4LE Physio HM Flashcards by harryl martinez

What are the components of the GI system?

Mouth
Pharynx
Esophagus
Salivary glands
Pancreas
Stomach
Liver
Gallbladder
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus

Mouth and Pharynx
Esophagus
Stomach
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus

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What are the accessory organs in the GI system?

Mouth and Pharynx
Esophagus
Salivary glands
Pancreas
Stomach
Liver
Gallbladder
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus

Salivary glands
Pancreas
Liver
Gallbladder

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What are the physiological processes of GIT

Motility
Secretion
Absorption
Digestion

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What are the secretory part of the GI system?

Mouth and Pharynx
Esophagus
Salivary glands
Pancreas
Stomach
Liver
Gallbladder
Small Intenstines
Deudenum, Jejunum, Ileum
Colon/Large Intestines
Anus

Mucosa of SI
Large Intestines
Esophagus
Pharynx
Salivary glands
Liver
Pancreas

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What neuroligic system of the body facilitates digestion and absorption that is most concerend with the process if digestion?

Autonomic Nervous system - parasympathetic
Enteric Nervous system - sympathetic
Somatic Nervous System

Autonomic Nervous system - parasympathetic

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It is a type of ANS that Inhibits control of the GIT

Sympathetic
Parasympathetic

Sympathetic

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It is the dominant neural control of the GIT

Autonomic Nervous system
Enteric Nervous system
Somatic Nervous System

ANS

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90% of GIT is mostly composed of?

SKELETAL MUSCLE
SMOOTH MUSCLE
GLANDS
CARDIAC MUSCLE

SMOOTH MUSCLE

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The ANS is usually most functional in?

SKELETAL MUSCLE
SMOOTH MUSCLE
GLANDS
CARDIAC MUSCLE

glands, cardiac muscle and smooth muscle

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Urge to vomit, nausea, abdominal pain and other SOS signals makes the ____ to communicate to the brain .

Autonomic Nervous system
Enteric Nervous system
Somatic Nervous System

ENS

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Neurological system that is for voluntary control of skeletal ms at the external anal sphincter, mouth and pharynx and the upper 1/3 of the esophagus

Autonomic Nervous system
Enteric Nervous system
Somatic Nervous System

Somatic Nervous System

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THE_____ facilitases localized contraction and secretions that can respond to the changes that are felt by the sensory neurons

Autonomic Nervous system
Enteric Nervous system
Somatic Nervous System

ENS

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interneuron projecting caudally and functions for muscle relaxation

Ach-
GCRP
somastatin
substance P

somastatin

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they are release by bipolar neurons and functions in pain pathways and modulate inflammation

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin

substance P
GCRP
Ach-

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two types of electrical waves that excites the GIT smooth ms

true action potential
not action potential

Slow wave
Spike potential

Slow wave - not action potential

Spike potential - true action potential

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It occur when the RMP of GI smooth ms becomes more positive that -40mV

Slow wave - not action potential
Spike potential - true action potential

Spike potential

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Inhibit motor and secretory function of GIT

Sympathetic NS
Parasympathetic NS

Sympathetic NS

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stimulates motor and secretory function of GIT

Sympathetic NS
Parasympathetic NS

Parasympathetic NS

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Parasympathetic and sympathetic nerve system both carry _____ nerve fibers

afferent
efferent

afferent

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Type of neurotransmitter that is in the myenteric plexus and contracts the smooth ms

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin

gamma - aminobutyric acid

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it is an interneuron meurotransmitter

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin

serotonin

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An inhibitory neurotransmitter from synapsing adregenic neuron

histamine
neuropeptide Y
gamma-aminobutyric acid
somastatin
serotonin

neuropeptide Y

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Pacemaker cells found in the CT interstitium near the smooth ms cells and is the pacemaker sites of slow waves

myenteric plexus
Interstitial cells of Cajal (ICC)
Cholecystikinin 
GIP
Sensing Cells

Interstitial cells of Cajal (ICC)

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True action potential found in the GIT that excites muscle contraction

