GI Flashcards
Describe the digestive system.
-GI tract = concentric muscle cylinders lined w epi
-accessory organs = teeth, tongue, salivary gland, liver, pancreas
Describe the digestive system of diff species.
- Carnivore = big stomach, short intestinal tract
- Ruminants = fermentation in forestomach
- Horse = fermentation in lg intestine
- Birds = food store (crop), glandular stomach (proventriculus), muscular stomach (gizzard)
Describe the main functions of the GI tract.
- Transport food
- Digest food into absorbable particles
- Absorption of food & transport into blood
- Regulation of water & electrolyte balance
- Immunologic barrier (GALT)
- Thermoregulation (fluid intake, panting)
Describe prehension.
*getting food into mouth
-species diff:
1. Horse = lips or incisors
2. Cattle = tongue & incisors
3. Goat & sheep = tongue & lips
4. Pigs = snout & mandible
5. Carnivorous = canine, incisors, forelimb
Describe mastication.
*1st act of digestion = teeth, jaw, tongue, cheeks
1. Carnivores
-sparse
-movement of manible is vertical
-molars & premolars in upper & lower jaws move like scissors
2. Herbivores
-long time masticating
-upper & lower jaws
-mastication movement horizontal
Describe motility & its function in the GI tract.
-after mastication, motility of diff GI tract seg is activated
-movement of GI functions:
1. Propel ingested food from one location to next
2. Retain ingested food for digestion, absorption, storage
3. Break up food physically & mix w digestive secretions
4. Circulate ingested feed = all portions in contacts w absorptive surfaces
Describe the involuntary & voluntary stages of deglutition.
- Voluntary (oral phase)
-food in oral cavity & molded into bolus
-tongue pushed back into pharynx
-food enters pharynx -> activate sensory nerve endings -> initiate involuntary part of deglutition - Involuntary (swallow reflex)
-in pharynx & esophagus -> directs food into digestive system (away from airway)
Describe the steps of deglutition.
- Soft palate elevated to close pharyngeal opening of nasopharynx preventing food from entering the internal opening of nostril
- Tongue is pressed against hard palate to close to oral opening
- Epiglottis moves back covering the entrance to the trachea preventing the movement of food into respiratory system
- Upper esophageal sphincter opens & food transported thru esophagus by peristaltic contractions = entrance to trachea reopened & respiration continues
Describe deglutition disorders.
-difficulty swallowing = neuromuscular disorder or mechanical obstruction
1. Dysphagia = 2 types
>oropharyngeal: bc malfunction of pharynx & upper esophageal sphincter
>esophageal: dysphagia bc of esophagus
2. Aspiration =
-food particles/fluid or stomach contents reach airways (can be result of dysphagia)
Describe the regulation of food intake.
*regulatory center for energy homeostasis = hypothalamus
-hunger center: nucleus paraventricularis, lateral hypothalamus, perifornical region
-satiety center: nucleus ventromedialis
1. Neuropeptides in hypothalamus
-stimulatory = neuropeptide Y (NPY), orexin
-inhibitory = melanocyte stimulating hormone (MSH) inhibit hunger & increase energy consumption
2. Non hypothalamic hormones
-stimulatory = ghrelin
-inhibitory =
>cholecystokinin (CCK)
>peptide YY (PYY)
>leptin (fat cells inhibit NPY release & activate MSH release)
>insulin (pancreas -> glu availability)
Describe agonist VS antagonist.
- Agonist
-function as reg hormone but more/less potent
-receptors bound by diff hormones
-diff agonists more/less potency when bound to receptors - Antagonist
-molecules bind to receptor & block binding of agonist
-receptor is nonfunctional
-block intracellular signaling events
-used as drugs
Describe Ghrelin.
-made in stomach by endocrine cells in muscosal epi of oxyntic glands in gastric fundus
-plasma ghrelin increases during fasting & decreases postprandially (after eating)
-function: increase appetite & food intake
Describe salivary glands.
