Jejunum and Ileum Flashcards

1
Q

Describe the location and structure of the jejunum and ileum (simply)

A

Jejunum is found in upper left quadrant of abdomen. It has a thick intestinal wall. Has long vasa recata and few arcades

Ileum is found in lower right quadrant of abdomen. It has a thin intestinal wall. Has short vasa recta and lots of arcades

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2
Q

What is the blood supply to the intestines

A

Blood supply is via the superior mesenteric artery which splits into:

Jejunal and ileal arteries

Ileocolic, Right colic and Middle colic arteries - supply colon

Venous drainage is via superior mesenteric vein

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3
Q

What adaptations are there in the small intestine that allow for maximal absorption

A

Large surface area - mucosa folded into villi with the villi being covered in a brush border. Plicae circularis

Slow movement of contents - precise control in intestines

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4
Q

What cell types are found in the intestines

A

Enterocytes - absorptive cells. Have brush border and tight junctions between them

Goblet cells

Enteroendocrine cells

Stem cells - at base of crypts of Lieberkuhn

Paneth cells - produce antimicrobial peptides

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5
Q

What carbohydrates are broken down in the small intestine, what are they broken down into and what enzymes break them down

A

Starch -> glucose/maltose - amylase and isomaltase

Maltose -> glucose - maltase

Lactose -> glucose and galactose - lactase

Sucrose -> glucose and fructose - sucrase

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6
Q

Describe how CHOs are absorbed

A

N-K-ATPase on basolateral membrane creates concentration gradient

Na moves into the cell from the intestinal lumen down its concentration gradient via SGLT-1 along with glucose

GLUT2 transports glucose out of enterocyte so it can diffuse into the capillaries

Fructose enters enterocyte via GLUT5

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7
Q

Where does protein digestion start and by what enzyme

A

Protein digestion starts in the stomach by the action of pepsin which digests proteins into oligopeptides and amino acids

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8
Q

What major proteases are released from the pancreas and how do they work

A

Endopeptidases - break middle of peptide chains to produce shorter polypeptides. E.g. trypsin, chymotrypsin, elastase

Exopeptidases - break at ends of polypeptide chains to produce amino acids, dipeptides or tripeptides. E.g. carboxypeptidase (A&B)

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9
Q

How are amino acids, di- and tri-peptides absorbed in the intestine

A

Peptide transporter 1 - transports short peptides along with H+ into the enterocyte. H+ concentration gradient set up by NHE

Na-amino acids co-transporters - transport similar to glucose

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10
Q

How does oral rehydration work

A

Oral rehydration fluid contains a mixture of glucose and salt which stimulate maximum water uptake

Na uptake generates osmotic gradient -> water follows

Glucose uptake stimulates Na uptake

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11
Q

How does Na uptake differ in the small and large intestines

A

Na uptake on apical membrane is different:

In small intestines, Na is co-transported with other substances

In large intestines, Na channels induced by aldosterone aid water reabsorption

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12
Q

What channels drive water secretion

A

Cl channels

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13
Q

Name some causes of vitamin B12 deficiency

A

Terminal ileum problems

Lack of intrinsic factor

Hypochlorhydria

Inadequate intake of food

Inflammatory disorders of the ileum

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14
Q

What happens when a lactose intolerant person consumes lactose

A

Lactose cannot be absorbed by a lactose interolerant individual causing it to remain in the gut and create a high osmotic effect

This means water is not absorbed -> diarrhoea

Lactose is fermented in the gut producing flatus/bloating

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15
Q

What are the symptoms of IBS

A

Abdominal pain - often cramping

Bloating

Flatulence

Diarrhoea

Constipation

Rectal urgency

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16
Q

What is coeliac disease

A

Coeliac disease arises from immunological response to gliadin fraction of gluten

Results in damage to mucosa of intestines causing:

  • Absence of villi
  • Lengthening of intestinal crypts
  • Lymphocytes infiltrate epithelium
  • Imparied digestion/malabsorption
17
Q

What are the symptoms of coeliac disease

A

Malabsorption -> diarrhoea, weight loss, flatulence, abdominal pain

Anaemia due to impaired iron absorption

Neurological symptoms due to hypocalcaemia

18
Q

What is the treatment for coeliac disease

A

Strict gluten free diet