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Physiology GI > Swallowing > Flashcards

Swallowing Flashcards

1
Q

what is the inner circular layer used for

A

peristalsis

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2
Q

what is the outer longitudinal layer used for

A

bowel shortening

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3
Q

nerve fibers what nerve innervate the upper tract?

lower tract?

A

upper = vagus

lower = pelvic

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4
Q

skeletal muscles in esophagus receive what kind of fibers…and signals

A

post-ganglionic fibers which release Ach for contraction and inhibit Ach release for relaxation

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5
Q

Auerbach’s plexus

A

preganglionic fibers end on the enteric nerves within this plexus

located between the ICM and OLM

initiate contraction by releasing Ach and relaxation by releasing NO

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6
Q

upper esophagus sphincter (UES)

A

between oropharynx and esophagus

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7
Q

lower esophagus sphincter (LES)

A

between esophagus and stomach

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8
Q

pyloric sphincter

A

between pyloric stomach and duodenum

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9
Q

ileocecal valve

A

between ileum and cecum (start of colon)

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10
Q

time in esophagus

A

7 seconds

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11
Q

time in stomach

A

2-3 hours

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12
Q

time in small bowel

A

2-3 hours

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13
Q

time in large bowel

A

2-3 days

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14
Q

3 phases of swallowing

A
  1. oral (voluntary) = mastication and decision to swallow
  2. pharyngeal (involuntary)
  3. esophageal (involuntary)
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15
Q

oral phase of swallowing

A

under control of cranial nerves and consists of mastication and the decision to swallow …

with the latter initiating the pharyngeal and esophageal phases by transmission of neural signals to the

medullary swallowing center

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16
Q

pharyngeal phase of swallowing

A

4 coordinated actions designed so that the food bolus is pushed from oral cavity across a relaxed UES into the esophagus

the soft palate and epiglottic simultaneously act to occlude the nasopharynx and larynx respectively

to ensure the food doesn’t go into the airway

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17
Q

epiglottic closure

A

actuated by contraction of laryngeal muscles which elevate the larynx and lowers the epiglottis

18
Q

1st step of pharyngeal phase of swallowing

A

soft palate elevates to occlude the nasopharynx

19
Q

2nd step of pharyngeal phase of swallowing

A

laryngeal muscles contract to enable epiglottis to close the trachea

20
Q

3rd step of pharyngeal phase of swallowing

A

UES relaxes to enable bolus to enter esophagus

21
Q

4th step of pharyngeal phase of swallowing

A

pharyngeal muscles contract to initiate peristalsis to push bolus through relaxes UES into esophagus

22
Q

esophageal phase of swallowing

A

coordinated by medullary swallowing center

sends efferent signals to organ via the Vagus Nerve

result in segments of the body of the esophagus contracting sequentially so that the luminal bolus is propulsed in a caudal direction (peristalsis)

at the same time…efferent signals from vagus results in relaxation of UES and LES areas

23
Q

conditions that result in LES relaxation

A
  1. primary peristalsis
  2. secondary peristalsis
  3. transient LES relaxation
  4. belch reflex
  5. deglutitive inhibition
24
Q

pressure rising in a given area of the esophagus precedes….

A

bolus movement through that area

25
Q

once bolus enters stomach…pressure in LES

A

returns to pre-swallow levels to act as a barrier to reflux

26
Q

primary peristalsis

A

initiated by a swallow

27
Q

secondary peristalsis

A

initiated by esophageal distention by a bolus that has failed to be moved into stomach by primary peristalsis

28
Q

transient LES relaxation and belch reflex

A

each initiated by gastric fundic distention by either food, liquid, or air

29
Q

deglutitive inhibition

A

initiated by rapid voluntary swallowing

30
Q

3 nuclei that form the major components of the medullary swallowing center

A
  1. nucleus tractus solitarius –> recepient of all sensory signals to the center
  2. nucleus ambiguous –> motor to skeletal muscle
  3. dorsal motor nucleus (DMN) –> motor to smooth muscle
31
Q

function of fundus of stomach

A

storage function - has receptive relaxation (NO)

32
Q

body of stomach

A

acid-pepsin secretion

where pacemaker region is located (3 contractions/min)
–> strength of contraction determined by stretch-induced release of Ach from vagus nerve and release of gastrin from antral G cells from distension, elevated pH

33
Q

antrum of stomach

A

gastrin secretion (G cells in response to distension and elevated pH)

34
Q

pylorus of stomach

A

controls gastric emptying into duodenum

35
Q

gastric pacemaker

A

specialized muscle in the upper body of the stomach

cells of cajal

spontaneously depolarize and repolarize

when depolarized enough to elicit an AP (from Ach and gastrin) –> contraction

36
Q

why is it important to only let small amounts of chyme into duodenum at a time?

A
  1. sample the contents
  2. accelerate the process of digestion by mixing contents with digestive enzymes secreted by the pancreas and bile salts delivered to duodenum from gallbladder
  3. begin absorption of nutrients and water from luminal contents
37
Q

duodenal sampling

A

designed to reduce the rate of gastric emptying whenever the material in chyme suboptimal for digestion and absorption

38
Q

pH of duodenal sample

A

if too low…stimulates secretion of secretin from duodenal cells

which (+) release of pancreatic basic juices and biliary juices for acid neutralization while also reducing gastic contractility

39
Q

osmolality of duodenal sampling

A

if too hyperosmolar –> stimulate vagus nerve (vasovagal) reflex that reduces vagal release of Ach in the vicinity of gastric musculature for reduction in gastric contractility

40
Q

fat content of duodenal sampling

A

if too fatty

stimulate CCK release from duodenal epithelial cells for contraction of the gallbladder and release of pancreatic enzymes

lipases

that enhance fat absoprtion while also reuding gatric contracting

41
Q

general conditions that reduce gastric contraction

A

low pH, hyperosmolality, high fat in duodenum content

Physiology GI (11 decks)

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