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Phys Exam 6 > Gi 2 > Flashcards

Gi 2 Flashcards

1
Q

What are the 3 main functions of the stomach?

A

Temporary storage of ingested material
Production of Chyme (Mechanical digestion and mixing)
*Meter delivery of chyme to duodenum

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2
Q

The following are functions of the ______:
Temporary storage of ingested material
Production of Chyme (Mechanical digestion and mixing)
*Meter delivery of chyme to duodenumPartially sterilize meal
Initiates protein digestion (Chemical Digestion)
Produce Specialized Secretions
-HCl acid
-Pepsinogen
-Intrinsic factor
-Mucus
-Hormones/Paracrines

A

Stomach

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3
Q

What are the 3 structural portions of the stomach?

A

Fundus, body, and pylorus

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4
Q

What are the 2 functional portions of the stomach?

A

Orad and caudad portion

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5
Q

What structural part of the stomach secretes mucous, pepsinogen, and HCl?

A

Body

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6
Q

What are the 4 stages of gastric motility?

A
  1. Receptive relaxation
  2. Peristalsis (trituration/homogenization)
  3. Emptying (pyloric sphincter)
  4. Migrating Motility Complex (MMC)
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7
Q

Accommodate the volume of the mealReduce pressure increases preventing gastric reflux and premature gastric emptying

A
  1. Receptive relaxation
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8
Q

Chyme production

Trituration: Mix ingested nutrients with gastric secretions, breakdown large particles and increase SA for digestion

A
  1. Peristalsis (trituration/homogenization)
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9
Q

≈ 200 kcal/hr released into small intestine

Important not to overload Small Intestine

A
  1. Emptying (pyloric sphincter)
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10
Q

Sweep ingested solids that cannot be digested out of stomach and through intestinal tract
Occurs during fastingTakes approximately 90 min to go from stomach to colon

A
  1. Migrating Motility Complex (MMC)
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11
Q

_____ is Initiated by:-stretch of gastric or duodenal wall-protein or fat in duodenum (CCK)

A

Gastric Receptive Relaxation

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12
Q

______functions: Accommodates increased volume of food and slows emptying.

A

Gastric Receptive Relaxation

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13
Q

Generated by pacemaker cells (Interstitial Cells of Cajal) located in GI smooth muscle
Smooth muscle cells undergo spontaneous phases of depolarizations and repolarizations = slow waves or Basic Electrical Rhythm (BER) of stomach
Frequency = 3/minute

A

Gastric Peristalsis/Trituration

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14
Q

______ functions:
Acts to mix and break down (triturate) gastric contents (Retropulsion)
Regulate Gastric emptying
Peristaltic wave forces chyme through pyloric sphincter
Causes pyloric sphincter to contract reducing volume released to Small Intestine.

A

Gastric Peristalsis/Trituration

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15
Q

What are the 3 things the rate of gastric emptying is influenced by?

A

Solid vs liquid
Nutrient content
Force of gastric contractions

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16
Q

On average:50% of stomach contents emptied ___ to ____ hours

A

2.5 to 3 hours

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17
Q

Total emptying of the stomach ___ to ____ hours

A

4 to 5 hours

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18
Q

Total emptying of the small intestine ____ to ____ hours

A

3 to 5 hours

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19
Q

Transit through the colon ___ to ____ hours

A

8 to 15 hours

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20
Q

Factors that increase force of antral contractions ______ Gastric emptying

A

Increase gastric emptying

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21
Q

What are the 2 things that increase force of antral contractions that increase gastric emptying?

A

Gastrin and Distension of stomach

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22
Q

Factors that decrease force of antral contractions _______ Gastric emptying

A

Decrease gastric emptying

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23
Q

What is the one thing that decreases force of antral contractions that decrease gastric emptying?

A

Contents of Duodenum

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24
Q

_________ = hormones secreted by duodenum in response to nutrients and acid in chyme.

A

Enterogastrones

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25
Q

What are the 3 enterogastrones?

A
  1. CCK
  2. Secretin
  3. GIP
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26
Q

What enterogastrone is secreted in response to fat and protein?

A

CCK

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27
Q

What enterogastrone is secreted in response to acid?

A

Secretin

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28
Q

What enterogastrone is secreted in response to carbs?

