Physiology

Question 1

Which salivary gland secrets 70% of all secreted saliva

Answer 1

Sub Mandibular Gland

Question 2

The facial nerve carries parasympathetic innervation For which gland

Answer 2

Sub Mandibular and sublingual

Question 3

the glossopharyngeal nerve carries parasympathetic innervation to which bland

Answer 3

parotid

Question 4

Describe the ionic movement of anciner cells As isotonic saliva Is moving through the duct cells

Answer 4

Efflux of chloride and sodium ion; Influx of potassium and bicarbonate ions; net result is hypotonic saliva relative to the plasma

Question 5

the nucleii salvatorii are located in which region of the CNS?

Answer 5

Medulla oblongata

Question 6

is the nucleii salvatorii carry parasympathetic innervation of the salivatory glands. Where are the ganglia & cell bodies for the sympathetic innervation located

Answer 6

cell bodies reside in the Superior cervical ganglion located in vertebral levels T1 to T3

Question 7

What constitutional symptoms inhibit the action of n theucleii salvatorii?

Answer 7

sleep; fatigue; dehydration

Question 8

Salivary glands secrete this glycoprotein To protect this vitamin From acid degradation in the stomach

Answer 8

transcobalamin protects vit. B12

Question 9

sjorgren syndrome Is an autoimmune disease that most often affects women around 50 to 60 years of age. what GI symptoms Are associated with this disorder?

Answer 9

no saliva production increases risk of gum infections and reduces dental protection from cavities

Question 10

Which cranial nerves carry sensory information to the medulla oblongata regarding swallowing

Answer 10

CN V & IX

Question 11

Which cranial nerves carry motor innovation To carry out the act of deglutition?

Answer 11

CN V, IX, X, & XII

Question 12

Relaxation of the lower esophageal spinchner Is regulated by what Endogenous hormone?

Answer 12

Vasoactive intestinal peptide (VIP) & NO

Question 13

In the absence of deglutition, Both esophageal spinchers stay contracted. This ensures that the following pressure gradient is maintained For proper movement of bullets through the esophagus.

Answer 13

Pp > Pues; Pe > Ples

Question 14

Which muscle Is primarily responsible for preventing bolus from entering the trachea And error from the esophagus during Inspiration

Answer 14

upper esophageal spinch tur

Question 15

Which neurotransmitters are involved in contraction of the lower esophageal spinach?

Answer 15

Ach & substance P

Question 16

Which layer of the gi canal Is missing in Zenker’s diverticulum

Answer 16

muscularis layer

Question 17

What is the pathogenesis of scleroderma

Answer 17

Excess production of collagen

Question 18

How would Excessive collagen production affect Mastication & deglutition

Answer 18

Epithelial thickening will make it harder to contract muscles and therefore reduce the amplitude of contraction
mastication is not affected
degluition however is affected

Question 19

Which cranial nerve Innervates autonomics of both esophageal spinach

Answer 19

Vagus

Question 20

How would chewing and swallowing be impacted if the lower esophageal spinchter Stays contracted

Answer 20

Bolus will stay in the esophagus Because pressure of the LES will exceed that of the esophagus
AKA: achalasia

Question 21

What happens when there is an increase in the amplitude of esophageal contractions Which is the case for diffuse esophageal spasm

Answer 21

bolus Will still be able To move through the esophagus into the stomach but at a much faster rate than normal

Question 22

How will mastication and deglutition be impacted if the pharynx is paralysed

Answer 22

Mastication and swallowing mechanisms will be impaired

Question 23

What dysfunction is occurring For gastroesophageal reflux disease

Answer 23

Dysfunctional LES

Question 24

What neuronal pathway Regulates secretion of gastric acid

Answer 24

M3

Question 25

Which cells regulate the hormonal pathway of gastric acid secretion

Answer 25

gastrin cells

Question 26

which cells are involved in the regulation of the paracrine pathway of gastric acid secretion

Answer 26

ECL & D cells

Question 27

What hormone is the primary inhibitor of gastric acid production

Answer 27

somatostatin

Question 28

secretin is secreted by which cells?

Answer 28

S cells

Question 29

What is the primary function of gastric secretin?

Answer 29

inhibition Of gastric Acid secretion (not production)

Question 30

somatostatin is secreted by what cells?

Answer 30

D cells

Question 31

Which cells can be stimulated by histamine

Answer 31

parietal cells

Question 32

What effect does histamine have on the regulation of gastric acid secretion

Answer 32

Stimulates parietal cells to secrete acid

Question 33

What are the primary stimulators of gastric acid secretion

Answer 33

histamine; gastrin; acetylcholine

Question 34

what are the main inhibitors of gastric acid secretion

Answer 34

Somatostatin; Secretin

Question 35

sight, smell, taste, & thoughts of food stimulate vagus action on the stomach; what cells are activated during this 1st step: cephalic phase

Answer 35

Mucus cells; chief cells; parietal cells; g cells

Question 36

What new players are introduced During the gastric phase (step 2) of gastric secretion

