Lecture 3 GI

Question 1

4 Components of response to a meal

Answer 1

Cephalic, Gastric, Intestinal, and Interdigestive.

Question 2

The cephalic phase begins with ____

Answer 2

The cephalic phase begins with presentation and ingestion of a meal.

Question 3

cephalic phase

The sight, smell and taste of food as well as ____ of the oral cavity and swallowing initiate a number of ____ which alter GI activities.

During this phase, ____is stimulated by ____ reflexes mediated by ___ nerves.

Answer 3

The sight, smell and taste of food as well as mechanical stimulation of the oral cavity and swallowing initiate a number of “long” reflexes (2-6) which alter GI activities.

During this phase, salivation is stimulated by cholinergic reflexes mediated by parasympathetic nerves.

Question 4

cephalic phase

Reflexes initiated during swallowing stimulate ___ in the esophagus and cause relaxation of…..

Answer 4

Reflexes initiated during swallowing stimulate primary peristalsis in the esophagus and cause relaxation of the upper and lower esophageal sphincters.

Question 5

cephalic phase

Vagal reflexes inhibit contractile activity in the ____

Answer 5

Vagal reflexes inhibit contractile activity in the proximal stomach [receptive relaxation].

Question 6

cephalic phase

Vagal reflexes initiated during the cephalic phase also stimulate ____ by parietal cells in the stomach.

These “long” reflexes, acting through cholinergic neurons of the enteric nerve plexus, stimulate secretion of ___ by parietal cells and secretion of ___ by enterochromaffin-like (ECL) cells.

Histamine in turn stimulates parietal cell secretion of ___.

Answer 6

Vagal reflexes initiated during the cephalic phase also stimulate acid secretion by parietal cells in the stomach. These “long” reflexes, acting through cholinergic neurons of the enteric nerve plexus, stimulate secretion of HCl by parietal cells and secretion of histamine by enterochromaffin-like (ECL) cells. Histamine in turn stimulates parietal cell secretion of acid.

Question 7

cephalic phase

vagal reflexes to the antrum stimulate secretion of ____ from G cells.

Elevated levels of circulating ___ increase acid secretion by direct stimulation of ___ cells and by stimulating ___ secretion from ECL cells.

Answer 7

vagal reflexes to the antrum stimulate secretion of the hormone gastrin from G cells. Elevated levels of circulating gastrin increase acid secretion by direct stimulation of parietal cells and by stimulating histamine secretion from ECL cells.

Question 8

cephalic phase

Vagal reflexes also induce a relatively small stimulation of ____ by the exocrine ____.

Answer 8

Vagal reflexes also induce a relatively small stimulation of enzyme secretion by the exocrine pancreas.

Question 9

cephalic phase

During the cephalic phase the process of digestion of complex carbohydrates is begun due to the activity of ____ secreted in ___. Little absorption occurs during this phase.

Answer 9

During the cephalic phase the process of digestion of complex carbohydrates is begun due to the activity of amylase secreted in saliva. Little absorption occurs during this phase.

Question 10

Gastric phase

The gastric phase begins when ____.

Distention of the stomach (*) activates ____ initiating a number of reflexes (1-7) which alter gastric, intestinal, colonic and pancreatic activities.

Answer 10

The gastric phase begins when food enters the stomach. Distention of the stomach (*) activates stretch receptors initiating a number of reflexes (1-7) which alter gastric, intestinal, colonic and pancreatic activities.

Question 11

Gastric phase

(1) Gastric acid secretion is stimulated by_____ and (2) “short” reflexes mediated by the _____

Answer 11

(1) Gastric acid secretion is stimulated by “long” vago-vagal reflexes and (2) “short” reflexes mediated by the enteric nerve plexus.

Question 12

Gastric phase

Long and short reflexes enhance acid secretion by: a) ____ stimulation of parietal cells,

b) stimulation of _____ secretion by ____cells &
c) stimulation of ____secretion by G cells.

Answer 12

Long and short reflexes enhance acid secretion by: a) cholinergic stimulation of parietal cells, b) stimulation of histamine secretion by enterochromaffin-like (ECL) cells and c) stimulation of gastrin secretion by G cells.

Question 13

Gastric phase

The hormone gastrin stimulates acid secretion by _____ and by stimulating _____

Answer 13

The hormone gastrin stimulates acid secretion by direct stimulation of parietal cells and by stimulating histamine secretion by ECL cells.

