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advanced human physiology > WEEK 13 > Flashcards

WEEK 13 Flashcards

1
Q

what is the main function of the small intestine

A

digestion and absorption of nutrients

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2
Q

Fill in.
Reduced expression or mistargeting of NHE3 protein
results in _______ in patients with a rare genetic
disorder

A

diarrhea

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3
Q

Fill in.
___________ ________ can inhibit NHE3 mediated Na-H+ exchange, that operates in parallel with Cl-HCO3- exchange, mediated by PAT1

A

Intestinal inflammation

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4
Q

Fill in.
NHE mechanisms mediate ________ _____ ______ in the small intestine

A

electroneutral NaCl absorption

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5
Q

true or false.
NHE expressed in the small intestine are also expressed in the colon.

A

True

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6
Q

fill in.
Electrogenic Na+ absorption is mediated by apical epithelial sodium channels called ______ _____ .

A

ENaC channels

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7
Q

ENaC channels are primarily found in the ______, and ______ but also observed in the ileum.

A

colon ; rectum

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8
Q

ENaC channels are expressed in the ______ _____ .

A

brush border

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9
Q

ENaC channels are strongly _______ by a ________, amiloride

A

inhibited; diuretic

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10
Q

ENaC channels are _________ by the mineralocorticoid hormone, ___________.

A

stimulated; aldosterone

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11
Q

What are three mechanisms utilized by chloride absorption?

A

1-2. electroneutral pathways: Na-H and Cl-HCO3- exchange. this is the main mechanism for chloride absorption

  1. paracellular absorption: passive ; absorbed between cells; This pathway predominates in the small
    intestine
    depends on the transmural potential difference
    and the chloride gradient.
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12
Q

fill in.
a. The products of lipid digestion- __________ and ______ _____ are dissolved in bile _______.

b. Lipid digestion in the _______ and duodenum yields monoglycerides and long chain fatty acids.
Other lipid products in the alimentary canal like phospholipids, cholesterol, and fat-soluble vitamins, along with the lipolysis products, form micelles with bile ______ .

c. Lipids are absorbed in the small intestine via _______

d. Fatty acids, monoglycerides leave micelles →
enter ________ cells → _________ formation → __________ formation → chylomicron enter ______ → ________

A

a. monoglycerides; fatty acids ; micelles

b. stomach ; salts

c. diffusion

d. epithelial ; triglyceride ; chylomicron ; lacteals ; lymphatics (enter blood vessel)

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13
Q

Fill in.
The three products of carbohydrate digestion are glucose, ________, and ________. The absorption of these sugars is a _____ – stage process

A

galactose; fructose; two

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14
Q

Fill in.
A. On the ______ membrane SGLT1 is a Na- dependent glucose and ______ transporter.

B. The transporter is expressed at the brush border of _________ in the small intestine. It transports sodium and glucose at a _:1 ratio. This transporter relies upon the Na-K ATPase to maintain the Na-gradient

C. Inhibition of the Na-K ATPase reduces glucose and
galactose absorption. Each cycle of the SGLT-1 transporter brings _____ _____ molecules with every molecule of glucose accounting for roughly ____ L of water absorption per day

D. This is the molecular basis of oral rehydration therapy used to treat ______ and other diarrheal diseases

E. GLUT5 is responsible for the apical absorption of ________ via _______ diffusion

F. Excess glucose, Fructose and galactose is transported out of the basolateral membrane using _______

A

A. Apical ; galactose ;

B. enterocytes; 2

C. 260 water ; 5

d. cholera

E. fructose ; facilitated

F. GLUT2

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15
Q

True of false.
The movement of glucose through this transporter will depend only on the relative concentrations of the sugar inside and outside the cell.

A

True.

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16
Q

True or false.
GLUT2, is a ________ sugar transporter.

A

facilitated

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17
Q

True of false.

The intestine is only capable of transporting single amino acids

A

False.
The intestine is capable of transporting not only
single amino acids, but also short oligomers,
encompassing di-, tri-, and perhaps even
tetrapeptides.

