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GI > swallowing, gastric emptying, and gastric motility > Flashcards

swallowing, gastric emptying, and gastric motility Flashcards

1
Q

phases of swallowing

A

oral
pharyngeal
esophogeal

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2
Q

oral phase

A

voluntary

bolus moved by tongue to pharynx

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3
Q

pharyngeal phase

A
  • involuntary
  • initiated in response to pressure receptors in pharynx
  • directs bolus into esophagus via relaxed UES
  • respiration inhibited
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4
Q

esophageal phase

A

involuntary

  • primary peristaltic wave: bolus from UES via peristalsis through LES to stomach
  • secondary peristalsis- initiated by distension, occurs only if primary wave not sufficient
  • both primary and secondary peristalsis modulated by CNS and ENS reflexes
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5
Q

LES control

A

resting tone set my intrinsic myogenic properties and cholinergic regulation
relaxation due to vagus, VIP, and NO
swallowing and/or esophageal distention decrease LES tone

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6
Q

achalasia

A 
absence of relaxation
dilated esophagus proximal to LES
LES fails to relax
peristalsis impaired in distal 2/3s 
unknown mechanism, possibly loss of VIP and/or NO
no treatment
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7
Q

GERD

A
  • LES low resting tone, allows reflux

- low bicarb in salivia

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8
Q

Orad region

A

fundus and proximal body

receives and stores food

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9
Q

caudad region

A

distal body and antrum

mixing and propelling

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10
Q

LES and cardia

A 
prevention of reflux
entry of food
regulation of belching 
mucus
bicarb
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11
Q

fundus and body

A 
resevoir 
tonic force during emptying
-H
-IF
mucus
-bicarb
-pepsinogens
lipase
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12
Q

antrum and pylorus

A 
mixing
grinding
sieving
regulation of emptying
mucus
bicarb
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13
Q

increase contractility

A 
distension
fluidity of chyme (increased fluidity increases emptying)
Ach
substance P
gastrin
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14
Q

inhibitory to gastric emptying

A 
distension in duodenum
presence of FAs, monoglycerides, acidic pH, hypertonicity, AA, and/or peptides in duodenum
CCK
secretin
GIP
NE
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15
Q

gastric mixing

A

propulsion
grinding
retropulsion
trituation- reduction of particle size, must be <2mm to leave stomach

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16
Q

relative rates of gastric emptying

A

liquid > carbohydrates > protein > fat

isotonic fluid >hypertonic or hypotonic

17
Q

pyloric sphincter control

A

constriction: CCK, secretin, gastrin, sympathetics
relaxation: parasympathetics, vagus, Ach constricts, VIP relaxes

18
Q

migrating myoelectric complex stomach

A

fasting state, every 75-120min, starts 2 hours after meal
burst of strong antral electrical activity for 5-10minutes with relaxation of pylorus
‘cleans’ tract from stomach thru SI

19
Q

Emesis

A

stimulated by

  • gastric and duodenal distension or irritants
  • dizziness, inner ear dysfunction, motion sickness, pregnancy
  • drugs
  • GU injury
  • emetics (tigger either chemoreceptors or gastric/duodenal receptors)
20
Q

segementation

A

postprandial period- alternating contractions of circular smooth m
slow process of propulsion and retropulsion:
- allows for digestion time
-mixes
maximizes contact w/mucosal layer for absorption

21
Q

peristalsis

A

postprandial- coordinated propulsive contractions of circular smooth m
relaxation in front of bolus (VIP and NO)
contraction behind bolus (Ach and supstance P)

22
Q

migrating myoelectric complex

A

new wave begins in stomach once wave had passed distal ileum
3 phases: quiescence, small disorganized contractions, strong propagating contractions (5-10min)
repeats every 75-120 min during fasting
correlated w/high levels of motilin

23
Q

slow waves

A

duodenum highest rate 11-13/min
jejunum 10-11/min
ileum 8-9/min

24
Q

colic motility

A

haustrations
loing duration contractions
mass movements

25
Q

haustrations

A

short duration contractions about 8 seconds

circular mixing contractions

26
Q

long duration contractions

A
  • taeniae coli
  • mixing contractions, may propagate short distance in either direction
  • antipropulsive movements in proximal colin reain chyme for absorption
27
Q

mass movements

A

high amplitude propagating contractions
sweep length of colon
1-3/day

28
Q

regulation of colonic motility

A

primarily neural regulation (ENS, PNS, SNS)
local reflexes- colonic distension (contraction behind, and relaxation in front of bolus)
long range reflex- gastric distension

29
Q

defecation reflex

A

requires extrinsic neural input
higher CNS and spinal cord coordination via pelvic nn
rectosphincter reflex (VIP and NO)

GI (14 decks)

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