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Phase 1 - S3 Gastrointestinal System > The Stomach > Flashcards

The Stomach Flashcards

1
Q

what are the 3 regions of the stomach?

A

the cardia, fundus and antrum

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2
Q

what do parietal cells do

A

produce HCl

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3
Q

what stimulates parietal cells

A

gastrin, histamine and ACh (from the vagus nerve)

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4
Q

what receptors does gastrin act n to activate parietal cells

A

CCK receptors

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5
Q

what receptors does histamine act on to activate parietal cells

A

H2 receptors

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6
Q

what receptors does Ach act on to activate parietal cells

A

Mcr receptors

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7
Q

what is the alkaline tide

A

during H+ production in the parietal cells, bicarb is also produced, which moves into the blood vessels draining the stomach making the blood here temporarily more alkaline

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8
Q

why do parietal cells require lots of mitochondria

A

they need lots of energy to use the proton pump against a large concentration gradient

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9
Q

what do chief cells do

A

produce pepsinogen

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10
Q

what stimulates chief cells

A

gastrin via the CCK receptor

vagus nerve Ach via the Mcr receptor

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11
Q

what do G cells produce

A

gastrin

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12
Q

what stimulates G cells

A

vagus nerve secreting ACh

amino acids in the stomach

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13
Q

what does gastrin do

A

activate parietal cells

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14
Q

what inhibits gastrin production

A

somatostatin

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15
Q

what do enterochromaffin cells do

A

secrete histamine

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16
Q

what stimulates ECL cells

A

gastrin via the CCK receptor

vagus Ach via the Mcr receptor

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17
Q

what role does histamine have in the stomach

A

activates parietal cells

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17
Q

what do D cells do

A

secrete somatostatin

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18
Q

what does somatostatin inhibit in the stomach

A

G cells and ECL cells

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18
Q

what are the roles of stomach acid

A
  • part of the innate immune system
  • chemical digestion
  • converts pepsinogen into pepsin
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19
Q

what types of cells are mostly found in the cardia of the stomach

A

mucus secreting cells

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22
Q

what types of cells are mostly found in the Antrum of the stomach

A

G cells and D cells

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23
Q

what type of cells are mostly found in the fundus/body of the stomach

A

mucus secreting cells, parietal cells, chief cells

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24
Q

what does the stomach do to help protect itself

A
  • bicarbonate rich mucus secretion
  • prostaglandins
  • high turnover of epithelia
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25
Q

what do prostaglandins do in the stomach

A

increase blood flow to the stomach - this brings more nutrients to the epithelia

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26
Q

what inhibits prostaglandin productions

A

NSAIDs like aspirin

27
Q

how does alcohol affect the stomach

A

dissolves the mucus layer

28
Q

what are the 3 phases of digestion in the stomach

A

cephalic
gastric
intestinal

29
Q

what happens in the cephalic phase of digestion

A

the smell and chewing of food stimulates parietal and G cells though the vagus nerve

30
Q

what happens in the gastric phase of digestion

A

stomach distension activates parietal and G cells (through the vagus nerve)
amino acids activate G cells
enteric NS causes smooth muscle contractions

31
Q

what happens in the intestinal phase of digestion

A

chyme in the duodenum stimulates gastrin production before the G cells become inhibited

32
Q

what stimulates D cells

A

when food leaves the stomach, the pH drops as it is no longer being buffered
the lower pH activates the D cells

33
Q

what test can be done to diagnose h-pylori

A

urease breath test

34
Q

what does the urease enzyme do

A

converts urea into ammonium

35
Q

how can urease damage the stomach

A

the ammonium produced is directly toxic to cells

36
Q

how does h-pylori cause damage

A
  • through ammonium production which is toxic

- is cytotoxic to the epithelia itself

37
Q

if h-pylori is found in the Antrum what will it cause

A

duodenal ulceration

38
Q

if h-pylori is found in the body what will it cause

A

stomach cancer

39
Q

give an example of a proton pump inhibitor

A

omeprazole

40
Q

give an example of a H2 antagonist

A

cimetidine

41
Q

what ways are there to treat stomach problems

A

proton pump inhibitors
H2 antagonists
stop NSAIDs
antibiotics for H-pylori

42
Q

what is GORD

A

where the stomach contents moves into the oesophagus

43
Q

what causes GORD

A

lower oesophageal sphincter problems
obesity
hiatus hernia (upper stomach into the thorax)
delayed stomach emptying (increase intra-gastric pressure)

44
Q

what symptoms are seen in GORD

A

heart burn
cough
sore throat
dysphasia

45
Q

what is Barrett’s oesophagus

A

where reflux causes metaplasia of the stratified squamous epithelia of the oesophagus to convert into simple columnar - increasing the risk of adenocarcinoma

46
Q

how do you treat GORD

A

antacids
H2 antagonists
proton pump inhibitors

47
Q

what is gastritis

A

inflammation of the lining of the stomach

48
Q

what may cause acute gastritis

A

heavy NSAID use, alcohol, chemotherapy

49
Q

what may cause chronic gastritis

A

h-pylori, autoimmune disease attacking parietal cells

50
Q

why may an autoimmune disease against parietal cells cause anaemia

A

as parietal cells produce intrinsic factor which helps in vitamin B12 absorption - without vitamin B12 you will develop anaemia

51
Q

what type of anaemia is developed from a lack of vitamin B12

A

pernicious anaemia

52
Q

what is peptic ulcer disease

A

where the mucosa is eroded down through the muscularis mucosa layer

53
Q

what may cause peptic ulcer disease

A

NSAIDs, h-pylori, stomach acid

54
Q

what are the symptoms of peptic ulcer disease

A

epigastric pain, weight loss, bleeding (if a vessel is eroded through)

55
Q

why may you get epigastric pain with peptic ulcers

A

as the stomach is a foregut structure

56
Q

what is Zollinger-Ellison disease

A

where theres a gastrin secreting tumour - this causes an up regulation of parietal cells causing increased acid production

57
Q

what can happen to the small intestine as a result of Zollinger Ellison

A

can lead to holes in the small intestine

58
Q

what can cause stress ulcers

A

burns, sepsis, trauma, multi organ failure

63
Q

when does acid production increase

A

when amino acids/peptides are detected in the stomach lumen and when the stomach is distended

64
Q

how will H. pylori appear on a gram stain

A

gram negative helix shaped bacteria

65
Q

how does the mucus layer help protect the stomach

A

it is strongly alkali so protects it from the acidic conditions

66
Q

where are the cells of the stomach located

A

within the gastric pits of the stomach

67
Q

why does the pyloric sphincter strongly control what it lets through

A

in order to ensure it doesn’t overflow the duodenum with liquid chyme as it is still highly acidic

68
Q

how does receptive relaxation prevent reflux

A

vagally mediated relaxation allows food to enter stomach without raising gastric pressure

Phase 1 - S3 Gastrointestinal System (12 decks)

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