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Physiology II Exam 1 > GI module 3 > Flashcards

GI module 3 Flashcards

1
Q

What is the total length of the small intestine?

A

5-6 meters

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2
Q

Where does the small intestine begin and end?

A

begins at pyloric sphincter, and ends at ileocecal valve

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3
Q

What are the 3 regions of the SI and their respective lengths?

A

Duodenum (25-30cm) Jejunum (2.5m), and ileum (3.5m)

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4
Q

What region begins at the duodenal bulb and ends at the ligament of Trietz?

A

Duodenum

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5
Q

What structure allow bile and pancreatic enzyme secretions?

A

Hepatopancreatic ampula (sphincter of Oddi)

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6
Q

What structure is located in proximal duodenum and secretes “bicarbonate rich mucus to protect against acid chyme entering the duodenum and lubricate intestinal wall?

A

Brunner’s glands

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7
Q

Describe the 2 major functions o the duodenum?

A

Digestion- stimulates release of enzymes from pancreas and gallbladder
Gastric feedback-provides feedback to regulate the rate of gastric emptying.

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8
Q

What is the initial signal for feedback pathways in the duodenum?

A

Acidic chyme entering the duodenum

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9
Q

What do the Long loop reflexes in the duodenum stimulate?

A

CNS increase sympathetic and decrease parasympathetic to stomach-

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10
Q

What do the short loop reflexes in the duodenum stimulate?

A

enteric neurons in stomach to decrease stomach motility

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11
Q

What hormones messengers work in the duodenum to inhibit motility/acid production?

A

Secretin, VIP, CCK

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12
Q

What is the major role of secretin in the duodenum?

A

Regulates the pH, inhibitory gastric activity and facilitates digestion

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13
Q

What stimulates the secretion of the hormone secretin in the duodenum?

A

Acidic (pH less than 4-5) chyme containing fats, partially digested protein, and hyper/hypotonic fluids

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14
Q

What are the target organs of the hormone secretin?

A

Stomach
Pancreas
Liver
Brunner’s glands

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15
Q

What is the driving force for Secretin?

A

pH

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16
Q

What is the driving force for CCK?

A

Fat content

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17
Q

What is the primary function of CCK?

A

Promotes bile/pancreatic enzyme release and inhibitory gastric activity

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18
Q

What is the stimulus for CCK?

A

Fatty chyme entering duodenum

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19
Q

What are the target tissues for CCK?

A

Stomach
Pancreas
Liver
Gallbladder

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20
Q

What is the action of CCK at the stomach?

A

Inhibitory gastric motility/secretions

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21
Q

What is the action of CCK at the Pancreas?

A

Stimulates release of pancreatic enzymes

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22
Q

What is the action of CCK at the Liver

A

Stimulates bile output (promotes fat digestion)

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23
Q

What is the action of CCK at the gallbladder?

A

Contraction to release stored bile

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24
Q

What is the action of Secretin at the stomach?

A

Inhibits gastric secretion and motility

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25
Q

What is the action of secretin at the pancreas?

A

stimulates pancreas to secrete bicarbonate solution (neutralizes)

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26
Q

What is the action of secretin at the liver?

A

Stimulates bile output (fat digestion)

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27
Q

What is the action of Brunner’s glands of the duodenum?

A

Stimulates secretion of “alkaline rich mucus”

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28
Q

What is GIP said to be a relative of?

A

Secretin

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29
Q

What is the stimulus for GIP?

A

Chyme entering the duodenum

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30
Q

What is the action of GIP at the stomach?

A

inhibitor to gastric motility/secretions

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31
Q

What major action does GIP have at the pancreas?

A

in stimulating insulin release

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32
Q

What is the stimulus for the release of VIP?

A

Chyme entering the duodenum

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33
Q

What is the acition of VIP at the stomach?

A

Inhibits gastric acid secretion

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34
Q

What is the major role of VIP at the intestine?

A

Vasodilates BV, promotes intestinal motility

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35
Q

What is the role of intestinal gastrin

A

similar as gastrin released in antrum of stomach-(promotes acid secretion/motility and gastric mucosa growth)

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36
Q

What is the stimulus for intestinal gastrin?

A

chyme entering the duodenum

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37
Q

t/f there is no major action of intestinal gastrin

A

T-not specific to any condition other than presence of chyme-sties motility and secretion

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38
Q

What is motilin also known as?

A

“housekeeper of intestinal tract”

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39
Q

What is the stimulus for motilin?

A

Fasting or periodic release (every few hours)

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40
Q

What is the major action of motilin at the intestine?

