digestive system part 3 Flashcards by Julie DiMuccio

what percentage of the US is affected by peptic ulcers

10%

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what is a peptic ulcer due to

gastric juice (HCL and Pepsin) digesting the mucosal lining of GI tract

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peptic ulcers is 8-% in duodenum of small intestine and the rest in

stomach and esophagus

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peptic ulcers are due to infection with

helibacter pylori

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what does helibacter pylori do

destroys mucus layer

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what are peptic ulcers linked do

gastritis and gastric cancer

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what are contributing factors for peptic ulcers

stress
diet
aspirin
NSAIDs
spcy food
coffee
smoking
alcohol-> stomach acid secretions

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who and when cultured h. pylori from stomach biopsies consumed solution and developed gastric inflammation. cured by ABX

1982 and dr barry marshall

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symptoms of PUD

gnawing epigastric pain, straight through to back
occurs 1-3 hours after eat, relieved by food
loss of appetite
nausea
frequent burping
weight loss

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in pud, stomach wall perforation-> ______->_______

peritonitis-> massive hemorrhage

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Dx for PUD

urea breath test, stool antigen and PCR test, upper endoscopy

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treatment for PUD

2 week course ABX (clarithromycin, metronidazole, amoxicillin, tetracycline)-> kill bacteria, promote ulcer healing, precents recurrence

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active ulcers block what

H2 (histamine) receptors inhibit HCL secretion by blocking histamine effects

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PPI is

omeoprazole- prilosec, protonix

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is PUD is due to long term NSAID’s what happens

block HCL secretion with proton pump inhibitors or use H2 receptor blockers

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you eradicate PUD via

ABX and antacids

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how much gastric juiced is produced each day

2-3 L

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amount of gastric juice produced is due to

type of food entering stomach

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how much gastric juice is secreted due to a typical meal

700 ml

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stomach secretion regulation is controlled by

negative feedback loops

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what is stomach secretions regulation affected by

nervous and hormonal mechanisms

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what do neural mechanisms (in stomach secretion regulation) involve

reflexes in medulla, local reflexes in ENS and higher brain centers

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what chemicals messengers are included in stomach secretion regulation

hormones (gastrin, secretin, CCK)

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what do chemical messengers do

increase, decrease gastric secretion and stimulates pancreatic secretion

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stomach secretion regulation has 3 phases which are?

cephalic gastric intestinal

what happens during cephalic phase in stomach secretion regulation

increases stomach secretions in anticipation of incoming food taste and smell of food, chewing and swallowing, pleasant thoughts of food

what happens in gastric phase

most stimulation occurs, distension of stomach stimulates mechanoreceptors

what happens in intestinal phase

stomach secretion decreases (secretin, CCK due to chyme into duodenum)

process of stomach filling

food enters stomach-> rugae flatten and stomach volume increases up to 20 fold

what does stomach expansion accomodate

large amount of food with little increased pressure until stomach is near max capacity

ingested food mixed with stomach gland secretions forms

chyme

what do mixing waves include

contractions that occur every 20 seconds from stomach body to pyloric sphincter

what occurs during peristaltic waves

occurs less frequently, more powerful and force chyme near stomach periphery to pyloric sphincter

what percent of waves and mixing? and peristalitic

80 mixing 20 peri

the amount of time food remains in stomach depends on

type/ volume of food

liquids pass through within how long

minutes

in stomach emptying complete meal in how long

3-4 hours

what do peristaltic contractions force

small amount of chyme through pyloric opening into dueodenum

peristalctic contractions are also called

pyloric pump

increased motility->

increased empyting

when do hunger pangs begin

12-24 hours after meal

in hunger pangs you have uncomfortable what

sensation due to low BS

without ingestine, reaches max intensity in how long

3-4 days and then weaken

what happens when stomach empty too fast

acidic gastric contents into dudenum and damage lining

what happens when stomach empty too slow

less absorption in intestine and stomach wall damaged by acid

stimulus for motility and secretion=

distension of stomach

increased stomach motility increases what

stomach empyting

in duedenum the CCK inhibits what

gastric motility which reduces rate of stomach empyting

what has the fastes clearance time from stomach in 1 hour

carbohydrates

what takes up to 6 hours to clear from stomach

lipids and proteins

what is protective mechanism against ingestin of toxic or harmful substances

vomiting

vomiting is due to

GI tract irritation

APS travel through what to the vomiting center in medulla

vagus nerves and spinal visceral nerves

reflex initated causing: (7)

1. deep breath taken 2. hyoid bone and larynx elevated, opening upper esophageal sphincter 3. opening of larynx closed 4. soft palate is elevated, closing naso and oropharynx connection 5. diaphragm and abdominal muscles are forcefully contracted, strongly compressing stomach and increasing intragastric pressure 6. LES is relaxed 7. gastric contents are forces out of stomach, through esophagus and oral cavity and out

3 parts of small intestine

duodenum jejunum ileum

what cells produce mucus

goblet cells

length of small intestine

6m or 20 feet

length of duodenum

25 cm

length of jejunum

2.5 m

length of ileum

3.5 m

accesory glands with small intestine

liver gallbladder pancrease

what does the pancreas empty secretions into

duodenum

the small intestine is the site of

digestion and absorption prior to large intestine

there are 3 strucutural modifications which increase surface area , which are

1. circular folds 2. villi 3. microvilli

what are mucosa and submucosa folds that run perpendicular to long axis of GI tract

circular folds

what are fingerlike projections of mucosa, covered by simple columnar epithelium, that contains lacteal

villi

what are cytoplasmic extensions that increase surface area

microvilli

as progress through small intestine what happens

decreased diameter, thickness of wall, # of circular folds, and # of villi

absorptive cells produce

digestive enzymes and absorb digested food

goblet cells produce

protective mucus

grandular cells do what

protext intestine from bacteria

endocrine cells produce what hormones

secretin and CCK

shortest part of small intestine

duodenum

the duodenum curves around what

pancreatic head

the secretions enter duodenum from

liver and pancreas

duodenal (brunners) gland=

mucous glands in submucosa

what has decreased diameter, thickeness of wal and # of circular folds and # of villi

jejunum

what contains peyer's patch

ileium

ileocecal valce goes from

ileum to cecum (1 way)

small intestine movement has

mixing of chyme and slow propulsion down GI tract

what mixes contents in small intestine

segmentation

what propels intestinal contents in GI tract

peristaltic contractions

contractions move at a rate of

1 cm/ min

3-5 hours chyme from

phylorous to ileocecal junction