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Fundies Second test > GI physiology > Flashcards

GI physiology Flashcards

1
Q

GI tract Layers (4)

relatively uniform throughout

A
  1. mucosa
  2. submucosa (blood, nerves, connective tissue)
  3. Muscularis (longitudinal, circular)
  4. serosa
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2
Q

oblique muscles in

A

stomach only–responsible for enhanced churning

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3
Q

nerves in SUBMUCOSA. func.

A

meissner’s plexus:

–senses environment w/in lumen–regulating BLOOD FLOW, directiong epithelial cell function

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4
Q

neves in muscle layers: func.

A

Myenteric (Auerback Plexus)

–digestive tract motility

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5
Q

nerves embedded in walls of GI tract

A

PNS–enteric enervation–

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6
Q

most common nT of:
symp:
parasymp:

A
  • norepi & some ACh (mainly inhibitory of motility and veins))
  • ACh (excitatory)
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7
Q

Myenteric responsible for:

both function under PNS control and independently

A

GI movement:

  1. ^ tonicity, intensity, rate, velocity of conduction
  2. v schincter tone
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8
Q

Meissner (submucosal) responsible for

A

GI secretion and local blood flow

1. –> unfolding of walls

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9
Q

Electrical System of GI:

Smooth muscle is ______ unit–when AP received, ______ travels in all direction.

A

single,

contraction

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10
Q

resting membrane potential exhibits ______ ______ ______. Do not cause contractions.

A

rhythmic slow waves–in response to food in instestines

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11
Q

Increasing positive charge of SLOW WAVES excite appearcance of ______ _______, exciting ______ ______

A

SPIKE POTENTIALS,

muscle contraction

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12
Q

AP caused by rapid ____ ______, only _____ so no contraction

A

Na+ entry,

sodium

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13
Q

much _____ enters leading to long duration of AP

A

Ca++ – much like heart

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14
Q

blood flow w/ nutrients from gut, spleen and panc travel to the ___ wia the ____ ____

A

SPLANCHNIC FLOW,
liver,
portal vein

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15
Q

____ do not go through the portal vein–instead travel through the ____ _____ bypassing liver

A

fats,

lymphatic system

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16
Q

reticuloendothelial cells of liver in ____ _____ remove ______

A

Liver sinusoids,

bacteria

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17
Q

Salivary glands and products–

A
  1. Parotid (serous–ptyalin–amylase)
  2. sublingual (serous and mucus)
  3. submandibular (serous and mucus
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18
Q

Saliva constituents (9): Hypotonic 6-7 pH

stimulated by PNS and SNS

A
  1. water,
  2. mucus
  3. bicarbonate
  4. K+
  5. salivary amylase
  6. lingual lipase
  7. Cl-
  8. Na+
  9. IgA
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19
Q

lingual lipase pH– digests?

A

4.5-5.4

digest fats

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20
Q

stimulates gastic and salivary response

cephalic phase

A
  1. sour, smooth
  2. aggression
  3. insulin secretion
  4. irritation/ nausea
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21
Q

Inhibition of salivary response

A
  1. anxiety, fear, dehydration, rage

2. ROUGH testure

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22
Q

2 phases of swallow

A
  1. voluntary component

2. involuntary comp

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23
Q

swallow reflex and respiration inhibited by _____ ______ _______

A

medulla swallowing center (involuntary component)

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24
Q

pathophys of disruption to mucosal surface as from (3).

A 
Apthous Ulcers (mouth/ oropharynx):
 -trauma, infection, or inflammation
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25
Q

Esophagus from–how long

A

C6-T10/11

25 cm

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26
Q

______ _______ _______must relax from ______ ____ ____ innervation for food to pass into esophagus

A

upper esophageal sphincter,

medulla swallowing center

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27
Q

____ _____ rises to close off nasopharynx

A

soft palate

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28
Q

GI muscle contraction takes ____ and ____ activity

A

Na+ and Ca++

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29
Q

esophageal mucosa layers (3)

A
  1. epithelium w/ mucus secreting cells
  2. lamina propria
  3. muscularis mucosa
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30
Q

UES
LES
Characteristics

A

Upper esophageal sphincter (both functional not anatomic)
Lower esophageal sphincter
–normally HIGHER tonicity so air won’t descend and acid won’t ascend

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31
Q

esophageal submucosa components: (5)

“out from mucosa”

A
  1. loose connective tissue
  2. blood vessels
  3. lymphatic and lymphoid follicels
  4. MEISSNER plexus
  5. mucus secreting glands
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32
Q

esophageal muscularis propria characteristic:

