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Digestion > 4A & 4B- S.I. A&P > Flashcards

4A & 4B- S.I. A&P Flashcards

1
Q

What is the beginning and end of the Duodenum? How long is it?

A

Pyloric Valve—> DuodenoJejunal Flexure….10-12in

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2
Q

Which stomach enzyme is inactivated in the duodenum because of the increased pH?

A

Pepsin!

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3
Q

What are the borders of the Jejunum? How long is it?

A

the DuodenoJejunal Flexure—->ileum…8ft long

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4
Q

What are the borders of the ileum? How long is it?

A

From the end of the jejunum to the IleoCecal Valve…12ft long

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5
Q

What is the anatomy of the mucosal layer of the S.I. from largest to smallest?

A

MacroVillae(Plicae Circulares—>villi—>microvilli

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6
Q

What level of SI anatomy would I find goblet cells? What about crypts?

A

Goblet Cells: Lined on a villus….Crypts in between villi

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7
Q

Which SI cells possess a layer of closely packed microvilli , brush border enzymes, and transporters?

A

Surface Absorptive Cells

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8
Q

What is the fancy full name for the crypts of the SI?

A

Crypts of Liber-Kuhn

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9
Q

What are the mucus producing cells of the SI?

A

Goblet Cells

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10
Q

Which SI cells secrete CCK, Secretin, and GIP?

A

EnteroEndocrine Cells (DNES/APUD cells)

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11
Q

Which SI cells divide to replace themselves and other types of epithelial cells?

A

Regenerative Cells

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12
Q

Which SI cells secrete the antibacterial enzyme lysozyme and other antibacterial agents?

A

Pan-eth Cells

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13
Q

What epithelial cell type composes the majority of enterocytes in the SI?

A

Simple Columnar Epithelial cell

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14
Q

What are the 2 end products of Pancreatic Amylase digestion on polysaccharides (starch/glycogen)?

A

1.Disaccarides 2.Oligosaccharides

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15
Q

Disaccharides are degraded by a group of ______ ______ ________ called __________.

A

Brush Border Enzymes called DisaccharidASES (maltase, lactase, sucrase, alpha-dextrin)

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16
Q

Glucose and galactose are absorbed (via _______ _______ transport) through a ___-dependent cotransporter known as _____.

A

secondary active…Na+…..SGLT1

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17
Q

Fructose enters by _______ _______ via ______ ______ ___ (_____) that does not require ___.

A

facilitated diffusion…..glucose transporter 5 (GLUT5)….Na+

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18
Q

ALL monosaccharides are transported out of the enterocytes and into the capillaries by ____’s (via ______ ______).

A

GLUT2’s…(via facilitated diffusion)

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19
Q

What causes lactose intolerance? Why does gas result? Why does bloating and diarrhea result?

A

Caused by no Lactase. Gas caused by bacterial fermentation of lactase. Bloating and diarrhea caused by water pulled into G.I. tract post bacterial ingestion.

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20
Q

Do we digest protein in the mouth?

A

Nope!

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21
Q

What enzyme is working to break down protein in the stomach?

A

Pepsin

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22
Q

Where does the BULK of protein digestion occur? What are the two main enzyme groups at work here?

A

The BRUSH BORDER of the S.I. 1.AminoPeptidAses 2.Proteases(Active Pancreatic Enzymes)

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23
Q

REVIEW: what are the 4 pancreatic enzymes involved in breaking down proteins to oilgopeptides in the SI?

A

1.Trypsin 2.Chymotrypsin 3.CarboxyPeptidases 4.Elastase

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24
Q

What is the size limit for bringing peptides/AA’s into an enterocyte?

A

Tripeptides, Dipeptides, and single AAs can enter the cell

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25
Q

What type of co transporter helps get PEPTIDES/AAs into the enterocyte (SOME of the time)? What is the other option?

A

Glucose co-transporters…other option is facilitated diffusion

26
Q

What is the FIRST step in Lipid digestion? What is the main players here?

A

Emulsification…Major player BILE ACIDS and Lecithin

27
Q

What do pancreatic lipase and coLipase break down triacylglycerides into?

A

a monoglyceride and 2 free fatty acids

28
Q

What is the difference between a chylomicron and a micelle?

A

Chylomicron=triacylglycerols into lacteals(lymph)…vs….Micelle=monoglycerol and free fatty acids going into an enterocyte

29
Q

Why do chylomicrons enter a lacteal instead of a blood vessel?

A

SIZE! capillaries are too small for the chylomicron.

30
Q

Once the chylomicrons enter the lymphatic circulation, they are transported upward through the ________ and emptied into the venous circulation at the juncture of the _______ and _______ veins.

A

thoracic duct……jugular and subclavian veins

31
Q

______ usually occurs within an hour after eating a fatty meal. _________ have a short half-life (< 60 min), so the plasma usually becomes clear within a few hours.