A

Initiates MMC (migrating motor complex)

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41
Q

Anatomically where are the Jejunum and the Ileum located in the GI system

A

From the ligament of Treitz and ends at ileocecal valve

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42
Q

What is the general function of the jejunum and ileum as a whole?

A

Continued digestion
absorption of water!!!
secretion of brush border enzymes to assist with digestion/absorption

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43
Q

What are the major functions of the jejunum?

A

Digested fat

carbohydrate, protein, water and electrolyte absorption

44
Q

What are the major functions of the ileum?

A

absorption of B12, bile salts and remaining digested nutrients and water not absorbed by the jejunum

45
Q

What are the 3 primary anatomical features that optimize absorption in the jejunum and ileum?

A

Mucosal folds
Villi (and microvilli)
Lamina propria layer
Crypts of Lieburkuhn

46
Q

What is the purpose of the mucosal folds in the jejunum and ileum?

A

Physically slows the passage of food

47
Q

Where are the Villi located?

A

Covering the mucosal folds

48
Q

What makes the villi a functional unit of the small intestine?

A

Site of both secretion and absorption

49
Q

What are the villi composed of?

A 
Goblet cells (mucus secreting cells)
Absorptive columnar cells (site of absorption)
50
Q

What structure is located at the end of each columnar cell and forms the “brush border” of the mucosal surface?

A

Microvilli

51
Q

What is the function of the “brush border fluid layer”

A

absorption of all substances except water/electrolytes

52
Q

Where is the Lamina Propria layer found?

A

Extending into each villi

53
Q

What are the two structures that are part of the lamina propria?

A

Central arteriole

Lacteal

54
Q

What is the function of the central arteriole in the Lamina propria?

A

Capillary transport of substances directly to liver via hepatic portal vein

55
Q

What is the function of the lacteal in the lamina propria layer?

A

Transports fats molecules/substances to systemic system via the thoracic duct

56
Q

Where is the Crypts of Lieburkuhn found?

A

At the base of the villi

57
Q

What are the crypts of lieburkuhn composed of?

A

Precursor cells (stem cells)
Paneth cells
Secretory cells

58
Q

What is the function of the precursor cells of the crypts of lieburkuhn

A

Turnover of intestinal epithelial cells

59
Q

How long does it take for Precursor cells to stimulate a complete turnover of intestinal epithelial cells?

A

4-7 days

60
Q

What is the function of Paneth cells?

A

Immune function-produce/secrete antibiotic peptides

61
Q

What is the function of secretory cells?

A

Secrete brush border digestive enzymes

62
Q

What is the average motility time in the small intestine?

A

1-3 hours

63
Q

What stimulates small intestine motility?

A

Secretin
CCK
Gastrin
Motilin

64
Q

What three motility patterns occur in the SI?

A

Segmentation
Peristalsis
Migrating motor complex

65
Q

When does the segmentation motility pattern occur in the small intestine?

A

During feeding

66
Q

t/f Segmentation motility pattern occurs less frequently than peristalsis?

A

F - occurs MORE frequently than peristalsis

67
Q

What is the function of the segmentation motility pattern?

A

Mixes chyme to allow contact with brush border which then facilitates absorption of all substances except water/electrolytes

68
Q

What is characteristic of the contractions that occur during the segmentation motility pattern?

A

Frequent small rhythmic contraction of circular muscle (8-12/min)

69
Q

Peristalsis motility pattern of the SI occurs when?

A

during feeding

70
Q

What is the characteristics of the contractions of peristalsis of the SI?

A

Coordinated waves of contraction/relaxation of longitudinal muscles-short segments 10cm
Wave of contraction moves slowly (1-2 cm/sec) to allow for digestion/absorption

71
Q

What is the major function of peristalsis in the SI?

A

Moves chyme toward the large intestine

72
Q

When does MMC (migrating motor complex) occur?

A

Fasting

73
Q

What are the characteristics of contractions during MMC?

A

Slow periodic waves of peristalsis that occurs every 1-2 hours, originating in the stomach and passing through the SI.

74
Q

What is the primary function of MMC?

A 
"house cleaning" sweeps out the stomach/SI.
Pushes along residual chyme
Bacteria homeostasis
-transport bateria to LI
-prevents reflux of bacteria from LI
75
Q

What reflex inhibits gastric motility and results in a slowing down of motility and adding more chyme to SI to allow terminal ileum to empty contents into LI?

A

Ileogastric reflex

76
Q

What stimulates the ileogastric reflex?

