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Gastrointestinal > 8. Brain to Gut and Gut to Brain Signalling > Flashcards

8. Brain to Gut and Gut to Brain Signalling Flashcards

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1
Q

name for the GUT’S OWN NERVOUS SYSTEM

A

ENTERIC NERVOUS SYSTEM (ENS)

has 100 million neurones (same as spinal cord)

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2
Q

by which NERVOUS PATHWAYS do the CNS and ENS COMMUNICATE

A

VAGUS NERVOUS PATHWAY
&
SPLANCHNIC NERVOUS PATHWAY

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3
Q

AFFERENT and EFFERENT NEURONES carry Signals between…

A

Afferent : GUT TO BRAIN
Efferent: BRAIN TO GUT

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4
Q

AFFERENT NEURONES from GUT TO BRAIN are:

A

VAGAL AFFERENTS and SPINAL AFFERENTS

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5
Q

EFFERENT NEURONES from GUT TO BRAIN are:

A

VAGAL EFFERENTS and SYMPATHETIC EFFERENTS

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6
Q

the SENSATION of FULLNESS is CARRIED in which NERVES

A

VAGUS NERVES

(proposed by Sir Arthur Hurst 1911)

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7
Q

PAINFUL SENSATIONS in the STOMACH are conveyed by which NERVE FIBRES

A

SYMPATHETIC
(NOT vagal)

(proposed by Sir Arthur Hurst 1911)

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8
Q

GI is CONTROLLED by which NERVOUS SYSTEM

A

AUTONOMIC NERVOUS SYSTEM

  • Parasympathetic and Sympathetic nerves
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9
Q

what do VAGAL (PARASYMPATHETIC) EFFERENTS act VIA

A

ENTERIC NEURONS

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10
Q

what do SYMPATHETIC EFFERENTS act on

A

BLOOD VESSELS and ENTERIC NEURONS

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11
Q

PARASYMPATHETIC NERVES …. DIGESTION

A

STIMULATE

(rest and digest)

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12
Q

SYMPATHETIC NERVES … DIGESTION

A

INHIBIT

(flight or fight)

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13
Q

which GI NERVES are PARASYMPATHETIC

A

VAGUS and PELVIC

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14
Q

EXTRINSIC NERVES (OUTSIDE GUT) have what effect on the Digestive System

A

Speed up or Slow down

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15
Q

what are the 2 NERVE PLEXUSES in the GUT WALL

A

MYENTERIC PLEXUS (Auerbach’s)
SUBMUCOSAL PLEXUS (Meissner’s)

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16
Q

what do the MYENTERIC and SUBMUCOSAL PLEXUSES do

A
  • SENSE LUMINAL CONTENTS
  • CONTROL MUSCLES and GLANDS
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17
Q

where is the MYENTERIC PLEXUS in the GUT WALL

A

BETWEEN LONGITUDINAL and CIRCULAr LAYERS

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18
Q

where is the SUBMUCOSAL PLEXUS in the GUT WALL

A

BETWEEN the CIRCULAR and MUCOSA LAYERS

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19
Q

ENTERIC NEURONS CONTROL:

A
  • MOTILITY
  • SECRETION
  • BLOOD FLOW
  • potentially MUCOSAL GROWTH
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20
Q

how does the ENS WORK

A

AUTONOMOUSLY - without input from CNS

in communication with SYMPATHETIC and PARASYMPATHETIC NERVES

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21
Q

GASTRIC DISTENSION (stomach stretching) is DETECTED BY

A

MECHANORECEPTORS

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22
Q

INTESTINAL CELLS DETECT NUTRIENTS as food enters/passes through and DRIVE PRODUCTION of:

A
  • HORMONES
  • PARACRINE MEDIATORS
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23
Q

what causes the VAGAL AFFERENTS to send SIGNALS TO the BRAIN

A

GASTRIC DISTENSTION and INTESTINAL NUTRIENTS

  • MECHANORECEPTORS and PARACRINE MEDIATORS
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24
Q