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18
Q

Fill in.
Amino acid transport utilizes Na+, ___ , ___, and ___ as it’s transport partners

A

K+, H+, Cl-

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19
Q

How do amino acid-Na+ coupled transporters differ

A
  • in their transport partners (Na+, K+, H+, Cl-)
  • whether they are electroneutral or electrogenic
  • In specificity for different classes of amino acids
  • Multiple brush border transport systems for amino acids depend on Na+ either directly or indirectly
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20
Q

true or false.
Dipeptides and tripeptides are inefficiently absorbed in the small intestine.

A

False. they are efficiently absorbed.

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21
Q

Fill in.
The transport of di- and tripeptides is ________ dependent on Na+ because:
1. Na+ is needed to drive the Na+/H+ exchanger (NHE3)
2. NHE3 generates a _______ gradient.
3. A proton gradient is needed for H+/peptide transport
4. In this way the absorption of Na+ is coupled to the absorption of another H+ important nutrient amino acids and ______.

PEPT1 ( peptide transporter-1) mediates proton-coupled uptake of a broad variety of peptides.
Its activity is coupled to the activity of the ______. It has an extremely ______ substrate specificity. It can transport peptides of various sizes (di-, tri-, tetra-peptides) and charges.

A

indirectly ; proton ; peptides ; NHE3 ; broad

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22
Q

True or false.
Cystolic digestion occurs during the transport of peptides

A

true.

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23
Q

Fill in.
Basolateral amino acid transport systems are organized into _______ transport systems based on amino acid characteristics.

A

six ;

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24
Q

The basolateral membrane can operate in both directions depending on what?

A
  1. the luminal amino acid concentration
  2. cellular demand
  3. electrogenic driving forces
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25
Q

Fill in.
Water soluble vitamins use a ___________ mechanism for absorption in the ______. This includes B vitamins, Vitamin ___, Folic acid , _______ acid, and ______ acid

A

Na-cotransport ; ileum; C ; Nicotinic ; Pantothenic

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26
Q

True or false.
B12 is found in animal products

A

true.

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27
Q

Fill in.
B12 is bound to _______ protein.

______ and the acidic pH liberate B12 from food
proteins.

In the stomach, B12 binds to a carrier protein
_________ , which protects B12 from _______.

In the small intestine, _______ degrades haptocorrin,
releasing B12. Free B12 binds to ______ intrinsic factor protects B12 from degradation.

Absorption into intestinal enterocytes is a ________
mediated process.

B12-IF complex is internalized and sent to _________
where intrinsic factor is degraded.

The released B12 is exported from the basolateral membrane by the _______ ________ _______ protein-1 (MRP1).

B12 deficiency results in ________ anemia.

A

dietary; Pepsin ; haptocorrin ; degradation ; trypsin ; gastric ; receptor; lysosomes ; multi-drug resistant associated ; megaloblastic

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28
Q

Fill in.
The small intestine extends from the _____ ______ to the ileocecal valve

A

pyloric sphincter

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29
Q

From proximal to distal, the small intestine is divided into which three regions?

A
  • duodenum, jejunum and ileum
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30
Q

Small intestine is made of what kind of cells?

A
  • Simple columnar epithelial cells, absorptive cells called enterocytes, and a small amount of goblet cells
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31
Q

What are the mucosa adaptations that expand the surface area of the small intestine?

A
  • Plicae circulares are microscopic folds of the mucosa and submucosa, and they circle the intestine. They are more organized than Rugae
  • Villi are microscopic, fingerlike projections of the mucosa. They are covered in simple, columnar, epithelium, and extend up from the mucosa.
  • Micro villi are tiny cytoplasmic extensions on the apical surface of epithelial cells.
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32
Q

What are the invaginations surrounding and between villi in the small intestine?

A
  • Crypts of lieberkuhn
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33
Q

Where do the stem cells that give rise to both crypt and villus epithelial cells reside?

A
  • Toward the base of the Crypts
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34
Q

Defined the brush border.

A
  • Found on the membrane of microvilli (small intestine)
  • Made of a dense glycocalyx
  • Protect the cells from digestive enzymes
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35
Q

What do brush border hydrolases do?

A
  • Perform the final steps of digestion for specific nutrients
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36
Q

What type of cells do the crypts contain?

