Chapter 8: Gastrointestinal Physiology Flashcards
(270 cards)
1
Q
summarize the path of the digestive tract
A
mouth -> esophagus -> stomach -> small intestine -> large intestine -> rectum -> anus
2
Q
the surface of the GI tract is considered to face the (1. inside/outside) of the body; thus, it is lined with (2)
A
- outside
- epithelium
3
Q
summarize the layers of the gut (from lumen)
A
lumen -> mucosal layer -> submucosa -> muscle layer -> serosa
4
Q
in the gut, the (1) faces the lumen, while the (2) layer faces blood
A
- mucosal
- serosal
5
Q
mucosal layer in the gut consists of:
A
- epithelial lining (contains mucosal glands)
- mucosa
- mucosal muscle
6
Q
found beneath the mucosal layer in the gut, and consists of elastin, collagen, glands, and blood vessels
A
submucosa
7
Q
the submucosal nerve plexus is also called the ()
A
Meissner’s nerve plexus
8
Q
the muscle layers of the gut consist of:
A
- longitudinal muscle (thin)
- circular muscle (thick)
9
Q
the () nerve plexus is found between the longitudinal and circular muscle layers of the gut
A
myenteric
10
Q
the GI tract is regulated in part by the ()
A
autonomic NS
11
Q
regulation of the GI tract has intrinsic and extrinsic components:
A
- intrinsic: enteric NS
- extrinsic: sympathetic and parasympathetic innervation
12
Q
parasympathetic innervation of the GI tract is supplied by the ff nerves:
A
- vagus nerve (CN X) - cranial PNS; upper GI tract
- pelvic nerve - sacral PNS; lower GI tract
13
Q
the upper GI tract consists of (1), while the lower GI tract consists of (2)
A
- esophagus to first half of transverse colon
- second half of transverse colon to anus
14
Q
neurons in the vagus and pelvic nerve serve as (pre/postganglionic neurons) in parasympathetic innervation
A
preganglionic
15
Q
parasympathetic ganglia in the GI tract are located at (1), thus they have (short/long) preganglionic fibers
A
- organ walls
- long
16
Q
parasympathetic postganglionic neurons in the GI tract are either (1) or (2), and are located w/in (3)
A
- cholinergic (release ACh -> muscle contraction)
- peptidergic (release peptides -> muscle relaxation)
- myenteric and submucosal plexuses
17
Q
stimulation of parasympathetic nerves in GI tract result in (1), which in turn results in (2)
A
- increased activity of entire enteric NS
- enhanced activity of GI functions
18
Q
sympathetic innervation of the GI tract originate from the (1), between (2) and (3)
A
- spinal cord
- lower thoracic (T5) segment
- upper lumbar (L2) segment
19
Q
sympathetic preganglionic fibers of the GI tract enter (1), which are (near/far from) target organs
A
- sympathetic chains
- far from
20
Q
sympathetic postganglionic neurons are found within the ()
A
sympathetic ganglia: celiac, superior/inferior mesenteric, hypogastric
21
Q
stimulation of sympathetic nerves in the GI tract result in (); sympathetic action can be broken down into a minor and major effect
A
inhibition of GI activity
22
Q
minor effect of sympathetic stimulation in GI tract
A
secreted NE inhibits smooth muscle contraction
23
Q
major effect of sympathetic stimulation in GI tract
A
secreted NE inhibits enteric NS neurons
24
Q
recall that all preganglionic neurons of the sympathetic NS are ()
A
cholinergic
25
recall that all postganglionic neurons of the sympathetic NS are ()
adrenergic (in GI tract, release NE)
26
the enteric NS is innervated by ()
sympathetic and parasympathetic NS
27
effect of enteric NS is mostly targeted to () GI tract functions
contractile, secretory, and endocrine
28
note that both the parasympathetic and sympathetic NS can directly innervate () in the GI tract
smooth muscle
29
the enteric NS consists of:
1. myenteric nerve plexus
2. submucosal nerve plexus
30
the myenteric nerve plexus mainly controls ()
GI movements
31
the submucosal plexus main controls ()
Gi secretion and local blood flow
32
3 types of reflexes in the GI tract
1. integrated entirely within gut wall enteric NS
2. from gut to prevertebral sympathetic ganglia
3. from gut to CNS then back to GI tract
33
reflexes () control Gi secretion, peristalsis, mixing contractions, local inhibitory effects, etc.