Question 14

Gastric phase

If the meal contains protein, protein digestion products (e.g. peptides) produced by the activity of acid and pepsin will stimulate ____ further enhancing _____

Answer 14

If the meal contains protein, protein digestion products (e.g. peptides) produced by the activity of acid and pepsin will stimulate G cell secretion of gastrin further enhancing acid secretion.

Question 15

Gastric phase

As acid is secreted, the pH of the lumenal contents
____.

Reduction of the pH will stimulate secretion of ____ from D cells in the stomach.

Answer 15

As acid is secreted, the pH of the lumenal contents

decreases. Reduction of the pH will stimulate secretion of somatostatin from D cells in the stomach.

Question 16

Gastric phase

Somatostatin acts to prevent ____ by inhibiting secretion of ____ and _____

Answer 16

Somatostatin acts to prevent excessive production of acid by inhibiting secretion of gastrin from G cells and histamine from ECL cells.

Question 17

Gastric phase

In addition to stimulating gastric acid secretion, long and short reflexes (1, 2) and elevated circulating gastrin stimulate ______

Answer 17

In addition to stimulating gastric acid secretion, long and short reflexes (1, 2) and elevated circulating gastrin stimulate gastric motility.

Question 18

Gastric phase

Long and short cholinergic reflexes stimulate secretion of ____ from ____ cells.

Answer 18

Long and short cholinergic reflexes stimulate secretion of pepsinogen from chief cells.

Question 19

Gastric phase

Gastrin released during the gastric phase causes an increase in the contractile activity of the ___ and relaxation of the____ while long reflexes may induce (6) _____.

Vagal reflexes also cause a relatively small (7) stimulation of enzyme secretion by the _____

Answer 19

Gastrin released during the gastric phase causes an increase in the contractile activity of the ileum and relaxation of the ileocecal sphincter [gastroileal reflex] while long reflexes may induce (6) mass movement in the distal colon [gastrocolonic reflex]. Vagal reflexes also cause a relatively small (7) stimulation of enzyme secretion by the exocrine pancreas.

Question 20

Gastric phase

In the stomach some proteins are digested by ___ & ___. Little absorption occurs during this phase.

Answer 20

In the stomach some proteins are digested by acid and pepsin. Little absorption occurs during this phase.

Question 21

The intestinal phase begins when ____ enters the ___.

Answer 21

The intestinal phase begins when chyme enters the small intestine.

Question 22

Intestinal phase

Chyme entering the small intestine initiates reflexes and hormonal mechanisms (1-5) which alter the activities of ….

Answer 22

Chyme entering the small intestine initiates reflexes and hormonal mechanisms (1-5) which alter the activities of the small intestine, pancreas, gallbladder and stomach

Question 23

Intestinal phase

As chyme empties from the stomach into the small intestine, the resulting ____(*) stimulates____

Answer 23

As chyme empties from the stomach into the small intestine, the resulting distention (*) stimulates intestinal contractile activity.

Question 24

Intestinal phase

Intestinal chyme also stimulates _____. Acidic chyme entering the small intestine will stimulate S cells in the mucosa of the ____ to secrete the hormone____.

Answer 24

Intestinal chyme also stimulates exocrine pancreatic secretion. Acidic chyme entering the small intestine will stimulate S cells in the mucosa of the duodenum to secrete the hormone secretin.

Question 25

Intestinal phase Elevated circulating secretin stimulates volume and ____ secretion by _____.

Answer 25

Elevated circulating secretin stimulates volume and bicarbonate secretion by pancreatic ductal cells.

Question 26

Intestinal phase Fat and protein digestion products in intestinal chyme stimulate secretion of _____ from I cells in the ___ & ____. The hormone CCK stimulates secretion of enzymes by _____

Answer 26

Fat and protein digestion products in intestinal chyme stimulate secretion of cholecystokinin (CCK) from I cells in the duodenum and upper jejunum. The hormone CCK stimulates secretion of enzymes by pancreatic acinar cells.

Question 27

Intestinal phase In addition to stimulating pancreatic enzyme secretion, CCK (3) induces contraction of the ____ and relaxation of ______

Answer 27

In addition to stimulating pancreatic enzyme secretion, CCK (3) induces contraction of the gallbladder and relaxation of the sphincter of Oddi.

