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Physiology Renal ABS 2018 > Secretions > Flashcards

Secretions Flashcards

1
Q

Where are the 7 places GI secretions take place in the digestive tract?

A
  1. Mouth
  2. Esophagus
  3. Stomach
  4. Small Intestine
  5. Pancreas
  6. Liver & Gallbladder
  7. Endocrine Glands
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2
Q

What are the seven secretions of the GI tract?

A
  1. Gastrin
  2. Secretin
  3. Cholecystokinin
  4. Glucose Insulinotrophic Peptide (gastric inhibitory peptide, GIP)
  5. Motilin
  6. Glucagon-like peptide (GLP-1) and Peptide YY
  7. Ghrelin
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3
Q

When your hungry and in a fasting state, what hormones are you secreting?

A

Ghrelin is secreted into the blood from oxnytic—-stimulates arcuate nucleus of hypothalamus to secrete of NPY—stimulating hunger

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4
Q

When your experiencing satiety what hormones are you secreting? (feeling of fullness)

A

After a meal, GLP-1 and Peptide YY are secreted into blood stream supressing NPY in the hypothalamus
Leptin also suppresses NPY in the arcuate nucleus
in the presence of glucose and insulin

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5
Q

What type of hormone is ghrelin?

A

Peptide hormone

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6
Q

Why do you feel full faster if you eat slowly?

A

As soon as you begin eating, chyme starts forming and the stomach secretes GLP-1 and Peptide YY, your satiety hormones

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7
Q

Where is leptin released from?

A

found in adipose tissue in and releases into circulation in response to glucose and insulin

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8
Q

What are the 3 types of glands found int the mouth? What type of gland are they?

A

Paired Exocrine (secretions comes out of the duct)

  1. Parotid
  2. Submandibular
  3. Sublingual
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9
Q

What is the first digestive enzyme in GI tract?

A

Salivary alpha amylase
breaks down starches
(large polymers of glucose with alpha linkages)—cleaves the of alpha linkages of glucose—malto-oligosaccharides—in the form maltose & isomaltose
(smaller polymers of glucose molecules)

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10
Q

What are components of saliva?

A
  1. Electrolytes
  2. Mucous
  3. Salivary amylase
  4. Transcarbalamin-1
  5. lingual lipase
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11
Q

What is the importance of transcabalamin-1? (TC-1, R-proteins/R-binders)

A

serve as protection for vitamin B-12 by binding to prevent the proteases in the gut essential vitamin for the maturation of red blood cells

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12
Q

A deficiency in TC-1 results in what?

A

inabiltiy to prevent the breakdown of B12
red blood cells are not able to mature
most severely-pernicious anemia

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13
Q

What is lingual lipase?

A

produced by glands in the tongue, 1st hydrolysis of lipids, hydrolyzes lipids (triglycerides, ester-cholesterol, phospholipids down to monoglycerides,cholesterol)

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14
Q

What two macromolecules are broken down in the mouth?

A
  1. Carbohydrates/Starch

2. Lipids

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15
Q

What is the main stimulus of salivation?

A

PNS -facial & glossopharyngeal nerves

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16
Q

What are the 7 functions of saliva?

A
  1. Taste
  2. Coagulation factors
  3. Antimicrobial action
  4. Protection
  5. Digestion
  6. Lubrication
  7. Oral hygiene
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17
Q

What are 7 factors that can increase salivary flow?

A
  1. PNS, Ach
  2. CNS
  3. Nausea
  4. Esophageal distension
  5. Chewy, flavorful foods
  6. Dry, acidic, alkaline
  7. Meats, sweets, bitter foods
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18
Q

What are the 6 factors that can decrease salivary flow?

A
  1. SNS, NE
  2. Hormones (ADH, ALDO)
  3. Sleep
  4. Dehydration
  5. Drugs
  6. Aging
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19
Q

What are the 8 gastric secretions?

“HIP GLOM” And the cells that secretes them?

A
  1. HCl- parietal cells
  2. Intrinsic Factor(IF)-parietal cells
  3. Pepspinogen-chief cells cleaves to pepsisn by acidic environment
  4. Gastrin-antral G-cells-HCl
  5. Lipases-chief cells hydrolysis of lipids
  6. Other-Histamine-enterochromaffan like cells; *HCl; somatostatin (SS)
  7. Mucous- protect epithelium from acidic environment
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20
Q

What is importance of the IF in stomach?

A

Binds to B12 to another binding site to protect B12 from pancreatic protease

21
Q

What is the importance of Histamine and SS in gastric secretions?

A

They are secreted in adjacent cells that work directly on the parietal cell
Histamine-Primary stimulus of HCl secretion
SS– suppress HCl just a little bit

22
Q

What 4 factors that stimulate acid secretion?

A 
Local direct stimulation parietal
1. Ach
2. Histamine
3. Gastrin
Extrinsically
4. Ach + Gastrin act on enterochromaffin cells to release histamine
23
Q

How do parietal cells make HCl?

A

they are inserting H/K ATPase in tubular vesicles in the membrane of the parietal cells to put H+ ion [] into lumen against concentration gradient

24
Q

What is the rate-limiting step for acid secretion in the parietal cells?

A

insertion H/K atpase pump on membrane

25
Q

Where does the H+ ions secreted into the lumen during HCl production come from?