that are integrated entirely within gut wall enteric NS
34
example of a GI reflex from gut to prevertebral sympathetic ganglia
gastrocolic reflex (stomach -> colon)
35
the gastrocolic reflex is triggered by (1), and causes (2)
1. distention of the stomach
2. evacuation of the colon
36
example of reflexes from gut to CNS then back to GI tract
vagovagal reflex
37
neurotransmitters and neuromodulators of the enteric NS
1. ACH
2. NE
3. vasoactive intestinal petide (VIP)
4. nitric oxide (NO)
38
neurotransmitters and neuromodulators of the enteric NS; released by enteric NS neurons
VIP and NO
39
neurotransmitter/neuromodulator of the enteric NS that causes:
1. smooth muscle contraction of wall
2. relaxation of sphincters
3. stimulates gastric, pancreatic, and salivary secretion
ACh
40
neurotransmitter/neuromodulator of the enteric NS that causes:
1. smooth muscle relaxation of wall
2. contraction of sphincters
3. stimulates salivary secretion
NE
41
neurotransmitter/neuromodulator of the enteric NS that causes:
1. smooth muscle contraction of wall
2. stimulates intestinal, pancreatic secretion
vasoactive intestinal peptide (VIP)
42
neurotransmitter/neuromodulator of the enteric NS that causes:
1. smooth muscle relaxation of wall
nitric oxide
43
3 classes of GI peptides
1. hormones
2. paracrines
3. neurocrines
44
GI peptide that is released from endocrine cells and enters systemic circulation
hormones
45
GI peptide that is released from endocrine cells and acts locally (within same tissue from which it was released)
paracrines
46
GI peptide that is synthesized by enteric NS neurons; released following an action potential
neurocrines
47
main GI hormones
1. gastrin
2. cholecystokinin (CCK)
3. secretin
4. gastric inhibitory peptide (GIP)
5. glucagon-like peptide-1 (GLP-1)
48
gastrin is secreted by ()
G cells of antrum (stomach), duodenum, jejunum
49
CCK (GI hormone) facilitates digestion of ()
fat and protein
50
CCK is released by ()
I cells of small intestine
51
CCK release inhibits ()
gastric emptying
52
secretin is secreted by ()
S cells of small intestine
53
secretin release inhibits ()
gastric acid secretion
54
GIP is also called ()
glucose-dependent insulinotropic peptide
55
GIP is secreted by ()
K cells of duodenum, jejunum
56
GIP release inhibits ()
1. gastric acid secretion
2. gastric emptying
57
GLP-1 is a GI tract hormone synthesized from ()
incretin
58
GLP-1 is released by ()
L cells of small intestine
59
hormones involved in insulin secretion
GIP and GLP-1
60
liraglutide drugs target () receptors to target diabetes and chronic obesity
GLP-1
61
why are liraglutides safer than directly injecting insulin
they only indirectly affect glucose levels; insulin injections result in abrupt drop in blood sugar
62
new GLP-1 receptor agonists; administered weekly
semaglutides
63
examples of liraglutides
victoza, saxenda
64
examples of semaglutides
ozempic, wegovy
65
new GIP and GLP-1 dual agonist
tirzepatide
66
() are slow, undulating waves in smooth muscle RMP
slow waves
67
slow waves appear to be caused by complex interactions between smooth muscle cells and (1), which act as (2)
1. interstitial cells of Cajal
2. electrical pacemakers
68
true action potentials of GI tract smooth muscles
spike potentials
69
spike potentials are caused by opening of (), which open and close more slowly compared to rapid Na+ channels
calcium-sodium channels
70
slow waves (do/do not) cause Ca2+ entry
do not
71
spike potentials are generated at () of slow waves; cause significant quantities of Ca2+ to enter smooth muscle cell
peaks
72
muscle layers of the GI tract act as (1) due to being electrically coupled via large numbers of (2)
1. syncytium
2. gap junctions
73
technical term for swallowing
deglutition
74
swallowing is controlled by the ff nerves
1. vagus nerve - esophagus
2. glossopharyngeal nerve - tongue and pharynx
3. trigeminal nerve - soft palate
75
3 phases of swallowing
1. buccal (oral) phase
2. pharyngeal phase
3. esophageal phase
76
the pharyngeal and esophageal phases of swallowing are (voluntary/involuntary)
involuntary
77
characteristics of pharyngeal phase of swallowing
1. closed trachea
