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Phase 1 Medicine - Riona > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

(108 cards)

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1
Q

What are the 9 sections of the abdomen?

A

R hypochondriac, epigastric, L hypochondriac
R lumbar, umbilical, L lumbar
R iliac, hypogastric, L iliac

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2
Q

In what directions do the 3 oblique muscles of the abdominal wall run?

A

External - downwards oblique
Internal - upwards oblique
Transverse - horizontal

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3
Q

What is the muscle that forms 2 strips running vertically?

A

Rectus abdominis

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4
Q

What do the 3 muscles aponeuorse & converge onto?

A

Linea alba

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5
Q

Where do the oblique fibres pass above the arcuate line?

A

External & half of internal pass in front of rectus abdomens
Transverse & half of internal pass posteriorly
Form rectus sheaf

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6
Q

What is the foregut & what is it innervated by?

A

Mouth to 2nd segment of duodenum

Greater splanchnic nerve T5-9

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7
Q

What is the midgut & what is it innervated by?

A

2nd segment of duodenum to 2/3 along transverse colon

Lesser splanchnic nerve T10-11

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8
Q

What is the hindgut & what is it innervated by?

A

2/3 along transverse colon to rectum

Least splanchnic nerve T12

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9
Q

What are the 2 layers of the peritoneum?

A

Parietal (external)

Visceral (internal)

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10
Q

What does it mean to be a retroperitoneal organ?

A

It is on the outside of the peritoneal cavity

Covered only anterior by peritoneum

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11
Q

Which organs are retroperitoneal?

A 
SAD PUCKER
Suprarenal glands
Aorta/IVC
Duodenum (middle 2 segments)
Pancreas (excluding tail)
Ureter
Colon (ascending & descending)
Kidneys
(o)Oesophagus
Rectum
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12
Q

What is a mesentary?

A

Reflections of peritoneum that attach the intraperitoneal organs to the posterior abdominal wall

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13
Q

Where does the greater omentum attach to?

A

Greater curvature of stomach to the transverse colon

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14
Q

Where does the lesser omentum attach to?

A

Lesser curvature of stomach to liver

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15
Q

How are the greater & lesser sacs connected?

A

Epiploic foramen

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16
Q

What are the sections of the stomach?

A 
Cardia
Fundus
Body
Antrum
Pylorus
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17
Q

What does the location of the sphincter of Oddi depict?

A

Opening of ampulla of Vater

End of foregut

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18
Q

In which region of the duodenum are Brunner’s glands?

A

Superior/1st section

Neutralise chyme from sphincter by secreting high levels of HCO3-

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19
Q

What does the coeliac trunk branch into?

A

Splenic artery > spleen
Left gastric artery > lesser curvature of stomach
Common hepatic artery

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20
Q

What does the splenic artery give rise to?

A

Short gastric artery > fundus

Left gastroepiploic artery > greater curvature of stomach

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21
Q

What does the common hepatic artery give branches of?

A

Gastroduodenal artery > pylorus & proximal part of duodenum
Proper hepatic artery > liver

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22
Q

What does the gastroduodenal artery give rise to?

A

Right gastroepiploic artery > greater curvature of stomach

Superior pancreaticoduodenal artery > pancreas & duodenum

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23
Q

What does the right hepatic artery give rise to?

A

Cystic artery > gallbladder

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24
Q

What is the blood supply of the midgut?

A

Superior mesenteric artery (at L1)

