Upper GI Disorder: Gastric system Flashcards

1
Q

What are examples of some GI tract disorders?

A
Gastroesophageal Reflux Disease (GORD)
Peptic Ulder Disease (PUD)
Duodenal Ulcer
Nausea
Emesis
IBS
Diarrhoea
Constipation
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2
Q

What are the main sites for therapeutic intervention in GI system?

A
Stomach
Oesophagus
Mouth 
Pancreas
Liver 
Large intestine
Small intestine
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3
Q

What are the accessory organs within the mouth?

A

Salivary Glands
Teeth
Oral cavity

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4
Q

What is the function of the mouth?

A

Ingestion and fragmentation of food

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5
Q

What is oral ulceration?

A

Break in oral epithelium, which exposes the nerve endings

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6
Q

What can cause oral ulceration?

A
Chemical/physical injury
Infections
Drugs
Malignancy
Systemic disease
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7
Q

What is Stomatitis?

A

Inflammation of the lining of any soft tissues in the mouth

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8
Q

What can cause Stomatisis?

A
Poor oral hygiene
Poorly fitted dentures
Heart burns
Drugs
Allergy 
Infection
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9
Q

What is Leukoplakia?

A

Painless white patches on the side of the mouth

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10
Q

What is Dysphagia?

A

Difficulty swallowing

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11
Q

What is the function of the Oesophagus?

A

Contracts rhythmically to propel food towards stomach

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12
Q

What is the function of the Upper Oesophageal Sphincter (UOS)?

A

It prevents air entering the oesophgus and oesophgopharyngeal reflux

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13
Q

What is the function of the Lower Oesophageal Sphincter (LOS)?

A

Prevents gastroesophageal reflux. The high intraluminal pressure keeps it closed until food needs to be dumped.

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14
Q

What are some dysfunctional physiologies and diseases of oesophagus?

A

GORD- Obesity, Medication, Spicy, acidic, Smoking
Hiatal hernia
Motility disorders

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15
Q

What are some examples motility disorders?

A

Achalasia
Diffuse oesophageal Spasm
Hypercontraction
Ineffective oesophageal Motility

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16
Q

What is Achalasia?

A

Inadequate LOS relaxation

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17
Q

What is Diffuse oesophageal Spasm?

A

Uncoordinated contraction

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18
Q

What is Dyspepsia?

A

Upper GI tract

Includes heartburn, abdominal discomfort, eructation, nausea

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19
Q

What is Peptic ulceration?

A

Benign lesion of gastric/duodenal mucosa at a site where mucosa is exposed to acif and pepsin

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20
Q

What are symptoms of dyspepsia?

A

Epigastric pain

Commonly vommitting

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21
Q

How is GORD caused?

A

Exposure of ‘unprotected’’ oesophageal epithelium to acid

Transient LOS relaxation in absence of swallowing

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22
Q

What are the three distinct types of GORD?

A

Non-erosive reflux disease
Erosive oesophagitis
Barrett’s oesophagus

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23
Q

What is Non-erosive reflux disease?

24
Q

What is Erosive oesophagitis?

A

Acute inflammatory response

25
What is Barrett's oesophagus?
Metaplasis of mucosa
26
Which one of the three types of GORD, poses a risk of cancer?
Barrett's oesophagus
27
What are the acid secreting cells in the oxyntic gland area?
Mucous cells Chief cells Parietal cells ECL cells
28
What are the secreting cells in the pyloric gland area?
Mucous cells G cells D cells No parietal cells
29
Why are there no parietal cells in the pyloric gland area?
Not necessary to secret HCL at the bottom of the stomach
30
Function of the mucous cells
Secrete mucous
31
Function of chief cells
Secrete pepsinogen
32
Function of ECL cells
Secrete histamine
33
Function of parietal cells
Secrete HCl
34
Function of D cells
Secrete somatostatin
35
Function of G cells
Secrete gastrin
36
How many litres of HCl is secreted per day by parietal cells?
1-2 L
37
What concentration is the HCl?
150-160 mM
38
What are the three positive factors in HCl acid production?
Gastrin ACh Histamine
39
What is the one negative regulator in HCl production?
D cells
40
What receptor does ACh bind to in the acid secretion pathway?
M3 receptor
41
What receptor does Gastrin bind to in the acid secretion pathway?
Cholecystokinin B (CKKB/CKK2) receptor
42
What receptor does Histamine bind to in the acid secretion pathway?
H2 receptor
43
Which pathway does ACh and Gastrin carry out acid secretion?
Act through G-coupled receptors | Increase in Ca2+ and diacylglycerol via PLC, IP3 pathway.
44
Which pathway does Histamine carry out acid secretion?
G-coupled receptor to increase cAMP. | MOST powerful stimulus for HCl secretion
45
What are the three phases of Acid Secretion Stimulation?
1) Celiac phase 2) Gastric phase 3) Intestinal phase
46
What is the Celiac phase?
The Sight/Smell/Thought of food
47
What is the Gastric phase?
When food is in the stomach and there is continuous secretion of HCl and pepsin Higher pH
48
What is the Intestinial phase?
Chyme enters duodenum Duodenal stimulation of hormones Lower pH stimulates D cell activity
49
Stomach distnetion via vagovagal reflex increases parietal cell acid by? (4 steps)
1) Direct stimulation of ECl to release histamine 2)Direct stimulation of G cells to release gastrin via GRP. 3)Inhibition of somatostatin release from D cells in antrum 4)Pyloric antrum exposure to peptides- G cells release gastrin >HCl by direct stimulation G cells and ECL histamine release
50
What happens when there is too much acid?
Stimulation of D cells to release somatostatin and inhibits gastrin release to limit acid secretion.
51
What are the 6 steps of HCl secretion?
1) CO2 diffuses into parietal cell from plasma 2) Combines with water to form carbonic acid 3) Carbonic acid dissociates into carbonate ions and H+ ions 4) H+/K+ ATPase actively transports H+ out, K+ in 5) K+ is recycled to gastric lumen via K+ channel 6) Cl- exists passively from cell via Cl- channel
52
How does Mucosal Protection from HCl happen?
1) Vagal stimulation and irritation stimulate gastric mucous cells --> mucin
53
What do gastric surface epithelial cells release?
HCO3-
54
What stimulates epithelial cells?
ACh HCl PGs
55
What happens to HCO3- released by Gastric epithelial surface cells?
Accumulate near the cell surface.
56
What happens to mucin produced by the epithelial cells?
They are cleaved by pepsin