2. open esophagus
3. fast peristaltic wave triggers by pharynx NS
78
whole pharyngeal phase of swallowing lasts ()
less than 2 seconds
79
2 movements of esophageal phase of swallowing
primary and secondary peristalsis
80
continuation of peristaltic wave from pharynx in esophageal phase
primary peristalsis
81
secondary peristalsis in the esophageal phase occurs if ()
primary peristalsis fails to move all bolus into stomach
82
secondary peristalsis is triggered by (1); continues until (2)
1. distension of esophagus
2. all bolus enters stomach
83
the lower esophageal sphincter (LES) is also called the ()
gastroesophageal sphincter
84
normally, the LES remains ()
tonically constricted
85
receptive relaxation in the LES occurs () to facilitates easy propulsion of food into stomach
ahead of peristalsis
86
the esophagus is lined with (), which is resistant to abrasion and similar to skin
squamous epithelium
87
where 2 different types of epithelium meet at the gastroesophageal junction
squamocolumnar junction
88
mucosa consists of () epithelium, specialized for absorption
gastric and intestinal
89
2 mechanisms that prevent esophageal reflux
1. tonic constriction of LES
2. valve-like mechanism of a short portion of the esophagus that slightly extends into stomach
90
increased () seals the valve-like section of the esophagus closed to prevent esophageal reflux
intra-abdominal pressure
91
gastroesophageal reflux disease (GERD) is caused by (1) LES, causing (2)
1. weak, incompetent open
2. reflux
92
frequent presence of (1) in esophagus due to GERD turns squamous epithelium into (2), thus increasing risk of (3)
1. stomach acid
2. mucosa
3. cancer
93
condition that results from failure of LES to relax during swallowing
achalasia (megaesophagus)
94
achalasia is characterized by ()
1. dilation of esophageal body
2. bird's beak
95
why does LES remain contracted in achalasia
damage to neural network in lower 2/3 of esophagus prevents myenteric plexus from sending signal for receptive relaxation
96
treatment options for achalasia
1. balloon angioplasty to stretch bird's beak
2. antipasmodic drugs
97
3 anatomic division of the stomach
1. fundus
2. body
3. antrum
98
thin-walled stomach division consisting of fundus and proximal portion of body
orad region
99
thick-walled stomach division consisting of distal portion of body and antrum
caudad region
100
caudad stomach region generates stronger contractions for ()
mixing stomach contents
101
receptive relaxation in the stomach results in ()
1. reduced pressure
2. increased orad stomach volume
102
receptive relaxation in the stomach is caused by ()
vagovagal reflex
103
neurotransmitter released in vagovagal reflex
vasoactive intestinal peptide (VIP)
104
() completely eliminates motor and sensory components of receptive relaxation
vagotomy
105
3 parts of the small intestine
1. duodenum
2. jejunum
3. ileum
106
the jejunum contains ()
plicae circulares
107
movement in small intestine that causes food to move forward along GI tract
propulsive movement (peristalsis)
108
movement in small intestine that keeps intestinal contents thoroughly mixed at all times
mixing movements (segmentation)
109
parts of the large intestine
1. ascending colon
2. transverse colon
3. descending colon
4. sigmoid colon
110
the rectum constitutes the lase () of the GI tract
15 cm (6 in)
111
expandable organ for temporary storage of feces
rectum
112
last portion of the rectum
anal canal
113
the anal canal contains small longitudinal folds called ()
anal columns
114
the anus is also called the ()
anal orifice
115
exit of anal canal; has keratinized, epidermis-like skin
anus
116
circular muscle layers of muscularis externa in anus; made up of smooth muscle -> involuntary
internal anal sphincter
117
encircles distal portion of anal canal; made up of a ring of voluntary skeletal muscle
external anal sphincter
118
the weak intrinsic reflex in defecation is triggered by ()
rectal wall distension due to entry of fecal matter
119
in the intrinsic reflex of defecation, signals from myenteric plexus result in ()
1. peristaltic waves that force feces into anus
2. relaxation of internal anal sphincter
120