Answer 36

Short reflex: Submucosal and Myanteric Plexissors Long Reflex: Vaso-vagal

Question 37

Step three or the intestinal phase of gastric secretion Introduces what new players into the action

Answer 37

Secretin; duodenal stretch and chemoreceptors, CCK & GIP

Question 38

What are the net metabolic effects of the gastric phase

Answer 38

Lower ph; distension; protein metabolites

Question 39

what are the net metabolic effects of the intestinal phase

Answer 39

hyper osmolarity; acidic chyme; fats

Question 40

CCK & GIP also inhibit HCl secretion but to a much lesser extent than secretin & somatostatin. Which cells secrete the former and the latter

Answer 40

K cells secret GIP I cells to create CCK

Question 41

cell bodies of sympathetic innervation to the stomach are located where

Answer 41

celiac ganglion

Question 42

what is the primary role of the meissner plexus?

Answer 42

control of local gi secretion and nutrient absorption

Question 43

What is the primary role of the auerbach plexus?

Answer 43

Intrinsic myogenic control of the GI tract

Question 44

what is the primary function of motilin?

Answer 44

produced by Mo cells; activated during fasted state; clears the stomach of any residue remaining from the previous meal

Question 45

Describe the process of receptive relaxation

Answer 45

Allows the stomach to accommodate large amounts of food and fluid; this is mediated by the vaso-vagal reflex and VIP

Question 46

gastrin stimulates parietal cells to release what and ECL cells to release what

Answer 46

HCL & histamine

Question 47

How does alcohol affect gastric motility

Answer 47

Stimulates gastric emptying

Question 48

how does gastrin affect gastric emptying

Answer 48

inhibits gastric emptying by increasing tone of the pyloric sphincter

Question 49

What is the primary function of GIP

Answer 49

contraction of the pyloric spinchter

Question 50

What are the primary roles of the enterogastric reflex

Answer 50

Increased tone of pyloric spinchter; Decreased rate of pyloric pump contractions; Inhibition of gastric emptying

Question 51

What is the primary role of cck in regulation of gastric motility

Answer 51

inhibition of pyloric pump; increased tone of the pyloric spinchter

Question 52

How does depression affect gastric emptying

Answer 52

Decreases gastric emptying

Question 53

How do anger and stress affect gastric emptying

Answer 53

Increases gastric ending

Question 54

How is bile acid from the gallbladder released into the bile duct

Answer 54

CCK facilitates contraction of gallbladder smooth muscle to release bile into the duct

Question 55

how Is bile In the bile duct released into the duedenum

Answer 55

CCK stimulates relaxation of the spinchter of Oddi

Question 56

How does CCK act as a neurotransmitter in addition to a hormone

Answer 56

CKK Also stimulates vagal afferents to initiate a positive feedback loop that further enhances acid secretion

Question 57

whatt Neurotransmitters and pathways are involved in vagus induced biliary secretion

Answer 57

vagal afferents stimulate the dorsal vagal complex to send vagal efferents down to the gallbladder to enhance biliary secretion Vagal efferents: AcH: gallbladder contraction NO & VIP: relaxation of sphincter of Oddi

Question 58

what biomolecules in the duodenum lumen stimulate secretion of CCK

Answer 58

lipids & fatty acids

Question 59

Pancreatic & gallbladder inflammation is likely to precipitate what kind of gall stones?

Answer 59

brown pigment stones

Question 60

Abnormal cholesterol metabolism is likely to promote the formation of what kind of stones

Answer 60

All cholesterol stones (most common) are derived from the gallbladder but can travel to the bile or cystic ducks

Question 61

What kind of stones would you expect to find in the gallbladder of a patient With a hemalytic disease

Answer 61

black stones (most commonly arise from the GB)

Question 62

What are primary bile acids

Answer 62

bile acids that are produced directly in the liver colic acid chenodeoxycholic acid

Question 63

what are secondary bile acids

Answer 63

These are primary bile acids With a removed hydroxyl group By the gut flora: deoxycholic acid lithocholic acid

Question 64

What amino acids are Used in the conjugation process of bile acids

Answer 64

glycine and taurine

Question 65

What's the difference between a bile acid and a bile salt

Answer 65

Bile salts are the product of bile acid conjugation

Question 66

Why Is bile acid conjugated to bile salt

Answer 66

Bile salts are more soluble in the duodenum

Question 67

What is the name of the detergent property of bile salts

Answer 67

amphipathic: both hydrophilic & lipophilic

Question 68

Describe the process of emulsification

Answer 68

Takes place in the small intestine Lipids are consumed by bile salts to form micelles when exposed to water

Question 69

What is the primary function of bile

Answer 69

Digestion and absorption of lipids and fat soluble vitamins Which include vitamin A, D, E, K

Question 70

What are other functions of bile

Answer 70

buffers pancreatic and duodenal content because bile content also contains bicarbonate ions