A
  • Enterocytes which are simple columnar epithelial cells with microvilli that are specialized for absorption.
  • Goblet cells that secrete mucus
  • Enteroendocrine cells. They are different from stem cells and are specialized for secretion of hormones.
    This includes:
    - Enterochromaffin cells that secrete serotonin,
    - D cells found in the duodenum that secretes somatostatin,
    - I cells found in the duodenum, and jejunum that secrete cholecystokinin,
    - S- cells in the duodenum and jejunum that secrete secretin.
  • Paneth cells found at the base of the intestinal glands and have a highly granular appearance. These granules contain several anti-microbial compounds like defensins and lysozyme.
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37
Q

Where are Brunners glands typically found?

A
  • In the submucosa of the proximal duodenum. This is where the duodenum is exposed to acid.
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38
Q

Brunners glands are unique to what type of animals?

A
  • Placental mammals
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39
Q

Describe Breuners glands.

A
  • The glands are made of mucin-secreting cuboidal to columnar cells, arranged on lobules
  • Secretion from Brunners glands contributes to a layer of mucus
  • The mucous layer protects delicate epithelial surface that first encounter gastric chyme and pancreatic juice.
  • Brunners Glands raise the ph luminal contents and provide an immunological defense.
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40
Q

What stimulates Brunner’s gland secretion?

A
  • Tactile irritating stimuli of the duodenal mucosa
  • Vagal stimulation
  • Secretin
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41
Q

What decreases secretion from brunner’s glands?

A
  • Sympathetic activity
  • Prolonged, sympathetic activity, makes mucosa vulnerable to acid chyme
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42
Q

In the small intestine, how is fluid absorbed?

A
  • Fluid absorption is driven by coupled transport of nutrients
  • Between meals, for the reuptake is driven exclusively by the movement of electrolytes
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43
Q

In the small intestine, how was fluid secretion accomplished?

A
  • Fluid secretion is driven by the active transport of chloride ions into the lumen through the CFTR channel
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44
Q

Describe the CFTR channel.

A
  • Stands for cystic fibrosis transmembrane regulator protein
  • CFTR is a cAMP- regulated anion channel highly expressed in the small intestine mucosa
  • CFTR mediates secretion of chloride, bicarbonate and fluid
  • Chloride secretion establishes an electrical driving force that makes the lumen negative. This driving force is for trans-epithelial sodium secretion via the paracellular pathways.
  • The movement of sodium and chloride into Luminal compartment generates the osmotic driving force for water flow producing an isotonic secretory product.
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45
Q

What are the three molecular requirements for chloride secretion into the lumen of the small intestine? Where must they be located?

A
  • Sodium potassium ATPase
  • Basolateral potassium channels
  • NKCC1 transporter
  • on the basolateral membrane of epithelial cells
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46
Q

What does a Basolateral potassium channel in the small intestine do?

A
  • Set the membrane potential
  • Recycle the potassium brought in by the sodium potassium ATPase
  • Activate the same cAMP/Pk-A pathway that activate CFTR
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47
Q

What does the NKCC1 transporter do?

A
  • Mediates the Basolateral influx of chloride
  • Import one sodium and potassium and 2 chlorides per cycle
  • The rate of chloride entry, through this transporter determines the overall rate of chloride secretion
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48
Q

True or false.
the small intestine enterocytes produces digestive enzymes found at the brush border .

A
  • True
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49
Q

What does isoMaltase do?

A
  • It is an enzyme that breaks isomaltase down
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50
Q

What is the most important mechanism for regulating the secretions of the small intestine?

A
  • Local enteric reflexes
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51
Q

What does intestinal lipase do?

A
  • Breaks neutral fats into glycerol and fatty acids
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52
Q

The chemical digestion in the small intestine relies on what three accessory digestive organs?

A
  • Liver
  • Gall bladder
  • Pancreas
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53
Q

What is the exocrine portion of the pancreas made of? what is the endocrine portion of the pancreas made of?

A
  • exocrine pancreas: acinar and duct tissue
  • Endocrine pancreas: islets of langerhans
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54
Q

what does the liver do? What does the gallbladder do? What does the pancreas do?