converts weak intrinsic reflex to powerful process of defecation
parasympathetic defecation reflex
121
purposely activates defecation reflexes by increasing intra-abdominal pressure and forcing fecal matter into rectum
valsalva maneuver
122
reflexes initiated by the Valsalva maneuver are (more/less) effective that reflexes that arise naturally
less
123
type of epithelium found in stomach, intestine, and gallbladder lining
simple columnar epithelium
124
main function of simple columnar epithelium
absorption, secretion, protection
125
type of epithelium found in glands, ducts, portion of kidney tubules, and thyroid gland
simple cuboidal epithelium
126
type of epithelium found on skin surface, lining of mouth, throat, esophagus, anus, and vagina
stratified squamous epithelium
127
main function of stratified squamous epithelium
provides physical protection against abrasion, pathogens, and chemical attack
128
most important organ for digestion of proteins
pancreas
129
interface between stomach antrum and duodenum
pylorus
130
Histamine, released by (1) is a strong stimulator for (2)
1. enterochromaffin-like (ECL) cells
2. acid secretion
131
to increase acid secretion, histamine stimulates (1), which release HCl and (2)
1. parietal cells
2. intrinsic factor
132
oxyntic means ()
acid-forming
133
() cells are found all over the stomach (both in oxyntic and pyloric gland)
mucus
134
the oxyntic gland consists of:
1. mucus neck cells -> mucus
2. chief cells -> pepsinogen
3. parietal cells -> HCl and intrinsic factor
135
chief cells are innermost cells; secreted pepsinogen passes by parietal cells, allowing pepsinogen to be ()
activated by HCl (from parietal cells)
136
pepsinogen is activated by contact with HCl to form ()
active pepsin
137
pepsin has no proteolytic activity above a pH of about ()
5
138
optimum pH range for pepsin activity
1.8 to 3.5
139
intrinsic factor is essential for the () in the ileum
absorption of vitamin B12
140
in patients with (), acid-producing parietal cells of the stomach are frequently destroyed
chronic gastritis
141
lack of stomach acid secretion
achlorhydria
142
results from the failure if red blood cell maturation due to the absence of vitamin B12 stimulation in the bone marrow
pernicious anemia
143
phases of gastric secretion
1. cephalic
2. gastric
3. intestinal
144
gastric secretion phase that occurs even before food enters the stomach, especially while it is being eaten
cephalic phase
145
during the cephalic phase of gastric secretion, neurogenic signals from the cerebral cortex and appetite centers (amygdala and hypothalamus) are transmitted through the () to the stomach
vagus nerves
146
the cephalic phase of gastric secretion normally accounts for about ()% of gastric secretion associated with eating a meal
30
147
gastric secretion phase in which multiple mechanisms cause secretion of gastric juice for several hours while food remains in the stomach
gastric phase
148
the gastric phase of secretion accounts for about ()% of the total gastric secretion associated with eating a meal
60
149
gastric secretion phase wherein presence of food in the upper portion of the small intestine (esp in duodenum) will continue to cause stomach secretion of small amounts of gastric juice
intestinal phase
150
continued secretion of gastric juice during the intestinal phase is partly due to ()
small amounts of gastrin released by the duodenal mucosa
151
the intestinal phase of secretion accounts for about ()% of the total gastric secretion associated with eating a meal
10
152
to neutralize gastric juice, presence of acid in the small intestine liberates (1) from the intestinal mucosa, which promotes rapid secretion of pancreatic juice containing a high concentration of (2)
1. secretin
2. sodium bicarbonate
153
an excoriated area of stomach or intestinal mucosa caused principally by the digestive action of gastric juice or upper small intestinal secretions
peptic ulcer (disease)
154
peptic ulcers are most frequent along the (1); aka (2)
1. lesser curvature of the antral end of the stomach
2. duodenal ulcer
155
gastric ulcers can be classified into:
1. ulcers in the cardia