Question 28

Intestinal phase Acidic chyme, chyme that differs significantly from isotonicity and chyme that contains fat will activate ____ which act to reduce the ______. While the pathways responsible for this inhibition of emptying have not as yet been defined, it is likely that ____ is involved.

Answer 28

Acidic chyme, chyme that differs significantly from isotonicity and chyme that contains fat will activate duodenal receptors which act to reduce the rate of gastric emptying. While the pathways responsible for this inhibition of emptying have not as yet been defined, it is likely that CCK is involved.

Question 29

Intestinal phase The presence of acidic or hyperosmotic chyme or chyme containing fat in the small intestine causes a reduction in _____. Part of this inhibition is due to ____ and part is the result of secretion of as yet unidentified hormones collectively known as ____.

Answer 29

The presence of acidic or hyperosmotic chyme or chyme containing fat in the small intestine causes a reduction in gastric secretion of acid. Part of this inhibition is due to neural reflexes and part is the result of secretion of as yet unidentified hormones collectively known as enterogastrones.

Question 30

Intestinal phase Most digestion and absorption occurs while chyme is in ____.

Answer 30

Most digestion and absorption occurs while chyme is in the small intestine.

Question 31

Intestinal phase Organic nutrients such as carbohydrates and proteins are first digested by ___ and then by enzymes in the _____.

Answer 31

Organic nutrients such as carbohydrates and proteins are first digested by pancreatic enzymes and then by enzymes in the brush border membrane of enterocytes.

Question 32

Intestinal phase Fats are digested by pancreatic enzymes with digestion and absorption being facilitated by ____ secreted by the _____.

Answer 32

Fats are digested by pancreatic enzymes with digestion and absorption being facilitated by bile salts (acids) secreted by the liver.

Question 33

Intestinal phase Some organic nutrients are absorbed by ____ (e.g. glucose, amino acids, dipeptides), some by _____ (e.g. fructose) and others by ____ (e.g. monoglycerides, fatty acids, cholesterol, fat soluble vitamins).

Answer 33

Some organic nutrients are absorbed by secondary active transport (e.g. glucose, amino acids, dipeptides), some by facilitated diffusion (e.g. fructose) and others by simple diffusion (e.g. monoglycerides, fatty acids, cholesterol, fat soluble vitamins).

Question 34

Intestinal phase In addition to organic nutrients, most electrolytes (e.g. sodium, potassium, chloride, bicarbonate) are absorbed/reabsorbed from the ____. Absorption of organic nutrients and electrolytes (particularly NaCl) sets up an osmotic gradient resulting in ____ of fluid. Most fluid (>90%) is absorbed/reabsorbed out of the______.

Answer 34

In addition to organic nutrients, most electrolytes (e.g. sodium, potassium, chloride, bicarbonate) are absorbed/reabsorbed from the small intestine. Absorption of organic nutrients and electrolytes (particularly NaCl) sets up an osmotic gradient resulting in absorption of fluid. Most fluid (>90%) is absorbed/reabsorbed out of the small intestine.

Question 35

The interdigestive phase is the period of ____ after most of the components of the previous meal have been ___ & ___ and the stomach and small intestine are relatively ____.

Answer 35

The interdigestive phase is the period of fasting after most of the components of the previous meal have been digested and absorbed and the stomach and small intestine are relatively empty

Question 36

Interdigestive phase This phase is characterized by brief periods of _____ appearing first in the ____ and then in the upper, middle and finally the distal small intestine.

Answer 36

This phase is characterized by brief periods of intense peristaltic contractions appearing first in the stomach and then in the upper, middle and finally the distal small intestine.

Question 37

Interdigestive phase These periods of intense contractile activity last for only 5-10 min and are followed by....

Answer 37

These periods of intense contractile activity last for only 5-10 min and are followed by longer relatively quiescent periods.

Question 38

Interdigestive phase This pattern (contraction/relaxation) repeats at intervals of approximately 90 min and has been called the ____. The MMC appears to be initiated in the stomach by cyclical changes in the level of circulating ____ and is abolished by ____.

Answer 38

This pattern repeats at intervals of approximately 90 min and has been called the migrating motility complex (MMC). The MMC appears to be initiated in the stomach by cyclical changes in the level of circulating motilin and is abolished by eating.

Question 39

Interdigestive phase In the colon, some components of the chyme are degraded by____ while residual electrolytes and fluid are _____

Answer 39

In the colon, some components of the chyme are degraded by colonic bacteria while residual electrolytes and fluid are absorbed.