Slow wave
Spike potential

Spike potential

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When does the frequency of spike potential increases? the higher the slow wave potential rises the higher the slow wave potential decreases the lower the slow wave potential rises the loweer the slow wave potential decreases

the higher the slow wave potential rises

Pathway of basic electrical rhythm a) ICC- interstitial cells of cajal -> Slow waves -> smooth muscle contraction -> spike potential b) Slow waves -> spike potential -> ICC- interstitial cells of cajal -> smooth muscle contraction c) ICC- interstitial cells of cajal -> Slow waves -> spike potential -> smooth muscle contraction d) ICC- interstitial cells of cajal -> spike potential -> Slow waves -> smooth muscle contraction e) ICC- interstitial cells of cajal -> smooth muscle contraction-> Slow waves -> spike potential

ICC- interstitial cells of cajal -> Slow waves -> spike potential -> smooth muscle contraction

Main endocrine hormones ``` myenteric plexus Interstitial cells of Cajal (ICC) Cholecystikinin GIP Sensing Cells ```

``` Cholecystikinin - gall bladder contraction - gastrointestinal motility - pancreatic exocrine secretion Secretin - pancreatic exocrine secretion GIP -incretin activity Motilin - gastrointestinal motility ```

Examples of paracrine ``` histanime neuropeptide Y gamma-aminobutyric acid somastatin serotonin ```

histanime | somatostatin

Function of Paracrine - processes where a chem messenger/regulatory peptide is released from ____ in the intestinal wall ``` myenteric plexus Interstitial cells of Cajal (ICC) Cholecystikinin GIP Sensing Cells ```

sensing cell

A mechanical digestion of food to facilitates enzymatic digestion

mastication or chewing

Saliva is secreted by: parotid gland (largest salivary gland) sublingual gland submandibular gland

parotid gland (largest salivary gland) sublingual gland submandibular gland

List major charactersitic of saliva - large vol relative to mass (1-1.5L per day) - low K conc - high osmolarity (quite diluted) - contains specialized inorganic materials

- large vol relative to mass (1-1.5L per day) - high K conc - low osmolarity (quite diluted) - contains specialized organic materials

salivary component involved in lubrication ``` mucins proline-rich glycoproteins Cholecystikinin GIP water amylase defensins lipase ribunuclease ```

``` mucins proline-rich glycoproteins water amylase defensins ```

salivary component involved in growth epidermal growth fator EGF Trasforming growth factor (TGF) - a, b fibroblast GF - FGF insulin-like gf

epidermal growth fator EGF Trasforming growth factor (TGF) - a, b fibroblast GF - FGF insulin-like gf

salivary component involved in buffering ``` water gustin mucin bicarbonate phosphate ions proteins ```

