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Systems 1 > Gastric Motility and secretion > Flashcards

Gastric Motility and secretion Flashcards

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1
Q

Gastric glands in the pyloric area consists of endocrine
cells that do what?

A

secrete gastrin and somatostatin

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2
Q

Receptive reflex is mediated by what?

A

Afferent and efferent limbs of vagus (vasovagal reflex).

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3
Q

Neurotransmitters involved in the receptive relaxation are what?

A

Vasoactive intestinal peptide and nitric oxide

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4
Q

Intrinsic innervation of stomach is via the

A

ENS

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5
Q

Myenteric neurons of the stomach provide

A

coordination of gastric motility

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6
Q

Interstitial cells of Cajal establish the

A

rate or frequency of contractions and setup the BER

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7
Q

Mechanoreceptors trigger activation and SM relaxation
occurs through

A

VIP and NO

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8
Q

Neural and hormonal input can affect the frequency of

A

spike potentials and increase contractile force

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9
Q

During fasting, periodic gastric contractions can
occur called

A

migrating myoelectric complexes

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10
Q

Migrating myoelectric complexes are mediated by what?

A

Motilin

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11
Q

What can increase the frequencies of spike potentials?

A

Parasympathetics, gastrin and motilin

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12
Q

What can decrease the frequency of spike potentials?

A

Sympathetics, secretin and GIP

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13
Q

During fed state, there are what type of contractions?

A

Circumferential for anterograde and retrograde movement

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14
Q

Emptying of fats is mediated by what?

A

CCK

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15
Q

Emptying of H+ ions is mediated by what?

A

Reflexes of the ENS

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16
Q

Dense meal will do what to gastric emptying?

A

Slow it down to avoid saturation of absorptive mechanisms in the remaining GI

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17
Q

IF has a receptor in the ileum called

A

cubulin (allows the uptake of Vit B12)

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18
Q

Amylin is co secreted with

A

insulin

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19
Q

Amylin decreases

A

pancreatic exocrine and bile acid secretions

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20
Q

Amylin stimulates

A

satiety via circumventricular organs

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21
Q

Amylin slows gastric emptying plus glucagon secretion reducing the

A

post-prandial plasma glucose spike

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22
Q

What is pramlintide?

A

Amylin mimetic, helps control glucose levels but is not used as first line therapy

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23
Q

What receptors activate the chemoreceptor trigger zone?

A

D2, 5-HTR3, NK-1 receptors

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24
Q

What does zofran do?

A

Blocks the serotonin receptor of the chemoreceptor trigger zone and therefore block emesis

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25
What events precede emesis?
- Inhibition of respiration, airway closure and diaphragm descent - Increased salivation for protection - Inhibition of gastric motility and inhibition of LES< UES and pyloric motor activities
26
Retropulsion can occur from mid small bowel through to the stomach via the
pyloric sphincter
27
What are the 4 major components of gastric juice?
- HCl - Pepsinogen - Intrinsic factor - Mucus
28
Parietal cells release what?
HCl and IF
29
Chief cells release what?
Pepsinogen
30
Pepsinogen requires H+ in order to
be converted to pepsin, its active form
31
Antrum of stomach contains
pyloric glands (that contain G cells and mucus cells)
32
G cells release what?
gastrin (goes into blood, not stomach acid)
33
Parietal cell- apical membrane contains what pumps?
H+/K+ ATPase pumps
34
The LES helps to prevent what?
Acid from entering the esophagus
35
Mucus is cytoprotective, and what will help with this?
Prostaglandins
36
What blocks prostaglandin sproduction?
NSAIDs, aspirin and ethanol
37
Stretch receptors will activate G cells to
release gastrin
38
Stretch receptors can also activate the ENS to stimulate
oxyntic glands to release HCl and pepsin
39
Long reflexes (vagovagal reflex) can receive sensory information from
stretch receptors and oxyntic glands to stimulate dorsal vagal complex and release GRP to stimulate G cells to release gastrin
40
Pepsinogen can be released from short and long reflex to ensure what?
That pepsinogen is only released when H+ ions increase in the lumen of the stomach
41
Stimulation of vagus will cause for the release of
GRP and ach
42
GRP will stimulate G cells to
release gastrin to go into blood
43
Ach can directly activate the parietal cell via what receptor?
M3
44
Gastrin release will also positively stimulate the ECL cell to cause the release of what?
Histamine
45
Histamine and gastrin will stimulate the apical expression of
H+/K+ ATPase pumps (Causes release of H+ and Cl- into lumen. K+ will enter cell)
46
Somatostatin is released from the antral D cells and can inhibit
gastrin release from G cells as well as H+ release from the parietal cell
47
Drugs, such as histamine receptor 2 antagonists and proton-pump inhibitors (PPIs) can
block the release of H+ into the lumen
48
Histamine signals through G(s) and activated what to generate cAMP?
Adenylyl cyclase
49
Ach activated M3 receptors to increase what?
IP3 and DAG
50
Gastrin activates CCK(B) receptors to do what?
Increase intracellular calcium
51
Increases in calcium will promote what?
Vesicle exocytosis of the H+/K+ ATPase pumps
52
What are the 3 phases of gastric secretion in response to a meal?
- Cephalic - Gastric - Intestinal
53
What is the cephalic phase of gastric secretion in response to a meal?
* Smell, taste, conditioning will result in an increase in HCl release by vagus either directly or indirectly through gastrin.
54
Describe gastric phase of gastric secretion in response to a meal
* Biggest contributor to HCl secretion (60%). * Stimulus is distension of stomach, small peptides and amino acids. Peptides and amino acids will stimulate gastrin release on the G-cells.
55
Describe intestinal phase of gastric secretion in response to a meal
* Smallest contributor to HCl release (10%). * Mediated by products of protein digestion.
56
What type of pH can inhibit the release of gastrin?
Low pH
57
What are erosions caused by?
Excessive H+ and pepsin on mucosa or loss of protective factors (such as mucus, prostaglandins, mucosal blood flow, growth factors or HCO3-)
58
H. pylori can colonize the gastric mucus, because it contains what enzyme?
Urease
59
What does urease do?
Converts urea to ammonia, which increases pH, so bacteria can colonize
60
Zollinger-Ellison syndrome is typically caused by what?
Pancreatic islet cell adenoma or gastrinoma
61
In Zollinger-Ellison syndrome, gastrin will be released unhindered, because of what?
No negative feedback pathways
62
Zollinger-Ellison syndrome- the increased gastrin will increase H+ release and increase
parietal cell mass (trophic effects)

Systems 1 (35 decks)

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