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Semester 4 (NME) > Intestines > Flashcards

Flashcards in Intestines Deck (69):
1

What is the name for the cells that line the SI, what type of cell are they?

Enterocytes
(Simple columnar epithelium)

2

How long is the duodenum? What parts is it split up into?

20-25cm
Superior/ descending/ inferior/ ascending (Terminates at duodenal flexure)

3

Where is the sphincter of Oddi found?

Surrounding the major duodenal papillae
(ampulla of vater)

4

What are vasa recta?

Straight arteries (which run longitudinally along jejunum and ileum)

5

What are plicae circulares?

Prominent folds which circle the lumen (mainly of jejunum and ileum)

6

What are some differences between the jejunum and ileum?

Jejunum is shorter and has a larger diameter
Jejunum has thicker walls and more plicae circulares
Jejunum has longer and less prominant vasa recta

7

How long is the SI and how does it change along it's length?

6-7m
Gets thinner walls and smaller diameter the further along it you traverse

8

What is trypsinogen?

A pro-enzyme secreted by the pancreas (Pro-enzyme so that it doesn't break down cells in the pancreas)
- It's converted to trypsin by enteokinase which is an enzyme on the brush border of SI lumen wall

9

What is the function of trypsin?

Causes hydrolysis of:
Chymotrypsinogen > chymotrypsin
Procarboxypeptidase > carboxypeptidase
Proelastase > elastase

10

What happens once trypsin has finished it's actions?

Once trypsin has converted all the other pro enzymes and they have acted you are left with a mix of AA's/ dipeptides and tripeptides

11

How is the resulting mix of AA's/ dipeptides and tripeptides broken down after trypsin and it's pro-enzymes have acted?

More brush border enzymes (dipeptidase and aminopeptidase) in the lumen wall of SI break all into amino acids

12

How are dipeptides and tripeptides absorbed in the SI?

Absorbed through co transport with H+ (Broken down into AA's by enteocytes and sent via blood to liver)
This is facilitated diffusion (primary active transport requiring ATP)

13

How are amino acids absorbed in the SI?

Absorbed through co transport with Na+ (Sent via blood to liver)
This is facilitated diffusion (primary active transport requiring ATP)

14

How do the enterocytes balance the amount of H+ being brought in with di/tripeptides?

H+ (out) / Na+ (in) antiporter balances this out

15

What is the overall effect of peptide/ AA absorption in the gut and how does this affect osmosis?

Net movement of Na+ into enterocytes
This draws in water by osmosis

16

Name three monosaccharide carbohydrates?

Glucose/ fructose/ galactose

17

Name three disaccharide carbohydrates?

Sucrose/ lactose/ maltose

18

Name a polysaccharide carbohydrate?

Starch (amylose and amylopectin)
Amylose= String of 1-4 linked glucose molecules
Amylopectin= String of 1-6 linked glucose molecules which also has branches

19

What is an oligosaccharide?

Not as big as poly but bigger than mono/di

20

How is starch broken down before the stomach?

Chewing and salivary alpha amylase (aka pytalin)
(low pH of stomach inactivates pytalin)

21

How is starch broken down once it reaches the duodenum?

Pancreatic alpha amylase
Brush border enzymes (maltase/ lactase/ sucrase)
80% broken down into glucose

22

How is glucose absorbed?

SGLT (Sodium glucose linked transporter) absorbs two Na+'s and 1 glucose into the enterocyte

23

What is the difference between primary and secondary active transport?

Primary: ATP used to move substance against conc gradient (has binding site for ATP)
Secondary: Energy comes from electrochemical gradient of pumping other ions out of the cell

24

How does glucose move from inside the enterocyte into the bloodstream?

GLUT2 transporter on basal surface

25

What happens to any starch not absorbed in the SI?

Undergoes bacterial fermentation in the colon then excreted

26

How are lipids digested before reaching the stomach?

Lingual lipase breaks down about 20% of the triglycerides (into monoglyceride + 2FA's)
- Inactivated by low pH in the stomach

27

Once in the SI how are lipids broken down and absorbed?

FA's and monoglycerides combine with bile salts to form complexes called micelles. These travel into the enterocyte by simple diffusion across the membrane

28

What happens to the micelles absorbed by enterocytes?

Enterocyte uses FA's and monoglycerides to form new triglycerides. They combine with steroids/ phosholipids/ fat soluble vitamins and protein to form complexes called CHYLOMICRONS

29

What happens to chylomicrons in the enterocytes?

Leave enterocyte via exocytosis
Stay in interstial spaces as too big for capillaries and travel via lymphatic capillaries (called LACTEALS) and enter blood stream via the L subclavian vein

30

How is water absorbed in the SI?

Via passive osmosis
(Na+ is continually absorbed by enterocytes so Na+ conc in lumen falls resulting in water leaving)

31

How much water goes into the GI tract each day?

2L food and drink 1.5L from saliva
1.5L from stomach 1L from liver bile
1L from pancreatic juice 2.2L from SI and colon
TOTAL OF 9.2L/ day

32

How much water leaves the GI tract each day?