bicarbonate phosphate ions proteins

salivary component involved in digestion ``` mucins proline-rich glycoproteins Cholecystikinin GIP water amylase defensins lipase ribunuclease ```

``` amylase lipase ribonuclease protease water mucin ```

salivary component involved in taste ``` water gustin mucin bicarbonate phosphate ions proteins ```

water | gustin

salivary component involved in speech ``` water gustin mucin bicarbonate phosphate ions proteins ```

water | mucin

a ) Phases in swallowing or deglutition b) reflex mechanism where nasopharynx close to prevent regurgitation c) palatopharyngeal folds are pulled medially to form passage for foor to move into the pharynx d) primary peristalsis - follows swallow and its secondary peristalsis - food remain stuck in the esophagus (ENS senses this condition) Oral Phase pharyngeal phase Esophageal phase

a) Oral Phase pharyngeal phase Esophageal phase b) pharyngeal phase c) pharyngeal phase d) Esophageal phase

Prevents reflux of acidic gastric contents into the esophagus VIP - vasoactive intestinal polypeptide LES - lower esophageal sphincter NO - nitric oxide Interstitial cells of Cajal (ICC)

LES - lower esophageal sphincter

receptive relaxation is mediated by vagus nerve secretes _______ when food is brought by peristalsis into esophagus ``` VIP - vasoactive intestinal polypeptide LES - lower esophageal sphincter NO - nitric oxide Interstitial cells of Cajal (ICC) Fundus of the stomach ```

VIP - vasoactive intestinal polypeptide | NO - nitric oxide

Other than LES, this also relaxes to accommodate more food ``` VIP - vasoactive intestinal polypeptide LES - lower esophageal sphincter NO - nitric oxide Interstitial cells of Cajal (ICC) Fundus of the stomach ```

Fundus of the stomach

Closes the LES - lower esophageal sphincter Coffee without the caffeine GERD - gastroesophageal reflux disease enterogastric reflex

Coffee without the caffeine

LES unable to maintain normal tone Coffee without the caffeine GERD - gastroesophageal reflux disease enterogastric reflex

GERD - gastroesophageal reflux disease

In gastric motility, what occurs during a. ) fundus enlarge as food enters the stomach b. ) food in the body and antrum increases contraction: peristalsis and retropulsion c. ) chyme is propelled through the polyric sphinctier into the intestines d) synchronous contractions of fundus , body and antrum e. fundus becomes quiescent, stores food ``` between meals mixing emptying storage right after meal ```

a. storage b. mixing c. emptying d. between meals e. right after meal

contractions that goes towards the caudal end enterogastric reflex mixing reflex lactating reflex Peristaltic

Peristaltic

excitatory hormone in gastric emptying ``` mucus bicarbonate gastrin pepsin HCl Ach ```

gastrin

Cholecystokinin and secretin are what type of gastric emptying hormone? excitatory inhibitory

inhibitory

local reflex taht streched the antrum and increase volume in gastric emptying excitatory inhibitory

excitatory

example of a inhibitory gastric emptying local reflex ``` enterogastric reflex mixing reflex lactating reflex vomiting reflexes Peristaltic ```

enterogastric reflex

They are for protection of gastric mucosa against acidic and peptic luminal environment ``` mucus bicarbonate gastrin pepsin HCl Ach ```

mucus and bicarbonate

It is consist of a gel-forming glycoprotein (mucins) and protective layer of epithelium ``` mucus bicarbonate gastrin pepsin HCl Ach ```

mucus

NaHCO3 a neutrulizer is increased by ____ and decreased by _____ ``` stress PNS aspirin-NSAIDs sympathetics (NE, Epi) mucosal irritation prostaglandins empty stomach smoking ```

``` increased by: mucosal irritation PNS prostaglandins empty stomach ``` ``` decreased by: stress sympathetics (NE, Epi) aspirin-NSAIDs smoking ```

Main digestive enzyme ``` mucus bicarbonate gastrin pepsin HCl Ach ```

pepsin

Pepsins secreted as inactive ___________ is activated by decrease in pH (HCl). gastric and intestinal phases mucus and bicarbonate pepsinogen I and II

pepsinogen I and II

_____ provides optimal pH for pepsins, it kills ingested bacteria and it stimulates the flow of bile ``` mucus bicarbonate gastrin pepsin HCl Ach ```

HCl

Increased Vit B12 leads to increase ____ secretion ``` mucus bicarbonate gastrin pepsin HCl Ach ```

HCl

It binds Vit B12 and aids its absorption in the ileum ``` Intrinsic Factor (IF) Extrinsic Factor ```

Intrinsic Factor (IF)

Stimulus for all the phases in the mechanisms of stimulating gastric secretions ``` mucus bicarbonate gastrin pepsin HCl Ach ```

Ach | Gastrin

Chewing and swallowing are stimuls for what? gastric phase cephalical phase intestinal phase

gastric and intestinal phases

Distension and digested protein are stimulus for? gastric phase cephalical phase intestinal phase

gastric and intestinal phases

Organs of the body that have all the phases of gastric secretion ``` esophagus stomach pancrease small intestine colon ```

stomach and pancreas

What ar the phases of gastric secretion gastric phase cephalical phase intestinal phase

gastric cephalic intestinal

TRUE or FALSE In the cephalic phase a. presence of food in the mouth inhibits gastric secretion b. increase in appetite also increase stimulation c. increase sympathetic stimulation (stress ) mucsla lining decreases

a. FALSE, it stimulates gastric secretion b. TRUE c. TRUE

Accounts for 60% (1.5L) of total gastric secretion associated with eating meals gastric phase cephalical phase intestinal phase

gastric phase

Accounts for 10% of total gastric secretion associated with eating meals gastric phase cephalical phase intestinal phase

