Phys Flashcards
(145 cards)
What are the functions of the gut (5)?
Digestion of food Absorption of nutrients Excretion of waste Prevention of invasion by pathogens Contains microbiome
What is the difference between fermentation and digestion?
Fermentation is bacterial and yeast based
Digestion is enzymatic
What needs to be regulated in the gut?
- Contraction of smooth muscle
- Secretion of digestive enzymes and solvents
- Water re-absorbtion
- Coordinate widely separated regions.
Why is it important for the gut to control smooth muscle contractions?
1) mixing/segmentation mixes water, enzymes, food 2) peristalsis propels contents
Why is it essential to control secretion of digestive enzymes and solvents
b. Regulate secretion of digestive enzymes and the solvents they require for proper function
i. Water into GI lumen → essential as digestive enzymes are water soluble [10L in, 9.9L reabsorbed]
1. If this process fails → diarrhoea or constipation (18 hours for death cf. 3 days for kidney)
ii. Bile from gall bladder
What is it important to control water re-absorbtion
prevent dehydration
9.9L secreted into the gut needs to be recycled
What is it important to coordinate coordinate the separate regions of the gut?
Need to properly regulate in order to regulate gastric emptying and ensure appropriate absorption of nutrients and re-absorption of water
What nervous system acts at a local level to regulate contractile activity and secretion of water and electrolytes?
The ENS and the Interstitial cells of Cajal
They also have the basic elements required to produce complex motor programs
What is the Enteric nervous system?
It is the intrinsic NS of the gut, component of the ANS, it has many neurons (more than the spinal cord)
What is the myenteric plexus?
- Myenteric plexus → between longitudinal and circular muscle layers
a. Provides motor innervation to both muscular layers
b. Has both parasympathetic and sympathetic input
c. It is the major nerve supply to the gastrointestinal tract and controls GI tract motility
What is the submucosal plexus?
- Submucosal plexus secretes NPY and ACh (immunoreactive) → It is found beneath circular muscle
a. Present from esophagus to anus; only neuron cell bodies from pylorus to anus
b. Neurons control movement of water and electrolyte across gut
c. Cells grouped together in smaller ganglia connected by nerve trunks
What is the role of the endocrine cells of the gut?
Signal from intestinal mucosa to ancillary organs like brain, pancreas and gall bladder
How does the intestinal mucosa act as an endocrine organ?
i. Intestinal mucosa is largest endocrine organ → hormone release → local regulation at a paracrine level to activate ENS, endocrine systems acting on peripheral organs and CNS (appetite / satiety)
ii. Essential for 1) secretion of enzymes and solvents into intestinal lumen 2) appetite regulation
What are MUCOSAL ENTEROENDOCRINE (EE) CELLS?
Endocrine cells in the mucosa
Many types defined by mediators they contain eg. 5HT containing EC cells (CCK, secretin, somatostatin, glucagon like peptides 1,2)
What are Enterochromaffin like-cell (ECL)?
contain and release histamine [stomach acid secretion]
What is the role of serotonin in the GIT?
SEROTONIN → 90% located in the gut with EC cell; controversial role
a. Serotonin acts as sensory intermediate in the gut lumen → activation of nerve signals to the brain through primary afferent neurons AND ENS activation
What do the vago-vagal reflex pathways do?
Coordinate movements in upper GI tract
What are the specific roles of the Vegus in the upper GIT?
1) control of swallowing ie. esophagus
2) acid secretion in stomach
3) coordinates contractions of stomach + duodenum
What type of neurons does the vegus nerve trunk contain?
10% of efferent to upper GIT. + 90% of sensory (primary afferent) axons to brain
- Pathways that control the upper intestine involve substantial feedback going up from the stomach to the brain and then back again down the efferents to regulate function
- Final behavior is produced because the vagus modulates the activity of the enteric NS locally within the regions that are involved (regulating complex circuitry going on in the periphery)
What mediates the intestino-intestinal reflexes?
- Some mediated by Vagus
a. Likely to be excitatory - Others via Dorsal root ganglia and spinal cord
a. Likely to be inhibitory (spinal cord – sympathetic) - Viscero fugal neurons: (enteric Neurons)
a. Cell bodies within the intestine
What are the intestino-intestinal reflexes?
3) project from GIT to pre-vertebral sympathetic ganglia and produce reflex inhibition of proximal regions when distal regions are distended (e.g. distention of colon inhibits motor activity in SI = reduced SM contraction and secretory activity
What is the CNS role in the GIT
- anticipation,
- mood,
- activity:
- e.g. nervous/anxious/fear/stress butterflies, increased bowel movements.
What is the role of vagal and sympathetic input?
Vagal and sympathetic input usually modulate enteric neural circuits
What is the role of GI hormones?
Many GI hormones excite enteric neurons and extrinsic sensory neuron terminals via a paracrine action before entering blood stream