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BRS GI Flashcards

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1
Q

parasympathetic innervation to the GI tract is mediated by which two nerves

A

vagus and pelvic nerves

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2
Q

preganglionic parasympathetic fibers synapse where in the GI tract

A

in the hyenteric and submucosal plexuses

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3
Q

parasympathetic innervation of the stomach, esophagus, pancreas and upper large intestine

A

Vagus n

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4
Q

parasympathetic innervation of the lower LI, rectum, anus

A

pelvic n

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5
Q

postganglionic sympathetic fibers leave the _______ ganglia and synapse in the ______ and ______ plexuses
usually results in an _______ response

A

leave the prevertebral ganglia and synapse in the myenteric and submucosal plexuses
inhibitory response

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6
Q

four official GI hormones

A

gastrin
CCK
secretin
GIP (glucose-dependent insulinotropic peptide)

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7
Q

increases gastric H+ secretion

stimulates growth of gastric mucosa

A

Gastrin

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8
Q

Stimulates contraction of gallbladder and relaxation of sphincter of Oddi
increase HCO3 from pancreas
INcrease growth of exocrine pancreas/gallbladder
inhibits gastric emptying

A

CCK

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9
Q

increases pancreatic HCO3 secretion

increases biliary HCO3 secretion

A

Secretin

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10
Q

increases insulin secretion

decreases gastric H secretion

A

GIP

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11
Q

stimuli for gastrin

A

small peptides and AA in lumen of stomach
distension of stomach
vagal stimulation (via GRP)

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12
Q

inhibition of gastrin

A

H+ in the lumen of the stomach (negative feedback)

somatostatin

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13
Q

Syndrome when gastrin is secreted by non-Beta cell tumors of the pancreas

A

Zollinger-Ellison syndrome (gastrinoma)

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14
Q

stimuli for CCK

A

small peptides and AA

FA and monoglycerides in duodenum

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15
Q

stimuli for secretin

A

H+ and FA in lumen of duodenum

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16
Q

stimuli for GIP

A

released in response to fat, protein, carbohydrate

FA, AA, orally administered glucose

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17
Q

inhibits release of all GI hormones, stimulated by presence of H+ in lumen

A

somatostatin

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18
Q

increases gastric H+ secretion, produced by mast cells of the gastric mucosa

A

histamine

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19
Q

GI neurocrines (3) - neurocrines are synthesized in neurons and moved by axonal transport down the axon, released by AP in nerves

A

VIP - vasoactive intestinal peptide
GRP (Bombesin)
enkephalins

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20
Q

neurocrine that produces relaxation of GI smooth muscle, including the LES
Stimulates pancreatic HCO3 secretion
inhibits gastric H+ secretion

A

VIP - vasoactive intestinal peptide

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21
Q

neurocrine that is released from vagus n that innervate G cells
stimulates gastrin release from G cells

A

GRP (bombesin)

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22
Q

neurocrine that stimulates contraction of GI smooth muscle (esp. sphincters)
also inhibits intestinal secretion of fluid and electrolytes

A

Enkaphalins
met-enkaphalin
leu-enkaphalin

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23
Q

contraction of circular smooth muscle in the GI tract results in what movement

A

decrease in diameter (segmentation)

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24
Q

contraction of longitudinal smooth muscle in the GI tract results in what movement