- Major
-parotid, mandibular, sublingual - Small
-ventral jaw, palate, pharyngeal, lip, zygomatic
*classified according to type of secretion:
>serous, mucous, seromucus
Describe the saliva functions.
- Primary function:
-protect oral mucosa & teeth
-facilitate deglutition
-initiate enzymatic carbohydrate digestion (human & pigs -> amylase)
-pH regulation (HCO3) - Secondary function:
-immunologic function (lysozyme, lgs)
-thermoreg
-defense (alpacas)
Describe saliva components and where they’re made.
-99% water, electrolytes (Na, K, Cl, HCO3)
-in the ducts the secondary saliva (K, HCO3) made
-in acinus (glandular epi) the primary saliva (Cl, Na, H2O) made
*disturbance in saliva production = dry mouth, buccal ulceras, dysphagia, proliferation of bacterial pop
Describe the regulation & stimulation of saliva secretions.
*regulation primarily thru cholinergic signaling (AcH) & neuropeptides via para
1. Regulation:
-para -> M3 -> contract of myoepithelial cells (increase secretion, saliva more dilute)
-sym -> a1 -> secretion of sm vol of consistent saliva
2. Stimulation:
-innate (reflex) = contact w oral mucosa (mechanorecptors)
-conditioned = sight, smell, imagination of food
Describe the 4 gastric secretion mechanisms.
neurocine: secretions by enteric neurons that affect muscle cells, glands, blood cells
Describe the regulation of gastric secretion.
A digestive hormone must:
1. Be secreted by one cell & affect another
2. Be transported in blood
3. Be stimulated by food & action mimicked by a synthetic analog molecule
KNOW THE 5 ENDOCRINE GI HORMONES!
Describe the 3 glandular zones of the stomach.
- Cardia = mucus
- Fundus = HCl, enzymes
- Pylorus = mucus
Describe the different types of cells found in the stomach.
- Gastric pits = invaginations of glandular mucosa lined w mucus secreting cells at luminal surface
- Surface mucous cells = make thick mucus to protect stomach from acid
- Gastric gland = each gastric pit leads to this
- Parietal cells = located in neck of gastric glands
- Chief cells (zymogenic cells) = make proteolytic enzyme precursors like pepsinogen self replicating - not from stem cells
- Mucous neck cells = make less viscous secretion (thin mucus) to serve as progenitor cells for chief cells
- Stem cells = after division they migrate down/up into pit & differentiate into diff types of gastric pit cells
Describe parietal cells.
-secrete intrinsic factor (IF = glycoprotein) essential for vit B12 absorption in ileum
all functional cell types of gastric pit originate from stem cells in neck of gland
-injured cells make meta plastic cells that are preneoplasic (cancer cells)
-proton pump inhibitors decrease HCl
Describe chief cells.
zymogen granules
-adults:
Pepsinogen (proenzyme) -> active in stomach (acidic pH) pepsin (autoproteolysis) -> hydrolysis of proteins
-calves/lambs:
Prochymosine -> acidic pH in abomasum chymosine -> hydrolysis of milk
Describe enteroendocrine cells.
-secrete endocrine substances:
1. G cells -> gastrin
2. D cells -> somatostatin
3. I cells -> CCK
4. ECL cells -> histamine
*enteroendocrine cells secrete granules content (gastrin, histamine, somatostatin) into lamina propria then to blood capillaries
Describe mucus producing cells.
-mucins (glycoprotein) secreted by exocytosis -> protection & lube of mucosa -> surface mucosa regen 3-5 days (increase mitotic activity in isthmus of gastric pit)
Describe gastric acid secretion.
HCl secretion regulation:
1. Neural = mediated by AcH
2. Hormonal = mediated by gastrin
3. Paracrine = mediated by histamine
STIMULATORY:
>gastrin, histamine, AcH
INHIBITORY:
>somatostatin
Describe resting & stimulated stages.