7.8L reabsorbed in SI
1.25L reabsorbed in colon
0.15L lost in faeces

33

How is sodium absorbed into the body and how is this regulated?

Uptake mainly with other substances but also by active transport .
Uptake is increased by Na content in food and increased by raised aldosterone levels

34

How is calcium absorbed into the body and how is this regulated?

Ca2+ absorbed by active transport.
Rate increased by calcitrol (active vitD)

35

How are Mg2+ and Fe2+ absorbed into the body?

Active transport

36

Which vitamins are fat soluble?

A, D, E, K

37

How are fat solube vitamins absorbed?

Absorbed with lipids

38

How often do you need to eat fat soluble vitamins?

Regularly but not daily as they can be stored in the liver or in fat

39

Name 3 types of water soluble vitamins, how do they get absorbed?

Folinic acid, vit C, the B vitamins
Diffuse across epithelium through channels

40

What is coeliac disease?

Allergy to gluten which causes villous atrophy

41

What is pernicous anaemia?

Lack of intrinsic factor production (due to gastritis) resulting in an inability to absorb vitB12

42

What is the main function of the duodenum and how is it adapted for this?

Digestion
Has villi and microvilli to increase surface area for brush border enzymes

43

What is the main function of the jejunum?

Absorbtion
(Sugars/ proteins/ lipids/ water/ ions)

44

What is the main function of the ileum?

Absorbtion of vitamins
(B12/IF complex, ADEK + bile salts)

45

What are the two types of movement of the SI?

Propulsive- Peristaltic waves, caused by gastroenteric reflex (caused by stomach distension)
Mixing (aka segmental)- Local distension causes concentric contractions

46

What are brunners glands in the duodenum and what do they do?

Release alkaline mucus in response to:
Touch, vagal stimulation, secretin

47

What are crypts of lieberkuhn?

In SI they lie between villi. They have an epithelum of goblet cells and enterocytes which secrete water and electrolytes (along with reabsorbing some)

48

What is the iliocecal valve?

Protrudes into lumen of cecum so is forcefully closed when pressure in cecum tried to push contents back into SI. It's normally mildly constricted but relaxes after a meal

49

What is the gastroileal reflex?

After a meal cecum and ileocecal valves relax

50

Where does the majority of iron absorbtion occur and what transporter facilitates this?

Duodenum
By DMT1

Basolateral: Ferroportin removes from cell into blood

51

How does malabsorbption most commonly present?

Chronic diarrhoea, weight loss, muscle wasting

52

What are the 4 types of diarrhoea?

Secretory- Isotonic stool, persists in fasting
Osmotic- (Due to absorbed solutes)
Malabsorptive- Failed nutrient absorption (steatorrheoa and relieved in fasting)
Exudative- Due to inflam disease (bloody/ continues in fasting)

53

Pseudocysts are most commonly a complication of?

Pancreatitis

54

What is the action of H2 receptor antagonists such as cimetidine?

Inhibit gastric acid secretion

55

What are paneth cells and what is their function?

In the epithelium of SI
Secrete anti-microbial compounds when stimulated by bacterial presence

56

What is the gastroenteric reflex?

Stretch in stomach wall stimulates movement of chyme into duodenum and causes peristalsis across whole of SI

57

What is the gastroileal reflex?

Distension of stomach induces opening of ileocecal valve in order to move materials from SI to LI to create room

58

How does material move along the SI?

Some weak peristalsis occurs periodically
Myenteric reflexes and PNS stimulation speed this up

59

What is stomatitis?

Any inflammation of mucus membranes of mouth or lips with or without ulceration (many causes incl chemotherapy)

60

Where is iron absorbed and how much of it do we need?

Absorbed in prox duodenum based on bodies need for it (1-2mg per day)

61

Through which transporter does iron normally enter a cell, which other metals additionally enter through this transporter?

DMT-1
(iron, zinc, copper, cobalt, manganese, lead)

62

What is transferrin?

Carrier iron in blodd, saturation is normally 20-45% (anything over is iron overload)
RBC's take up iron from transferrin by receptor mediated endocytosis)

63

What type of anaemia is iron deficiency anaemia?

Microcytic (often cause by bleeding)

64

What is haemochromotosis?

Iron overload
Causes deposits in tissues such as joints/ heart/ liver and induces free radical formation and cell damage

65

What is the difference between short and long reflexes?

Long: Involves CNS and ENS
Short: Involves only ENS

66

Where are enteroendocrine cells and what do they secrete?

In mucosa
Secrete gastrin/ secretin/ CCK etc

67

What is the role of versatile enterochromaffin cells?

Make up 90% enteroendocrine cells
Detect luminal contents and then release 5-HT to 5-HT3 receptors on nerves to increase their firing

68

How does PNS both excite and inhibit the ENS?

Excites (ACh and substance P) = Increased motility
Inhibits (NO and VIP) = Decreased motility
Remember acts with ENS first!!!
Allows PNS to do two different things at once (gall bladder contract/ duodenal sphincter relax)

69

Which enzyme converts trypsinogen to trypsin?

Enteokinase (on SI brush border)