intestinal phase

Distended intestines ________ gastric emptying stimulate inhibit

inhibits

``` increase or decrease ??? cephalic phase a. loss of appetite b. stimulation of taste and smell receptors c. sight and thought of food d. depression gastric phase e. excessive acidity in stomach f. stomach distention g. emotion upset h. food chemicals intestinal phase i. presence of partially digested food in the duodenum when stomach begins to empty j. presence of acidic, hyper or hypotonic chime/irritants in the duodenum ```

a. dec b. inc c. inc d. dec e. dec f. inc g. dec h. inc i. inc j. dec

The three agonist of parietal cells in gastric secretion ``` gastrin bicarbonate histamine pepsin ranitidin Ach ```

gastrin histamine acetylcholine

blocks H2 receptors wherein 90% of acid production is inhibited ``` gastrin bicarbonate histamine pepsin ranitidin Ach ```

ranitidin

type of receptor acetycholine: __ histamine: __ gastrin: __ somatostatin: ___ H2 receptor muscarinic receptor inhibitor; secreted by D cells CCKB receptor

: muscarinic receptor : H2 receptor : CCKB receptor : inhibitor; secreted by D cells

Taking Lozec premanently inhibits the ______ but the stomach produces new parietal cells daily so these drugs are taken daily to dec acidity and not totally terminated H-K pumps Na-glucose cotransporter Na-K pumps

H-K pumps

Is triggered by stimulation of vomiting center (medulla), chemoreceptor trigger zone and duedenal receptor (intestines) ``` enterogastric reflex mixing reflex lactating reflex vomiting reflexes Peristaltic ```

vomiting reflexes

Sequence of events during emesis / vomiting - reverse peristalsis - LES relaxes - forceful contraction of abdominal muscle - increased intraabdominal pressure - pyloric sphincter and stomach relax - forced inspiration on closed glottis - dec intrathoracic pressure - UES relaxes

1. reverse peristalsis 2. pyloric sphincter and stomach relax 3. forced inspiration on closed glottis - dec intrathoracic pressure 4. forceful contraction of abdominal muscle - increased intraabdominal pressure 5. LES relaxes 6. UES relaxes

Continous vomiting results in: - increase acidity in lumen - decrease acidity in lumen - increase activity of H-K pump - decrease activity of H-K pump - metabolic alkalosis - metabolic acidosis

- decrease acidity in lumen - increase activity of H-K pump - metabolic alkalosis (loss of H+)

what are the origin of vomitus and determine their determined by color stomach intestines - yellowish and greenish

stomach | intestines - yellowish and greenish

movements of intestines that does mixing contractions is __a__ and movement that does propulsive contractions is __b__? segmentation perstalsis

a. segmentation | b. perstalsis

keeps the bacterial concentration low in the small intestines

ileocecal junction

It occurs in between meals.

migrating myoelectric complex

In migrating myoelectrical complex, peristalsis occurs in _____

circular to longitudal muscle contraction

_____ and _____ inhibit small intestines motility

secretin ; glucagon

This is a localized stimulation of the SI at a certain point will produce a contraction at the area near the oral end and relaxation at the area near the anal end

Peristaltic reflex

A response where it removes blockage and distention occur

intestinointestinal reflex

The stomach stimulates the ileum to increase motility

gastroileal reflex

A reflex , when stomach is full the ileum will increase motility, if the ileum is full the stomach stop moving

ileogastric reflex

in anointestinal reflex, a full anus inhibits ____

intestinal motility

the only part of the large intestine taht is complete in all the layering would be ____

the part near the rectum

What are the principal function of the colon?

- absorption of water and electrolytes from the chyme to form solid feces - storage of fecal matter until it can be expelled

Large intestine motility is regulated primarily by the

ENS - neural pathways

The only movement when we are asleep which is more prominent in the sigmoid colon and rectum

rectal motor complex

Phases of migrating myoelectric complex

phase 1: Quiescent pahse - there is no significant elec and mech activity. SI is still Phase 2: Increasing action potential frequency - period of small disorganized contraction Phase 3: Peak electrical and mech activity - large or intense contraction

Hormone responsible for peak electrical and mechanical activity of the mograting myoelectric complex

motilin

Secreted by the upper duodenum during fasting

motilin

it is the most important reflex

peristaltic reflex

gastrocolic and duedenocolic reflexes are transmitted by way of ____

ANS

Reflex contraction of the rectum and relaxation of the internal and external anal sphincter

defacation

Strongly inhibits the excitatory nerves and thereby causes intestinal paralysis, especially in patients with peritonitis

peritoneointestinal reflex note: results from irritation of peritoneum

inhibit intestinal activity as a result of kidney irritation

renointestinal reflex

inhibit intestinal activity as a result of bladder irritation

vesicointestinal reflex

contraction of puborectalis muscle forms

anorectal angle

it maintains fecal continence

puborectalis muscle

In the pancreas, the digestive enzyme are secreted _______ and the large volumes of bicarbonate solution are secreted by the _________

- pancreatic acini | - small ductules and larger ducts leading to the acini

Pancreas secretes insulin and glucagon from where

Islets of langerhans

The liver secretes ____ which can be stored in the ______

- bile | - gallbladdes

What is the quantity of Bile production of the liver

600-1000 ml/day

what are the function of bile?

- emulsify fat particles | - aid in absorption of digested fats

what are the stages of bile secretion

- initial portion is secreted by the hepatocytes - bile flows in the canaliculi -> interlobular septa -> terminal bile ducts -> larger ducts -> hepatic duct and common bile duct

What is the bile capacity of the Gallbladder?

30-60ml

What are the endocrine function of the pancreas?

insulin | glucagon

what are the exocrine functions of the pancreas?