A
  • Inner: circular layer for ring contractions
  • AUERBACH plexus
  • outer layer logitudinal–shortening contractions
      • muscularis propria muscle
        a. top 1/3 skeletal muscle
        b. middle 1/3 smooth/skeletal
        c. bottom 1/3 smooth
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33
Q

Stimulation of esophagus (3)

A
  1. meissner plexus
  2. auerbach plexus
  3. vagus nerve (along adventitia)
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34
Q

LES tone relaxes w/ (3)

A
  • non-adrenergic, non-cholinergic vagal impulses

- progesterone and glucagon

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35
Q

coordinated contractions to propel bolus down esophagus–gravity assisted

A

PRIMARY peristalsis–from mouth –> anus

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36
Q

If bolus gets stuck, stretch receptora signal swallowing center for

A

secondary waves of peristalsis until clear

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37
Q

Pathophys of esophagus–greater stretch leads to ^ ________

A

Esophageal spasm,

contraction

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38
Q

narrowing of esophagus from scar tissue

A

Esophageal stricture–as from GERD (irritation)

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39
Q

LES fails to relax–food backs up

A

Achalasia

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40
Q

Thick bands of muscle form in lower esophagus

A

Esophageal rings–as from GERD (irritation)

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41
Q

space btwn peritoneal membranes

A

peritoneal cavity

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42
Q

Stomach functions: (4)

A
  1. stores food
  2. digestive juices secreted
  3. mixes food via peristalsis
  4. proples chyme into duodenum
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43
Q

proximal boundary of stomach:

distal boundary of stomach:

A
  • LES

- pyloric sphincter

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44
Q

serous membrane with visceral and parietal surfaces

A

peritoneum

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45
Q

inner surface of stomach–increase volume w/out increasing pressure–^area utilized for digestion

A

rugae

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46
Q

oxyntic glands in ______ and _______

A

fundus and body

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47
Q

parietal cells secrete (2) (in OXYNTIC glands)

A 
HCl,
intrinsic factor (imp for Vit B12 absorption)
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48
Q

Chief cells secrete (in OXYNTIC glands)

A

(aka peptic cells),

pepsinogen (HCl splits into pepsin)

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49
Q

Enterochromiffin cells secrete

A

ECL cells,

histamines (encourages acid secretion)

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50
Q

Goblet (aka) secrete (in OXYNTIC and PYLORIC glands)

A

(mucous neck cells),

mucus

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51
Q

G cells secrete–stimulates? (in Pyloric glands)

A

gastrin (stimulates gastric acid secretion)

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52
Q

churning of stomach imp for (2)

A
  1. breakdown of macromolecules

2. introduce molecules to mucosa throughout stomach

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53
Q

point at which esophagus enters stomach

A

cardia (just area no function)

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54
Q

lateral boundaries of stomach

A

greater and lesser curbatures

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55
Q

D cells secrete–function? (in Pyloric glands and OXYNTIC)

A

somatostatin–inhibits HCl secretion

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56
Q

abundance of very ALKALINE viscid mucus for stomach protection secreted by

A

surface mucous cells

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57
Q

somatostatin _________ ECF, Parietal, and G cells

A

inhibits

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58
Q

pyloric glands in

A

antrum

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59
Q

Histamine binds to ____ _______ on ______ ______ –>

A

H2 receptors (as in H2 channel blocker)
parietal cells,
^ HCl production

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60
Q

stimulation of gastric phase of digestion (4)

A
  1. ^est in afternoon/evening vest in morning
  2. ^w/ aggression
  3. cephalic phase stimulates before food arrives
  4. ParaNS
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61
Q

Inhibition of gastric phase of digestion (2)

A
  1. SNS (inhibs GI secretns, sphincter and vessel contractions)
  2. bad tastes, rage, fear, pain
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62
Q

PNS’ role in gastric phase

A
  1. stimulates release of HCl, hist, intrinsic factor, mucus)
  2. contractions of GI tract
  3. relaxation of sphincters
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63
Q

Swallowing causes ____ to relax

A

fundus (distends and pH lowers)

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64
Q

_____ _____ inactive in mouth–needs low ____ to break down ____

A

lingual lipase,
pH,
fats

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65
Q

pace of stomach peristalsis mediated by ____ of _____

A

cells of cajal (pacemakers for slow waves)

