Stomach and duodenum Flashcards

1
Q

What is stomach: secretory function

A
  • epithelial lining is composed of- goblet cells that produce a coat alkaline mucus this mucus surface layer traps a bicarbonate-rich fluid beneath it.
  • gastric pits contain gastric glands that secrete gastric juice, mucus, and gastric
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2
Q

Namer the secretory cells and function

A

A= mucus neck cells= secrete acid mucus
B= parietal cells= secrete HCI and intrinsic factor
C= chief cells= produce pepsinogen (pepsinogen is activated to pepsin by.)
1. HCI in the stomach
2. Pepsin it self via a positive feedback mechanism
D=enters endocrine cells- secrete gastrin, histamine, endorphins, serotonin,cholecystokinin and somatostatin into the laming propria

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3
Q

Explain the process of gastric secretion

A

Neural and hormonal mechanism regulate the release of gastric juice stimulator and inhibitory events occur in three phases:

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4
Q

Name phases of gastric secretion and explain

A
  • Cephalic (reflex) phase: prior to food entry
  • gastric phase: once food enters the stomach
  • intestinal phase: as partially digested food enters the duodenum
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5
Q

Explain cephalic phase

A

Excitatory events include:
= sight or thought of food
= stimulation of taster or smell receptors
Intribitory events include:
= loss of appetite or depression
= decrease in stimulation of the parasympathetic division

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6
Q

Explain gastric inhibitory and excitatory events

A

Excitatory events include=
stomach distension,
activation of stretch receptors neural activation,
activation of chemoreceptors by peptides, caffeine and rising ph
release of gastric to the blood
Inhibitory events:
• A ph lower than 2
• emotional upset that overrides the parasympathetic division

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7
Q

Explain intestinal phase excitatory and inhibitory events

A

Excitatory= low ph, partially digested food enters the duodenum and encourages gastric gland activity
Inhibitory= distension of duodenum, presence of fatty, acid, or hypertonic chyme, and/or it rants in the duodenum
- initiates inhibition of local reflex and vague nuclei
- closes the pyloric sphincter
-releases enterogastiones that inhibit gastric secretion

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8
Q

Explain how gastric filling works

A
  • stomach pressure remains constant until about 1L of food is ingested
  • relative unchanging pressure results from reflex-mediated relaxation and plasticity
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9
Q

What is included in reflex mediated events

A

Receptive relaxation = as food travels in the oesophagus stomach muscles relax
Adaptive relaxation= the stomachdialates in response to gastric filling

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10
Q

In gastric filling what does plasticity mean

A

It is the intrinsic ability of smooth muscle to exhibit the stress-relaxation response.
(peristaltic waves move toward the pelorus at the rate of 3 per minute)

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11
Q

What initiates the basic electrical rhythm in gastric filling

A

Pacemaker cells called cells of Cajal

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12
Q

Where is the most vigorous peristalsis

A

Near the pylorus

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13
Q

Explain how chyme is delivered

A

It is derived is small amounts to the duodenum or

Forced back ward into the stomach for further mixing

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14
Q

Which two mechanisms assist in gastric emptying

A

The neural enterogastic reflex

Hormonal (enterogastrone) mechanism

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15
Q

What is the function of mechanisms of gastric filling

A

To inhibit gastric secretion and duodenal filling
• carbohydrate-rich chyme quickly moves through the duodenum
O fast laden chyme is cligested move slowly causing food to remain in the stomach longer

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16
Q

What affect gastric emptying

A
• fluidity of chime
• volume of gastric contents
• Osmolality of chime
• caloric density eg fats
• acidity of chime
• body position
• hormones= cholecystokin, secreting somatostatin slow GE;motilitin t3 and
Insulin enhance GE
17
Q

Explain vomiting

A

• forceful expulsion of gastric and intestinal contents through mouth
• usually preceded by nausea (ANS response)
• controlled by vomiting centre (VC) in medulla
• efferent impulses= diaphragm and abdominal muscles
• following irritation or stimulus vomiting begins with deep
(inspiration = glottis closes = soft palate is elevated= abdominal muscles
Contract increased intra-abdominal pressure)= cardiac sphincter and stomach body relates = gastric contents are forced upward

18
Q

What is the epithelium of duodenum mucosa made up of

A

• absorptive cells and goblet cells
• Enteroendocrine cells
Interspersed T cells called intraepithetial lymphocytes (IELS) (IELS immediately release cytokines upon encountering Ag

19
Q

What is the function of duodenum

A

1= movement of contents by peristalsis- parasympathetic stimulation 2= secretion of intestinal juice- parasympathetic stimulation
3= completion ct chemical digestion of carbohydrates protein and fats in the enterocytes of the villi
4= protection against infection by microbes that have survived theantimitrobial action of the hydrochloric acid in stomach by the solitary
Lymph follicles and aggregated lymph follicles
5= secretion of the hormones cholecystokinin (CCK) and secretion
6= absorption of nutrients

20
Q

What secrets intestinal juice

A

Secreted by intestinal glands in response to distension cr irritation of mucosa
It is slightly alkaline and isotonic with blood plasma (5-34/d9)
Largely water, enzyme-poor, but contains mucus