``` enzyme lipase amylase protease bicarbonate ```

Pancreatic enzymes are used for?

Starch, protein, fat and DNA digestion

Pancreas secretion are inactivated but are activated by a ?

neural or basic pH blood supply

Secretions by this organ are quantitatively the largest contributors to enzymatic digestion of the meal

Pancreas

It attaches lipase to fat molecule

colipase

It prevents activation of trypsinogen to trypsin

PSTI (Pancreatic Secretory Trypsin Inhibitor)

Whys is PSTI (Pancreatic Secretory Trypsin Inhibitor) important?

Prevents pancreatitis (while trypsin is activated while in the pancreas)

A trypsin activator secreted by the intestinal mucosa when chyme comes in contact with mucosa

Enterokinase

___ are the most important enzymes in the pancreas for digesting protein

- trypsin - chymotrypsin - carboxypeptidase note: pancreatic amylase - digest carbohydrates pancreatic lipases - digests fats trypsin is the most abundant enzyme

It neutralizes the HCL acid emptied into the duodenum from the stomach

bicarbonate

Secretin is secreted by the ___

intestine (S Cells)

_____ stimulates the ductal cells of the pancreas to secrete/produce bicarbonate

secretin

Cholecystokin is secreted by the

intestine (I cell)

It stimulates the acinar cells of the pancreas leads to the secretion/production of pancreatic digestive enzyme

cholecystokinin

Factors regulating pancreatic secretion after a meal

Cephalic phase - stimulated by thought of food -> mediated by release of Ach and gastrin by vagal stimulation -> inc. secretion, with greater effect on enzyme output Gastric phase - stimulus is protein in food -> mediated by gastrin -> inc. secretion with greater effect on enzyme output - stimulated by gastric distention -> mediated by vago-vagal reflex -> inc. secretion with greater effect on enzyme output Intestinal phase - -stimulated by acid in chyme -> mediated by secretin secreted by duodenal S-cells -> inc. water and bicarbonate secretion - stimulated by Long chain fatty acid -> mediated by cholecystokini and vago-cagal reflex -> inc. secretion with a greter effect on enzyme output - stimulated by amino acids and peptides -> mediated by vago-vagal reflex and cholecystokinin -> inc. secretion with greater effect on enzyme output

What are the digestive function of the liver release bile acids and bicarbonate

release bile acids and bicarbonate

Responsible for the feces' yellowish or golden brown color

bile

what are the primary and secondary bile acids? deoxycholic and lithocholic acid chenodeoxycholic and cholic acid

primary: chenodeoxycholic and cholic acid secondary: deoxycholic and lithocholic acid

4LE Physio HM Flashcards

(127 cards)