Gut motility Flashcards

(34 cards)

1
Q

What is the role of the upper oesophageal sphincter?

A

Controls entry of food bolus into GI tract (initiated by the process of swallowing)

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2
Q

What is the role of the External anal sphincter?

A

allow defecation

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3
Q

what are the 2 main areas of innervation of GI tract?

A

o Myenteric plexus – most important

o Submucosal plexus

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4
Q

Role of the Interstitial cells of Cajal?

A

These are cells located within the muscle layers of the alimentary tract.
They mediate communication between the autonomic nervous system and smooth muscle

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5
Q

When is the enteric nervous system active?

A

all the time

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6
Q

what are the extrinsic factors that influence the enteric nervous system?
what effect do they each have on non-sphincteric muscle ?

A
o  Parasympathetic (Vagal) – excitatory to non-sphincteric muscle
o  Sympathetic – inhibitory to non-sphincteric muscle, excitatory to sphincteric muscle
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7
Q

What are the neurohormonal influences on the enteric nervous system?

A

o 5 hydroxy tryptamine (serotonin)
o Motilin
o Opioid receptors

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8
Q

what does interprandial mean?

A

between meals

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9
Q

Describe the difference between the muscular layers found in the 1/3 of the oesophagus versus the lower 2/3

A

upper 1/3: striated voluntary muscle

Lower 2/3: smooth muscle, circular and longitudinal layers (involuntary)

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10
Q

When does the migrating motor complex occur and what is its role?

A

occurs in interprandial period (between meals)

It is a cyclic contraction sequence which cleanses stomach and intestine of any remaining food in between meals

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11
Q

How often does the migrating motor complex occur? what is it regulated by ?

A

Every 90 minutes

Regulated by Motlin

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12
Q

Describe the 4 stages of the migrating motor complex

A

1) prolonged period of quiescence
2) increased frequency of contractility
3) a few minutes of peak electrical and mechanical activity
4) declining activity merging to next phase 1

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13
Q

What is motilin and what is it produced by?

A

A Polypeptide hormone

Produced by M cells in the small intestine

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14
Q

How often is motilin secreted and what effect does it have?

A

Secreted every 90 minutes

It stimulates contraction of gastric fundus and enhances gastric emptying

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15
Q

Name a motilin agonist and what is a common side effect of it?

A

Erythromycin: common side effect = diarrhoea as there is too much cleansing of the gut

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16
Q

During mealtime, what replaces the migrating motor complex?

A

MMC is replaced by contractions of variable amplitude and frequency, allowing mixing and digestion

17
Q

What does the gastric pacemaker do?

A

It generates rhythmic depolarisations and

Controls the FREQUENCY and DIRECTION of gastric muscular contractions

18
Q

How frequently does the gastric pacemaker generate rhythmic depolarisations?

A

at a frequency of 3 cycles per minute

19
Q

what size do Digestible food particles become before they leave the stomach?

A

when size is reduced to 2mm

20
Q

How long do liquids take to leave the stomach ?

21
Q

How long do solids take to leave the stomach ?

22
Q

define Gastroparesis

A

disease which causes delayed Gastric emptying

23
Q

List some causes of Gastroparesis

A
  • Idiopathic/ unknown
  • Longstanding diabetes with macrovascular disease
  • Drugs – e.g. opiates
  • Post viral
24
Q

Describe motility in the colon

A

No pacemaker activity
Colon mixes material without prpulsion (moving it forward) - for water absorption
Acts as a temporary storage site and expels faeces

25
How long is the transit from caecum to rectum ? IS the transit shorter in men or women?
1-2 days | Shorter duration in men (they have increased faecal content)
26
How is colon transit measured?
USing Serial X-Rays with radio-opaque markers
27
If there are no markers left, what does this mean?
normal transit
28
If there are markers left in rectosigmoid, what does this mean?
pelvic outlet obstruction
29
If there are markers scattered throughout colon, what does this mean?
slow transit constipation
30
which drugs reduce gut motility (reduce diarrhoea)?
Opiates Anti-cholinergic Loperamide = Imodium
31
which drug increase gut motility (reduce constipation)?
Laxatives
32
Describe the internal anal sphincter in terms of muscle, control and when it is used?
Smooth muscle Involuntary control Remains contracted in resting conditions
33
Describe the external anal sphincter in terms of muscle, control and when it is used?
Striated muscle Voluntary control recruited in reflex reaction to coughing/sneezing
34
What happens in Hirschsprung's disease ?
Nerves are missing from part of the intestine – causes constipation