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25
What makes the jejunum different from the ileum?
``` Both intraperitoneal Mainly in upper L not lower R quadrant Thick not thin intestinal wall Longer vasa recta Fewer arcades Red not pink ```
26
Does the jejunum or ileum have Peyer's patches?
Ileum | Patches of lymphatic tissue
27
What are taenia coli?
3 longitudinal muscles which contract to short & widen sections Causes large intestine wall to bunch into haustrations
28
What are the epiploic appendices
Small patches of peritoneum filled with fat along the colon
29
What are the branches of the SMA?
Middle colic artery > transverse colon Right colic artery > ascending colon Ileocolic artery > into ileal & colic arteries Inferior pancreaticoduodenal artery > some of pancreas, ucinate process, duodenum
30
What is the blood supply of the hindgut
Inferior mesenteric artery (at L3)
31
What are the branches of the IMA?
Left colic artery | Sigmoid arteries
32
What does the marginal artery of Drummond do?
Connects middle colic artery to left colic artery - anastomosis
33
Define swallowing
The process by which food/liquid is passed from the oral cavity, through the pharynx & down the oesophagus, to the stomach, whilst simultaneously closing the epiglottis in order to prevent anything going down the trachea
34
What occurs during the oral phase of swallowing?
Voluntary Moistening & mastication Intrinsic muscles of tongue contract to form trough Mylohyoid muscle elevates tongue to roof of mouth to form slope Pressure receptors stimulated, impulses to swallowing centre in medulla
35
What occurs during the pharyngeal phase of swallowing?
Involuntary Impulses send that inhibit respiration, elevate larynx, close epiglottis Tensor palatini tenses soft palate Levator palatini elevates soft palate Closes off nasopharynx Pharyngeal constrictor muscles push bolus down pharynx
36
What occurs during the oesophageal phase of swallowing?
Involuntary Skeletal muscle in upper 1/3rd CNX Smooth muscle in lower 2/3rds CNX Propagation of bolus
37
What is the gag reflex?
Reflex elevation of pharynx
38
What are the sensory and motor limbs of the gag reflex?
Sensory - CNIX | Motor - CNX
39
What are the 3 main salivary glands?
Parotid Submandibular Sublingual
40
What nerve passes through the parotid gland?
Facial
41
What type of saliva does the parotid gland have?
Serous
42
What type of saliva does the submandibular gland have?
Serous & mucous
43
What type of saliva does the sublingual gland have?
Mucous
44
What innervates the submandibular and sublingual salivary glands?
Facial nerve CNVII
45
What are the types of acinar cell?
Serous & mucous Serous - alpha amylase, digests carbs Mucous - mucins, lubrication
46
What do the cells in ducts secrete and reabsorb?
Via ion transport proteins Secrete K+, HCO3- Absorb Na+, Cl-
47
What are the main functions of saliva? (4)
Lubrication Oral hygiene Buffer Digestion
48
Define BMR
Total amount of energy produced her unit time
49
How much fuel is stored in each substance? (3)
Glycogen - 15kg Lipid - 350g Protein - 6kg
50
What are the fat soluble vitamins?
ADEK
51
What is the use of vitamin A?
Cellular growth & differentiation | Production of llymphocytes
52
What is the use of vitamin B12?
Brain development DNA synthesis Formation of RBCs
53
What is the use of vitamin C?
Collagen production Absorption of iron Neurotransmitter synthesis Antioxident
54
What is the use of vitamin D?
Aids absorption of calcium from gut
55
How is vitamin B12 absorbed?
B12 binds with R-protein in mouth R-protein protects B12 from HCl in stomach Protease in duodenum releases B12 from R-protein Intrinsic factor helps B12 be absorbed
56
Where are the vitamins absorbed?
A - jejunum | C, D, K - jejunum & ilium
57
What are the 3 layers of muscle in the stomach? (from superficial to deep)
Longitudinal Circular Oblique
58
What are rugae?
Folds of the stomach wall which increase SA & allow the stomach to expand
59
What do goblet cells secrete?
Mucous
60
What do parietal cells secrete?
Gastric acid | Intrinsic fator
61
What do chief cells secrete?
Pepsinogen
62
What do enterochromaffin-like cells secrete?
Histamine
63
What do D cells secrete?
Somatostatin
64
What do G cells secrete?
Gastrin
65
What stimulates release from the parietal cells?
ACh Gastrin Histmine
66
What stimulates release from chief cells?
ACh | Acid secretion
67
What stimulates release from D cells?
Acid in stomach
68
What is the function of gastrin?
Stimulates gastric acid stimulation
69
What is the function of gastric acid?
Activates pepsin | Kills bacteria
70
Where are the parietal cells in the stomach?
Fundus & body
71
How is gastric acid produced and secreted?