2. marginal ulcers
156
ulcers in the cardia are due to ()
reflux of gastric juice
157
marginal ulcers are due to ()
surgical openings (e.g. gastrojejunostomy)
158
usual cause of peptic ulceration is an imbalance between
1. gastric juice secretion rate (H+, pepsin) -> destructive
2. degree of protection offered by gastroduodenal mucosal barrier and neutralization of gastric acid (by HCO3- in duodenal juice) -> protective
159
NSAIDs (non-steroidal anti-inflammatory drugs) work by inhibiting (1); decrease in 1 results in less inhibition of acid secretion in stomach, so NSAIDs should be taken (before/after) eating a meal
1. prostaglandins
2. after
160
common damaging factors involved in development of peptic ulcer disease
1. smoking
2. alcohol
3. consumption of aspirin and other NSAIDs
161
at least 75% of people with peptic ulcers have chronic infection of the terminal portions of the gastric mucosa and initial portions of the duodenal mucosa, most often caused by the bacterium ()
Heliobacter pylori
162
action of H. pylori infection
1. physically burrows through mucosal barrier
2. releases ammonium that liquifies the barrier and stimulates the secretion of HCl
163
treatment options for peptic ulcer disease
1. antibiotics
2. acid-suppressant drugs
3. surgery
164
acid-suppressant drug that works as an antagonist at histamine H2 receptors
cimetidine
165
acid-suppressant drug that works as a blocker of H+-K+ ATPase (proton inhibitor, PPI)
omeprazole
166
2 major kinds of cells in pancreas
1. endocrine cells (of pancreatic islets
2. exocrine cells
167
endocrine cells of the pancreatic islets secrete () into the bloodstream
insulin and glucagon
168
2 major kinds of exocrine cells
1. acinar cells
2. ductal cells
169
pancreatic exocrine cells secrete ()
pancreatic juice
170
() stimulate pancreatic acinar cells
ACh and CCK
171
(1) stimulates secretion of large quantities of water solution of NaCO3- by (2)
1. secretin
2. ductal cells
172
main function of small intestine is:
completed digestion of food
173
main function of large intestines
only absorbtion
174
salivary or pancreatic enzyme involved in initial digestion of starch
alpha-amylase
175
after initial digestion by alpha-amylase, other enzymes, found at the (), further digest alpha-amylase products into glucose/galactose
intestinal brush-border
176
lactose intolerance is caused by (1), and results in (2)
1. lactase deficiency
2. osmotic diarrhea
177
osmotic diarrhea is caused by the presence of an () -> attracts increased amount of water
inabsorbable osmole
178
carbohydrates are absorbed in the form of ()
monosaccharides
179
3 monosaccharides absorbed by the gastrointestinal tract
glucose, galactose, fructose
180
glucose and galactose are transported into the small intestine epithelial cells by ()
Na+ co-transport mechanism
181
fructose is absorbed into small intestine epithelial cells by ()
facilitated diffusion
182
blood (containing monosaccharides) from the digestive system must first pass through the () before returning to the heart
liver
183
summary of portal circulation
artery -> capillary -> portal vein -> capillary -> vein
184
protein digestion first starts is (1), but majorly occurs in (2)
1. stomach
2. small intestine (via pancreatic enzymes)
185
gastrointestinal protease that hydrolyzes interior peptide bonds
endopeptidase
186
types of endopeptidases
1. pepsin
2. trypsin
3. chymotrypsin
4. elastase
187
gastrointestinal protease that hydrolyzes from the C-terminal ends
exopeptidases
188
examples of exopeptidases
carboxypeptidase A and B
189
activator for all other proenzymes (including itself) in the small enzyme
trypsin
190
activator of trypsinogen to produce trypsin; located in the brush border
enterokinase
191
"absorbable" forms of proteins
1. amino acids
2. dipeptides
3. tripeptides
192
products of protein digestion by pepsin in stomach lumen
amino acids, oligopeptides
193
L-amino acids are absorbed into small intestine epithelial cells via ()
Na+ - amino acid transporter
194
dipeptides and tripeptides are commonly absorbed through (1); afterward they are hydrolyzed to amino acids by (2)
1. H+ dependent cotransporters
2. cytosolic peptidases