A
  1. the break down of CO2 and H20 to H2CO3 and H20—*HCO3 is reclaimed into the capillary and H+ is secreted to the lumen of digestive tube
  2. Chloride can move into the lumen against [] gradient because of all the positive protons in the lumen
26
Q

How do potassium contribute to the acidity of the lumen?

A

The Na/K ATPase pump and H/K pump are both pumping K into cell against [] gradient,extremely increasing K—-so K begins to move out and form KCl

27
Q

What is the benefit of acid secretions on bacteria of ingested food?

A

protective against bacteria by dissolving it by the acid

28
Q

What is unique about bacteria, Helicobacter?

A

gram negative bacteria can live in the stomach

29
Q

What is the danger of Helicobacter pylori?

A

its mechanism of survival colonization in the mucous layer of digestive tract resulting in an ulcer
formation

30
Q

What is the mechanism of ulcer formation caused by helicobacter pylori?

A

Bacteria move into mucous layer of intestines—-begins producing an enzyme, urease, making NH3—NH3 combines with the HCl and makes and neutralizes acidic environment, while also stimulating a pro-inflammatory response in tissue, disrupting mucous layer allowing acid layer to come into contact with and ulcerate tissue

31
Q

How do we treat an ulcer?

A

First determine whether it is NSAID or helicobacter related via urea breath test or test stool
if heliobacter related,
prescribe proton pump inhibitor and antibiotics

32
Q

What 5 regulators that inhibit HCl secretion?

A
  1. Secretin-dudoenal hormones, NF on gastrin
  2. Somatostatin
  3. GIP-duodenal hormones, NF on gastrin
  4. Peptide YY
  5. Prostaglandins
33
Q

How do NSAIDS cause ulceration?

A

NSAID’s block prostaglandins which primary function to decrease histamine secretion, cause more acid being secreted

34
Q

How is acid secretion secreted neurally?

A 
Controlled in 3 phases:
1.Cephalic phase
2.Gastric Phase
3.Intestinal Phase
as long as chyme in upper part of the stomach and duodenum, acid is being secreted, no more chyme acid secretion is turned off
35
Q

What is the function of the hydrolases found on the brush border villus cells of of the small intestine?

A

increase surface area for absorption

breakdown rest of carbs via bb saccharadiases, peptidases

36
Q

What is the importance of crypts of lieberkuhn?

A

secretes buffers and mucous into lumen , contain CTFR Cl- channels that help with secretions, stimulated by secretin

37
Q

Is bile a good buffer?

A

Yes, bile is an osmotic agent so every time bile is secrete water and electrolytes follow

38
Q

Cystic fibrosis is caused by disruption in what protein?

A

CTFR, mucous filled GI tract, lungs etc

39
Q

What 4 hormones are going secreted in duodenum when chyme is sensed in upper GI tract?

A

1.Gastrin-duodenum and antral of g-cells stomach—Increase . HCl;Increase motility of GI tract
2. Secretin- stimulated by acid secretion; Increase Pancreatic and intestinal buffers
3. CCK; increase bile production; gallbladder constriction, relaxation sphincter of oddi; .pancreatic enzymes
4. GIP-gastric inhibitory peptidase
decrease acid secretions; increase insulin secretion before glucose appear in the blood

40
Q

What hormone works on enzyme vs buffer?

A

CCK works on enzyme secretion

and secretin works on buffer secretion

41
Q

What are the 5 pancreatic enzyme ? 3 pancreatic proteases? and what form are they secreted?

A
  1. Trypsinogen
    2.chymotrypsinogen
  2. pro-carboxypeptidase
    + all are secreted as zymogens, and activated by trypsin
  3. Pancreatic Lipase and co-lipase–hydrolyze lipids
  4. Pancreatic amylase-starch digestion
42
Q

What enzymes finish the 70% post-duodenally ?

A

Pancreatic protease

  1. trypsin
  2. chymotrypsin
  3. carboxypeptidase
43
Q

What activates typsinogen to trypsin?

A

enterokinase

44
Q

When the chyme moves down to the lower part of the tact, pancreatic secretion cease due to what stimulations?

A

reduction of vagal stimulation

reduction of multiple secreteogogues

45
Q

What is the importance of secretion of H+ and HCO3 into the lumen in the illeum and jejunum ?

A

facilitating the reabsorption sodium, chloride, and water that has been used as buffer secretions

46
Q

How do we reclaim/reabsorption sodium, chloride and water back into ECF?

A

Na/H+ antiporter—pumps H+ & Cl-/HCO3 exchanger —NaCl is reabsorped along w/water— moves back to ECF

47
Q

What happens to the H+/HCO3- pumped into illeum and jejunum during NaCl reabsorption pumped out?

A

They are broken down into H20;H+ , flow back into cell to fuel the transporters to reclaim as much NaCl as possible

48
Q

How is NA+ reasbsorption occurs in the colon?

A

FINAL RECLAIMATION OF NA
Aldosterone-mediated
elevated aldosterone—insertion of more epithelial Na channels in lumen and stimulate reabsorption of any Na left in the chyme

49
Q

What 2 electrolytes are found in the feces?

A
  1. HCO3-
  2. K+
    * unless you have diarrhea

Physiology Renal ABS 2018 (5 decks)

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