Question 40

Interdigestive phase Because chyme remains in the colon for a protracted period of time, colonic processing usually occurs during ...

Answer 40

Because chyme remains in the colon for a protracted period of time, colonic processing usually occurs during all four phases of the digestive process.

Question 41

Interdigestive phase Division of the digestive process into these four phases is somewhat arbitrary since there is considerable temporal overlap among the phases. Thus, control mechanisms from different phases may be operating ______

Answer 41

Division of the digestive process into these four phases is somewhat arbitrary since there is considerable temporal overlap among the phases. Thus, control mechanisms from different phases may be operating concurrently.

Question 42

Diarrhea refers to the _______. It is sometimes | clinically defined as > 250 g of feces/day.

Answer 42

Diarrhea refers to the frequent passage of soft unformed watery stools. It is sometimes clinically defined as > 250 g of feces/day.

Question 43

Diarrhea results when the volume of fluid delivered to small intestine and colon .... This may be due to an increase in the ____ delivered and/or to a decrease in ______

Answer 43

Diarrhea results when the volume of fluid delivered to small intestine and colon exceed their ability to absorb that fluid. This may be due to an increase in the volume of fluid delivered and/or to a decrease in absorptive capacity.

Question 44

Osmotic diarrheas are diarrheas caused by ....

Answer 44

Osmotic diarrheas are diarrheas caused by retention of ingested solute in the lumen of the small intestine and colon.

Question 45

Osmotic diarrheas Retention of solute in the small intestine will require ____ to maintain isotonicity. The volume of fluid delivered to the colon may exceed its _____ thereby causing an osmotic diarrhea.

Answer 45

Retention of solute in the small intestine will require additional water retention to maintain isotonicity. The volume of fluid delivered to the colon may exceed its absorptive capacity thereby causing an osmotic diarrhea.

Question 46

Osmotic diarrheas can be caused by: 1) ingestion of solutes that are ____ (e.g. Mg salts, sorbitol), 2) primary ____(e.g. loss of solute transporter, uncommon) and 3) malabsorption secondary to_____.

Answer 46

1) ingestion of solutes that are inherently difficult to absorb (e.g. Mg salts, sorbitol), 2) primary malabsorptions (e.g. loss of solute transporter, uncommon) and 3) malabsorption secondary to maldigestion.

Question 47

Osmotic diarrheas A relatively common cause of osmotic diarrhea is _____

Answer 47

A relatively common cause of osmotic diarrhea is lactose intolerance (a malabsorption secondary to maldigestion).

Question 48

Osmotic diarrheas Lactose induced diarrhea occurs when an individual, who has lost the_____, ingests dairy products. The milk sugar lactose cannot be digested and therefore cannot be ____resulting in an osmotic diarrhea.

Answer 48

Lactose induced diarrhea occurs when an individual, who has lost the brush border enzyme lactase, ingests dairy products. The milk sugar lactose cannot be digested and therefore cannot be absorbed resulting in an osmotic diarrhea.

Question 49

Osmotic diarrheas Osmotic diarrheas are usually______

Answer 49

Osmotic diarrheas are usually LARGE VOL DIARRHEAS (> 1000 ml/day) that abate when fasting.

Question 50

Secretory diarrhea resulting from: 1) intestinal and/or colonic secretion of ___ into the lumen of the GI tract. This increases the ____ of the ____ causing concomitant secretion of ____

Answer 50

diarrheas resulting from 1) intestinal and/or colonic secretion of electrolytes into the lumen of the GI tract. This increases the osmolarity of the chyme causing concomitant secretion of water.

Question 51

Secretory diarrhea may be caused by _____. These bacteria produce enterotoxins that stimulate ______.

Answer 51

may be caused by bacterial infections of the GI tract (e.g. cholera). These bacteria produce enterotoxins that stimulate intestinal and colonic secretion.

Question 52

Secretory diarrhea _____ can cause a secretory diarrhea. In the colon, bacteria metabolize fats to produce substances that are secretogogues to ____

Answer 52

Fat malabsorption can cause a secretory diarrhea. In the colon, bacteria metabolize fats to produce substances that are secretogogues to colonocytes.

Question 53

Secretory diarrhea Secretory diarrheas are ____ and those caused by bacterial enterotoxins do not abate when ______.

