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Gastrointestinal > 8. Brain to Gut and Gut to Brain Signalling > Flashcards

8. Brain to Gut and Gut to Brain Signalling Flashcards

1
Q

name for the GUT’S OWN NERVOUS SYSTEM

A

ENTERIC NERVOUS SYSTEM (ENS)

has 100 million neurones (same as spinal cord)

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2
Q

by which NERVOUS PATHWAYS do the CNS and ENS COMMUNICATE

A

VAGUS NERVOUS PATHWAY
&
SPLANCHNIC NERVOUS PATHWAY

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3
Q

AFFERENT and EFFERENT NEURONES carry Signals between…

A

Afferent : GUT TO BRAIN
Efferent: BRAIN TO GUT

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4
Q

AFFERENT NEURONES from GUT TO BRAIN are:

A

VAGAL AFFERENTS and SPINAL AFFERENTS

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5
Q

EFFERENT NEURONES from GUT TO BRAIN are:

A

VAGAL EFFERENTS and SYMPATHETIC EFFERENTS

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6
Q

the SENSATION of FULLNESS is CARRIED in which NERVES

A

VAGUS NERVES

(proposed by Sir Arthur Hurst 1911)

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7
Q

PAINFUL SENSATIONS in the STOMACH are conveyed by which NERVE FIBRES

A

SYMPATHETIC
(NOT vagal)

(proposed by Sir Arthur Hurst 1911)

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8
Q

GI is CONTROLLED by which NERVOUS SYSTEM

A

AUTONOMIC NERVOUS SYSTEM

  • Parasympathetic and Sympathetic nerves
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9
Q

what do VAGAL (PARASYMPATHETIC) EFFERENTS act VIA

A

ENTERIC NEURONS

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10
Q

what do SYMPATHETIC EFFERENTS act on

A

BLOOD VESSELS and ENTERIC NEURONS

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11
Q

PARASYMPATHETIC NERVES …. DIGESTION

A

STIMULATE

(rest and digest)

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12
Q

SYMPATHETIC NERVES … DIGESTION

A

INHIBIT

(flight or fight)

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13
Q

which GI NERVES are PARASYMPATHETIC

A

VAGUS and PELVIC

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14
Q

EXTRINSIC NERVES (OUTSIDE GUT) have what effect on the Digestive System

A

Speed up or Slow down

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15
Q

what are the 2 NERVE PLEXUSES in the GUT WALL

A

MYENTERIC PLEXUS (Auerbach’s)
SUBMUCOSAL PLEXUS (Meissner’s)

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16
Q

what do the MYENTERIC and SUBMUCOSAL PLEXUSES do

A
  • SENSE LUMINAL CONTENTS
  • CONTROL MUSCLES and GLANDS
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17
Q

where is the MYENTERIC PLEXUS in the GUT WALL

A

BETWEEN LONGITUDINAL and CIRCULAr LAYERS

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18
Q

where is the SUBMUCOSAL PLEXUS in the GUT WALL

A

BETWEEN the CIRCULAR and MUCOSA LAYERS

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19
Q

ENTERIC NEURONS CONTROL:

A
  • MOTILITY
  • SECRETION
  • BLOOD FLOW
  • potentially MUCOSAL GROWTH
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20
Q

how does the ENS WORK

A

AUTONOMOUSLY - without input from CNS

in communication with SYMPATHETIC and PARASYMPATHETIC NERVES

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21
Q

GASTRIC DISTENSION (stomach stretching) is DETECTED BY

A

MECHANORECEPTORS

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22
Q

INTESTINAL CELLS DETECT NUTRIENTS as food enters/passes through and DRIVE PRODUCTION of:

A
  • HORMONES
  • PARACRINE MEDIATORS
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23
Q

what causes the VAGAL AFFERENTS to send SIGNALS TO the BRAIN

A

GASTRIC DISTENSTION and INTESTINAL NUTRIENTS

  • MECHANORECEPTORS and PARACRINE MEDIATORS
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24
Q

what is the RESPONSE of the BRAIN that is sent via VAGUS EFFERENTS

A
  • REDUCE FOOD INTAKE (sense of fullness)
  • DECREASED GASTRIC EMPTYING
  • INCREASED PANCREATIC and GASTRIC SECRETIONS
  • INCREASED GUT IMMUNE RESPONSES
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25
Q

how do GUT IMMUNE RESPONSES change from BRAIN RESPONSE to GASTRIC DISTENSION and INTESTINAL NUTRIENTS

A

INCREASE

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26
Q

what NERVES cause DECREASED FOOD INTAKE

A

VAGAL EFFERENTS (from brain)

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27
Q

in the INTERDIGESTIVE PERIOD what HORMONE RELEASE is stimulated and what does this CAUSE

A

GHRELIN release

  • INHIBITS RESPONSE from VAGAL AFFERENT NEURONES

hence informs brain to EAT

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28
Q

GHRELIN INHIBITS..

