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Gastoenterology > Small intestine > Flashcards

Small intestine Flashcards

1
Q

What three substances are secreted into the duodenum and where do they come from?

A

Chyme - stomach
Bile - gall bladder
Pancreatic juice - Pancreas

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2
Q

What three things increase the surface area of the small intestine?

A

Circular folds
Villi
Microvilli

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3
Q

What juice is secreted by the small intestine itself?

A

Succus entericus

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4
Q

What hormones are released from the small intestine and where are they released into

A 
Systemic Circulation:
CCK
Gastrin
GLP-1
GIP
Secretin
Motilin
Ghrelin
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5
Q

What is included in the succus entericus and where are they released from?

A

Mucous - goblet cells at top of villi

Aqueous salt - dips between villi

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6
Q

Where is chlorine excreted from and to and which ion channel is involved in the second part of this?

A

From the lumen of the GI tract across the mucosa and into systemic circulation - through CTFR ion channel (CF)

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7
Q

What is segmentation for and how does it occur?

A

Mixing of food in the small intestine by contraction of smooth muscle

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8
Q

What are the two types of peristalsis that occur between meals?

A

Localised peristaltic contractions

Migrating motor complex (MMC) - sweeps from top to bottom of GI tract

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9
Q

How is segmentation affected by feeding?

A

It increases

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10
Q

What are the two parts of the pancreas and what do they each secrete?

A

Exocrine - digestive enzymes + alkaline fluid

Endocrine - insulin + glucagon

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11
Q

What is secreted in the pancreatic juice?

A

Digestive enzymes

Bicarbonate rich solution (neutralises acidic chyme from stomach)

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12
Q

What are the three types of digestive enzyme released from the pancreas and what do they each digest?

A

Proteases - protein (not activated until in small intestine as would auto digest the pancreas)
Amylases - carbohydrates
Lipases - fat

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13
Q

What are the 3 phases of pancreatic secretion?

A

Cephalic
Gastric
Intestinal

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14
Q

What are the two types of digestion and where are the enzymes from?

A

Luminal digestion - enzymes from pancreas

Membrane digestion - enzymes on brush border of membrane

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15
Q

What is the overall process of absorption and digestion called?

A

Assimilation

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16
Q

What is the process of digestion of carbohydrates (luminal/membrane digestion)?

A

Starch –> oligosaccharides (luminal digestion)

Oligosaccharides –> monosaccharides (membrane digestion)

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17
Q

Why is lactase so important?

A

Is is the only enzyme that can break down lactose into glucose

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18
Q

What form must carbohydrates be in to be absorbed?

A

Monomers

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19
Q

Where does absorption of carbohydrates occur?

A

Duodenum + jejeunum

20
Q

What are the three types of intestinal failure?

A

Type 1: self-limiting
Type 2: prolonged with complications
Type 3: long term, stable

21
Q

What is enteral and parenteral nutrition?

A

Enteral: Feeding directly into the small intestine
Parenteral: feeding directly into systemic circulation

22
Q

What are the four parts of the duodenum?

A

Superior (with duodenal cap),
Descending,
Horizontal,
Ascending

23
Q

Where does the duodenum start and end and what are these parts?

A

Starts: pyloric sprinter - anatomical sphincter controlling release of chyme into the stomach (parasympathetic)
Ends: duodenaljejunal flexure - change in the small intestine

24
Q

Describe + name the parts and path of the biliary tree?

A

Left + right hepatic duct
==> common hepatic duct
common hepatic duct + cystic duct
==> common bile duct

25
Q

What is the name of the blood supply to the gall bladder?

A

Cystic artery

26
Q

Name the 4 parts of the pancreas

A

Head,
Neck,
Body,
Tail

27
Q

What types of cell are in the pancreas?

A

Acinar cells

28
Q

Is the pancreas parasympathetic or sympathetic?

A

All glands = parasympathetic

29
Q

What drains the cells of the pancreas and what ‘hole’ does it pass through at the end?

A

The main pancreatic duct

Major duodenal papilla

30
Q

What do the main pancreatic duct and the common bile duct pass through into the duodenum and what sphincter is associated with this?

A 
Hepatopancreatic ampulla (of Vater) 
Sphincter of Oddi
31
Q

Which hormone stimulates opening of the sphincter and release of digestive enzymes and bile into the duodenum?

A

CCK

32
Q

Which arteries supply the pancreas and how do they join?

A

Superior pancreaticduodenal artery and inferior pancreaticduodenal artery
Anastomose

33
Q

Does the pancreas have foregut or midgut blood supply

A

Both
The superior pancreaticduodenal artery is foregut (from the coeliac trunk) and the inferior pancreaticduodenal is midgut (off the superior mesenteric artery)

34
Q

Which parts of the small intestine are fore or midgut organs?

A

Foregut: duodenum
Midgut: jejunum + ileum
(DJ ileum)

35
Q

What are the differences between the jejunum and the ileum?

A 
Jejunum = thicker
Jejunum = more vasculature
Jejunum = more circular folds
Jejunum = more red
Ileum = more fat (responsible for fat absorption)
36
Q

Which arteries supply the jejunum and ileum?

A

Superior mesenteric artery via jejunal and ill arteries

37
Q

What is the venous drainage of the jejunum and ileum?

A

Jejunal and Ileal veins into the superior mesenteric vein and the hepatic portal vein

38
Q

At which vertebrae does the superior mesenteric artery leave the aorta?

A

L1

39
Q

What does pepsin do?

A

Cleave protein to peptides

40
Q

How do di-, tri- + tetra- peptides enter the cell?

A

PepT1 transporter - uses the proton gradient due to acidic microenvironment at brush border

41
Q

What is the issue to digestion caused by fats?

A

They are insoluble/very limited solubility so must be emulsified to break into smaller particles for lipase action

42
Q

What lipases are active where?

A

Gastric lipase in the stomach (stimulated by gastrin release - denatured by higher pH in the duodenum)
Pancreatic lipase in the duodenum (stimulated by CCK release - aided by bile salts from gall bladder)

43
Q

What prevents lipid salts coalescing?

A 
Bile salts (have -ve charges which repel each other)
Hydrophobic/hydrophilic coat
44
Q

How are free fatty acids absorbed?

A

Passive diffusion

45
Q

Which circulation are short and long chain fatty acids transferred into?

A 
Short = systemic
Long = lymphatic
46
Q

How is cholesterol absorbed?

A

Invagination of the apical membrane when bound to a specific protein

47
Q

Describe the foregut blood supply

A

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Gastoenterology (15 decks)

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