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GI/Liver > Lec 11 GI Motility > Flashcards

Lec 11 GI Motility Flashcards

1
Q

What plexus is between submucosa and circular muscle layer?

A

meisseners = mucosal plexu

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2
Q

What plexus is circular and longitudinal muscle layers?

A

auerbachs = myenteric plexus

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3
Q

What makes up the muscularis propria?

A
  • inner circular

- outer longitudinal

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4
Q

How is the longitudinal muscle layer arranged in the colon?

A

arrounded in 3 parallel bundles = tenia coli

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5
Q

What cells are located in auerbach’s plexus?

A

interstitial cells of cajal = pacemaker of the gut

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6
Q

What is the slow wave of GI tract?

A
  • constant background rhythm
  • initiated by interstitial cells of Cajal in myenteric plexus
  • controls the timing of phasic contractions
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7
Q

What is frequency of slow waves in stomach?

A

3 per minute

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8
Q

What is frequency of slow waves in duodenum and jejunum?

A

11-12 per minute

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9
Q

What is frequency of slow waves in distal small bowel?

A

7-8 per minute

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10
Q

What is frequency of slow waves in colon?

A

3-6 per minute

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11
Q

What is the spike activity of the stomach?

A
  • contractions of smooth muscle that occur only when slow wave depolarizations reach threshold for AP
  • rapid depolarization results in contraction of smooth muscle through release of Ca
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12
Q

What is action of ACh on MMC?

A

increases = pro motility

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13
Q

What is action of gastrin on MMC?

A

increases = pro motility

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14
Q

What is action of motilin on MMC?

A

increases = pro motility

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15
Q

What is action of VIP on MMC?

A

inhibits = anti-motiliy

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16
Q

What is action of secretin on MMC?

A

inhibits = anti-motility

17
Q

What is action of neuropeptide Y on MMC?

A

inhibits = anti-motility

18
Q

What are the 2 major types of contractions in the small intestine?

A

peristalsis = slow proximal to distal movement; from longitudinal smooth muscle

segmentation = major contractile grinding/churning/crushing from circular smooth muscle

19
Q

What things control peristalsis?

A
  • mediated by ACh
  • 5HT plays a big role
  • substance P may also add to contraction
  • NO mediates distal relaxation
20
Q

What is function of fundus/body of stomach?

A

receptive relaxation + reservoir; regulates emptying of liquids

21
Q

What is function of antrum of stomach?

A

mixes/grinds; regulates emptying of solids

22
Q

What is fed motor pattern of small intestine?

A

slow waves w/ increased number of spike potential to promote mixing/absorption of food; segmental

23
Q

What is fasting motor pattern of small intestine?

A
  • cyclic migrating motor complex

- keeps intestine swept clean of bacteria/residue

24
Q

What are the 3 phases of the migrating motor complex (MMC)?

A

Phase I: 45-60 min, no spike potentials, no contractions

Phase II: lasts 30 min; intermittent spikes + contractions [50% of slow waves associated w/ spikes]

Phase III: 5-15 min; each slow wave has spikes and contractions

25
Q

What are some common causes of small bowel dysmotility?

A 
neuro: parkinsons, post viral
scleroderma
DM, hypothyroid
opiates
visceral neuropathy
26
Q

What is chronic intestinal pseudo-obstruction?

A

problem where almost no motility of certain segments of bowel; no physical obstruction but basically is obstructed

27
Q

What are characteristics of high amplitude propagating contractions [HAPC] of colon?

A
  • have amplitude > 100 mmHg
  • occur infrequently ~6/day
  • function = mass movement
  • associated w/ defection
28
Q

What are characteristics of low amplitude propagating contractions [LAPC] of colon?

A
  • have amplitude < 50 mmHg
  • occur > 100/day
  • function = transport fluid contents
  • associated w/ distension and flatus
29
Q

What is ogilvie’s syndrome?

A

non-obstructive colonic dilation

have colonic ieus –> usually due to drugs [narcotics], post op state, electrolyte imbalance, immobility

30
Q

How do you treat ogilvies?

A

decompress colon if needed; neostigmine to stimulate parasympathetics

31
Q

What are criteria for IBS?

A

recurrent abdominal pain or discomfort with 2 or more of

  • improvement with defecation
  • change in stool frequency
  • change in stool appearance/form
32
Q

What is treatment for IBS?

A
  • laxative
  • anti-diarrheals
  • anti-depressants
  • serotonin receptor agonists
33
Q

What is mech behind IBS?

A

not clear; thought that mech is due to decrease 5HT which is responsible for controlling motility of bowel through enteric nervous system

34
Q

What things normally determine continence?

A
  • stool volume and consistency
  • anal sphincter function
  • neurologic integrity
  • rectal sensation
  • rectal storage capacity
  • psychological motivation
35
Q

most of resting tone of anus depends on what?

A

internal anal sphincter determines most of resting tone

36
Q

What are some causes of fecal incontinence?

A
  • back trauma
  • sphincter disruption
  • medical illness

GI/Liver (36 decks)

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