A

distended ileum

77
Q

What reflex relaxes the distal small intestine resulting in the ability to move chyme toward the LI?

A

Intestinointestinal reflex (inhibitory-protective reflex)

78
Q

What stimulates the inestinointestinal reflex?

A

Section of small intestine becomes distended

79
Q

What reflex promotes terminal ileum motility/ileocelcal valve relaxation and results in emptying of the SI so it can receive more chyme from the stomach?

A

Gastroilieal reflex

80
Q

What stimulates the Gastroileal reflex?

A

Increased stomach (gastric) motility/secretion

81
Q

T/F the ileocecal valve is intrinsicaly regulated and normally closed?

A

TRUE

82
Q

What regulatory system occurs to open the ileocecal valve?

A

approaching peristalsis in the ileum-results in a relaxed ileocecal sphincter

83
Q

What regulatory system occurs to close the ileocecal valve?

A

Distention of the cecum/ascending large intestine-results in constriction of the ileocecal valve.

84
Q

Which movement pattern provides 90% of motility in the LI?

A

Haustral segment contractions

85
Q

When do austral segment contractions occur?

A

During FASTING

86
Q

Other than Haustral segment contractions what other movement pattern works to contract the LI? (only occurs 10% of time)

A

Multihaustral segmentation

87
Q

When does multihaustral segmentation occur?

A

during FASTING

88
Q

What are the 4 movement patterns of the LI?

A

Haustral segment contraction
Multihaustaral segmentation
Mass movement peristalsis
Intestinal reflexes (orthocolic, and gastrocolic)

89
Q

When does the orthocolic reflex occur?

A

in the morning upon standing up

90
Q

what stimulates the gastrocolic reflex?

A

Ingestion of food (during or immediately after eating)

91
Q

Which of the 4 Motility patterns of the LI occurs while eating?

A

Intestinal reflex-gastrocolic

92
Q

What motility pattern is considered a “continuation” of the gastroileal reflex?

A

gastrocolic

93
Q

What is the stimulus for the rectal reflex (defecation)

A

Stretch of the rectum wall-obviously this reflex can be overcome by voluntary control

94
Q

What clinical application can result in loss of bowel control?

A

Cauda equina syndrome

95
Q

Explain the pathway of carbohydrate digestion in the GI system

A

Mouth-salivary amylase breaks down
SI-Pancreatic amylase further breaks down
Brush border enzymes secreted from base of Villi breakdown further into galactose, glucose, fructose

96
Q

Explain the pathway of Carbohydrate absorption in the GI system

A

occurs in the brush border of villi

monosaccharides (galactose, glucose, fructose) are absorbed by villi capillaries and transported directly to liver.

97
Q

Explain the pathway of protein digestion in the GI system

A

Stomach-pepsinogen released from chief cells converts into pepsin when combined with acid, breaks down protein into smaller protein molecules
SI-Pancreatic enzyme secret by pancreas into duodenum breakdown protein into smaller molecules
Brush border-Enzymes secreted from base of villi breakdown into AA and polypeptides

98
Q 
What is the primary site of protein digestion in the body? 
A- SI
B-Stomach
C-Mouth
D-brush border
A

SI

99
Q

Explain the pathway of protein absorption in the body

A

occurs in the villi in SI

AA are absorbed by villi capillaries and transported directly to the liver

100
Q

Which of the following completes absorption step by being absorbed by villi capillaries and transported directly to the liver? Choose all that apply.
a. Carbohydrates
b. Proteins
C. Fat

A

A. Carbohydrates

B. Protein

101
Q

What needs to occur to allow fat digestion to occur?

A

Emulsification

102
Q

What emulsifying agents exist in the GI tract?

A

Major players- Lecithin, bile salts

also-Fatty acids, monoglycerides, cholesterol, protein

103
Q

Explain the pathway of Fat digestion in the GI tract?

A

Stomach-gastric lipase initiates breakdown
SI-Emulsifies fat droplets into smaller fat droplets
Lypolysis-occurs via molecules that are released from the pancreas

104
Q

Explain the pathway of fat absorption in the GI tract

A

Micelle formation
Transport of fats into columnar epithelial cells of SI
Transport of fats into lacteals-which then form chylomicrons which exit the cell via exocytosis

105
Q

How much fluid is reabsorbed through the SI back into the bloodstream?

A

85-90%

106
Q

Where does vitamin B12 absorption occur?

A

in the terminal ileum

107
Q

Lack of B12 causes what?

A

Pernicious anemia

Physiology II Exam 1 (5 decks)

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