A

VAGAL AFFERENTS RESPONSE to BRAIN (to decrease food intake)

-> INCREASE FOOD INTAKE (HUNGER)

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29
Q

What are the 3 PHASES of GASTRIC ACID SECRETIONS

A
  1. CEPHALIC
  2. GASTRIC
  3. INTESTINAL
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30
Q

what happens in the CEPHALIC PHASE of GASTRIC ACID SECRETION

A

SIGHT,SMELL, THOUGHT of FOOD TRIGGERS GASTRIC SECRETION

  • INSTIGATED by VAGAL FIBRES

-> RELEASE of ACETYLCHOLINE (ACH) and GASTRIN RELEASING PEPTIDE to start acid secretion

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31
Q

in CEPHALIC PHASE what is RELEASED in order to START GASTRIC ACID SECRETION

A

ACH and GASTRIN RELEASING PEPTIDE

32
Q

CEPHALIC PHASE INSTIGATED by which NERVE FIBRES

A

VAGAL FIBRES

33
Q

what happens in the GASTRIC PHASE of GASTRIC ACID SECRETIONS

A

food entering STOMACH STRETCHES IT

  • TRIGGERS SECRETION VIA LONG (VAGAL) and SHORT (MYENTRIC) REFLEXES
  • RELEASE of GASTRIN
34
Q

GASTRIN SECRETION in GASTRIC PHASE is triggered VIA which REFLEXES

A

LONG (VAGAL) and SHORT (MYENTERIC)

35
Q

what happens in the INTESTINAL PHASE of GASTRIC ACID SECRETION

A

FOOD in INTESTINES INDUCES the RELEASE of HORMONES

  • which ALTERS GASTRIC SECRETION-FEEDBACK

-> RELEASE of INHIBITORY FACTORS so GASTRIC ACID SECRETIONS FALL

36
Q

which GASTRIC ACID PHASE has the HIGHEST OUTPUT

A

1ST, CEPHALIC

37
Q

what causes INHIBITION in INTESTINAL PHASE

A

RELEASE or HORMONES and INHIBITORY FACTORS as food enters intestines

38
Q

PAIN in the GUT is DERIVED from which NEURONS

A

SPLANCHNIC AFFERENT NEURONS

39
Q

SPLANCHNIC NERVES are … nerves

A

PAIRED VISCERAL NERVES

VISCERAL EFFERENT (carry fibres of ANS)
VISCERAL AFFERENT (SENSORY fibres from Organs)`

40
Q

ALL SPLANCHNIC NERVES carry SYMPATHETIC Fibres EXCEPT…

A

PELVIC SPLANCHNIC Nerves

  • PARASYMPATHETIC FIBRES
41
Q

GREATER SPLANCHNIC NERVES

ORIGIN:
GANGLION:
VISCERA:
REGION of referred PAIN:

A

ORIGIN: T5-T9

GANGLION: CELIAC

VISCERA: FOREGUT

REGION of referred PAIN: EPIGASTRIC

42
Q

LESSER SPLANCHNIC NERVES

ORIGIN:
GANGLION:
VISCERA:
REGION of referred PAIN:

A

ORIGIN: T10/T11

GANGLION: SUPERIOR MESENTERIC

VISCERA: MIDGUT

REGION of referred PAIN: PERIUMBILICAL

43
Q

LEAST SPLANCHNIC NERVES

ORIGIN:
GANGLION:
VISCERA:
REGION of referred PAIN:

A

ORIGIN: T12

GANGLION: AORTICO-RENAL

VISCERA: KIDNEYS

REGION of referred PAIN: LOWER THORACIC

44
Q

LUMBAR SPLANCHNIC NERVES

ORIGIN:
GANGLION:
VISCERA:
REGION of referred PAIN:

A

ORIGIN: L1, L2

GANGLION: INFERIOR MESENTERIC

VISCERA: HINDGUT

REGION of referred PAIN: HYPOGASTRIC

45
Q

GUT-DERIVED PAIN
NOCICEPTION EXAMPLES:

A
  • HYPERALGESIA : INCREASED RESPONSE to PAINFUL STIMULI
  • ALLODYNIA: PAINFUL RESPONSE to a NORMALLY INNOCUOUS (harmless) STIMULI
46
Q

GUT-DERIVED PAIN
ACID-PEPTIDE RELATED EXAMPLES:

A
  • HEARTBURN: REFUF of ACID into OESOPHAGUS
  • PEPTIC ULCER in STOMACH, OESOPHAGUS, DUODENUM
47
Q

GUT-DERIVED PAIN
DISTENSION EXAMPLE:

A

MECHANORECEPTOR RESPONSE to stretch is ABOVE THRESHOLD

(may feel bloated)

48
Q

GUT-DERIVED PAIN
INFLAMMATORY BOWEL DISEASE
examples and what it includes

A
  • CROHN’S
  • ULCERATIVE COLITIS

INFLAMMATION SENSITISES SPINAL AFFERENT NEURONS

49
Q

GUT-DERIVED PAIN
IRRITABLE BOWEL SYNDROME includes..