A
  • liver: produces bile
  • Gallbladder: stores, concentrates, and releases bile
  • Pancreas: produces pancreatic juice, which contains digestive enzymes, and bicarbonate ions
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55
Q

What do acinar cells do?

A
  • Synthesize store and secrete digestive enzymes
  • They have a very high protein synthesis rate. Due to the highly developed ER combined with the mechanisms to modify and transport, newly synthesize proteins through the secretory pathway
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56
Q

What are digestive enzyme stored as in acinar cells?

A
  • zymogen granules, inactive form
57
Q

What is the ER in the acinar cells used for?

A
  • Major storage of intracellular calcium
  • Calcium mediates secretion of stored digestive enzymes into the pancreatic ductal system.
58
Q

How is how much in granules released from acinar cells when they are stimulated?

A

-Through exocytosis

59
Q

What prevents leakage of digestive enzymes out of the ducts in small intestine?

A
  • tight junctions between acinar cells
60
Q

How are acinar cells coupled?

A
  • Through gap junctions
61
Q

What is needed to trigger exocytosis in acinar cells?

A
  • An increase in intracellular calcium
62
Q

Where is secretin made?

A
  • s cells in duodenum, in the crypts of lieberkuhn
63
Q

What effect does secretin have on duct epithelial cells?

A
  • Causes the pancreas to secrete large quantities of fluid with a high bicarbonate concentration
64
Q

What accounts for the majority of the total secretion of pancreatic digestive enzymes?

A
  • CCK
65
Q

Describe the absorb, nutrient phase in the pancreatic secretions?

A
  • Directly stimulate pancreatic acinar cells
  • Activate hormonal in neural pathways
66
Q

What is in a portal triad?

A
  • Hepatic portal vein
  • Hepatic artery
  • Bile duct
67
Q

What is a functional unit of the liver?

A
  • Lobule
68
Q

Describe what the liver does

A
  • Important in digestion and metabolism
  • Stores, glycogen, fat-soluble vitamins, iron and copper
  • handles cholesterol homeostasis
  • Responsible for a plasma, proteins synthesis, which is important in maintaining plasma osmotic pressure
  • Involved in heme breakdown ( bilirubin)
  • Involved in detoxification of drugs
69
Q

Describe blood flow in a lobule of the liver.

A
  • Hepatic portal vein to hepatic artery to sinusoids to Central vein to hepatic vein to the inferior vena cava
70
Q

What are the cells of the liver that produce bile?

A
  • Hepatocytes
71
Q

What is bile composed of?

A

-Water, electrolytes, bio salt, bile acids cholesterol, bio pigment, bilirubin, and phospholipids

72
Q

Describe the flow of bile secretion.

A
  • hepatocytes to bile canaliculi to smaller ducts to larger ducts to the duodenum or stored in the gallbladder
73
Q

What does epithelial cells line the bile duct secrete?

A
  • A Sodium bicarbonate solution.
  • This is stimulated by secretin
74
Q

What are the roles bio has in digestion?

A
  • emulsify fat
  • Facilitate fat and cholesterol absorption
75
Q

What attaches the gallbladder to the rest of the extrahepatic biliary system?

A
  • Cystic duct
76
Q

The gallbladder is a part of what type of biliary system?

A
  • extrahepatic
77
Q

In regards to an acidic fatty containing chyme enters the duodenum. What does secretin,CCK and ACH do?

A
  • secretin: stimulates the biliary duct to secreate a watery bicarbonate, rich fluid
  • CCK: the main stimulator. Stimulates the smooth muscle of the gallbladder to contract. and signal sphincter of Oddi to relax.
  • ACh: produces weak gallbladder contractions
78
Q

What are the different regions the colon is divided into?

A
  • Cecum
  • Colon: ascending colon, transverse colon, descending colon, sigmoid colon
  • Rectum and anal canal
79
Q

How long is the large intestines and when does it begin?

A
  • 5 feet long
  • Begins after the ileocecal valve
80
Q

Fill in.
The large intestine processes ________ material after most _______ are removed

A
  • indigestible, nutrients
81
Q

True or false.
After a meal is ingested, MMC is immediately interrupted.