RESTING:
-H/K ATPase limited access to apical membrane
STIMULATED: (via acid secretion)
-canaliculi fuse w apical (luminal) membrane & vesicles contain H/K ATPase go to apical membrane to increase HCl secretion
Describe secretion of gastric enzymes.
-enzymatic secretion stimulated via:
1. Neural (AcH, NA)
2. Hormonal (secretin, CCK)
>release of secretin & CCK from enteroendocrine cells of sm intestine depends on presence of food particles in intestinal lumen & pH
>amino acids & fatty acids -> CCK
>low pH -> secretin
Describe the 3 phases of gastric secretion.
- Cephalic
-before food enters stomach
-sight, smell, thought, taste - Gastric
-induced by vagovagal reflexes from stomach to brain
-dilation of stomach
-presence of amino acids & peptides in GI lumen - Intestinal
-induced by presence of food in duodenum
Describe the importance of mucus secretion.
-AcH & prostaglandin E (PGE) stim mucus secretion
>low pH -> AcH & PGE secretion -> mucus
>secretion altered by gastric acid & enzymatic secretion
-NSAID block synthesis of prostaglandins that promote formation of gastric ulcers
Describe gastric ulcers.
-gastric acid: HCl (pH 1-4)
>defense system to kill microorganisms (except H. Pylori)
>colonization of mucosa & neutralizes acid pH by making enzyme urease to produce bicarb
Describe gastric ulcers in horse/pig.
PH = 4-6
-colonize bacteria -> hydrolysis of carbohydrate in short chain fatty acids & lactate -> more acidic pH -> damage mucosa -> gastric ulcer
Describe the sm intestine.
-lg surface area due to:
>plicae circulares, villi, microvilli
-base of villi = glands called ‘crypts of lieberkuhn’
Describe the cell types in the sm intestine.
- Mature enterocytes/absorptive cells:
-absorb nutrients, secrete digestive enzymes & H2O, Cl, HCO3) - Goblet cells:
-secret mucus - Enteroendocrine cells:
-hormones like CCK, secretin, GIP - Paneth cells:
-antimicrobial enzymes & peptides
Describe Brunners glands.
-tubulo alveolar glands (submucosa)
-secrete mucus thru exocytosis
-secrete glycoproteins & bicarb ions
(PH of secretions = 8-9)
FUNCTION:
-sm intestine mucosa protection by neutralizing acid containing chime delivered from stomach
Describe peyers patch.
-immune surveillance of intestinal lumen
-generation of immune resp within mucosa
Describe cells of the crypt & regen.
-division & replication of enterocytes occur in crypts
-intestinal crypt cells regen & migrate up villi
-length of villi by rate of cell loss & replacement
>turnover time of enterocytes = 4-7 days
-progenitor cells arise from stem cell & differentiate into absorptive enterocytes or secretory goblet, enteroendocrine, paneth cells
>paneth cells move down into crypt
Describe sm intestine water movement.
-mediated via osmosis
-food entering is hyperosmotic or become after digestion
-osmotically active substances draw water from lateral space (paracellular) into intestinal lumen
-solutes absorbed on other side as water follows back thru epi into vascular system
-water moves to keep isomotic (low -> high)
-water reabsorption in sm intestine:
>lg solute reabsorption
>lg SA (villi & microvilli)
>lg opening in tight junctions
>capillary network in villi
Describe the lg intestine.
- Microbial metabolism
- 1 layer cylindrical epi w crypts
- Water absorption, vit
- Goblet cells -> mucus
- Secretion: sm volume, isotonic to plasma, mucin, bicarb, K rich (alkaline)
Describe the lg intestine in the immune system.
-cecum & colon = crypts but no villi lined by goblet cells & some absorptive epi cells (absorb electrolytes & water)
-base of crypts = stem cells
Describe the GI tract & nutrients movement.