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66
Q

protein digestion (in stomach) products ____ the acid

A

buffer–increasing the pH

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67
Q

stomach contractions stimulated by (3)

A
  1. Auerbach plexus (from distension)
  2. chemicals or irritants
  3. strong paraNS signal
68
Q

pepsin digests–so problem with this cell will cause problems in meat breakdown

A

cholagen,

chief cells

69
Q

Protein breakdown particularly in S.I. by _______ and _____ from________

A

trypsin and chymotrypsin,

pancreas

70
Q

reflex leading to ^ ilial emptying triggered by distention of stomach

A

gastroileal reflex increases ileal motility

71
Q

distention of stomach triggers peristalsis

A

gastroenteric reflex

72
Q

Pathophys of stomach:

mucosa attack due to permiability of mucus layer

A

gastritis / gastric ulcer (may be caused by helicobacter Pylori, smoking, alcohol)

73
Q

Small Intestine:

epithelium makeup

A
  1. circular folds
  2. valves of kerckring
  3. plicae circulares
74
Q

GI reflex word breakdown

A
  • first part where stimulus coming from

- second part location of response

75
Q

villi (slow food movement ) secrete ______ _______ and _____ _______

A
  1. digestive enzymes

2. absorb nutrients

76
Q

microvilli create a _______ ______ which ^ _______ ______. It has thick _______ layer of fluid for absorption

A

brush border,
absorptive surface,
“unstirred”

77
Q

duodenum beginning and end

A

pylorus –> treitz ligament

retroperitoneal

78
Q

Jejunum is __________

A

intraperitoneal

79
Q

ileum ends at

A

ileocecal valve (sphincter) intraperitoneal

80
Q

outer layer of esophagus

A

adventitia

81
Q

LACTEALS in SI w/ ______ _______ to absorb and transport _____ molecules and drain into _______ ______

A

lymphatic channel,
fats,
thoracic duct

82
Q

rugae called ______ in SI

A

plica near valves of kirkring

83
Q

mucous glands at top of duodenum secrete BICARB

A

Brunner’s gland

84
Q

secrete digestive juices in duodenum

A

Crypts of Leiberkuhn (undifferentiated cells in crypt base)

85
Q

secrete cholecystokinin slowing gastric emptying and ^ bile ejection in duodenum and jejunum

A

I-cells

86
Q

Peyer’s patch/ lamina propria only in

A

Ileum

87
Q

Submucosa has ______ _______ (only in duodenum) and _____ ______

A

Brunner’s glands,

Meissner’s plexus

88
Q

Willi have absorptive columnar cells w/ ______ _____ to absorb ____ and ______

A

tight junctions,

water and electrolytes

89
Q

Muscularis Propria in SI components (3)

A
  1. inner circular layer
  2. Auerbach plexus (Myenteric)
  3. outer longitudinal layer
90
Q

outermost layer of SI / GI in general

A

serosa/adventitia

91
Q

ILEOCECAL valve protrudes into _____ of ______ _________; lips reverse into ileum preventing ______

A

cecum,
large intestine,
backflow

92
Q

each villi has good ______ _______ for ^ absorption

A

blood supply,

93
Q

When cecum is distended, both cecum ______ and ileal _____ ^

A

contraction,

peristalsis

94
Q

intrinsic factor binds to

A

Vitamin B12

95
Q

Improper nourishment to small intestine villi as from malnourishment–villi will get ______ and ______ will decrease leading to ______

A

smaller,
absorption,
diarrhea

96
Q

stimulation of SI (intestinal phase) (6)

A
  1. peristalsis triggered by stretch of duodenum
  2. gastrin
  3. CCK
  4. insulin
  5. motilin
  6. serotonin ^ peristalsis
97
Q

__________ stimulates the digestion of fat and protein–through release of bile from the ________ and enzymes from the _________ (INHIBITS Chief/Parietal/Peristalsis)

A

Cholecystokinin CCK (stimulatory and inhibitory),
gallbladder,
pancreas

98
Q

Inhibition of SI intestinal phase

A
  1. distention
  2. irritant
  3. acidity
  4. CCK/ GIP
  5. Secretin
99
Q

Further inhibition of SI intestinal phase

A
  1. Presence of fat, protein breakdown products, hyperosmotic or hypo-osmotic fluids, or irritants in duodenum
100
Q

Irritants in duodenum stim relase of ____ and ___ into circulation

A

CCK and GIP

101
Q

DECREASE in pH stimulate release of _____ into circ, it inhibits _____ _____ ______

