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GI > Session 1 > Flashcards

Session 1 Flashcards

1
Q

Purpose of gut

A

Ingest, digest, and absorb what’s needed

Egest what we don’t need

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2
Q

Describe the gut as a tube

A

Has Inputs, is divided into regions (usually by sphincter)

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3
Q

What is needed to create correct environment

A

Water, acid, HCO3 and enzymes

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4
Q

The lumen of the gut is what type of surface

A

External (lined with epithelia)

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5
Q

Which parts of the gut need to temporarily store food

A

Stomach and colon

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6
Q

Control of gut involved which notable nervous system

A

Enteric (intrinsic)

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7
Q

Describe the enteric nervous system

A

Semi-autonomous, in gut- controlling motor functions, immune function, blood flow, secretions, and transport across mucosa

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8
Q

Where is enteric nervous system mostly contained

A

In submucosa (Meissner’s plexus) and between external muscle layers (Auerbach’s plexus)

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9
Q

enteric nervous system is heavily interlinked with

A

Both divisions of the autonomic nervous system

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10
Q

Perception of visceral abdominal pain is related to

A

Structure of sympathetic innervation to the gut

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11
Q

How many layers does the gut tube have

A

4

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12
Q

Name the layers of the gut tube

A

Mucosa, submucosa, external muscle layers and serosa

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13
Q

Describe mucosa

A

Selectively permeable interface layer between the gut lumen - facilitates movement of molecules (absorption and secretion)

Deeper layers contain muscle, nerve plexuses and blood and lymph vessels

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14
Q

What is an enterocyte

A

Cell located in intestine that is specialised to absorb. Modified to include micro villi

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15
Q

What are micro villi

A

Very fine microscopic cellular protrusions designed to massively increase surface area

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16
Q

What are goblet cells

A

Specialised cells that secrete mucus- increase in number from duodenum to colon.

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17
Q

What does mucus do

A

Protects the gut epithelium from friction, chemical damage and bacteria

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18
Q

Describe the internal surface of the gut

A

Not smooth- much folding.

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19
Q

Describe the different types of folds

A

Rugae in stomach - temporary

Plica circulares in SI- permanent

Haustra in colon (result from contraction of the longitudinal muscle layer)

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20
Q

Describe surface of small intestine

A

Finger like projections called villi, lined mainly by enterocytes

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21
Q

What are crypts

A

Invaginations of the epithelial surface of the small intestine and are present in both small and large intestine

Contain stem cells, paneth cells and enteroendocrine cells (specialised)

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22
Q

Stem cells divide and differentiate into other epithelial cells every

A

2-4 days

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23
Q

2 major organs that deliver gut secretions

A

Liver and pancreas

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24
Q

Other sources of gut secretions

A

Saliva, gastric and intestinal secretions

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25
Q

4 major muscle groups that form anterolateral abdominal wall

A

External oblique, internal oblique, transverse abdominus

Rectus abdominus

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26
Q

Describe muscles forming anterolateral abdominal wall

A

Lateral muscles with flat tendons (aponeuroses) project anteriorly to envelop the midline rectus abdominus muscle in a sheath (rectus sheath)

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27
Q

Describe peritoneal cavity

A

Mesothelium lined cavity that contains lubricating fluid - potential space formed by continuous layer of peritoneum

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28
Q

What is the name for the peritoneum that is in contact with the abdominal wall

A

Parietal peritoneum

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29
Q

What is the name for the peritoneum that envelops the abdominal viscera

A

Visceral peritoneum

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30
Q

What is the cavity

A

The space that lies between the parietal peritoneum and the visceral peritoneum

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31
Q

Difference in peritoneal cavity in males and females

A

In males it is enclosed but in females it is open at the entrance to the fallopian tubes

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32
Q

What happens as the peritoneum reflects off the abdominal wall

A

Envelopes viscera

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33
Q

What happens if the peritoneum folds back on itself

A

Mesentery is formed

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34
Q

What is mesentry

A

Double layer of peritoneum

Fat and Blood and lymph vessels lie between

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35
Q

Abdominal viscera that are enveloped in peritoneum are termed

A

Intraperitoneal structures

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36
Q

Abdominal viscera that lie behind the peritoneum are termed

A

Retroperitoneal structures

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37
Q

Order of travel in alimentary canal

A

Mouth, Oesophagus, Stomach, Pancreas, Duodenum of SI, Jejunum of SI, Ileum of SI, Cecum of LI, LI, Anus