A

FEELINGS of distension, BLOATING, SWELLING, DISCOMFORT

  • CONSTIPATION or DIARRHOEA
50
Q

what is SATIATION

A

Prompts the TERMINATION OF EATING
- feel full

51
Q

what is SATIETY

A

FULLNESS that PERSISTS AFTER EATING

52
Q

what does SATIATION DETERMINE

A

the AMOUNT CONSUMED at ONE SITTING

53
Q

what does SATIETY DETERMINE

A

the LENGTH of TIME UNTIL NEXT EATING OCCASION

54
Q

what are the CELLS in the INTESTINE that RESPOND to LUMINAL NUTRIENTS

A

ENTEROENDOCRINE CELLS (EECs)

  • approx 12 Cell types
  • largest Endocrine Organ
55
Q

How do the ENTEROENDOCRINE CELLS (EECs) STIMULATE SECRETIONS from the INTESTINES

A

cause INCREASE in INTRACELLULAR Ca2+

-> EXOCYTOSIS of SECRETORY VESICLES

56
Q

what is SECRETED from INTESTINES in response to the ENTEROENDOCRINE CELLS (EECs) causing INCREASED CALCIUM

A

LIPID MEDIATORS and GUT HORMONES (REGULATORY PEPTIDES)

57
Q

GUT HORMONE RECEPTORS are on what part of VAGAL AFFERENT NEURONS

A

NODOSE GANGLION

receptors transported from cell soma to peripheral

58
Q

what does CCK HORMONE from GUT STIMULATE

A

PANCREATIC ENZYME SECRETIONS
& GALLBLADDER CONTRACTIONS

  • PROMOTES SMALL INTESTINE DIGESTION
59
Q

GANGLION on VAGAL AFFERENT NEURON that has RECEPTORS for GUT HORMONES

A

NODOSE GANGLION

60
Q

what does CKK HORMONE INHIBIT

A

FOOD INTAKE and GASTRIC EMPTYING

VIA VAGAL AFFERENT NEURONS

61
Q

FOOD INTAKE and GASTRIC EMPTRYING is INHIBITED VIA which NEURON

A

VAGAL AFFERENTS

62
Q

what does GLP-1 (GLUCAGON-LIKE PEPTIDE) GUT HORMONE STIMULATE

A

INSULIN RELEASE post meal
- to DECREASE blood GLUCOSE

63
Q

what does GLP-1 INHIBIT

A

FOOD INTAKE and GASTRIC EMPTYING

VIA VAGAL AFFERENT

64
Q

in OBESITY, VAGAL AFFERENT NEURONS are INSENSITIVE to…

A

CCK

65
Q

GLP-1 BASED THERAPY includes…

(type 2 diabetes)

A

DPP-IV Inhibitors which DELAY GLP-1 BREAKDOWN
(GLP-1 persists in blood for longer)

GLP-1 ANALOGUES which MIMIC the EFFECT of GLP-1

66
Q

how does GLP-1 LEVELS CHANGE after BARIATRIC SURGERY

A

INCREASE

67
Q

GLP-1 DECREASE what levels

A

BLOOD GLUCOSE
- by stimulating INSULIN

68
Q

what does GHRELIN GUT HORMONE STIMULATE

A

FOOD INTAKE and GASTRIC EMPTYING

69
Q

when is GHRELIN SECRETION HIGHEST

A

BEFORE a MEAL
(hunger)

70
Q

where are GHRELIN RECEPTORS EXPRESSED

A

on VAGAL AFFERENT (NODOSE GANGLION) and HYPOTHALAMIC NEURONS

71
Q

What does GHRELIN INHIBIT

A

ACTIONS of CKK on VAGAL AFFERENT NEURONS (which would normally inhibit food intake and gastric emptying)

72
Q

which GUT HORMONES INHIBIT FOOD INTAKE

A

CCK and GLP-1

73
Q

which GUT HORMONE acts on PANCREAS and GALLBLADDER

A

CCK

  • pancreatic ENZYME secretions
  • gallbladder CONTRACTS
74
Q

which GUT HORMONE PROMOTES SMALL INTESTINE DIGESTION

A

CCK

75
Q

which GUT HORMONE action (on vagal afferent) is INHIBITED by GHRELIN

A

CCK

76
Q

how does GHRELIN INHIBIT CCK actions on VAGAL AFFERENT

A

RECEPTORS for ghrelin and CCK are on the SAME PLACE of NODOSE GANGLION (overlap)

Gastrointestinal (19 decks)

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