Question 71

Almost 100 percent of all dietary lipids are what type

Answer 71

triglycerides

Question 72

In what vessels does the distribution of chylomicrons take place

Answer 72

lacteal lymphatic vessels situated in The intestinal interstitum

Question 73

Where does the assembly of micells take place

Answer 73

in the lumen Of the small intestine

Question 74

Where does the breakdown of lipids to fatty acids and monoglycerides take place

Answer 74

lumen of the small intestine

Question 75

What happens after the fatty acids and monoglycerides passively diffuse into the epithelium of the small intestine

Answer 75

they are reformed into triglycerides And packaged into lipoproteins called Chylomicrons

Question 76

chylomicrons are exocytosed into the lacteal and enter what duct

Answer 76

Thoracic duct and then to liver

Question 77

conjugated bile acids are reabsorbed in which section of the small intestine

Answer 77

terminal ilium

Question 78

How are bile salts transported into enterohepatic circulation

Answer 78

Passive diffusion (unconjugated bile acids) And via active transportation through sodium bile salt co-transporters (conjugated bile acids)

Question 79

Which two co activators Are required for activation of fxr transcription

Answer 79

Retinoic and bile acids

Question 80

FXR inhibits what metabolic pathways

Answer 80

Gluconeogenesis; lipogenesis; Cholesterol Conversion to bile acid; BA reabsorption in the intestine

Question 81

FXR Promotes the release of what factor to inhibit the conversion of cholesterol to bile acids

Answer 81

FGF 19

Question 82

What role does FXR play in the conjugation process of BA

Answer 82

It reduces ba toxicity by increasing the expression of BA modifying enzymes

Question 83

How does FXR decrease BA reabsorption in the small intestine

Answer 83

It down regulates expression of the sodium dependent BA transporter On the apical side of the intestinal epithelium This promotes absorption of BA into enterohepatic circulation to be recycled

Question 84

Fxr Up regulates expression of this protein in fatty liver disease

Answer 84

ceramide

Question 85

How does FXR have an anti inflammatory effect

Answer 85

Promotes differentiation to the macrophage M2 phenotype And up regulates secretion of IL-10 both of which are anti inflammatory mediators

Question 86

where are Pancreatic juices produced

Answer 86

the pancreatic acinus

Question 87

In what cells are zymogen granules stored

Answer 87

acinar cells

Question 88

Pancreatic duct cells secret

Answer 88

bicarbonate

Question 89

the Endocrine component of the pancreas involves what hormones

Answer 89

Cck and secretin

Question 90

The neurocrine Component of the pancreas involves what substances

Answer 90

substance P; Ach; grp; VIP

Question 91

What second messengers Are involved in receptor mediated exocytosis of pancreatic juices

Answer 91

Calcium and cyclic amp

Question 92

What pancreatic cells secrete CCK

Answer 92

I cells

Question 93

What key zymogen Is secreted by the pancreas To activate all other pancreatic proteases once they enter the duodenum

Answer 93

Tripsynogen

Question 94

What duodenal enzyme Converts trypsinogen to trypsin

Answer 94

Enterokinases Located on the Brush border of duodenal enterocytes

Question 95

What pancreatic enzymes Break peptide bonds to form peptide fragments

Answer 95

Tripsyn, elastase, chymotrypsin

Question 96

What pancreatic enzyme cleaves the terminal carboxyl Segment of peptides into amino acid monomers

Answer 96

carboxypeptidase

Question 97

Amino acids are absorbed into enterocytes via what co-transporter ion

Answer 97

sodium

Question 98

What role does secretin have in the pancreatic duct cells

Answer 98

biCarbonate & water secretion

Question 99

VIP & GRP specifically act on pancreatic acinar cells to stimulate what?

Answer 99

Secretion of digestive enzymes

Question 100

How is water transported Into the pancreatic lumen

Answer 100

via an Osmotic gradient

Question 101

What drives Sodium ion transportation into the pancreatic lumen

Answer 101

Electrical gradient +charged BLM to the -charged AM

Question 102

What condition stimulates pancreatic s cells to secrete secretin

Answer 102

low pH in the duodenal lumen

Question 103

What effect does secretin have on ductal cells in the pancreas to promote secretion of bicarbonate into the pancreatic duct lumen

Answer 103

It increases intracellular cyclic amp which is a second messenger that enhances the activity of CFTR

Question 104

How is bicarbonate secreted into the lumen of the pancreatic duct on the apical side

Answer 104

facilitated via CFTR: Exchanges bicarbonate For chloride

Question 105

What effect do acetylcholine and CCK have in pancreatic S cells

Answer 105

Potentiation of cyclic amp

Question 106

What is the primary role of Secretin in the pancreas

Answer 106

facilitation of bicarbonate secretion in the gi canal

Question 107

what is the primary role of pancreatic CCK

Answer 107

Digestion of fats and protein

Question 108

What effect Do vagal efferents have on pancreatic duct cells

Answer 108

Potentiation of bicarbonate secretion

Question 109

What effect do vagal efferents have on pancreatic aciner cells

Answer 109

Stimulates release of zymogens

Question 110

What substances can stimulate the vago-vagal reflex?

Answer 110

CCK & monomers of macro-biomolecules