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38
Q

Functions of mouth

A

Physical breakdown of food
Initial digestive enzymes released
Infection control

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39
Q

Functions of oesophagus

A

Rapid transport of bolus to stomach through thorax
Upper Oesophageal Sphincter - prevents air from entering GI tract
Lower Oesophageal Sphincter- prevents reflux into oesophagus

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40
Q

Functions of stomach

A

Storage facility
Produce chyme
Infection control (HCL)
Secrete intrinsic factor (Vit B 12)

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41
Q

What is chyme

A

Fluid that passes out from stomach that consists of gastric secretions and partially digested food

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42
Q

Functions of chyme

A

Physical breakdown
Chemical breakdown (proteases and acid)
Digestion started
Storage

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43
Q

What is duodenum

A

Start of small intestine

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44
Q

Functions of duodenum

A

Neutralisation/osmotic stabilisation of chyme - HCO3 rich secretions (bicarbonate rich secretions from pancreas and liver)
Digestion wrapping up (pancreatic secretions and bile from liver)

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45
Q

What is the osmotic property of chyme

A

Hypertonic- lots of water from gut vasculature

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46
Q

How and why do liver and pancreas connect to SI

A

Connect to Second part of duodenum through a common entrance

Deliver bile and pancreatic secretions into gut tube

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47
Q

What is released in duodenum of SI to help protein breakdown

A

Pepsin

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48
Q

Property of Jejenum/ileum

A

Lots of folds = large s.a.

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49
Q

Roles of Jejenum/ileum

A

Final digestion, nutrient absorption (mainly jejenum), water/electrolyte absorption (mainly ileum), bile recurculation (ileum), B12 absorption (terminal ileum)

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50
Q

What is terminal ileum

A

End of ileum just before start of large bowel

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51
Q

Functions of large bowel

A

Final water absorption, temporary storage, final electrolyte absorption, bile salt absorption, production of some SCFAs (carbs)

52
Q

Interesting thing about final water absorption in large bowel

A

energy dependent process as against conc grad

53
Q

Purpose of rectum/anus

A

Defacation

54
Q

Feature of rectum

A

When stretched sends signals to poo as usually empty

55
Q

Big difference between internal environments of small and large intestine

A

SI = relatively sterile
LI = lots of bacteria

56
Q

Features of water absorption in large and small bowel

A

One of main functions of Large bowel, but small bowel absorbs a greater volume of water overall

57
Q

Protective feature in large intestine

A

Lots of mucus secretion to provide barrier between bacteria and epithelium

58
Q

Structures deep in the abdominal cavity

A

Kidneys, Spleen

59
Q

Structures middle in the abdominal cavity

A

Stomach, small intestine, Liver

60
Q

Structure top in abdominal cavity

A

Large intestine

61
Q

What is the peritoneal cavity made of

A

Layers made of simple squamous epithelium (serous)

62
Q

What are mesentries

A

Double folds in peritoneum

63
Q

Why does line between the intraperitoneal structure of stomach and retroperitoneal structure not count as mesentery

A

Short and doesn’t allow stomach to move like SI

64
Q

What does a mesentary do

A

Allows passage of blood vessels and lymphatics and various other things to go from retroperitoneal space to the viscera

65
Q

Intra peritoneal viscera is enveloped by

A

Peritoneal cavity

66
Q

What connects the liver and stomach

A

Ligament- double fold of peritoneum connecting viscera but does not connect to retroperitoneal space

67
Q

What is an aponeurosis

A

Flattened tendon

68
Q

Which muscles have aponeurosis

A

External and internal oblique, transverse abdominus

69
Q

External oblique Origin, insertion, innervation and action

A

Origin- 5th-12th rib

Insertion- iliac crest, inguinal ligaments, linea alba

Action- compress abdominal viscera, flex trunk and rotate trunk to opposite side

Innervation- anterior rami T7 to T12

70
Q

Internal oblique origin, insertion, action and innervation

A

Origin- lateral portion of inguinal ligament, iliac crest, thoracolumbar fascia

Insertion- pubic crest, linea alba

Action- compress abdominal viscera, flex trunk and rotate trunk to same side

Innervation- anterior rami T7 to T12, L1

71
Q

Transverse abdominus origins, insertions, action and innervation

A

Origin- costal cartilages of lower ribs, thoracolumbar fascia, medial lip of iliac crest, inguinal ligament