Answer 53

Secretory diarrheas are large volume diarrheas (> 1 L/day) and those caused by bacterial enterotoxins do not abate when fasting.

Question 54

Exudative diarrhea results from ____ to the mucosa causing impairment of ____ and exudation of serum proteins, ____, mucus and _____.

Answer 54

result from gross structural damage to the mucosa causing impairment of absorption and exudation of serum proteins, white cells, mucus and blood.

Question 55

Exudative diarrhea One class of exudative diarrheas is the _____

Answer 55

One class of exudative diarrheas is the dysenteries

Question 56

Exudative Dysentery refers to diarrhea containing visible ____. Two specific varieties are ____ (Shigella) and _____ (amebiasis) often caused by Entamoeba histolitica.

Answer 56

Dysentery refers to diarrhea containing visible blood and mucus. Two specific varieties are bacillary dysentery (Shigella) and amoebic dysentery (amebiasis) often caused by Entamoeba histolitica.

Question 57

Exudative diarrhea Additional causes of exudative diarrheas are the inflammatory bowel diseases: ___ & _____

Answer 57

Additional causes of exudative diarrheas are the inflammatory bowel diseases: Ulcerative Colitis, and Crohn' s Disease.

Question 58

Exudative diarrheas are characterized by _____ (> 6 times/day) of small volume stools 1 L/day)

Answer 58

Exudative diarrheas are characterized by frequent passage (> 6 times/day) of small volume stools 1 L/day)

Question 59

Increased motility the role of hyper-motility as a primary cause of diarrhea is uncertain but _____ is undoubtedly a contributing factor in diarrheas resulting from a variety of causes.

Answer 59

the role of hyper-motility as a primary cause of diarrhea is uncertain but increased motor activity is undoubtedly a contributing factor in diarrheas resulting from a variety of causes.

Question 60

Increased motility Altered motility is probably an important factor in the irregular bowel function seen in ______ (see constipation).

Answer 60

Altered motility is probably an important factor in the irregular bowel function seen in irritable bowel syndrome (see constipation).

Question 61

excess use of ___ may be a primary cause of diarrhea.

Answer 61

Laxatives: excess use of laxatives may be a primary cause of diarrhea.

Question 62

Chronic diarrhea can result in.....

Answer 62

Chronic diarrhea can result in dehydration, hyponatremia, hypokalemia, metabolic acidosis and, in severe cases, death.

Question 63

Constipation refers to _____ It is hard to specify “normal" frequency of bowel movements. “Normal" varies from after every meal or once or twice a week.

Answer 63

Constipation refers to infrequent or difficult evacuation of the feces. It is hard to specify “normal" frequency of bowel movements. “Normal" varies from after every meal or once or twice a week.

Question 64

Causes of constipation

Answer 64

1. Blockage of the rectum 2. Dilated or atrophic colon 3. Elevated levels of progesterone (constipation of pregnancy) 4. Lack of dietary fiber 5. Emotional disturbances (depression) 6. Medications, e.g. chronic opiates (cancer patients)

Question 65

The symptoms of constipation may include ____.

Answer 65

The symptoms of constipation may include mental depression, restlessness, dull headache, loss of appetite and sometimes nausea and abdominal discomfort.

Question 66

The symptoms of constipation appear to be caused by prolonged distention of the ____ and ___ and not due to absorption of ___ from the retained fecal material (autointoxication).

Answer 66

The symptoms of constipation appear to be caused by prolonged distention of the descending colon and rectum and not due to absorption of “toxins” from the retained fecal material (autointoxication).

Question 67

A common cause of irregular bowel habits is ___ or ___

Answer 67

A common cause of irregular bowel habits is Irritable Bowel Syndrome (IBS) or Spastic Colon.

Question 68

IBS symptoms include episodes of ____, bloating and alternating __ & ___. The cause of IBS is ___.

Answer 68

IBS symptoms include episodes of abdominal pain, bloating and alternating diarrhea and constipation. The cause of IBS is unknown.

Question 69

Perhaps 20% of the population has symptoms of IBS. IBS is the most common GI disorder and the most common cause of...

Answer 69

Perhaps 20% of the population has symptoms of IBS. IBS is the most common GI disorder and the most common cause of outpatient visits to gastroenterologists.

Question 70

Breakdown in mucosa of stomach or intestine causes ____. They are located in stomach and/or ____. The lesions can vary in size from 5 mm to several centimeters.