195
3 types of dietary lipids absorbed by GI tract
triglycerides, cholesterol, phospholipids
196
first step of lipid digestion; physically breaking fat globules into small sizes so that water-soluble digestive enzymes can act on the globule surfaces
emulsification
197
emulsification in the duodenum occurs due to the influence of (1), which contains (2)
1. bile juice
2. bile salts, lecithin
198
bile acids conjugated with amino acids (glycine or taurine); amphiphatic
bile salts
199
triglycerides are broken down into () by the action of lingual, gastric, and pancreatic lipases
monoglyceride, 2 fatty acids
200
cholesterol ester is broken down into (1), by the action of (2)
1. cholesterol, fatty acid
2. cholesterol ester hydrolase
201
phospholipids are broken down into (1) by the action of (2)
1. lysolecithin, fatty acid
2. phospholipase A2
202
major site of intestinal Na+ absorption
jejunum
203
secretion of HCO3 neutralizes the acidity generated by ()
bacteria in the gut
204
absorbed fluid in small intestine epithelial cell is always ()
isosmotic
205
Na+ absorption through Na+ channels in colon epithelial cells can be facilitated by ()
aldosterone
206
aldosterone is secreted from adrenal gland in response to ()
blood volume deficiency
207
absorbed Na+ can help with blood volume deficiency because
Na+ (extruded by NaK ATPase) in blood holds onto water and prevents it from entering cell; water stays in blood and increases blood volume
208
tight junctions between epithelial cells of the colon are much tighter than those of the jejunum and ileum, which prevents ()
significant amounts of back-diffusion of Na+ ions
209
bacteria in the colon is capable of digesting small amounts of () -> provides a few extra calories of extra nutrition for the body
cellulose
210
essential substance for blood clotting
vitamin K
211
substance required for maturation of red blood cells
vitamin B12
212
intestinal Cl- channels are usually (open/closed), but can be opened by (2)
1. closed
2. cAMP-dependent signalling pathway
213
cholera toxin enters epithelial cells to cause () of G_alpha_S protein -> results in loss of GTPase activity -> adenylyl cyclase is constantly active
ADP ribosylation
214
due to action of cholera toxin, (1) builds up in GI tract lumen -> attracts a lot of water via osmosis -> form of (2)
1. Cl-
2. secretory diarrhea
215
common causes of diarrhea
1. enteritis
2. psychogenic
3. lactose intolerance
216
inflammation in intestinal tract, usually caused by bacteria or virus -> causes secretory diarrhea
enteritis
217
only problem of diarrhea
dehydration
218
cause of diarrhea that accompanies periods of nervous tension -> caused by excessive stimulation of parasympathetic NS (increases motility and secretion)
psychogenic
219
gross anatomy of the liver: (1) lobes separated along the line of the (2)
1. left and right
2. falciform ligament
220
functional anatomy of the liver: (1) sectors and (2) segments; separated by (3)
1. 4
2. 8
3. blood supply or biliary drainage
221
the liver has dual blood supply: (1)% of blood supply is arterial blood from the hepatic artery, while (2)% is venous blood from hepatic portal vein
1. 30
2. 70
222
arterial blood supply from hepatic artery provides (1)% of liver's oxygen supply; venous blood from portal vein delivers remaining (2)%
1. 60
2. 40
223
delivers blood from GI tract and spleen to liver; not a true vein and is rich in nutrients
portal vein
224
why is the portal vein not a true vein
it doesn't deliver blood back to heart
225
hepatocellular carcinoma (HCC) takes is blood supply almost completely from the ()
hepatic artery
226
the portal triad runs along the ()
porta hepatis
227
the portal triad consists of ()
1. portal vein
2. hepatic artery
3. bile duct
228
basic fundamental units of the liver
liver lobules
229
each liver lobe is divided by () into about 100k liver lobules about 1mm diameter each
connective tissue
230
liver lobules are () in cross section
hexagonal
231
blood from portal vein and hepatic artery flows to central vein through ()
sinusoid
232
() in the liver (histology) absorb many substances from from plasma
hepatocytes
233