-water & nutrients enter ECF then vascular system
-forces drive movement of solutes & water between extra/intravascular fluids via osmotic & hydrostatic forces
-absorbed nutrients enter capillaries by diffusion from interstitium (drives water to capillary)
-venous blood from GI tract (except terminal colon & rectum) collected into hepatic portal vein & pass thru liver to vena cava back to heart
-lymph drain from gut bypass liver entering blood thru thoracic duct
Describe the anatomy of liver.
-liver lobule: portal venule, arteriole of hepatic artery, bile duct -> sinusoids, hepatocytes, bile canaliculi
-endothelial wall: fenestrated -> passage of big molecule (glu, amino acids, etc)
Describe the liver functions.
- Carbohydrates metabolism (gluconeogenesis, glycolysis)
- Amino acid & protein metabolism (synthesis of plasma proteins)
- Lipid metabolism (fatty acids oxidation, ketone bodies synthesis)
- Storage (glycogen, lipids, vitamins, copper, iron)
- Synthesis & secretion of bile acids, bile formation
- Biotransformation (medicaments, xenobiotics, metabolism byproducts)
- Synthesis of hormones & mediators
- Synthesis of components of immune system
Describe the synthesis of plasma proteins.
-liver makes the body circulating plasma proteins
-albumins
-lipoproteins:
>VLDLs = transport of triglycerides from liver to other organs
>LDLs = transport of cholesterol esters from liver to other organs
>HDLs = remove cholesterol from peripheral tissue & transport to liver
-glycoproteins = haptoglobin, transferrin
-prothrombin & fibrinogen
-nonimmune alpha & beta globulins
Describe the endocrine functions of the liver.
- angiotensinogen = prohormone
- thrombopoietin = hormone (GF)
- IGF (insulin like GF) = IGF1 & 2
- hepcidin = sm peptide hormone (iron homeostasis)
Describe biotransformation.
-reactions that do conversion of toxic molecules in nontoxic, water soluble, & easier to excrete substances
-most drugs liposoluble (stay long in body)
-imp for termination of action & elimination from body
-liver is site of biotransformation (cytochrome P450) microsomal enzymes
-drug metabolism = increase polarity (more water soluble)
Describe the phase I & II.
Phase I: ‘oxidation’
-hydroxylation (add OH)
-carboxylation (add COOH)
-in sm ER & mitochondria
-reaction w cytochrome P450
Phase II: ‘conjugation’
-conjugation w glucuronic acid, glycine or taurine
-makes product of phase I more water soluble so it can be easily eliminated
Describe phase I outcomes.
-induce chemical change (oxidation) drug is more conducive to phase II
1. inactivation
2. activation from a ‘pro-drug’ to active form of drug
3. modification of activity = formation of active metabolites can have equal, greater, or lesser activity to that of the parent compound
4. formation of toxic metabolites
Describe phase II outcomes.
-conjugative/synthetic addition of a lg, polar molecule allows drug to be water soluble for renal excretion
Describe bile acid production.
-bile made in hepatocytes & is modified in epi cells of gallbladder
-gallbladder = bile storage & bile conc. thru electrolyte & water reabsorption
-bile acids synthesized from cholesterol & conjugated w amino acids (glycine, taurine) to make bile salts
>amphipathic & secreted into duodenum where they emulsify fat droplets in sm intestine
Describe the liver relationship with bile acids.
-bile excreted into common bile duct
-sphincter of smooth muscle cells ‘sphincter of oddi’ guards entrance of bile into duodenum
-bile stored in gallbladder (no digestion in duodenum)
-20% bile loss thru feces
-enterohepatic circ & hepatic syn of bile acids = 5%
Describe the emptying the gallbladder after a meal.
-high AA & FA in duodenum -> high CCK -> contraction of smooth muscle & relax of oddi sphincter
-reflex -> increase AcH -> contract of smooth muscle
Describe the structure of the pancreas.
