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Block 3 Week 3 Dani > Ward Small and Large intestine (1) > Flashcards

Ward Small and Large intestine (1) Flashcards

1
Q

duodenal (blank) increases surface area for absorption

A

folds

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2
Q

Pancreatic exocrine cells are arranged in (blank)

A

acini

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3
Q

Pancreatic secretions flow into larger (blank).

A

intralobular ducts

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4
Q

Pancreatic secretions flow into larger intralobular ducts, and into the (blank) which drains directly into the duodenum

A

pancreatic duct

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5
Q

Embedded within the exocrine tissues are islets of langerhans which secrete what?

A

insulin, glucagon etc.

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6
Q

What are the four types of pancreatic secretions?

A

proteolytic enzymes
Pancreatic Amylase
pancreatic lipase
cholesterol esterase

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7
Q

What are the proteolytic enzymes of the pancreas?

A

trypsin, chymotrypsin, and carboxypeptidase

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8
Q

What does pancreatic amylase of the pancreas do?

A

hydrolyzes starches, glycogen, and other carbs (not cellulose) to di and tri saccharides

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9
Q

What does pancreatic lipase do?

A

hydrolyzes fat to fatty acids and monoglycerides

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10
Q

What does cholesterol esterase of the pancreas do?

A

hydrolyzes cholesterol esterases and phospholipase which splits fatty acids from phospholipids

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11
Q

What are the inactive forms of the protolytic enzymes of the pancreas?

A

trypsinogen, chymotrypsinogen, procarboxypolypeptidase

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12
Q

(blank) is activated by enterokinase (secreted by mucosa when chyme comes into contact with it) and by trypsin

A

trypsinogen

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13
Q

How is chymotrypsinogen activated into chymotrypsin?

A

activated by trypsin

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14
Q

(blank) stops the pancreatic enzymes from degrading the pancreas.

A

trypsin inhibitor

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15
Q

(blank) it is released from glandular cells and inhibits the activation of trypsin inside secretory cells, in the acini and in the pancreatic duct

A

trypsin inhibitor

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16
Q

Where is trypsin inhibitor released from?

A

glandular cells

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17
Q

Where will you find trypsininhibitor be inhibiting stuff?

A

in secretory cells, acini and pancreatic duct

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18
Q

Explain the release of zymogen granules

A

protein synthesis via RER-> proteins enter cisternal cavity-> enzymes are condensed into vacuoles-> concentrated enzymes become zymogen granules-> zymogen granule fuses with apical membrane and ruptures to release contents

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19
Q

Enzymes of the pancreas are secreted by (blank)

A

acini

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20
Q

What 2 things are secreted by the epithelial cells of the ducts from the acini?

A

bicarb and water

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21
Q

When the pancreas is stimulated to secrete pancreatic juices it also releases (blank)

A

bicarbonate ions (X5 that of the plasma)

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22
Q

The (blank) and (Blank) concentrations in pancreatic secretion are approx. similiar to that of plasma but (blank) concentration is lower.

A

Na+ and K+

Cl-

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23
Q

The (blank) ion secretion increase with secretion rate yielding a solution of pH 8.2 in the pancreas.

A

HCO3-

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24
Q

What is the first proposed mechanisms for secretion of bicarb ions?

A

Acinar cells secrete Na and Cl
duct cells secrete Bicarb
Differing rates of secretion from these cells results in diff concentration of ions in secretion

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25
Q

What is the second proposed mechanism for secretion of bicarb ions?

A

Primary secretion; rich in HCO3-. As secretion moves down ducts, primary secretion is modified, HCO3- ions are exchanged for Cl- ions. When flow is fast little exchange takes place.

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26
Q

There are 2 proposed mechanisms for Bicab ion secretion, do they work together or are they independent of one another?

A

work together

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27
Q

Explain the mechanism of secretion of bicarb

A

Co2 diffuses from the blood into the cell, this combines with water via carbonic anhydrase= carbonic acid->this dissociates into bicarb and H, H+ is pushed into the blood via Na/H exchanger, and HCO3 is pushed into lumen via HCO3/Cl exchanger. Na diffuses into lumen and water follows.

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28
Q

As secretion rate increases there is a marked increase in (blank) secretion and a decrease in (blank) secretion and (blank) stays steady throughout.

A

HCO3-
Cl-
Na+

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29
Q

HCO3 secretion is dependent upon availability of luminal (blank) ions which is dependent upon the opening of (blank) channels on the apical membrane.