A

Lipidemia….Chylomicrons

32
Q

Chylomicrons are removed from the blood as they pass through the capillaries of ________ and the ______. Both contain large quantities of __________.

A

adipose tissue and the liver…lipoprotein lipase

33
Q

Where is lipoprotein lipase especially active?

A

The capillary endothelium

34
Q

What are the 5 classes of lipoproteins? Which one is the ONLY type made in enterocytes?

A
  1. Chylomicrons (ONLY one made in enterocytes) 2.VLDL 3.IDL 4.LDL 5.HDL
35
Q

_____ are the most effective drugs currently in use for treating elevated LDL-C. What enzyme are they targeting?

A

Statins..HMG CoA REDUCTASE inhibitors!!

36
Q

What is the #1 adverse side effect of Statins? What are the 3 subcategories? WHAT do you see/not see in the blood?

A

MyoPathy…1.Myalgia(muscle weakness WITH OUT Creatnine Kinase in the blood) 2.MyoSitis (elevated CK in the blood) 3.RAB-DOH (RhabdoMyoLYSIS)

37
Q

What are the 4 things you find in the blood/urine to diagnose Rhabdomyolysis?

A

Creatnine Kinase….creatinine…dark urine and myoglobinuria

38
Q

What is the % of Pt taking a Statin to report MyoPathy?

A

10%

39
Q

Risk factors for _______ ______ include being elderly, small size, high statin dose, liver or renal disease, diabetes, uncontrolled hypothyroidism, and interacting medications.

A

statin myopathy

40
Q

What is the drug aimed at increasing HDL? What does this drug REDUCE?

A

Niacin..Also reduces VLDL production

41
Q

What are the 3 preparations of Niacin?

A

1.Immediate(crystalline) Release 2.Sustained Release 3.No-flush

42
Q

What are the two other names for Niacin?

A

Nicitinic Acid, Vitamin B3

43
Q

Niacin can cause a ___-___% increase in HDL-C

A

15-35% increase in HDL-C

44
Q

What can you do to combat the harmless side effect of the warm flash of Nacin?

A

Its a PROSTAGLANDIN mediated effect, so you can block them with ASA or NSAIDs 30-45min before!

45
Q

The _______ are among the oldest of the hypolipidemic drugs and sometimes considered the _____ since they are not absorbed from the intestine.

A

Bile Acid Binding Resins…safest

46
Q

BOOM! What are the two resins available in Granular form?

A

Cole-Stid and Quest-Ran

47
Q

BOOM! What are the two resins available that are tablets mixed with water?

A

Cole_Stid and Wel-Chol

48
Q

What are the two methods of action for Bile Acid Resins?

A
  1. Decreased emulsification of fat 2.No bile acid reabsorption (liver then uses cholesterol to make more bile!)
49
Q

What do Bile Acid Resins do to LDL, HDL, and Triacylglyceride levels in the blood?

A

REDUCE LDL, no effect on HDL nor TAGs

50
Q

What are the 9 adverse effects of Bile Acid Resins? How can you combat them?

A

1.Constipation 2.Bloating 3.Abdominal Distention 4.Pain 5.Flatulence 6.Nausea 7.Vomiting 8. Dyspepsia 9. Oily Anal Leakage…Combat with FIBER supplement

51
Q

What are the 7 drugs and substances that Bile Acid Resins can bind to?

A

1.Fat Sol Vitamins 2.Folate 3.ThiAZides 4.TetraCyclines 5.Warfarin 6.Propanolol 7. Penicillin

52
Q

All H20 absorption in the small intestine is ______ and secondary to ______ movement.

A

passive…solute

53
Q

Most K+ is absorbed passively when luminal [K+] rises because of absorption of water (_________).

A

Solvent drag

54
Q

Calcium absorption occurs in the ________ & _______ and is primary regulated by ________ (_____________)

A

duodenum & jejunum….vitamin D3 (1, 25 dihydroxycholecalciferol)

55
Q

What does absorption of Calcium stimulate the production of in enterocytes?

A

CalBindIns (Calcium binding proteins)

56
Q

How are fat soluble vitamins absorbed? What about water soluble?

A

Fat-soluble= like other lipids…Water sol=SIMPLE DIFFUSION

57
Q

Which water soluble vitamin requires Intrinsic Factor (IF) for normal absorption? WHERE do these get absorbed?

A

B12(Cobalamin/CBL)..Absorbed in the ileum

58
Q

What becomes deficient with atrophy of the gastric mucosa?

A

Vitamin B12

59
Q

Where are the three places I can find Peristaltic Contractions?

A

1.Esophagus 2.Stomach 3.Small Intestine

60
Q

How long does it take for chyme to move through the entire SI?

A

3-5 hours

61
Q

REVIEW:Which autonomic digestive process helps with mechanical digestion of food?

A

Segmentation

Digestion (16 decks)

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