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Small Intestine Flashcards

1
Q

what are the three areas of the small intestine called

A

duodenum
jejunum
ileum

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2
Q

what substances does the small intestine receive

A

chyme from stomach
bile from gallbladder
pancreatic enzymes

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3
Q

what are some adaptions the small intestine has to allow for maximum absorption

A

villi
microvilli
circular folds of Kerchring

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4
Q

what is segmentation

A

mixing and churning of chyme driven by sympathetic activity

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5
Q

what hormones are secreted into the small intestine and from what cells

A

gastrin from G cells
secretin from S cells
CCK
ghrelin

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6
Q

what does secretin stimulate

A

promotes gastric secretions and biliary HCO3

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7
Q

what does CCK stimulate secretion of

A

bile through relaxing sphincter of Oddi and contracting gallbladder

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8
Q

what are ghrelin and leptin

A

ghrelin - hunger signal

leptin - decreases appetite

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9
Q

the basolateral membrane of enterocyte faces the

A

lumen/blood vessel

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10
Q

the apical membrane of enterocyte faces the

A

opposite side of the lumen

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11
Q

what is digestion

A

enzymatic conversion of complex dietary substances into smaller form that can be absorbed

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12
Q

what mediates luminal digestion

A

pancreatic enzymes - secreted into the duodenum

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13
Q

what enzymes are involved in membrane digestion

A

brush border enzymes

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14
Q

what is absorption

A

what absorbable products are transferred across apical and basolateral membranes

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15
Q

carbohydrates make up what % of total food intake

A

45%

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16
Q

name 2 polysacchardies and % total intake of carbohydrates

A

starch
glycogen
(50%)

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17
Q

name 2 oligosaccharides and % total intake of carbohydrates

A

lactose
sucrose
(30-40%)

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18
Q

name 3 monosaccharides and % total intake of carbohydrates

A

glucose
fructose
galactose
(10%)

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19
Q

what happens to carbohydrates to allow them to be absorbed

A

complex carbohydrates are all converted into monosaccharides

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20
Q

what is the function of alpha-amylase

A

breaks down polysaccharides into oligosaccharides such as maltose

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21
Q

why does alpha-amylase not break carbohydrates completely down into monosaccharides

A

it can only break internal alpha 1,4 glycosidic bonds and not terminal alpha 1,4 glycosidic bonds