A
  • True. The small intestine his enter the Fed pattern or state.
82
Q

What happens when bile emulsifies lipids?

A
  • Increases the surface area available for lipases to break down the lipid
83
Q

Fill in.
The ascending colon is the ______ site of _________ water, and any other nutrient.

A
  • primary, absorption
84
Q

What is the primary secretion of the large intestine?

A
  • Mucus from goblet cells
85
Q

Fill in.
The descending colon stores _____ until they are emptied into the rectum .

A
  • feces
86
Q

What are the primary functions of the colon?

A
  • Absorb water
  • Absorbed electrolytes
  • Produce and absorb vitamins
  • Form and propel feces forward into the rectum for elimination
87
Q

The large intestine has three unique anatomical features. Name them and describe them.

A
  • Teniae Coli : three longitudinal ribbons of smooth muscle; make up the entire longitudinal muscle layer of the muscularis of the large intestine
  • Haustra: balloon like pouches; singular = hostrum ; tonic contractions of the teniae coli cause a colon to bunch up into these
  • Epiploic appendages: attach to the teniae coli; small fat, filled sac to visceral peritoneum; unknown function
88
Q

What is the mucosa in the large intestine made of ?

A
  • Simple, columnar epithelium
  • Epithelial cells for absorption
  • Goblet cells
89
Q

What is gut Flora?

A
  • 100 trillion nonpathogenic bacteria found in the large intestine.
  • Gut flora, turns dietary fiber into short chain fatty acids that can be absorbed. Via fermentation. This is food for the bacteria in the gut
  • It is responsible for the synthesis of vitamin K
  • It competes with pathogenic strains of bacteria
  • It educates the host immune system
90
Q

What are the two types of movement in the large intestine?

A
  • haustral contractions
  • Mass movements. Aka high amplitude, propagating contraction.
91
Q

What triggers haustral contractions?

A
  • Chyme in the colon
92
Q

Where do haustral contractions occur?

A
  • primarily in the transverse and descending colons
  • But does also occur in the sigmoid colon to further concentrate fecal waste
93
Q

How often do haustral contractions occur?

A
  • about 30 minutes throughout the day
  • Last for 1 min
94
Q

Fill in.
Haustral contractions help in the absorption of _________

A
  • water
95
Q

True or false.
Compared to haustral contractions, mass movements in the large intestine are slow.

A
  • False. They are strong waves of contractions and quickly force contents forward
96
Q

Where do mass movement begin in the large intestine?

A
  • Midway through the transverse colon
97
Q

What provokes gastrocolic reflex?

A
  • Distention in the stomach and the breakdown products of digestion in the small intestine
98
Q

Does mechanical digestion occur in the esophagus?

A
  • no. Neither mechanical or chemical digestion occurs in the esophagus
99
Q

True or false.
Cellulose is digestible.

A
  • False. It is not cellulose provides no nutritional benefit. It is an important dietary component in the form of fiber.
100
Q

What do maltose, sucrose and lactose all have in common?

A
  • They are all disaccharides, and they all contain glucose.
101
Q

True or false.
The average American diet is 50% carbohydrates.

A
  • True
102
Q

What is maltose broken down into?

A
  • 2 glucose
103
Q

What is sucrose broken down into?

A
  • One glucose and one fructose
104
Q

What is lactose broken down into?

A
  • One glucose and one galactose
105
Q

What breaks down starch, and glycogen in the oral cavity?

A
  • Salivary amylase; into dextrins, maltose and maltotriose
106
Q

True or false.
the stomach breaks down carbohydrates

A
  • False
107
Q

What breaks down carbohydrates in the small intestine?

A
  • pancreatic amylase; into disaccharides
108
Q

Where do disaccharides get broken down into monosaccharides?

A
  • The brush border of the small intestine.
  • A lot of glucose to absorb here
109
Q

True or false.
15 to 20% of the average American diet is proteins with another 35 g coming from G.I. secretions .

A
  • true
110
Q

Where does protein digestion begin?

A
  • In the stomach via HCl
111
Q

What function does HCl serve in the stomach for digesting proteins?

A
  • It’s denatures ingested proteins
  • Activates pepsin
112
Q

What does pepsin do?

