to amino acids
nuclease - DNA to nucleosides
bicarbonate ions neutralise stomach acid

96
Q

what stimulates bicarbonate release from pancreas?

A

stimulated by secretin
bicarbonate secreted into duct lumen via Cl-/ HCO3- exchanger on cells lining ducts
Cl- recycled back into lumen by CFTR channel

97
Q

cells in endocrine pancreas

A

alpha, beta and delta
delta = somatostatin
- inhibit exocrine secretions of pancreas
- reduce gastric emptying

98
Q

main enzyme required in phase 1 detoxification reactions

A

cytochrome P450

99
Q

urea cycle

A

in cytosol and mitochondria

100
Q

which mesenteries does the foregut have?
midgut
hindgut

A

dorsal and ventral
dorsal
ventral

101
Q

gag reflex

A

afferent ticking - glossopharyngeal
efferent response - motor vagus

102
Q

what passes through parotid gland?

A

facial
external carotid
retromandibular vein

103
Q

submandibular secretions

A

mixed serous and mucus
wharton’s duct
serous acini form crescents around mucous acini
facial

104
Q

parotid gland

A

serous
stensens duct

105
Q

sublingual

A

mucus
whatrons duct
anterior to submandibular

106
Q

cells in cardia

A

foveolar - mucus

107
Q

cells in fundus

A

parietal
chief
ECL

108
Q

cells in body of stomach

A

G cells

109
Q

duodenal cells

A

D - somatostatin
I - choleocystokinin
S - secretin

110
Q

action of gastrin and histamine

A

more H+/K+ ATPase pumps

111
Q

enterogastrones

A

secretin and CCK

112
Q

effect of secretin

A

stimulate somatostatin
inhibit gastrin

113
Q

gastric embryology

A

week 4
trilaminar disc folds medially and horizontally
endoderm fuses to form primitive gut tube
end of week 4
- oropharyngeal membrane ruptures
week 7
- cloatal membrane ruptures

114
Q

midgut and hindgut development

A

longation
herniation
rotation
retraction
fixation

115
Q

foregut development

A

week 4 - fusiform dilation in primitive gut tube
week 7 - 90 degree clockwise longitudinal rotation creates lesser sac
week 8 - ventrodorsal rotation - curves up

Phase 1 flashcards (27 decks)

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