Answer 70

Breakdown in mucosa of stomach or intestine. Ulcers (also known as peptic ulcers) are located in stomach and/or duodenum. The lesions can vary in size from 5 mm to several centimeters.

Question 71

Ulcers may lead to complications such as ____, obstruction, penetration, and _____.

Answer 71

Ulcers may lead to complications such as GI bleeding, obstruction, penetration, and perforation of the GI tract.

Question 72

H. pylori This type of ulcer was originally thought to be due to ___. H. Pylori are spiral gram-negative ___-producing bacterium found in the mucus coating the ____ or between the mucous layer and ____.

Answer 72

This type of ulcer was originally thought to be due to stress. H. Pylori are spiral gram-negative urease-producing bacterium found in the mucus coating the gastric mucosa or between the mucous layer and gastric epithelium.

Question 73

H. pylori account for 30-60% of gastric ulcers and __-__% of duodenal ulcers. The discovery of the cause of these ulcers and the treatment has drastically reduced the recurrence of these types of ulcers.

Answer 73

H. pylori account for 30-60% of gastric ulcers and 70-90% of duodenal ulcers. The discovery of the cause of these ulcers and the treatment has drastically reduced the recurrence of these types of ulcers.

Question 74

H. pylori Treatment is a combination of drugs to ____ (antihistamines and/or proton pump inhibitors) and _____.

Answer 74

Treatment is a combination of drugs to prevent acid release (antihistamines and/or proton pump inhibitors) and antibiotics.

Question 75

Anti-inflammatory agents are cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) inhibitors. Inhibition of COX-1 inhibits the protection of the ____. Newer COX-2 selective anti-inflammatory inhibitors have reduced the ___ side effects. However, these drugs (Celebrex, Vioxx, Bextra) have been shown to have a small, but significant increased incidence of heart attacks and ____.

Answer 75

Anti-inflammatory agents are cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) inhibitors. Inhibition of COX-1 inhibits the protection of the mucosa. Newer COX-2 selective anti-inflammatory inhibitors have reduced the ulcer side effects. However, these drugs (Celebrex, Vioxx, Bextra) have been shown to have a small, but significant increased incidence of heart attacks and stroke.

Question 76

Zollinger-Ellison syndrome- ____-secreting tumors, account for only 1% of ulcers. Gastrin stimulates ____secretion directly and though stimulation of ____ release from ECL cells.

Answer 76

- gastrin-secreting tumors, account for only 1% of ulcers. Gastrin stimulates HCl secretion directly and though stimulation of histamine release from ECL cells.

Question 77

Gas Stomach: most gas is ____ with volumes varying from 50- 500 cc. Most of this gas is eliminated by ____ but some may pass into the small intestine.

Answer 77

Stomach: most gas is swallowed air with volumes varying from 50- 500 cc. Most of this gas is eliminated by eructation (belching) but some may pass into the small intestine.

Question 78

Gas Small intestine: neutralization of acid with ____ produces large volumes of ___ that is rapidly absorbed. Unless there is obstruction or bacterial overgrowth, there is little ____ in the small intestine.

Answer 78

Small intestine: neutralization of acid with bicarbonate produces large volumes of CO2 that is rapidly absorbed. Unless there is obstruction or bacterial overgrowth, there is little bacterial fermentation in the small intestine.

Question 79

Gas ____: major site for production of gas by bacterial fermentation of ____. Gases (~200 cc) present in the colon may include: CO2, H2, CH4, H2S, N2.

Answer 79

Colon: major site for production of gas by bacterial fermentation of carbohydrates. Gases (~200 cc) present in the colon may include: CO2, H2, CH4, H2S, N2.

Question 80

Gas ____: the sound made as gas passes along the GI tract, particularly as it passes through the _____

Answer 80

Borborygmus: the sound made as gas passes along the GI tract, particularly as it passes through the sphincters

Question 81

Gas Difficult to find definitive data on the average volume and composition of flatus. Volumes range from 500-1500 cc/day. Composition varies depending on the ____ and the ____

Answer 81

Difficult to find definitive data on the average volume and composition of flatus. Volumes range from 500-1500 cc/day. Composition varies depending on the bacterial flora and the diet.

Question 82

Gas Dependent on the pressure gradient between the ___ and ____

Answer 82

Dependent on the pressure gradient between the rectum and the external environment.