A
  • It is an endonuclease
  • A Cleves internal peptide bonds of aromatic amino acids
  • Allows the polypeptides to pass into the small intestine to be further broken down
113
Q

What breaks down large polypeptides in the small intestine?

A
  • Trypsin, chymotrypsin, Carboxypeptidase
114
Q

What does trypsin do? What does chymotrypsin do?

A
  • trypsin: Cleves peptides at the carboxyl side of lysine and arginine
  • Chymotrypsin: Cleves, peptide bonds on the carboxyl side of tyrosine, phenylalanine, tryptophan, leucine
115
Q

What breaks down, short polypeptides and amino acids into amino acids at the brush border?

A
  • Carboxypeptidase- liberates individual amino acids
  • Amino peptidase- liberates individual amino acids
  • Dipeptidase- acts on short couplets of amino acids to break into individual amino acids
116
Q

What does carboxypeptidase do?

A
  • Release one amino acid at a time from the carboxyl terminal end of a protein
117
Q

What lipases carryout lipid digestion?

A
  • Lingual lipase
  • Gastric lipase
  • Pancreatic lipase
118
Q

What breaks triglycerides down in the oral cavity?

A
  • Lingual lipase
119
Q

What breaks Diacylglycerol, fatty acid, and triglycerides down in the stomach?

A
  • Gastric lipase
120
Q

Fill in.
Lingual and gastric lipases are considered ______ lipases

A
  • acidic
121
Q

True or false.
Lingual lipase, swallowed with food remains active for a time in the stomach.

A
  • true
122
Q

True or false.
both lingual and gastric lipases break individual fatty acids off, the ingested triglycerides.

A
  • true
123
Q

Fill in.
Lingual and gastric lipases make minor contribution to lipid digestion in adults but I’m much more important in ______ .

A
  • infants
124
Q

How does bile aid, pancreatic lipase in the small intestine?

A
  • Increases the available surface area available for pancreatic lipase to work
125
Q

Describe pancreatic lipase.

A
  • Eight digest triglycerides into their components
  • Such as monoglycerides, glycerol, fatty acids
  • Found in the lumen of the small intestine
126
Q

Fill in.
Plant and animal tissue we consume contains ________ _____.

A
  • nucleic acids ( DNA and RNA)
127
Q

Where does nucleic acid digestion begin?

A
  • Lumen of the small intestines
128
Q

What breaks DNA down into nucleotides in the small intestine?

A
  • Pancreatic nucleuses: deoxyribonuclease, ribonuclease
129
Q

What is a nucleotide?

A
  • A phosphate, a sugar (ribose or deoxyribose), and a base
130
Q

What breaks nucleotides down into nucleosides?

A
  • Nucleotidases
  • Brush border of small intestine
131
Q

What breaks nucleosides into nitrogenous bases, sugars, and phosphates?

A
  • Nucleosidases and phosphatases
132
Q

Where does carbohydrate and protein absorption take place specifically in the small intestine ?

A
  • The jejunum
133
Q

Where are bile salts and vitamin B 12 absorbed in the small intestine?

A
  • The distal ileum
134
Q

Where are the majority of electrolytes in water, absorbed in the alimentary canal?

A
  • The small Intestine
135
Q

What does the apical absorption of sodium depend on?

A
  • Sodium- dependent nutrient transporters; like sugar or amino acid transporters
  • Sodium-proton exchangers; this mediates the electroneutral NaCl absorption
  • Na+ channels; this mediates colon-predominant electrogenic Na+ absorption
136
Q

Disruptions in electrolyte concentration of the aluminal contents will lead to passive movement of water, which can cause what?

A
  • Diarrhea or constipation
137
Q

fill in.
Studies suggests that _____ is primarily responsible for sodium and water absorption.

A
  • NHE3
138
Q

True or false.
Three NHE I saw forms have been identified in enterocyte apical membranes

A
  • true. They are NHE2 , NHE3 , NHE8
139
Q

Fill in.
Missense mutations in the gene encoding for NHE3 result in _____ ______ ______

A
  • congenital sodium diarrhea

advanced human physiology (13 decks)

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