A

GIP

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29
Q

Occurs in between meals (fasting state) approximately every 90 minutes
Intervals of strong propulsive contractions
Sweep stomach and small intestine of indigestible material
Intrinsic to ENS and involves hormone Motilin.
Continue until meal ingested.

A

Migrating Motility Complex (MMC)

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30
Q

______ gland: secretes into duct

A

Exocrine gland

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31
Q

______ gland: secretes into blood

A

Endocrine gland

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32
Q

______ gland:
Exocrine Gland
Produce gastric juice
Variety of cell types and secretions

A

Gastric gland

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33
Q

_____ gland:
Abundant Mucus-secreting cells
Hormones that regulate gastric function

A

Pyloric Gland (Antral)

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34
Q

______ gland:

Abundant Parietal and Chief cells

A

Oxyntic Gland (Corpus)

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35
Q

The parietal cell secretes _____ and reabsorbs _____

A

Secretes HCl and reabsorbs HCO3

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36
Q

Oxyntic cells are activated by what 3 things?

A

gastrin, histamine, and acetylcholine

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37
Q

Oxyntic cells are inhibited by what thing?

A

Somatostatin

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38
Q

Oxyntic cells secrete what 2 things?

A

2L/day of HCl

Intrinsic Factor

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39
Q

Proton pumps are inserted into the ____ membrane of the oxyntic cells

A

Apical membrane

40
Q

– combination of factors creates a greater level of acid secretion than just additive

A

Synergism

41
Q

Pharmacologically, inhibiting the activity of any one factor (gastrin, Ach, or histamine) _________ acid secretion

A

greatly reduces

42
Q

What is the stimulus for neuronal activation of oxyntic glands?

A

Stretch of gastric wall

43
Q

What are the 2 neurotransmitters involved in activating oxyntic gland?

A

ACh

GRP

44
Q

As the pH drops, what is released to cause less acid production?

A

Somatostatin

45
Q

What phase of GI activation involves sight, smell, and sound?

A

Cephalic phase

46
Q

What phase of GI activation involves contents in stomach?

A

Gastric phase

47
Q

What phase of GI activation involves contents in intestine?

A

Intestinal phase

48
Q

What are the 4 stimulants of the cephalic phase of acid secretion?

A

Sight of food
Smell of food
Taste of food
Thoughts of food

49
Q

Increased food in stomach leads to ____ somatostatin due to buffering of acid

A

Decreased somatostatin

50
Q

____ phase of acid secretion inhibits acid secretion via neural reflex and enterogastrones

A

Intestinal phase

51
Q

What 4 things stimulate intestinal phase of acid secretion?

A

Increased H+
Distension
Osmolarity
Fats in Duodenum

52
Q

In ______ period of acid secretion:
Acid is secreted at low levels
Lack of buffer (no food) causes low pH in stomach (3)
Basal secretions stimulated by Histamine and Ach
Gastrin low due to low pH in gastric lumen
Function: Possibly to sterilize gastric lumen
Basal Secretion Rate = 0-11 mEq/hr
Stimulated Secretion Rate = 10-63 mEq/hr

A

Interdigestive Period

53
Q

______ functions:
Facilitates digestion of proteins.
Protects against some pathogens.
Increases absorption of B12, iron, calcium.

A

Acid functions

54
Q

Binds to and inhibits H+ - K+ pump
Produces nearly 100% inhibition.
May have side effects related to functions of acid.

A

PPIs

55
Q

What are the 2 things secreted by parietal cells?

A

HCl

Intrinsic factor

56
Q

_____ is an exocrine product that functions in the Activation of Pepsinogen and Sterilization of meal

A

HCl

57
Q

_____ is an exocrine product that functions in Vitamin B12 Absorption

A

Intrinsic factor

58
Q

What do chief cells secrete?

A

Pepsionogen

59
Q

_____ is an exocrine product that functions in protein digestion

A

Pepsinogen

60
Q

_____ and _______ are exocrine products that function in gastroprotection

A

Mucus/HCO3-

Trefoil factors

61
Q

What doe surface mucous cells secrete?

