Gastric secretion Flashcards

(43 cards)

1
Q

What does the stomach secrete (5) ?

A
H+
Pepsinogen
Mucus
HCO3-
Intrinsic factor (IF)
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2
Q

What part of the stomach secretes the most acid, pepsinogen and IF?

A

Body

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3
Q

What does antrum do?

A

Secrete somatostain, gastrin and holds food

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4
Q

What is the structure of the gastric gland?

A

Gastric pits which open into necks and leads to base, deep invaginations in the epithelial layer

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5
Q

What 6 cells make up gastric pits?

A

Parietal (oxyntic) cells in the base and neck: secrete HCl and intrinsic factor (for vitamin B12 absorption in the ileum)

Chief (peptic) cells in the base and neck: secrete pepsinogen

Endocrine cells in the base: secrete regulators such as gastrin, somatostatin via the bloodstream

Mucous neck cells: secrete mucus

Superficial epithelial cells in the pit and on the surface lining: secrete mucus along with HCO3- ions

Basal regenerative cells

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6
Q

What cells secrete IF?

A

Parietal

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7
Q

What secretions are there in an unstimulated stomach, what cells from?

A

Non-parietal surface epithelial cells

Juice is rich in Na+, Cl-, and is isotonic.

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8
Q

What secretions are there in a stimulated stomach, what cells from?

A

Secreted by parietal cells

Concentrated HCl.

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9
Q

What factor determines which juice is secreted by the stomach, how does it vary in a stimulated vs unstimulated stomach?

A

Secretory rate

When stimulates the secretory rate is much faster

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10
Q

What do parietal tubovesicles contain?

A

H+/K+ATPase.

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11
Q

What does stimulation of parietal cell trigger tubovesicles to do?

A

Merge into the apical membrane

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12
Q

How does the shape of the parietal cell membrane change when stimulated?

A

Stimulated parietal cells posses deep invaginations of apical membrane called secretory canaliculus.

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13
Q

How does the surface area of the parietal cell change?

A

When stimulated H+/K+ATPase containing tubovesicles merge with the membrane and the number of canaliculi ride

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14
Q

Why does the H+/K+ATPase have no effect on cytoplasm pH when in vesicles?

A

Vesicle is arranged so that ATPase is ‘inside out’ (H+ pumped in K+ pumped out)

K+ cannot recycle by entering the vesicle (vesicle impermeable to K+)

[K+] in the vesicle falls, low K+ availability within the vesicle ‘brakes’ the activity of the ATPase.

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15
Q

Describe the mechanism and transporters behind secretion of H+ and Cl-

A

Intracellular CA catalyses hydration of CO2 to yield H+ and HCO3-

H+/K+ATPase pumps H+ ions into the lumen in exchange for K+

K+ recycles out of the cell through apical K+ channels

HCO3- exits across basolateral on Cl-/HCO3- exchanger

Cl- ions diffuse through apical channels to join H+ ions in the lumen.

Water follows by osmosis

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16
Q

What are 3 ways of regulating gastric acid secretion?

A

Neurocrine: ACh from vagus binds M3 and stimulate GRP (gastrin releasing peptide) and histamine release

Endocrine: gastrin (in response to GRP from vagus nerve or AA in lumen) binds CCKB receptors, triggers IP3 cascade

Paracrine: histamine from ECL cells, binds H2 receptors (adenylyl cyclase cascade)

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17
Q

What underpins all the mechanisms behind activating parietal cells?

A

Kinase activation leads to cytoskeletal rearrangement via phosphorylation which leads to tubulovesicle insertion

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18
Q

What is the common mediator hypothesis?

A

ACh and gastrin bind M3 and CCKB receptors on ECL (enterochromaffin-like cells) cells to induce histamine release, as well are their role on parietal cells.

19
Q

Why is histamine action arguably the most important factor for affecting parietal cell secretions?

A

It is unregulated by ACh and gastrin

20
Q

What are 3 phases of gastric acid secretion?

A

Cephalic: ACh and GRP release after vagal stimulation

Gastric: distension initiates vagovagal reflex (triggers acid & histamine secretion) and protein digestion products trigger gastrin release

Intestinal: protein digestion products stimulate duodenal G cells

21
Q

What do endocrine D cells do?

A

Release somatostatin which reduces gastric acid secretion

22
Q

What do endocrine D cells do?

A

Release somatostatin which reduces gastric acid secretion

23
Q

What hormones does secretin stimulate and inhibit?

A

Stimulates somatostatin

Inhibits gastrin

24
Q

What do chief cells secrete?

25
How are pepsinogens activated?
Activated by N-terminal truncation, spontaneous activation occurs in acidic lumen. Low pH is also required for optimal activity of pepsin.
26
What % of ingested protein do pepsins digest?
20%
27
What is pepsin release stimulated by (&pathway)?
ACh, via M3 receptors, Ca2+ signalling Gastrin and CCK, via CCKB receptor, Ca2+signalling Secretin, via adenylyl cyclase-coupled receptors, cAMP signalling
28
What is mucin?
Large glycoprotein with high viscosity
29
Why is it essential to have a protective mucous layer?
Gel is a barrier to H+ ion diffusion from the acidic bulk solution in the lumen Protects the gastric mucosa
30
What cells secrete HCO3-?
Surface cells
31
How does mucous move out of the pits?
Secretion of gel raises the hydrostatic pressure inside the gastric pits, this forces the secretions upwards in the pit.
32
How does pressure in pit act as a protective mechanism?
Encourages the acid to bore through the mucous without lateral spread
33
What is the stream of H+ exiting the pit termed as?
Viscous finger
34
What induces mucous secretions?
ACh induced Ca2+ signalling
35
What prevents autodigestion of stomach mucosa from acidic contents?
Mucous cells produce mucus which is barrier to H+ diffusion Surface epithelial cells secrete HCO3- to neutralise H+ which penetrates mucous lining
36
What are the causes of peptic ulcers?
Diet e.g. spicy food, alcohol H pylori Excess acid from hypo/hyperglycaemia or Zollinger Ellison NSAID drugs directly damage mucosa
37
What is the secondary messenger for histamine induced acid release?
cAMP
38
What action does CCK have on gastric acid secretion?
Inhibits it
39
What does ranitidine inhibit?
H2 receptors - acid secretion by histamine action
40
What does omeprazole inhibit?
H+/K+ATPase - acid secretion
41
What is the common mediator for stimulation of gastric acid secretion?
Histamine
42
What is the main inhibitor of gastric acid secretion?
Somatostatin (secretin also does by upregulating it) CCK? (if only option)
43
What drug most completely suppresses gastric acid secretion?
Omeprazole