what is the RESPONSE of the BRAIN that is sent via VAGUS EFFERENTS

A
  • REDUCE FOOD INTAKE (sense of fullness)
  • DECREASED GASTRIC EMPTYING
  • INCREASED PANCREATIC and GASTRIC SECRETIONS
  • INCREASED GUT IMMUNE RESPONSES
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25
how do GUT IMMUNE RESPONSES change from BRAIN RESPONSE to GASTRIC DISTENSION and INTESTINAL NUTRIENTS
INCREASE
26
what NERVES cause DECREASED FOOD INTAKE
VAGAL EFFERENTS (from brain)
27
in the INTERDIGESTIVE PERIOD what HORMONE RELEASE is stimulated and what does this CAUSE
GHRELIN release - INHIBITS RESPONSE from VAGAL AFFERENT NEURONES hence informs brain to EAT
28
GHRELIN INHIBITS..
VAGAL AFFERENTS RESPONSE to BRAIN (to decrease food intake) -> INCREASE FOOD INTAKE (HUNGER)
29
What are the 3 PHASES of GASTRIC ACID SECRETIONS
1. CEPHALIC 2. GASTRIC 3. INTESTINAL
30
what happens in the CEPHALIC PHASE of GASTRIC ACID SECRETION
SIGHT,SMELL, THOUGHT of FOOD TRIGGERS GASTRIC SECRETION - INSTIGATED by VAGAL FIBRES -> RELEASE of ACETYLCHOLINE (ACH) and GASTRIN RELEASING PEPTIDE to start acid secretion
31
in CEPHALIC PHASE what is RELEASED in order to START GASTRIC ACID SECRETION
ACH and GASTRIN RELEASING PEPTIDE
32
CEPHALIC PHASE INSTIGATED by which NERVE FIBRES
VAGAL FIBRES
33
what happens in the GASTRIC PHASE of GASTRIC ACID SECRETIONS
food entering STOMACH STRETCHES IT - TRIGGERS SECRETION VIA LONG (VAGAL) and SHORT (MYENTRIC) REFLEXES - RELEASE of GASTRIN
34
GASTRIN SECRETION in GASTRIC PHASE is triggered VIA which REFLEXES
LONG (VAGAL) and SHORT (MYENTERIC)
35
what happens in the INTESTINAL PHASE of GASTRIC ACID SECRETION
FOOD in INTESTINES INDUCES the RELEASE of HORMONES - which ALTERS GASTRIC SECRETION-FEEDBACK -> RELEASE of INHIBITORY FACTORS so GASTRIC ACID SECRETIONS FALL
36
which GASTRIC ACID PHASE has the HIGHEST OUTPUT
1ST, CEPHALIC
37
what causes INHIBITION in INTESTINAL PHASE
RELEASE or HORMONES and INHIBITORY FACTORS as food enters intestines
38
PAIN in the GUT is DERIVED from which NEURONS
SPLANCHNIC AFFERENT NEURONS
39
SPLANCHNIC NERVES are ... nerves
PAIRED VISCERAL NERVES VISCERAL EFFERENT (carry fibres of ANS) VISCERAL AFFERENT (SENSORY fibres from Organs)`
40
ALL SPLANCHNIC NERVES carry SYMPATHETIC Fibres EXCEPT...
PELVIC SPLANCHNIC Nerves - PARASYMPATHETIC FIBRES
41
GREATER SPLANCHNIC NERVES ORIGIN: GANGLION: VISCERA: REGION of referred PAIN:
ORIGIN: T5-T9 GANGLION: CELIAC VISCERA: FOREGUT REGION of referred PAIN: EPIGASTRIC
42
LESSER SPLANCHNIC NERVES ORIGIN: GANGLION: VISCERA: REGION of referred PAIN:
ORIGIN: T10/T11 GANGLION: SUPERIOR MESENTERIC VISCERA: MIDGUT REGION of referred PAIN: PERIUMBILICAL
43
LEAST SPLANCHNIC NERVES ORIGIN: GANGLION: VISCERA: REGION of referred PAIN:
ORIGIN: T12 GANGLION: AORTICO-RENAL VISCERA: KIDNEYS REGION of referred PAIN: LOWER THORACIC
44
LUMBAR SPLANCHNIC NERVES ORIGIN: GANGLION: VISCERA: REGION of referred PAIN:
ORIGIN: L1, L2 GANGLION: INFERIOR MESENTERIC VISCERA: HINDGUT REGION of referred PAIN: HYPOGASTRIC
45
GUT-DERIVED PAIN NOCICEPTION EXAMPLES:
- HYPERALGESIA : INCREASED RESPONSE to PAINFUL STIMULI - ALLODYNIA: PAINFUL RESPONSE to a NORMALLY INNOCUOUS (harmless) STIMULI
46
GUT-DERIVED PAIN ACID-PEPTIDE RELATED EXAMPLES:
