Transport along and across the GI tract Flashcards
What does gastric accommodation decrease?
Decreases cholinergic activity
What factors promote accommodation?
VIP/NO promote accommodation
Where does tonic contraction start from?
Starts from the top of the antrum
What does tonic contraction impact on?
Impact on the propulsive forces
What does tonic contraction lead to?
Lead to the emptying of gastric reservoirs
What does the proximal stomach do to store food at low pressure?
the proximal stomach relaxes to store food at low pressure whilst it is acted upon
by acid, enzymes and mechanically
Why is emptying carefully regulated?
o this is carefully regulated to ensure adequate acidification/neutralisation, action of enzymes, mechanical breakdown and to avoid swamping of the duodenum.
What is gatroparesis and what is the stomach unable to do?
gastroparesis is a chronic condition in which the stomach cannot empty itself of food in the normal way, causing food to pass through it slowly
Steps involved in the emptying of food contents
1) contraction around the antrum area
2) pyloric sphincter will be contracted
a. grinding action of the antrum will make the particles smaller
What happens to large food particles?
- Large food particles are retained in the proximal part of the stomach; antrum repulses them→ mixing and grinding with digestive juices
What is gastric emptying dependent on ?
- Propulsive force generated by the tonic contractions of proximal stomach
- Stomach’s ability to differentiate types of meals ingested and their components
What decrease the force and rate of gastric emptying?
fatty, hypertonic, acidic chyme in the duodenum
How does gastric emptying of a liquid occur?
- Liquids pass in spurts
How does Gastric emptying of solids occur?
- Solids are broken down to 1-2mm sizes
How does gastric emptying of large indigestive materials occur?
- Large indigestive materials remain
o Cleared by Migrating Motor Complex or vomiting
Emptying of liquids
- Rapidly disperse, empty without lag time
* Rate of emptying is influenced by nutrient content (nutrient-containing liquids retained longer)
In how many phases are solids emptyed and what are those phases?
• 2 phases (lag time and linear phase)
When solids are emptied, what happens to the liquid and solid component?
• Liquid part emptied and solid component is retained in proximal stomach
What regulates the passage of material?
• Pylorus regulates passage of material
What happens to fatty food at body temperature when they’re being emptied?
• Liquefy at body temperature; float on top of liquid layer and empty slowly
What are fats potent inhibitors of?
• Fats are potent inhibitors of gastric motor events and gastric emptying
How are indigestible solids emptied?
• Not emptied in immediate post-prandial period
What activity is involved with the emptying of indigestible solids?
MMC activity
What are determinants of the rate of gastric motility?
- Type of food eaten
- Osmotic pressure of duodenal contents
- Vagal innervation upon over-distension of the duodenum
- Hormones
- Injury to intestinal wall and bacterial infections
What does BER allow?
BER allows the smooth muscle cell to depolarise and contract rhythmically when exposed to hormonal signals
What do stomach muscle cells produce and what does it move?
Stomach muscle cells produce electric depolarisations from resting potential
And move ripples towards the antrum
What control is the fundus under?
Fundus is under vagal excitatory control
What can alter GI membrane potential and consequently what?
Stretch, ACh, parasympathetic stimulation and GI hormones can alter the GI resting membrane potential (-50mv to -60mV; average = -56mV) and consequently BER of GI smooth muscle.
What do slow waves not allow?
Slow waves alone do not allow action potential generation and contraction to occur
What determines the frequency of contraction in the GI?
The basal or basic electrical rhythm (BER) or electrical control activity (ECA) determines the frequency of the contractions in the gastrointestinal tract
When can the contraction of smooth muscle occur in gastric motility?
Contraction of the smooth muscle can occur when the BER reaches its plateau.
What does BER allow smooth muscles to do?
The basal electrical rhythm allows the smooth muscle cell to depolarise and contract rhythmically when exposed to hormonal signals.
What are ICC and where are they located?
The intestinal cells of cajal (ICC) are specialised pacemaker cells located in the wall of the stomach, small intestine, and large intestine.
What do the cell membranes of the ICC undergo?
The cell membranes of the pacemaker cells undergo a rhythmic depolarisation and repolarisation
What does the rhythm of depolarization-repolarisation of the cell membranes of the ICC create?
This rhythm of depolarization-repolarisation of the cell membrane creates a slow wave known as a BER, and it is transmitted to the smooth muscle cells.
What are factors which decrease BER?
Sympathetic system → NA
What are the effects of NA or adrenaline on membrane of GI smooth muscle?
Depolarisation of GI smooth muscle is caused by calcium-sodium entry
Repolarisation of GI smooth muscles is caused by K+ efflux
What mediate a decrease in fundic motor activity?
Cholecystokinin (CCK) Secretin VIP Somatostatin Duodenal distension, duodenal acid
What does motilin increase?
Increases fundic acitvity
What factors initiate and maintain peristalsis and mixing in the movement through small intestines?
Hormonal and nervous factors initiate and maintain peristalsis and mixing
What happens to the duodenum during movement through small intestine?
Localised distention of the duodenum
What increases intestinal motility?
Serotonin, insulin, Cholecystokinin (CCK), gastrin and motilin increase intestinal motility
What decreases intestinal motility?
Secretin decreases the activity
What does glucagon do to fundic motor activity?
decreases fundic motor activity
What system is gastric emptying regulated by?
regulated by negative feedback systems
Examples of negative feedback systems which control gastric emptying
Antral over-distension: Vago-vagal reflex Duodenal over-distension and chemical stimulation: Vago-vagal reflex and hormones
What can the pyloric sphincter contract in response to?
pyloric sphincter can contract in response to antral or duodenal rhythm (e.g. fatty acids in duodenum)
Where is regulation elicited from in gastric motility and emptying?
Regulation is elicited from the small intestine
Steps involved in motility in the intestine during gastric emptying
Segmentation (mixing contractions): stationary contraction & relaxation
Peristalsis (propulsive): in stomach (3 waves/min)
Migrating Motor Complex
Mass movements (evacuation)
What are the phases of motor activity on the motility of intestines?
Phase I: quiescence (state of inactivity)/quiet period
Phase II: irregular propulsive contractions
Phase III: burst of uninterrupted phasic contractions (peristaltic rush)