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GI - mine > stomach - physiology + disease > Flashcards

stomach - physiology + disease Flashcards

1
Q

what is the function of the stomach (4)

A

stores/churns food
continues the digestion of carbohydrates
initiates digestion of protein
regulates the delivery of chyme

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2
Q

name the main anatomical regions of the stomach

A 
lower oesophagus sphincter 
fundus
body
antrum
greater and lesser curve
pylorus/pyloric sphincter
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3
Q

what are the two sphincters associated with the stomach

A

lower oesophagus sphincter (LOS)

pyloric sphincter

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4
Q

what are the two types of glands within the stomach

A 
PGA = pyloric gland area
OM = oxyntic mucosa
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5
Q

what is the location of the pyloric gland area

A

antrum

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6
Q

what is the location of the oxyntic mucosa

A

body and fundus

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7
Q

what cells are found in the oxyntic mucosa

A

D cells and G cells

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8
Q

what cells are found in the pyloric gland area

A

parietal cells, chief cells, and entrochromaffin-like cells

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9
Q

what is produced in the oxyntic mucosa

A

HCL
pepsinogen
intrinsic factor & gastroferrin
histamine

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10
Q

what is produced in the pyloric gland area

A

somatostatin

gastrin

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11
Q

what does gastrin do

A

stimulates HCL secretion

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12
Q

where is gastrin produced and by what cells

A

G cells in the pyloric gland area

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13
Q

what does somatostatin do

A

inhibits HCL secretion

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14
Q

where is gastrin produced and by what cells

A

D cells in the pyloric gland area

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15
Q

what does HCL do

A

activates pepsinogen to pepsin

denatures proteins

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16
Q

where is HCL produced and by what cells

A

parietal cells in the oxyntic mucosa

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17
Q

what does pepsinogen do

A

inactivate precursor to pepsin

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18
Q

where is pepsinogen produced and by what cells

A

chief cell in the oxyntic mucosa

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19
Q

what does histamine do

A

stimulates secretion of HCL

20
Q

where is histamine produced and by what cells

A

entrochromaffin-like cells in the oxyntic mucosa

21
Q

what does in the intrinsic factor and gastroferrin

A

binds to B12 to allow absorption in terminal ileum

22
Q

where are intrinsic factor and gastroferrin produced and by what cells

A

parietal cell in the oxyntic mucosa

23
Q

what does parietal cells produce

A

HCL

intrinsic factor and gastroferrin

24
Q

what does chief cells produce

A

pepsinogen

25
Q

what does entrochromaffin-like cells produce

A

histamine

26
Q

what does D cells produce

A

somatostatin

27
Q

what does G cells produce

A

gastrin

28
Q

what determines the passage of chyme

A

the strength of the astral wave

29
Q

what are the 3 phases of gastric acid secretion

A

cephalic phase
gastric phase
intestinal phase

30
Q

when does the cephalic phase take place

A

before food reaches the stomach, prepares it to receive food

31
Q

how is the cephalic phase driven

A

directly and indirectly by the CNS and vagus nerve (CNX)

32
Q

when does the gastric phase take place

A

when food is in the stomach

33
Q

when does the intestinal phase take place

A

after food has left the stomach

34
Q

what stimulates the intestinal phase

A

chyme entering the upper small intestine via neuronal and hormonal mechanisms (WEAK stimulation)

35
Q

how is are gastric secretions in the cephalic phase inhibited

A

vagal nerve activity decreased upon cessation of eating and following stomach emptying
(pain, nausea and negative emotions also decrease vagal activity)

36
Q

how are the gastric secretions in the intestinal phase inhibited

A

via the same methods that reduce gastric motility

37
Q

how are the gastric secretions in the gastric phase inhibited

A

antral pH falls when food leaves the stomach causing somastostain release from D cells

38
Q

how is the mucosa protected from HCL and pepsin

A

located produced prostaglandins: PGE2 and PGI2

39
Q

what do prostaglandins PGE2 and PGI2 do

A

reduce acid secretion
increase mucus and bicarb secretion
increase mucosal blood flow

40
Q

what causes acute gastritis

A 
⇒	irritant chemical injury
⇒	Severe burns
⇒	Shock
⇒	Severe trauma
⇒	Head Injury
41
Q

what are the 3 causes of chronic gastritis

A

autoimmune (rare)
bacterial/H.pylori (most common)
chemical

42
Q

what is the cause of autoimmune chronic gastritis

A

anti-parietal and anti-intrinsic factor antibodies

43
Q

what is the main symptom of autoimmune gastritis

A

pernicious anaemia

44
Q

what causes pernicious anaemia

A

B12 deficiency

45
Q

what causes chemical chronic gastritis

A

NSAIDs
alcohol
bile reflux

46
Q

describe what happens in chemical chronic gastritis

A

direct injury to mucus layer by fat solvents leading to marked epithelial regeneration, hyperplasia, congestion and little inflammation

GI - mine (17 decks)

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