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Physiology: GI > Upper GI Disorder: Gastric system > Flashcards

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?

A

Heartburn

24
Q

What is Erosive oesophagitis?

A

Acute inflammatory response

25
Q

What is Barrett’s oesophagus?

A

Metaplasis of mucosa

26
Q

Which one of the three types of GORD, poses a risk of cancer?

A

Barrett’s oesophagus

27
Q

What are the acid secreting cells in the oxyntic gland area?

A

Mucous cells
Chief cells
Parietal cells
ECL cells

28
Q

What are the secreting cells in the pyloric gland area?

A

Mucous cells
G cells
D cells
No parietal cells

29
Q

Why are there no parietal cells in the pyloric gland area?

A

Not necessary to secret HCL at the bottom of the stomach

30
Q

Function of the mucous cells

A

Secrete mucous

31
Q

Function of chief cells

A

Secrete pepsinogen

32
Q

Function of ECL cells

A

Secrete histamine

33
Q

Function of parietal cells

A

Secrete HCl

34
Q

Function of D cells

A

Secrete somatostatin

35
Q

Function of G cells

A

Secrete gastrin

36
Q

How many litres of HCl is secreted per day by parietal cells?

A

1-2 L

37
Q

What concentration is the HCl?

A

150-160 mM

38
Q

What are the three positive factors in HCl acid production?

A

Gastrin
ACh
Histamine

39
Q

What is the one negative regulator in HCl production?

A

D cells

40
Q

What receptor does ACh bind to in the acid secretion pathway?

A

M3 receptor

41
Q

What receptor does Gastrin bind to in the acid secretion pathway?

A

Cholecystokinin B (CKKB/CKK2) receptor

42
Q

What receptor does Histamine bind to in the acid secretion pathway?

A

H2 receptor

43
Q

Which pathway does ACh and Gastrin carry out acid secretion?

A

Act through G-coupled receptors

Increase in Ca2+ and diacylglycerol via PLC, IP3 pathway.

44
Q

Which pathway does Histamine carry out acid secretion?

A

G-coupled receptor to increase cAMP.

MOST powerful stimulus for HCl secretion

45
Q

What are the three phases of Acid Secretion Stimulation?

A

1) Celiac phase
2) Gastric phase
3) Intestinal phase

46
Q

What is the Celiac phase?

A

The Sight/Smell/Thought of food

47
Q

What is the Gastric phase?

A

When food is in the stomach and there is continuous secretion of HCl and pepsin
Higher pH

48
Q

What is the Intestinial phase?

A

Chyme enters duodenum
Duodenal stimulation of hormones
Lower pH stimulates D cell activity

49
Q

Stomach distnetion via vagovagal reflex increases parietal cell acid by? (4 steps)

A

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
Q

What happens when there is too much acid?

A

Stimulation of D cells to release somatostatin and inhibits gastrin release to limit acid secretion.

51
Q

What are the 6 steps of HCl secretion?

A

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
Q

How does Mucosal Protection from HCl happen?

A

1) Vagal stimulation and irritation stimulate gastric mucous cells –> mucin

53
Q

What do gastric surface epithelial cells release?

A

HCO3-

54
Q

What stimulates epithelial cells?

A

ACh
HCl
PGs

55
Q

What happens to HCO3- released by Gastric epithelial surface cells?

A

Accumulate near the cell surface.

56
Q

What happens to mucin produced by the epithelial cells?

A

They are cleaved by pepsin

Physiology: GI (6 decks)

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