2 glandular tissue:
>endocrine (secrete hormones)
>exocrine (secrete digestive enzymes)
—acinar gland (acini connected by ducts)
—looks like salivary gland
*vagus & CCK stim pancreatic enzymes
Describe secretion of the pancreas.
-in acinus = primary saliva
-HCO3 in duct lumen
Describe proteases in the pancreas.
-protein-digesting enzymes harmful to pancreatic cells & synthesized as zymogen (inactive form)
Describe digestive enzymes made in the pancreas.
- Peptidases (inactive)
-trypsinogen, chymotrypsinogen, proelastase, procarboxypeptidase A & B - Nucleases
-ribonuclease, desoxyribonuclease - Amylase
-a-amylase - Lipase
Describe the hormones of the pancreas.
-pancreatic cells have receptors for AcH, CCK, secretin
*adjusted by food
-AcH & CCK stim secretion of enzyme & Cl rich fluid
-secretin stim bicarb rich secretion
*high starch = high amylase
*high fat & protein = high lipase & peptidase
Regulation:
Cephalic, gastric, intestinal phase
Describe the impairment in pancreas secretion.
- Pancreatic insufficiency
-insufficient production of digestive enzymes by exocrine pancreas = bad digestion
-CS: steatorrhea, polyphagia, weight loss - Pancreatitis
-acini destroyed (multi factorial) & replaced by CT bc auto digestion
-increased risk when eating garbage
Describe carbohydrate functions.
*most abundant
FUNCTIONS:
1. Energy
2. Store energy
3. Cell membrane component (communication)
4. Structural component (cell wall of bacteria)
-all carbohydrates made from monosaccharides
>disaccharides = linked by glycosidic bonds
>oligosaccharies = 3-10 mono
>polysaccharides = 10+ mono
Describe carbohydrates in digestion.
*humans & pigs digestion of carbohydrates in mouth = amylase
-dietary carbohydrates = starch, glycogen, sucrose, lactose
-digestion of carbohydrates via pancreatic enzymes & finished by enzymes in intestinal mucosa
-absorption of carbohydrates in duodenum & upper jejunum via:
>Na dependent transport mechanism (SGLT1) at apical membrane
>facilitated transport mechanisms at apical (GLUT5) & basolateral membrane (GLUT2)
Describe proteins in the stomach.
-denatured in stomach
-partially hydrolyzed by pepsin
-final digestion & absorption of proteins in sm intestine
Describe lipids.
-amphipathic = hydrophobic hydrocarbon & hydrophilic carboxyl
EX: prostaglandins, steroid hormones, phospholipids, PAF, sphingomyelin
Describe emulsification of lipids.
*in duodenum
GOAL:
1. Reduce size of lipid droplets
2. Increase SA of hydrophobic lipid droplets
-both imp for lipase function which binds at interface droplet/aqueous solution
-bile acids emulsify fat droplets
>bile acids (liver) have sterol ring w side chain of amino acid (taurine/glycine)
Describe the digestion of lipids.
*dietary lipids: cholesterol esters, phospholipids, triglycerides
-lipid digestion start in stomach (gastric lipase)
-bile acids emulsify lg fat drops
-emulsified fat drops too lg to enter space between microvilli
-pancreas lipases hydrolyze triglycerides into monoglycerides & FFA
Describe mixed micelles.
-monoglycerides, FFA, cholesterol, liposoluble vit = mixed micelles
-mixed micelles approach BB of enterocytes & absorbed
-short chain FA dont form mixed micelles (can be directly absorbed)
Describe what happens once the mixed micelles are absorbed.
-LCFA go into ER for re-esterification (resynthesis) of more complex lipids:
MAG + FFA -> TAG
-chylomicrons released by exocytosis into lymphatic vessels -> thoracic duct -> L subclavian vein -> blood