A

Cl-

Cl-

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30
Q

What are the four basic stimuli that are important for the stimulus of pancreatic secretion?

A

ACh, Gastrin, CCK, Secretin

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31
Q

(blank) is released from parasympathetic vagus nerve terminals and nerves in ENS

A

ACh

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32
Q

(blank) is released during the gastric phase of the stomach.

A

Gastrin

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33
Q

(blank) is secreted by the duodenal mucosa when food enters the small intestine.

A

CCK

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34
Q

(blank) is secreted when low pH products enter the small intestine.

A

secretin

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35
Q

ACh, Gastrin and CCK all stimulate the (blank) of the pancreas to produce large quantities of digestive enzymes, without much fluid, resulting in the build up of enzymes in the acani and ducts.

A

acinar cells

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36
Q

(blank) stimulates the secretion of large quantities of sodium bicarbonate solution by ductal epithelium, but little enzyme secretion.

A

Secretin,

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37
Q

ACh released at neural endings in the pancreas cause moderate amounts of enzymes to be secreted into the acini, however only a little flows into the intestine, Why is this?

A

because of the lack of water in the secretion.

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38
Q

(blank) via the gastric phase also causes relatively little pancreatic secretions.

A

Gastrin

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39
Q

Pancreatic secretion is increased considerably when chyme enters the duodenum in response to the hormones (Blank and blank)

A

secretin and CCK

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40
Q

(blank) is released from S cells in the mucosa of the upper small intestine in an inactive form.

A

secretin

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41
Q

What is the stimulus for release of secretin?

A

gastric acid and long chain fatty acids

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42
Q

(blank) is the most potent stimulant of secretin, with a threshold for secretin release being 4.5 .After secretin is released from small intestine, it is absorbed into the blood, stimulating the (blank) to release large quantities of fluid and bicarbonate ions.

A

HCL

pancreas

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43
Q

Does secretin stimulate the acinar cells?

A

no

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44
Q

Explain how HCl reacts in the intestinal phase?

A

HCl reacts with NaHCO3 to make NaCl and carbonic acid (H2Co3) which dissociates into H20 and CO2

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45
Q

What happens to the CO2 produced in the reaction of HCl during the intestinal phase?

A

The CO2 is absorbed into the blood expired in the lungs.

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46
Q

Why does co2 get expired in the lungs during the intestinal phase?

A

This is a protective mechanism to avoid the digestion of the intestinal mucosa by HCl

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47
Q

Also during the intestinal phase, (blank) secretion also increases the pH of luminal contents which is more optimal for pancreatic enzymes (pH 8)

A

bicarb secretion

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48
Q

(blank) is released from I cells within the mucosa of the duodenum and upper jejunum. The stimulant that causes the release of CCK appears to be (blank and blank) (products of partial protein and long chain fatty acid digestion

A

CCK

proteoses and peptones

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49
Q

(blank) is absorbed into the blood stream and travels to the pancreas where it stimulates the release of large amounts of digestive enzymes, similar to the effects of vagal stimulation and gastrin.

A

CCK

50
Q

What wil ACh and CCk do to secretin release?

A

increase it!

51
Q

During a normal meal pH does not drop below 4.5, why?

A

Pancreatic enzyme release gets increased by CCK and ACh working with secretin

52
Q

What are the 2 major functions of bile?

A

to emulsify and transport fat into small intestine

Allow for excretion of waste products from blood (bilirubin,cholesterol)

53
Q

(blank) is A complex mixture of organic and inorganic components. Separately some of the components would precipitate out of solution in an aqueous medium.

A

bile

54
Q

(blank) is a major organic constituents accounting for 50% of solid components. Several features are unique to account for their behavior in solution.

A

bile acids

55
Q

In solution bile acid behavior depends upon their (blank). At (blank) concentrations there is little interaction among bile acids. At (blank) concs. bile acids aggregate into micelles.

A

concentration
low
higher

56
Q

What is the point when bile acids turn into micelles?

A

The Critical Micellar Concentration.

57
Q

(blank) is the primary bile acid from cholesterol

A

cholic acid

58
Q

(blank) is the primary bile acid from choelsterol.

A

chenodeoxycholid acid

59
Q

(blank) is one of the secondary bile acids, which are metabolic byproducts of intestinal bacteria.

A

Deoxycholic acid

60
Q

(blank) is a secondary bile acid that acts as a detergent to solubilize fats for absorption. Bacterial action in the colon produces this.

A

lithocholic acid

61
Q

Most bile acids exist as conjugates of (blank and blank).