A

secretin,

Chief, Parietal/ Peristalsis

102
Q

GIP–stimulates RELEASE of _____ inhibiting ______ _____ and ________

A

insulin,

chief, parietal, peristalsis

103
Q

Addition of (4) facilitate digestion of carbs –> absorption –> liver

A

SI: sucrase, maltase, lactase
Panc: amylase

104
Q

Organization of SI allowing to “mix and cut”

A

segmentation– this along with peristalsis allow INTESTINAL MOTILITY (2 separate actions)

105
Q

Most proteins absorbed in ____, pancreas adds _____ and _____ for their digestion

A

SI,

trypsinogen (1st) and chymotrypsinogen (must be converted to trypsin by peptides–> breakdown proteins into aa’s)

106
Q

Digestion of fats by ______ ____ from ______ & _____ from _______

A
  • bile salts from liver

- lipase from pancreas

107
Q

prevent fat reformation in SI

A

partially digested fats bathed w/ bile salts and lecithin

108
Q

If ileum is distended the ______ _______ inhibits ______ _____ into the SI

A

ILEOGASTRIC REFLEX,

gastric motility

109
Q

________ _______ initiates propulsion through the colon to the ____ and ____

A

gastrocolic reflex,

sigmoid and rectum

110
Q

The ________ ______ INHIBITS intestinal motility if any segment is ______-_______

A

intestinointestinal reflex,

over-distended

111
Q

Ca++ absorbed in SI via _____, _____, and ______ -______

A

passive,
active,
carrier proteins

112
Q

Ca++ and Vit D absorption facilitated by ____ ______. Increased _____ leads to ______ uptake.

A

bile salts,
demand,
increased

113
Q

Vitamin B12 released from ___ ____. Binds to ______ _____, making it resistant to ________.

A

animal proteins,
intrinsic factor,
digestion

114
Q

Vitamin B12 aborbed in _____. Necessary for _______ _______

A

ileum,

erythrocyte maturation

115
Q

*Recycling of bile for reuse in liver

A

enterohepatic circulation

116
Q

___-___% of fluids and electrolytes absorbed in SI–rest in _____

A

80-95%,

colon

117
Q

____ is released from heme (hemoglobin/ myoglobin) in meat. Amount absorbed = _____ ______. Absorption facilitated by ________ _

A

iron,
amount required (if low in blood dif. from Ca++ absorption)
Vitamin C

118
Q

Most aborption of (8) in SI

A

carbs, proteins, lipids, Ca++, Vit B12, Iron, Fluids, Electrolytes

119
Q

In SI:

  1. Na+ enters in exchange for____
  2. Cl- enters in exchange for ______
  3. K+ moves _______
A
  1. H+
  2. bicarb. HCO3-
  3. passively
120
Q

Inside paritenium is (3)

Pathophys:

A
  1. liver
  2. stomach
  3. some of SI
    Pathophys–hardening–>paritenitis (adhesions from scar tissue btwn loops of S/L intestine)
121
Q

Prolonged diarrhea may lead to (2)

A
  1. hypokalemia

2. metabolic acidosis

122
Q

Function of LI

A
  1. absorb H2O and electolytes (some left)

2. store feces

123
Q

draped over front of LI

A

mesentery

124
Q

____ ______ present in cecum

A

tenaie coli

125
Q

2 sections of LI

A
  1. absorbing section

2. storing section

126
Q

Mucosa of LI (2) and function

A
  1. Rugae

2. ^ crypts of Leiberkuhn (secrete bicarb & mucus –absorbe Cl-)

127
Q

sigmoid colon contains only

A

waste/feces

128
Q

controls movement of waste from sigmoid colon to rectum

A

O’Beirne sphincter

129
Q

Stimulation of LI ()

A
  1. ParaNS ^ peristalsis
  2. irritant –> ^ H2O and electrolyte secretion (for dilution of irritant ) –> diarrhea
  3. intrinsic (myenteric plexus) and extrinsic (vagus) innervate
130
Q

external anal sphincter control

A

skeletal muscle–voluntary

Ex-Ske

131
Q

Internal anal sphincter control

A

smooth muscle–involuntary

Inter-invol

132
Q

defecation reflex stimulated by

A

rectal wall stretching from movement into rectum

133
Q

Rectal reflex inhibited by

A

pain or fear of pain

134
Q

defecation starts when _____ ______ relaxes, causing urge to defecate

A

sphincter relaxes

135
Q

defecation facilitated by ______, ____ or ______–increase ____-_____ pressure

A

squatting, sitting, or valsalva,

intra-abdominal

136
Q

Bacteria in LI

A
  1. increase as tract descends
  2. colonized few hours after birth
  3. doesn’t help in digestion or absorption
  4. does metabolize molecules
137
Q

inflammatory disease particularly in apenix

A

Crohn’s disease

138
Q

2 bands that run in colon

Allow giant mass movements–move much fast thru colon

A
  1. circular–
  2. tenai coli–longitudinal bands to shorten colon
    (form pockets (haustra)–motility like SI)
139
Q

In L/S I outpouches? If they get inflammed?