CO2 + H2O > H2CO3 in cytoplasm of parietal cell H2CO3 > H+ + HCO3- HCO3- pumped out in exchange for Cl- in H+ from H2CO3 + OH- > H2O Then dissociates again H+ + OH- H+ actively transported out of cells & K+ actively transported in Converts one ATP > ADP + Pi Cl- & K+ that have been pumped into cell (capillary side) diffuse out of parietal cell into stomach lumen
72
What stimulates release from enterochromaffin-like cells
ACh | Gastrin
73
What are the phases of gastric acid secretion regulation?
Cephalic Gastric Intestinal
74
Describe the phases for the secretion of gastric acid
Cephalic phase: environmental stimuli ACh released & acts directly on parietal cells release of gastrin & histamine Gastric phase: gastric distension & peptides & amino acids presence gastrin & histamine released (feedback on eachother) presence of protein causes rise in pH (as buffer) decreases secretion of somatostatin
75
Describe the phases for the inhibition of the secretion of gastric acid
Gastric phase: low pH inhibits secretion of gastrin & indirectly histamine somatostatin secretion stimulated by low pH Intestinal phase: duodenal distension, low intestinal pH, amino acids & fatty acids release of enterogastrones secretin & CCK secretin inhibits gastrin release & promotes somatostatin release CCK stimulates contraction of gallbladder
76
What catalyses the conversion of pepsinogen to pepsin?
HCl | Pepsin
77
What is the role of pepsin?
Accelerates protein digestion
78
What mixes the contents of the stomach?
Peristaltic waves
79
What cells determine the frequency of peristaltic waves?
Pacemaker cells - cells of Cajal
80
What are peristaltic waves strengthened by?
Gastrin | Gastric distension
81
What are peristaltic waves weakened by?
``` CCK Duodenal distension Increased duodenal fat Increased duodenal osmolarity Decreased duodenal pH Increased sympathetic NS action Decreased parasympathetic NS action Fats & amino acids in duodenum ```
82
What are some defences against acid secretion?
Mucous Tight junctions Feedback loops
83
How is Na+ transported into the epithelial cells in the intestine?
Actively transported by pumps
84
How is K+ transported into the epithelial cells in the intestine?
Passive diffusion
85
How is Cl- transported into the epithelial cells in the intestine?
Absorbed in exchange for HCO3-
86
What are two types of proteolytic enzyme?
Endopeptidases - break non-terminal bond | Exopeptidases - break terminal peptide bond
87
What is the bond between glycerol & a fatty acid?
Ester bond
88
Where is the protein co-lipase secreted from?
Pancreas | ended to help lipase digest fats
89
How do bile salts emulsify fats?
Detergent action Form micelles Further solubilises lips & provides a mechanism for their transport Can enter cell by passive diffusion
90
What are chylomicrons?
Droplets of fat containing triglycerides & cholesterol
91
Define malnutrition
State of nutrition in which deficinecy/excess of energy/nutrients causes adverse effects on body
92
What is the epithelia of the submandibular glands?
Simple/stratified columnar
93
What parts of the GI system have stratified squamous keratinised epithelium? (3)
Gums Top of tongue Hard palate
94
What is the epithelia of the oesophagus?
Stratified squamous non-keratinised
95
What is the epithelia of the stomach?
Simple, columnar & non-ciliated | gastric epithelium
96
What is the epithelia of the small and large intestines?
Simple, columnar & non-ciliated | intestinal epithelium
97
What is the epithelia of the rectum?
Simple, columnar & non-ciliated
98
What are the two types of epithelium in the anus?
Upper - simple columnar | Lower - stratified squamous & keratinised
99
What is the epithelium of the mesothelium of the body cavities? (pleura/peritoneum)
Simple squamous
100
What are the 3 main papillae in the tongue?
(dorsum of tongue in complex folds) Filiform - tall, pointed, anterior 2/3rds Fungiform - mushroom shaped, tips & sides Circumvallate - separate anterior 2/3rd & posterior 1/3d They bear taste buds
101
What are the 3 layers of the oesophageal mucosa?
Mucosa Submucosa Muscular externa
102
What makes up the upper oesophageal sphincter?
Cricopharyngeus
103
Where are the chief cells found in the stomach?
Body & fundus
104
What are the differences between the gastric glands of the cardia and of the pyloric region?
Pyloric region - glands shorted & coiled
105
What are the plicae circulares?
Circular folds in the intestine | Most in jejunum, least in distal colon
106
What is a major absorptive cell of the intestines?
Enterocyte
107
What do Paneth cells do & where are they found?
Help regulate bacterial flora | Small intestine
108
What are the plexuses in the gut?
Meissner’s Plexus | Auerbach’s Plexus

Phase 1 Medicine - Riona (13 decks)

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