- HEARTBURN: REFUF of ACID into OESOPHAGUS - PEPTIC ULCER in STOMACH, OESOPHAGUS, DUODENUM
47
GUT-DERIVED PAIN DISTENSION EXAMPLE:
MECHANORECEPTOR RESPONSE to stretch is ABOVE THRESHOLD (may feel bloated)
48
GUT-DERIVED PAIN INFLAMMATORY BOWEL DISEASE examples and what it includes
- CROHN'S - ULCERATIVE COLITIS INFLAMMATION SENSITISES SPINAL AFFERENT NEURONS
49
GUT-DERIVED PAIN IRRITABLE BOWEL SYNDROME includes..
FEELINGS of distension, BLOATING, SWELLING, DISCOMFORT - CONSTIPATION or DIARRHOEA
50
what is SATIATION
Prompts the TERMINATION OF EATING - feel full
51
what is SATIETY
FULLNESS that PERSISTS AFTER EATING
52
what does SATIATION DETERMINE
the AMOUNT CONSUMED at ONE SITTING
53
what does SATIETY DETERMINE
the LENGTH of TIME UNTIL NEXT EATING OCCASION
54
what are the CELLS in the INTESTINE that RESPOND to LUMINAL NUTRIENTS
ENTEROENDOCRINE CELLS (EECs) - approx 12 Cell types - largest Endocrine Organ
55
How do the ENTEROENDOCRINE CELLS (EECs) STIMULATE SECRETIONS from the INTESTINES
cause INCREASE in INTRACELLULAR Ca2+ -> EXOCYTOSIS of SECRETORY VESICLES
56
what is SECRETED from INTESTINES in response to the ENTEROENDOCRINE CELLS (EECs) causing INCREASED CALCIUM
LIPID MEDIATORS and GUT HORMONES (REGULATORY PEPTIDES)
57
GUT HORMONE RECEPTORS are on what part of VAGAL AFFERENT NEURONS
NODOSE GANGLION receptors transported from cell soma to peripheral
58
what does CCK HORMONE from GUT STIMULATE
PANCREATIC ENZYME SECRETIONS & GALLBLADDER CONTRACTIONS - PROMOTES SMALL INTESTINE DIGESTION
59
GANGLION on VAGAL AFFERENT NEURON that has RECEPTORS for GUT HORMONES
NODOSE GANGLION
60
what does CKK HORMONE INHIBIT
FOOD INTAKE and GASTRIC EMPTYING VIA VAGAL AFFERENT NEURONS
61
FOOD INTAKE and GASTRIC EMPTRYING is INHIBITED VIA which NEURON
VAGAL AFFERENTS
62
what does GLP-1 (GLUCAGON-LIKE PEPTIDE) GUT HORMONE STIMULATE
INSULIN RELEASE post meal - to DECREASE blood GLUCOSE
63
what does GLP-1 INHIBIT
FOOD INTAKE and GASTRIC EMPTYING VIA VAGAL AFFERENT
64
in OBESITY, VAGAL AFFERENT NEURONS are INSENSITIVE to...
CCK
65
GLP-1 BASED THERAPY includes... (type 2 diabetes)
DPP-IV Inhibitors which DELAY GLP-1 BREAKDOWN (GLP-1 persists in blood for longer) GLP-1 ANALOGUES which MIMIC the EFFECT of GLP-1
66
how does GLP-1 LEVELS CHANGE after BARIATRIC SURGERY
INCREASE
67
GLP-1 DECREASE what levels
BLOOD GLUCOSE - by stimulating INSULIN
68
what does GHRELIN GUT HORMONE STIMULATE
FOOD INTAKE and GASTRIC EMPTYING
69
when is GHRELIN SECRETION HIGHEST
BEFORE a MEAL (hunger)
70
where are GHRELIN RECEPTORS EXPRESSED
on VAGAL AFFERENT (NODOSE GANGLION) and HYPOTHALAMIC NEURONS
71
What does GHRELIN INHIBIT
ACTIONS of CKK on VAGAL AFFERENT NEURONS (which would normally inhibit food intake and gastric emptying)
72
which GUT HORMONES INHIBIT FOOD INTAKE
CCK and GLP-1
73
which GUT HORMONE acts on PANCREAS and GALLBLADDER
CCK - pancreatic ENZYME secretions - gallbladder CONTRACTS
74
which GUT HORMONE PROMOTES SMALL INTESTINE DIGESTION
CCK
75
which GUT HORMONE action (on vagal afferent) is INHIBITED by GHRELIN
CCK
76
how does GHRELIN INHIBIT CCK actions on VAGAL AFFERENT
RECEPTORS for ghrelin and CCK are on the SAME PLACE of NODOSE GANGLION (overlap)

Gastrointestinal (19 decks)

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