A

divertiula,

diverticulitis

140
Q

Accessory GI organs:
The liver produces ____ for ______ & _____ of fats. Metabolizes nutrietns from ____ _____ –nutrients released into blood stream or stored

A

bile,
digestion & absorption,
small intestine

141
Q

Stores and _________ bile btwn meals–ejects bile into ducts for release into ________

A

CONCENTRATES,

duodenum

142
Q

EXOCRINE pancreas produces enzymes for digestion of ________, ______, and ______.

A

carbs, proteins, and fats,

143
Q

pancreas produces _____ ______ (bicarb) to neutralize ______. Makes Duodenal pH supportive of ______ ______

A

alkaline fluid,
chyme,
enzymatic action

144
Q

vein from inferior/superior mesenteric and splenic veins through liver

A

hepatic portal vein–70% of venous supply

145
Q

_____ _____ divides liver L from R. Superrior to liver.

A

falciform ligament,

diaphragm

146
Q

capsule around liver

A

Glisson gibroelastic capsule–stretch = pain

147
Q

_________ form bile from conjugation of bile acid-bile salts

A

hepatocytes (functional cell of liver–grouped make up lobule)

148
Q

Liver stores (8)

A
  1. fat
  2. glycogen
  3. iron
  4. copper
  5. Vit B12, A, D, and E
149
Q

small capillaries next to hepatocytes

A

sinusoids

150
Q

carries bile from hepatocytes to bile ducts

A

bile canaliculi

151
Q

Mucosa of gallbladder absorbes ______ & ________, ________ bile

A

water & electrolytes,

concentrating

152
Q

Gallbladder ejects bile ____ min after eating. Bile ejections mediated by _____ _____ & ____ from _ _____

A

30,
vagus nerve,
CCK,
I cells

153
Q

Bile from Gallbladder:

cystic duct–>common bile duct–>sphincter of Oddi at…

A

Ampula of Vater–>duodenum

154
Q

Pancreas secretes aqueous: (4)

A
  1. K+
  2. Na+
  3. HCO3-
  4. Cl-
155
Q

inactive pancreatic enzymes (trypsinogen, chymotrypsinogen, procarboxypeptidase) activated by _____ in ______

A 
enterokinase in duodenum--
active forms (trypsin, chymotripsin, carboxypeptidase)
156
Q

pancrease releases _____ _____ for carb digestion

A

Alpha Amylase

157
Q

when bile comes back to liver, synthesis of ______ happens

A

lipids, triglicerides

158
Q

slow waves do not cause _______

A

contractions

159
Q

liver synthesizes ______ from simple lipids

A

cholesterol

160
Q

Pain after eating:
Gastric ulcer:
duodenal ulcer:

A
  • abdominal pain worsens w/ food intake

- pain occurs 2 hrs after food intake

161
Q

CCK stimulated by + stimulates digestion of: cause

A

protein and fats,

release of enzymes and bile from pan and liver

162
Q

Pyloric glands in…

A

Antrum of stomach

163
Q

In stomach propulsion back from sphincter resulting in ^ mixing

A

Retropulsion

164
Q

Trypsin oven converted by

A

Enterokinase– secreted by SI

165
Q

Secretory cells in duodenum and products (3)

A

Brunners –> bicarb mucus
Crypts of Leiberkuhn –> digestive juices (hold undif cells)
I-cells –> CCK (slows stomach emptying, ^ bile ejection)

166
Q

compounds released by duodenum in response to chyme arrival/ drop in pH (3)

A

All inhibit Chief/ parietal/peristalsis

  1. CCK
  2. GIP (gastric inhibaroty polypeptide)
  3. Secretin
167
Q

Crypts of Leiberkuhn in L/S I

A

SI: digestive juice–undifferentiated cells
LI: bicarb & mucus secretion, Cl- absorption

Fundies Second test (8 decks)

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