A

taurine or glycine

62
Q

Which are more soluble, conjugated or unconjugated biile acids?

A

conjugated

63
Q

(blank) and bile salts are components of micelles and together, are better to solubilize other lipids (cholesterol) than bile salts alone.

A

phospholipid

64
Q

What breaks up phospholipids?

A

bile salts (bile salts make phospholipids more soluble to become parts of micelles)

65
Q

(blank) contributes to about 4% of solids in bile.

A

cholesterol

66
Q

(blank) may be excreted and helps regulated body cholesterol levels.

A

Bile cholesterol

67
Q

Where would you find cholesterol in a micelle?

A

on the inside (in hydrophobic portion)

68
Q

(blank) contributes to about 2% of solids in bile.

A

bile pigements

69
Q

Do bile pigments take part in micelle formation?

A

no

70
Q

What is the most important bile pigment and what are bile pigments used for?

A

bilirubin

color of feces/bile and utilized to assay function of liver

71
Q

What are the inorganic ions of bile?

A 
Na
K
Ca
Cl
HCO3
72
Q

What are all the components of bile?

A 
bile acids
phospholipids
cholesterol
bile pigements
inorganic ions
73
Q

(blank) is isosmotic, because of the highly charged molecules bile acids attract a layer of cations that act as counter ions on the micelles and exert little osmotic activity.

A

Bile

74
Q

The bile that is secreted passes into the small (blank) that lie between the hepatic cells and the hepatic plates.

A

bile canaliculi

75
Q

Once bile flows into bile canaliculi, how does it flow from there?

A

canaliculi–>hepatic duct-> common bile duct-> either cystic duct or empty into duodenum

76
Q

How does bile empty into the duodenum?

A

via the sphincter of Oddi

77
Q

How often are bile acids and pigments secreted?

A

continually

78
Q

How is the rate of secretion of bile altered?

A

the rate is dependent upon amount of bile delivered to the liver by the reuptake of bile. (hepatic circulation)

79
Q

What are the three pathways involved in bile absorption?

A

I. passive diffusion
II. terminal ileum absorption (active carrier mediated)-> very efficient
III. Bacteria in terminal ileum and colon decongugate bile salts to bile acids (bile acids are able to reabsorbed)

80
Q

How is bilirubin transported to liver?

A

albumin

81
Q

Old RBC’s are broken down into Hemoglobin. Hemoglobin is broken down in the reticuloendothelial system to hemin and globin. Hemin is then further broken down into (blank)

A

bilirubin

82
Q

(blank) extract bilirubin.

A

hepatocytes

83
Q

How do hepatocytes extract bilirubin?

A

via an active anion transport system, they conjugate bilirubin with glucuronic acid and then secrete it

84
Q

Is bilirubin actively absorbed?

A

no

85
Q

Some of the bilirubin is reduced by bacteria to (blank)

A

urobilinogen.

86
Q

Some urobilinogen is excreted in feces as (Blank).

A

stercobilin

87
Q

What are all the places urobilinogen can go?

A

excreted in feces
transported to liver
extracted, conjugated and secreted into bile
oxidized to form urobilin and excreted in urine

88
Q

How are electrolytes secreted?

A

1) Bile acid dependent: Bile acids create osmotic gradient, water follows and passibely ions follow water
2) Bile acid independent: active transport of Na+ by heptocytes, in ducts bicarb is actively secreted and Na and Cl are absorbed. Bile becomes alkaline and Cl- decreases

89
Q

How does the bile acid independent secretion of electrolytes stimulated?

A

by secretin

90
Q

As bile acids are propelled towards the distal ileum, primary acids are converted to (bank)

A

secondary acids

91
Q

(blank) acids are absorbed passively.
(blank) acids are absorbed by a sodium coupled active transport system. A minor fraction of bile acids are not absorbed but transported to (blanK)

A

hydrophobic
hydrophilic
colon

92
Q

Where do absorbed bile acids end up?

Why?

A

liver

They can be actively extracted from the blood and resecreted

93
Q

When we lose bile acids in the large intestine we make more from (blank)

A

cholesterol

94
Q

What are the 2 main organic solutes of bile?

A

bile salts, phospholipids, and cholesterol

95
Q

(blank) are actively secreted into bile through distinct bile salt-transport pumps.

A

bile salts

96
Q

What are the four ways we can get gallstones?

A

1) Too much absorption of water from bile.
2) Too much cholesterol in bile, leading to precipitation.
3) Too much absorption of bile acids from bile.
4) Inflammation of the epithelium.

