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NME 2 > NME 2.23 > Flashcards

NME 2.23 Flashcards

1
Q

describe the functional microanatomy of large intestine?

A
  • mostly absorptive epithelial
  • in the crypts are mostly secretory
  • stem cells for regeneration
  • more goblet cells in the colon than small intestine
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2
Q

what is the mucus for?

A
  • lubrication
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3
Q

describe fluid secretion in the colon?

A
  • secrete very little fluid
  • secrete bicarbonate in faeces
  • enhanced secretion will cause loss of potassium and bicarbonate
  • cause acidosis
  • lack of potassium
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4
Q

describe the fluid secretion in the small intestine?

A
  • bicarbonate is secreted

- sodium, chloride, potassium and water is absorbed

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5
Q

describe absorption and secretion of sodium in the duodenum and jejunum?

A
  • sodium will be absorbed
  • water will be absorbed
  • the sodium gradient will draw amino acids into the cells
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6
Q

how is the sodium gradient attained in duodenum and jejunum?

A
  • sodium potassium pump
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7
Q

describe absorption and secretion of sodium in the ileum and proximal colon?

A
  • sodium is absorbed through sodium hydrogen exchanger
  • bicarbonate is pumped out
  • chloride will follow bicarbonate cause bicarbonate secretion
  • sodium absorption and water will follow
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8
Q

describe the absorption and secretion of sodium in distal colon?

A
  • sodium concentration is kept low inside cell
  • sodium concentration is controlled by sodium potassium pump
  • sodium will be absorbed
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9
Q

describe absorption and secretion of chloride?

A
  • paracellular will draw chloride
  • chloride will follow sodium movements
  • bicarbonate is secreted at the ileum, proximal and distal colon
  • build up of chloride concentration inside the cell
  • then when concentration is high enough leave using channel as chloride flow into lumen
  • as chloride move will draw sodium to move togther
  • sodium will draw water movement into the lumen
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10
Q

what is the secretory pathway follow?

A

chloride movement

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11
Q

what is the absorptive pathway driven by?

A

sodium movement

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12
Q

describe the absorption and secretion of potassium at proximal and distal colon?

A
  • secreted at paracellular
  • chloride is absorbed at basolateral therefore sodium and potassium will follow
  • sodium and potassium are recycled
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13
Q

describe the absorption and secretion of potassium at distal colon?

A
  • potassium is absorbed as hydrogen ions is secreted into lumen
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14
Q

describe control of intestinla fluid through enteric nervous system?

A
  • secretagogues increase calcium concentration or cAMP to increase chloride transport cause increase in secretion and decrease in absorption
  • enkephalins and norepinephrine will cause decrease in calcium concentration and increase NaCl absorption and water will follow which cause drying out of faeces
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15
Q

how does angiotensin II help with control of intestinal fluid?

A
  • increase absorption of sodium through apical sodium hydrogen exchange
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16
Q

how does aldosterone help with control of intestinal fluid?

A
  • increase in sodium absorption through ENaC and sodium/potassium ATPase
17
Q

how does somatostatin help with control of intestinal fluid?

A
  • increase in sodium absorption through increase calcium concentration
  • increase NaCl absorption
18
Q

how does guanylin help with control of intestinal fluid?

A
  • secreted by cells
  • stimulate chloride secretion
  • binds to receptors that bacteria or pathogens bind to
19
Q

how does inflammatory mediators help with control of intestinal fluid?

A
  • NF-KB make the paracellular route across epithelia more permeable allowing fluid to pass into the lumen of the intestine
20
Q

how does prostaglandin secretion help with control of intestinal fluid?

A
  • stimulate chloride secretion by increasing cAMP
21
Q

how does antigens help with control of intestinal fluid?

A
  • act on immune cells

- histamine released will cause increase chloride secretion through enteric nervous system

22
Q

how does bacterial toxins affect intestinal fluid?

A
  • cause secretory diarrhoea
  • activation of adenylate cyclase
  • activation of guanylate cyclase
  • opening tight junctions
23
Q

how does cholera affect intestinal fluid

A
  • endocytosis of toxin receptor complex
  • activates adenylate cyclase
  • increase cyclic AMP
  • activation of protein kinase A
  • PKA phosphorylate proteins and opens CFTR
  • increase chloride secretion
24
Q

what does neurotransmitters do to affect control of intestinal fluid?

A
  • activate adenylate cyclse and cause chloride to be secreted
25
Q

what does histamine do to affect control of intestinal fluid?

A
  • activate adenylate cyclase and increase chloride secretion
26
Q

what does pathological alterations do to affect control of intestinal fluid?

A
  • nutrient malabsorption which cause osmotic diarrhoea
  • intestinal hypermotility
  • congenital chloride diarrhoea through chloride malabsorption
  • pancreatic cholera will cause decrease in absorption and cause secretory diarrhoea
27
Q

what three pharmalogical control of diarrhoea by reducing motility?

A
  • morphine
  • opiate
  • atropine
28
Q

what does kaolin do to control diarrhoea?

A
  • absorbents
29
Q

what three pharmalogical control of diarrhoea by inhibiting secretion?

A
  • opiates
  • non-steriodal anti inflammatory agents
  • antibiotic and pro-biotic therapy

NME 2 (24 decks)

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