Regulation of gut function Flashcards
Where do sympathetic preganglionic neurones arise from?
Thoracolumbar origins
What effect does the sympathetic nervous system exert onto the GI tract?
Inhibitory effect
Where do sympathetic preganglionic neurones enter into the sympathetic chain of ganglia?
Through the white ramps communicans, synapsing with psot-ganglionic unmyelinated neurones at their respective ganglion
What is the sympathetic neurotransmitter?
Noradrenaline
Which vertebral nerves innervate the stomach? (t)
T6-T9
Which vertebral nerves innervate the colon?
L2-5
Which ganglion contains the postganglionic neurones to the stomach?
Coeliac ganglion
Which ganglion contains the post-ganglionic neurones to the small intestine and proximal colon?
Superior mesenteric ganglion
Which ganglion contains post ganglionic neurones innervating the distal colon and rectum?
Inferior mesenteric and pelvic ganglionic
Which nerve supplies parasympathetic innervation to the stomach, small intestine and proximal colon?
Vagus nerve
Where do pre ganglionic parasympathetic neurones originate which stimulate the GI tract?
Sacral spinal cord,
Dorsal vagal complex within the cranial spinal cord innervates the stomach, pancreas and small intestine
What is the main parasympathetic neurotransmitter?
Acetylcholine
What is the extrinsic nervous system that innervates the gastrointestinal tract?
Autonomic nervous system,
What is the intrinsic nervous system of the gastrointestinal tract?
Enteric nervous system
What is the enteric nervous system?
The enteric nervous system functions autonomously, interacting with the sympathetic and parasympathetic nervous system. Lesions to the autonomic nervous system does not significantly impeded function of enteric system.
What are the four layers of the GI wall (deep to superficial)?
Mucosa (epithelium, lamina propria, and muscularis mucosa)
Muscularis
Submucosa
Serosa
What two muscles are contained within the muscularis layer?
Internal circular muscles
External longitudinal muscles
Which plexus resides intermediate of the internal circular muscles and the external longitudinal?
Myenteric plexus
Which nerve stimulates the myenteric plexus?
Vagus nerve, responding through transmission to myocytes
What is the myenteric plexus?
Receives communication from the vagus nerve, responding through transmission to myocytes, thereby activated to contract, initiating peristaltic waves and segmentation. Control of nerve impulses is involuntary.
Stretch receptors within the myenteric plexus are activated upon chyme entry within the duodenum, in addition to the movement of bolus Muscular contractions causing peristaltic waves
Controls gastric motility , subsequent tone, velocity and intensity of contractions
How is the myenteric plexus stimulated?
Stretch receptors are activated upon chyme entry within the duodenum in addition to the movement of the bolus
What is the Meissners plexus?
Submucosal plexus,
Senses the local environment of the gut lumen, stimulation of the submucosal plexus results in secretion of hormones from enteroendocrine cells embedded within the enterocyte mucosal layer
Which plexus stimulates the secretion of hormones from enteroendocrine cells?
Submucosal plexus
Which plexus exhibits influence on blood flow, and epithelia, in addition to endocrine cell function?
Submucosal plexus
How is the enteric plexus stimulated and activated?
Chyme enters within duodenum and lumen, stretches the intestinal smooth muscle.
Distention of the gut causes stimulation of sensory stretch neurones in the myenteric plexus residing within the muscularis.
How is the submucosal plexus stimulated?
Chemicals in chyme stimulates sensory neurones in the submucosal plexus, causing the secretion of hormones
What is the purpose of peristaltic movements?
Facilitates movement of bolus along GI tract
What is the definition of peristalsis?
Method of muscular contraction that facilitates the movement of bolus through the intestinal tract
Describe the contractions of muscularis muscles during peristaltic movement:
Internal circular muscles posterior to the bolus contact
Simultaneously, the external longitudinal muscles relax, stretching.
What is the relationship between circular and longitudinal muscles?
Work antagonistically
How is the peristaltic wave achieved?
Through subsequent relaxation of circular muscle and contraction of longitudinal muscles to accommodate the bolus, widens the lumen
What are the four main functions of the parasympathetic nervous system on the GI tract?
Increase peristalsis
Increase absorption
Increases secretion
Increases blood flow
What is the effect of sympathetic innervation on the GI tract?
Sense bolus within the lumen Stimulates a local response within the submucosal and the myenteric plexus Inhibitory effect Reduction: Peristalsis, absorption, secretion (Via enteroendocrine cells, hormones, bile & bicarbonate secretion) and subsequent reduction in blood flow.
What is absent in Hirshprung’s disease?
Congenital absence of ganglion of myenteric (between the smooth muscle layer), and submucosal plexus (within the submucosa of the GI wall). Therefore, the affected segment of colon cannot relax and is unable to pass stool through - causes obstruction - there is a reduced peristaltic movement
What is Hirshchprung’s disease?
Unopposed contractions of the rectum sigmoid, therefore dilation above this becomes capacious Intestinal distention proximal to aganglionic segment of bowel.
The tonal contractions without reciprocal relaxation therefore impedes peristaltic flow.
N.B: Constipated state