15. GI Tract Introduction Flashcards Preview

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Flashcards in 15. GI Tract Introduction Deck (42)
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1
Q

What are the layers of the gut tract wall from outer to inner?

A
  1. serosa
  2. longitudinal smooth muscle
  3. myenteric plexus
  4. circular smooth muscles
  5. meissner’s corpuscle
  6. submucosa
  7. mucosa
2
Q

What is the serosa layer?

A
  1. outer layer of connective tissue and simple squamous epithelium
  2. continuous with the mesentery (pathway for blood to gut tube)
3
Q

Where is the serosa layer missing in the GI tract?

A
  1. esophagus, where it is replaced with adventitia to connect to abd wall
4
Q

What is the submucosa?

A
  1. lamina propria but thicker

2. incorporates the blood vessels and submucosal plexus

5
Q

What layers does the mucosa include in order to form a continuous sheet that lines the entire GI tract?

A
  1. lamina propria: loose CT with nerve, blood vessel, glands

2. muscularis mucosa: thin smooth muscles, form mucosal ridge

6
Q

What type of cells help form the mucosa layer of gut?

A
  1. simple columnar epithelium with goblet cells

2. line entire gut tract

7
Q

What forms the enteric nervous system?

A
  1. myenteric and meissners plexuses

2. neurons are supported by intrinsic glial cells

8
Q

How does the enteric nervous system operate?

A
  1. intrinsic regulation and sensory reflexes
  2. parasympathetic increase GI activity
  3. sympathetic decrease GI activity
9
Q

Where are myenteric plexus and what does it control?

A
  1. in between longitudinal and smooth muscles
  2. tonic and rhythmic contraction of smooth intestinal muscles
  3. excitatory (Ach, NO)
  4. inhibitory (VIP)
10
Q

Activation of the myenteric plexus will lead to what effects?

A
  1. increased tonic contraction of gut wall
  2. more intense rhythmic contractions
  3. increased rate of contractions
  4. increased velocity
11
Q

What does the Meissner’s plexus mostly control?

A
  1. GI secretion, absorption, and local blood flow

2. mostly local effects not long distant.

12
Q

What is peristalsis?

A
  1. propulsion of food along the gut tract forcing bolus from one direction to the other
13
Q

How does peristalsis work?

A
  1. circular muscles contract to prevent backflow
  2. longitudinal muscle will propel the bolus forward, causing distension of the tube
  3. distension will cause contraction of next circular ring, and the next segment of longitudinal muscle
14
Q

What is receptive relaxation?

A
  1. vagovagal reflex, which activated by food and casues distension of the proximal region of stomach
  2. CCK is then released causing distal distention of stomach
15
Q

What is the role of the distal stomach with mixing food and beginning digestion?

A
  1. contraction of distal region mixes food with gastric secretions
  2. contraction seals off distal end and propels food back into the “body” of stomach for mixing
16
Q

What will increase gastric contractions, to improve mixing?

A
  1. stimulation of vagus nerve (parasympathetic)
17
Q

Stimulation of what nervous system leads to decreased gastric mixing?

A
  1. stimulation of sympathetic nervous system, and inhibition of signals to vagus nerve
18
Q

When is gastric emptying the fastest?

A

with isotonic solutions, occur with contraction of distal end of stomach to duodenum

19
Q

What will slow the emptying of the stomach contents into the duodenum?

A
  1. hypo-/hypertonic solutions

2. fat (increases CCK that slows emptying)

20
Q

Why would acid in the duodenum slow gastric emptying?

A
  1. the duodenum is a basic environment, that can be damaged by too low a pH, therefore gastric secretions will be reduced to protect the duodenal lining
21
Q

What does food in the stomach continue to activate?

A
  1. the gastroileal reflex

2. mediated by extrinsic ANS and gastrin

22
Q

What increases mixing and digestion in the small intestine?

A
  1. vagus nerve (parasympathetic) increases digestion

2. sympathetic NS, inhibits vagus nerve signaling. decreasing digestion

23
Q

What is the role of enterochromaffin cells?

A
  1. sense food in intestine
  2. release serotonin
  3. serotonin activate primary afferent neurons for peristalsis
24
Q

What system is in control of the peristalsis in the small intestine?

A
  1. enteric nervous system
25
Q

What causes the ileocecal sphincter to close, and prevent fecal backflow into the small intestine?

A
  1. distension of the proximal colon

2. site of mass colonic water absorption

26
Q

What creates haustra?

A

segmented contraction in proximal colon

27
Q

What occurs in the distal colon?

A
  1. semisolid, slow moving fecal material

2. fecal material propelled into rectum in mass movement

28
Q

Defecation

A
  1. internal anal sphincter must relax allowing movement into rectum, and urge begins with 25% filling of rectum
29
Q

What prevents defecation?

A

external anal sphincter under voluntary control

30
Q

What maneuver will increase the ability to defecate?

A
  1. valsalva maneuver which increase intra-abdominal pressure
31
Q

What is the gastrocolic reflex?

A
  1. stretching of stomach increases parasympathetic stimulation and frequency of mass movements along the GI tract.
  2. CCK and gastrin react but at slower rate.
32
Q

What are slow waves?

A
  1. slow oscillating potentials inherent to smooth muscles of GI tract
33
Q

Where do slow waves originate from?

A
  1. interstitial Cajal cells
  2. can vary intensity from 5-15mV
  3. frequency from 3-12/min
34
Q

What cause muscle contraction of the smooth muscles in the GI tract?

A
  1. spike potentials
35
Q

What do spike potentials generate?

A
  1. open Ca channels, and Na channels in GI smooth muscles

2. have a longer time of activation than normal action potential

36
Q

What is a spike potential?

A
  1. action potential of smooth muscle GI
  2. frequency= the amplitude of the signal
  3. last 10-40x longer than normal action potential
37
Q

What factors cause depolarization of GI smooth muscles cells?

A
  1. muscle stretching
  2. Ach stimulation (parasympathetic)
  3. GI specific hormone stimulation
38
Q

What factors cause hyperpolarization of smooth muscles of GI tract?

A
  1. norepi/epi

2. sympathetic nerve stimulation

39
Q

What cause tonic contractions of GI tract?

A
  1. continuous repetitive spike potential
  2. hormones
  3. continuous entry of Ca ion
40
Q

What are the major three different types of GI reflexes?

A
  1. reflex integrated within gut wall enteric nervous system
  2. from gut to prevertebral sympathetic ganglia and back to GI
  3. from gut to spinal cord/brainstem and back to GI
41
Q

What are the different type of reflexes that are associated with the enteric nervous system?

A
  1. GI secretions
  2. peristalsis
  3. mixing contractions
  4. local inhibitory effects
42
Q

What reflexes send signals from the gut to the prevertebral sympathetic ganglia and back to the GI?

A
  1. gastrocolic (evacuation of colon)
  2. enterogastric (inhibit stomach motility/secretion)
  3. colonoileal (empty ileal content into colon)