A

Mucus/HCO3-

Trefoil factors

62
Q

___ is made by ECL cells

A

HIstamine

63
Q

_____ is made by G cells

A

Gastrin

64
Q

_____ is a endocrine product that functions in regulation of gastric secretion

A

Gastrin

65
Q

_____ and ____ are neurotransmitters that function in regulation of gastric secretion

A

GRP

ACh

66
Q

_____ and ______ are paracrines involved in the regulation of gastric secretion

A

Somatostatin and histamine

67
Q

Somatostatin is released by _____ cells

A

D cells

68
Q

____ is an endocrine that stimulates hunger

A

Ghrelin

69
Q

_____ is made by Gr cells

A

Ghrelin

70
Q

_____ controls emptying of the stomach to the small intestine

A

Pyloric sphincter

71
Q

_____ is a structural portion of stomach involved in mixing and grinding; secretes mucus, pepsinogen, and gastrin

A

Antrum

72
Q

Glycoprotein secreted by oxyntic cells.
Exocytosis
•Secretion activated by same secretagogues that activate HCl secretion
Mechanisms for secretion unknown but different than acid secretion (inhibitors of proton pump do not inhibit intrinsic factor secretion, but does reduce its function)
Required for Vitamin B12 absorption
Vitamin B12 important in red cell production; deficiency causes “pernicious anemia.”

A

Intrinsic factor

73
Q

Intrinsic factor is required for ________ absorption

A

Vit B12 absorption

74
Q

Intrinsic factor is secreted by ______

A

exocytosis

75
Q

Secretion of intrinsic factor activated by same secretagogues that activate ____ secretion

A

HCl

76
Q

Are the mechanisms for secretion of HCl and intrinsic factor the same or different?

A

Different

77
Q

Deficiency in _____ causes pernicious anemia

A

INtrinsic factor

78
Q

Secretes pepsinogen to initiate digestion of protein.
Exocytosis
Pepsinogen activated to pepsin by low pH (inactivated by pH > 5)
Protein digestion (not significant)
Main activation through local and vagal reflexes that release Ach.

A

Chief cell

79
Q

At what pH in the stomach is pepsinogen inactivated?

A

pH 5

80
Q

Pepsinogen is secreted by ______

A

exocytosis

81
Q

Main activation of pepsinogen is through vagal reflexes that release _____

A

Ach

82
Q

Produced by endocrine cells located in oxyntic glands
Only known appetite stimulant
Individuals given Ghrelin eat 30% more than placebo control
Stimulates hypothalamic NT Neuropeptide Y
May partly account for the anorexia and weight loss seen in some patients following gastric resection

A

Ghrelin

83
Q

What are the 2 main effects of ghrelin?

A

Increase hunger and eating

Decrease metabolism

84
Q

____ is the only known appetite stiumulant

A

Ghrelin

85
Q

Ghrelin stimulates what hypothalamic NT?

A

Neuropeptide Y

86
Q

Why Doesn’t the Stomach Digest Itself?

A

Gastric mucosal barrier

87
Q

Two hydrophilic layers separated by hydrophobic barrier
Mucus is secreted by mucous cells onto surface of epithelium
Contains long chains of oligosaccharides that expand and retain water
Viscoelastic substance that coats surface of gastric epithelial cells
Limit diffusion of acid through the plane of the gel via a mechanism known as viscous fingering
Micro-climate with high pH produced by surface cell secretion of HCO3-
Mucus secretion stimulated by Prostaglandins (NSAIDS)
Trefoil proteins help stabilize barrier

A

Gastric Mucosal Barrier

88
Q

Contains long chains of oligosaccharides that expand and retain water
Viscoelastic substance that coats surface of gastric epithelial cells
Limit diffusion of acid through the plane of the gel via a mechanism known as viscous fingering

A

Mucous

89
Q

The mechanism where mucous Limits diffusion of acid through the plane of the gel is called _____

A

viscous fingering

90
Q

Mucus secretion stimulated by _______

A

Prostaglandins (NSAIDS)

91
Q

_______ help stabilize barrier

A

Trefoil proteins

92
Q

What are the 3 common disorders of gastric function?

A

Ulcers
Mucosal destruction
Emptying

93
Q

If there is no ____, there can be no ulcers

A

No acid

94
Q

_____ (bacteria) infection destroys the gastric diffusion barrier

A

Helicobacter pylori

95
Q

_____ is a g cell tumor that increases gastrin and increases acid

A

Zollinger-Ellison Syndrome

96
Q

Disorders of _____ is seen in gastritis, mostly oxyntic gland mucosa where there is decreased mucous leading to ulcers

A

Mucosal destruction

97
Q

Disorders of _____ are seen in obstruction, gastroparesis, and dumping

A

Emptying

Phys Exam 6 (4 decks)

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