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22
Q

name two oligosaccharidases

A

sucrase

lactase

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23
Q

sucrase breaks sucrose into

A

glucose

fructose

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24
Q

lactase breaks lactose into

A

glucose

galactose

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25
what is lactose intolerance
form of lactase insufficiency with lacking enzyme
26
describe the three types of lactose intolerance
primary - lack of lactase persistence allele secondary - development post infection congenital - rare autosomal recessive condition
27
at the brush border membrane how are glucose, fructose and galactose absorbed
glucose and galactose - SGLT1 transporter | sucrose - GLUT5 transporter
28
at the basolateral membrane how are glucose, fructose and galactose absorbed
all absorbed via GLUT2 transporter
29
what are proteins broken down to before they can be absorbed
oligopeptides and amino acids
30
where does the most important part of protein digestion occur and what happens
duodenum - pancreatic proteases convert oligopeptides into amino acids
31
how are amino acids absorbed in the enterocyte
via secondary active transport mediated by Na+ dependent transport
32
define malabsorption
failure of the small intestine to absorb nutrients correctly
33
what are the main causes of malabsorption
``` coeliac disease chronic pancreatitis Crohn's disease primary biliary cholangitis infection ```
34
what are the main symptoms of malabsorption
steatorrhoea diarrhoea fatigue weight loss
35
what is a sign of vitamin C and K deficiency
easy bruising
36
what is kolonychia and what is it a sign of
spooning of the nails | sign of iron deficiency
37
what is leukonychia and what is it a sign of
white patches on the nails | sign of calcium and zinc deficiency
38
what is glossitis and what is it a sign of
swollen tongue | sign of vitamin B12 or iron deficiency
39
what is angular cheilitis a sign of
sign of vitamin B12 or iron deficiency
40
what is Coeliac disease
autoimmune response causing reaction to a component to gluten (wheat, flour)
41
what is the overall effect of coeliac disease on absorption
damages enterocytes and reduces absorptive capacity
42
what immune cells produce the response in Coeliac disease and what structures change
T cells produce response | causes villous atrophy, flat duodenal mucosa and reduced SA for absorption
43
what are the symptoms of Coeliac disease
``` smelling stools that wont flush away (steatorrhoea) diarrhoea abdo pain and bloating apthous ulcers weight loss and fatigue ```
44
what investigations are carried out to diagnose Coeliac disease
biopsy but avoided in children serology - IgA anti-TTG (anti-transglutaminase) or TTG if someone has IgA deficiency
45
what is the main treatment for Coeliac disease
gluten free diet - available from pharmacist
46
what is the most common type of emergency operation to occur
appendicitis
47
what causes appendicitis
aetiology unknown but could be due to faecal obstruction or irritation - can lead to oedema, necrosis and perforation
48
appendicitis most commonly presents in which age group
children but also in the elderly
49
what are the main symptoms of appendicitis
periumbilical pain that moves to RIF mild fever and tachycardia anorexia possible nausea and vomiting
50
on examination what is found if someone has an appendicitis
abdominal guarding pain on percussion Rosvings sign
51
what is Rosvings sign
pain in RIF when palpating the LIF
52
what investigations are required for appendicitis
ultrasound - gold standard CRP and WCC urinanalysis
53
what is the treatment for appendicitis
analgesia antipyretics urgent lap appendicectomy
54
what treatment is required after surgery for appendicitis
antibiotics and IV fluids
55
what is Meckels diverticulum and are the complications of it
congenital condition which when becomes irritated can mimic the symptoms of appendicitis - complications include bleeding, obstruction and diverticulitis
56
what are the two classifications for mesenteric ischaemia
acute and chronic
57
what causes acute mesenteric ischaemia
embolus formed elsewhere travels to the SMA and becomes lodged causing infarction
58
what causes chronic mesenteric ischaemia
angina of the gut - SMA becomes atherosclerosed
59
what are the symptoms of mesenteric ischaemia
severe abdominal pain (possibly colicky) with no obvious signs on examination possible signs of hypovolaemic shock
60
what investigation is carried out for suspected mesenteric ischaemia
abdominal contrast CT - will show gasless abdomen
61
what is the treatment and complications of mesenteric ischaemia
surgical resection and re-anastomose
62
what are the three ways the small bowel can become obstructed and examples of each
in the lumen - food, gallstone, bezoar in the wall - tumour, radiation, Crohn's outside wall - adhesions, herniation
63
what happens to bowel proximal to the obstruction during bowel obstruction
becomes distended due to formation of gas that cannot pass through
64
what are the signs and symptoms of bowel obstruction
``` extreme vomiting (possibly faeculent) absolute constipation distension burping no bowel sounds ```
65
what is the treatment for small bowel obstruction
``` nil by mouth IV fluids NG tube for draining not feeding antibiotics and anticoagulants surgery if becomes strangulated ```
66
what is intestinal failure
umbrella term to describe conditions where there is an inability to maintain adequate nutrition or fluid status
67
lipids make up what % of total energy intake
50%
68
lipids are soluble true/false
false - either poorly soluble or completely insoluble
69
what two areas are lipids digested
stomach and small intestine
70
what enzyme breaks down lipids in the stomach
gastric lipase
71
what enzyme breaks down lipids in the small intestine and when is it released
pancreatic lipase and released in response to CCK
72
what is the function of bile salts
released from gallbladder into duodenum to help emulsify large fat droplets into small ones
73
what is the function of colipase
allows access of lipase to hydrophobic core of small droplets
74
what is B12 required to bind to for correct absorption and where is it released from
intrinsic factor - released from parietal cells
75
what are the fat soluble vitamins
A, D, E, K
76
what are the water soluble vitamins
B (except B12) C and H

Gastrointestinal (7 decks)

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