97
Q

(blank) are found found extensively in the duodenum between the pylorus and papilla of Vater,

A

Brunner’s glands

98
Q

Brunner’s gland will secrete mucous in response to what four things?

A

(i) tactile stimuli
(II) irritating stimuli
(iii) vagal stimulation
(iv) GI hormones - in particular secretin.

99
Q

The function of the mucus secreted from the brunners glands is….????

A

to protect the intestinal wall from digestion by gastric juices,
lubricate
dilute noxious agents

100
Q

What inhibits secretion of Brunner’s glands?

A

sympathetic stimulation

101
Q

If Brunner’s glands is inhibited by sympathetic stimulation, what can this lead to?

A

unprotected duodenal bulb (may lead to peptic ulcer)

102
Q

What do crypts of leiberkuhn of the small intestine secrete?

A

extacellular fluid (pH 7.5-8) which is reabosrbed by the villi.

103
Q

What does the solution secreted by the crypts of leiberkuhn work as?

A

carrier for absorption of nutrients

104
Q

What are the ions in the extracellular fluid solution secreted by the crypts of leiberkuhn?

A

Active secetion of Chloride
Active secretion of Bcarb
and Passive secretion of Na+

105
Q

What does the Na+ of the solution secreted by the crypts of leiberkuhn create?

A

an osmotic potential which results in the movement of water into the crypt

106
Q

(blank) line the mucosa of the large intestine

A

crypts of liberkhnn

107
Q

Do the crypts of lieberkuhn have villi?

A

no

108
Q

Mucus which contains large quantities of bicarbonate ions is secreted by (blank) cells in the crypts of lieberkuhn.

A

mucous

109
Q

(blank) stimulation results in copious amounts of mucus secretion

A

parasympathetic

110
Q

(blank) in the large intestine protects the lining from acid that is formed deep in feces. It also provides a medium for the formation and binding of fecal material.

A

mucus

111
Q

What is the mechanism of the secretion of the crypts of lieberkuhns?

A

Na-CL cotransport at basal lateral side allows cl to move down gradient due to Na moving down its gradient. Cl secretion is regulated by cAMP.cAMP levels are controlled by VIP after meal

112
Q

What is this:\Responsible for numerous pandemic infections of extreme diarrhea and dehydration across the globe, resulting in millions of deaths.

A

Vibrio cholerae.

113
Q

What is this:
Onset of symptoms include abdominal pain followed by a sudden onset of massive diarrhea. This initial stool may be composed of over one liter of fluid, and several liters of fluid can be secreted within hours after. Vomiting is another common symptom of early cholera infection. As infection progresses, the stool becomes much more watery, and may have white flakes of mucus in it. These flakes are composed of slewn off gastrointestinal cells.

A

Vibrio cholerae.

114
Q

What is this:
characterized by severe fluid loss, leading to extreme dehydration, fever, tachycardia, and dry skin and/or mucous membrane. During this time fluid released from the bowls or vomitus is rich in cholera toxin. If this late stage cholera is not treated, the mortality rate is approximately 50%. If cholera is detected and treated mortality rates decline drastically, to less than 2%.

A

Late stage cholera

115
Q

neural endings and receptors that cause and increase in salivary secretion are predominantly located on the basal side of the cell membrane.
T or F?

A

T

116
Q

Stimulation of the parasympathetic and sympathetic nerves can lead to an increase in salivary gland secretion. During periods when parasympathetic stimulation is high, sympathetic stimulation leads to a reduction in secretion mainly by constricting blood vessels that supply the respective glands.
T or F?

A

T

117
Q

Parasympathetic stimulation causes the membrane potential in glandular secretory cells to become more positive resulting in saliva that is low in sodium. T or F?

A

False, actually when you have high amounts of secretion (which parasympathetic stimulation induces) you will have less time to reabsorb Na+ ions therefore you will have a more negative membrane potential and you will and saliva that is higher in sodium :)

118
Q

Is heparin in the ECM?

A

nope

119
Q

At low gastric secretion rates parietal cells produce a secretion that is high in NaCl ions, HCL and production increases as gastric secretion increase. T or F?

A

True

Apparaently when you have low secretion you have high NaCl and as secretion increase you will get more HCL

120
Q

What do parietal cells use to place H+ ions into the lumen of oxyntic glands during acid production?

A

a K+/H+ ATPase!

Cl- hops a ride with H thus HCl is born

Block 3 Week 3 Dani (10 decks)

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