A

decrease in length - inchworming that poop along

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25
slow waves originate from
interstitial cells of cajal - pacemaker cells
26
the frequency of slow waves determines the ______ for any given section of the GI tube
determines the maximum frequency of contractions lowest in stomach - 3/min highest in duodenum - 12/min
27
where in the brain is the swallowing mechanism coordinated and what nerves carry it
the medulla | vagus and glossopharyngeal nerves carry info between GI and medulla
28
three events of swallowing
1. nasopharynx closes and breathing is inhibited 2. Laryngeal muscles contract to close glottis and elevate larynx 3. Peristalsis begins in the pharynx and UES relaxes to permit food bolus to enter esophagus
29
because the esophagus is located in the thorax, intraesophageal pressure equals thoracic pressure, which is ______ than atmospheric pressure.
lower than atmospheric
30
primary peristaltic contraction creates an area of ____ pressure behind the bolus that, along with gravity, propels the bolus towards the stomach
creates an area of high pressure
31
relaxation of the LES is mediated by what neurotransmitter
VIP
32
reflex that occurs when the orad region of the stomach relaxes to accommodate the ingested meal
receptive reflex
33
caudad region of the stomach serves what two purposes
mix foods with gastric secretions and begins digestion process
34
during fasting, do gastric contractions occur?
yes, they clear the stomach of residual food | mediated by motilin
35
gastric emptying is the fastest when the contents are what tonicity compared to (i'm not sure what actually)
isotonic emptying is fastest though
36
FA are able to slow gastric emptying by prompting the release of which hormone
CCK
37
describe the gastroileal reflex
presence of food in the stomach triggers increase in peristalsis in the ileum and relaxation of the ileocecal sphincter
38
characteristics of saliva ____ HCO3, K ____-tonic major enzymes (2)
high HCO3, K Hypotonic alpha-amylase lingual lipase
39
characteristics of gastric secretions
HCL pepsinogen intrinsic factor
40
characteristics of pancreatic secretion ____ HCO3 ___-tonic major enzymes (3)
high HCO3 isotonic pancreatic lipase, amylase, proteases
41
major characteristics of bile
bile salts bilirubin phospholipids cholesterol
42
at the lowest flow rate, what is the composition of saliva?
low osmolarity and lowest Na, Cl and HCO3 concentrations | highest K concentration
43
at the highest flow rates, what is the composition of saliva?
composition resembles saliva
44
which part of the a saliva gland modifies its composition?
ducts (as they are impervious to water)
45
what hormone acts on ductal cells to increase reabsorption of Na and secretion of K (recall)
aldosterone
46
atropine (anticholinergic) has what effect on the production of saliva?
inhibits its production causes dry mouth parasympathetic innervation Ach --> muscarinic receptor signal blocked by atropine
47
secondary messenger of parasympathetic innervation to acinar and ductal cells
IP3 and Ca (from DAG)
48
secondary messenger of sympathetic innervation to acinar and ductal cells
cAMP
49
what stimuli increase the production of saliva?
food in mouth, smells, conditioned reflex and nausea
50
what stimuli decrease the production of saliva?
sleep, dehydration, fear and anticholinergic drugs
51
cell type that secretes HCL (and reabsorbs HCO3) and intrinsic factor
parietal cells
52
cell type in stomach that secretes pepsinogen
chief cells
53
cell type in stomach that secretes gastrin
G cell
54
pump in parietal cells that excretes H
H+,K+ ATPase (antiporter, exchanges H and K)
55
omeprazole inhibits what ion transporter in the stomach
H+, K+ ATPase of parietal cells, blocking H secretion
56
drug that blocks H secretion by inhibiting the H+. K+ ATPase in the stomach
omeprazole
57
what is the MoA for vomiting to induce metabolic alkalosis?
gastric H+ never arrives in the small intestine, no stimuli for pancreatic HCO3 secretion, arterial blood becomes alkaline
58
stimulation of gastric H+ secretion occurs 2 ways:
1. vagus n innervates parietal cells and stimulates secretion directly (ACh to muscarinic, IP3 and DAG) 2. vagus n innervates G cells and stimulates gastrin secretion, which then indirectly stimulates H secretion (NT::GRP)
59
atropine blocks which pathway of gastric H+ secretion
direct pathway, atropine is a cholinergic muscarinic antagonist
60
atropine is unable to completely stop gastric H+ secretion for what reason?
since indirect stimulation of gastric H+ secretion relies on G cells being stimulated by the NT GRP, the cholinergic muscarinic antagonist, atropine, is unable to completely inhibit H+ secretion
61
what surgical intervention would be effective in total inhibition of gastric H+ secretion
vagotomy (vagus n innervates parietal cells directly and G cells, which produce gastrin [induces H+ secretion])
62
signal released from ECL cells in the gastric mucosa that stimulates H+ secretion by activating H2 receptors
histamine
63
histamine is able to induce gastric H+ secretion through activation of which receptor and cascade in parietal cells
H2 receptor adenylyl cyclase cAMP
64
cimetidine primarily blocks which receptor and signalling molecule
blocks H2 receptors on parietal cells that normally bind histamine to produce H+
65
inhibitory drug that works on the H2 receptor
cimetidine
66
term that refers to the response of simultaneous administration of two stimulants is greater than the sum of responses to either agent given alone
potentiation

GI Final (8 decks)

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