bile flows into the (), which opposes the flow in the sinusoid
bile canaliculi
234
the space in which fibers (collagen) accumulate as a consequence of liver cirrhosis
space of Disse
235
final outcome of almost all liver diseases
liver cirrhosis
236
like macrophages -> immune cells in the liver
Kupffer cells
237
physiologic functional unit of the liver
liver acini
238
liver acini are divided into 3 zones according to distance from blood supply:
1. periportal zone (closest)
2. intermediate zone
3. perivenular zone (farthest)
239
advantage of viewing the acinus as a functional unit
helps to explain the patterns and zonal property of many diseases
240
mesenchymal cell located in the space of Disse; involved in production of collagen and cell matrix when activated
hepatic stellate cell
241
other cells in the liver include:
endothelial cells, bile ductular cells
242
term for vomiting blood
hematemesis
243
abdominal cavity accumulates fluid (water)
ascites
244
liver cirrhosis causes portal vein hypertension because ()
hardening of liver narrows porta hepatis
245
portal vein hypertension causes (1) to distal vein, leading to (2) formation
1. venous blood reflux
2. varices
246
liver maintains blood glucose level -> () function
glucose buffer
247
fatty acids hydrolyzed from dietary fat are important (1) and (2) of the cell
1. energy sources
2. structural components
248
() are synthesized by the liver and intestine -> play a key role in transport of liquid
apolipoproteins
249
excess glucose in the liver is converted to (1) and stored as (2)
1. fatty acid
2. adipose tissue
250
lipoprotein that contains high concentrations of triglycerides and moderate concentrations of both cholesterol and phospholipids
very low density lipoprotein (VLDL)
251
VLDL from which a share of the triglycerides has been removed -> concentrations of cholesterol and phospholipids are increased
intermediate-density lipoprotein (IDL)
252
derived from IDLs by the removal of almost all the triglycerides, leaving an especially high concentration of cholesterol and a moderately high concentration of phospholipids
low-density lipoprotein (LDL)
253
contain a high concentration of protein (about 50 percent) but much smaller concentrations of cholesterol and phospholipids.
high-density liproprotein (HDL)
254
ultra-low-density lipoprotein formed in intestinal mucosa that goes to the liver
chylomicron
255
transported triglycerides and cholesterol are repackaged into () in the liver and delivered to other organs
VLDL
256
HDL facilitates a process called () -> cholesterol in plasma membrane of peripheral cells is transported to liver
reverse cholesterol transport
257
increased HDL level may reduce the risk of ()
atherosclerosis
258
binding protein in the blood -> regulates oncotic pressure of blood; produced from liver
albumin
259
(increased/decreased) albumin level is a strong indicator of liver cirrhosis -> new albumin level results in ascites and peripheral edema
decreased
260
the phase 1 pathway in the liver for the inactivation of various substances absorbs (1); mediated by (2) -> most reactions are (3)
1. fat-soluble toxins
2. cytochrome p450
3. oxidations
261
the phase 2 pathway in the liver for the inactivation of various substances releases (1); reactions involve (2) to result in a (3)
1. water-soluble waste
2. conjugation of drug metabolites
3. water-soluble conjugate
262
the biliary system consists of ()
1. bile duct
2. gallbladder
263
2 components of bile duct
intrahepatic, extrahepatic ducts
264
the intrahepatic duct is composed of
left and right hepatic ducts
265
the extrahepatic duct consists of
common hepatic duct, common bile duct
266
pear-shaped muscular sac that stores and concentrates bile prior to excretion
gallbladder
267
contraction of the gallbladder is due to () stimulation
cholecystokinin (CCK)
268
functions of bile juice
1. intestinal lipid digestion
2. maintenance of cholesterol homeostasis
3. excretion of substances
269
the function of () is to make lipids stable with forming micelle -> lipid becomes soluble in water
bile salt
270
results from supersaturation (increased cholesterol, decreased bile salts)
cholesterol stone