Insertion- via aponeurosis, linea alba, pubic crest and internal oblique

Action- compress abdominal viscera, important for core stability

Innervation- anterior rami T7 to T12, and L1

72
Q

Rectus abdominus origin, insertion and action

A

Origin- pubic crest, tubercle and symphysis

Insertions- costal cartilages of ribs 5-7, zephoid process

73
Q

Features of rectus abdomninus

A

Paired muscle, tendinous intersections = 6 pack

74
Q

What is the rectus sheath

A

Aponeurosis of the lateral muscles surrounding the rectus abdominus

75
Q

What is arcuate line

A

Lower limit of the posterior layer of rectus sheath

Roughly halfway between umbilicus and pubic crest

76
Q

What is the posterior layer of the rectus sheath

A

Parietal peritoneum

77
Q

4 layers of gut external surface

A

Mucosa (innermost), submucosa, external muscle layers, serosa (outermost)

78
Q

What is the mucosa layer made up of

A

Epithelial layer and lamina propria, then muscularis mucosa

79
Q

Characteristics of epithelial layer of mucosa

A

Selectively permeable barrier
Facilitate transport and digestion of food
Promote absorption
Produce hormones
Produce mucus

80
Q

Characteristics of lamina propria of mucosa

A

Lots of lymphoid nodules and macrophages
Produced antibodies (mainly IgA which is resistant to proteases) - protects against bacteria or viral invasion

81
Q

Distribution of epithelia from distal oesophagus to distal anal canal

A

Stratified squamous prior to distal oesophagus, then columnar

82
Q

important features of muscularis mucosae of mucosa layer

A

Layers of smooth muscle oriented in different directions
Keeps epithelium in contact with gut contents
Helps keep crypt contents dynamic

83
Q

Submucosa characteristics

A

Contains dense connective tissue, blood vessels, glands, lymphoid tissue

Contains submucosa plexus (Meissner’s)

84
Q

External muscle layer

A

Inner circular muscle - reduced width when constrict (myenteric/Auerbach’s plexus) - Muscularis propria

Outer longitudinal muscle reduces length

85
Q

What are serosa layer features

A

Blood and lymph vessels and adipose tissue
Continuous with mesenteries

86
Q

Characteristics of stratified squamous epithelium

A

Non keratinised (not concerned about water loss), often secrete mucous, resists abrasion

87
Q

Where in the gut are stratified squamous cells found

A

Oesophagus and distal anus

88
Q

Where in the gut are simple columnar cells found

A

Stomach to proximal anus

89
Q

Describe the cells that line the stomach

A

Surface mucous cells- line gastric mucosa/pits, secrete mucus/HCO3 that forms barrier to stomach acid

90
Q

Predominant cell of small intestine and colon function

A

Enterocyte- one cell thick

Transport nutrients through- apical membrane, basolateral membrane

Blood vessels/lymphatics lie immediately below the enterocyte

91
Q

What gives large SA for absorptive areas in SI

A

Permanent folds, villi, microviili

92
Q

Characteristics of intestines

A

Goblet cells- mucus compresses nucleus to base, increase from duodenum to colon, scattered between enterocyte

93
Q

In intestines, mucus protects epithelia from

A

Friction (acts as lubricant), chemical damage (acidic environment), Bacterial inflammation (forms physical barrier)

94
Q

Features of crypts

A

Enteroendocrine cells
Stem cells
Panneth cells
Villi
Anti bacterial proteins

95
Q

What are enteroendocrine cells

A

Predominantly located deeper in crypts and gastric glands
Secrete hormones that control the function of the gut

96
Q

What do enteroendocrine cells secrete

A

Gastrin, Cholecystokinin, Secretin

97
Q

What do stem cells in crypts do

A

Constantly divide to replace epithelia every 2-4 days

98
Q

What do paneth cells do

A

Base of crypts, secrete antibacterial proteins, protect stem cells

99
Q

What is the specialised gland in duodenum

A

Brunner’s glands- produce alkaline mucoid material from mucosa layer. Counteract very acidic chyme

100
Q

Where does most fat, proteins and carbs go

A

Fat to lymph

Proteins and carbs to blood

101
Q

Which specialised cells are present in colon

A

Goblet cells (form crypts), stem cells, enteroendocrine cells, colonocytes (tall columnar epithelia)

102
Q

How is water movement in colon controlled

A

Columnar cells use sodium transfer in lateral intercellular spaces

103
Q

Describe para and symp in terms of pre and post

A

Para is long pre
And symp is short pre and long post

104
Q

Key components of parasympathetic nervous system

A

Vagus nerve, pelvic splanchnic nerves S2-S4

105
Q

In parasympathetic, post ganglionic fibres release

A

Acetylcholine, peptides (gastrin releasing peptide and vaso inhibitory peptide)

106
Q

What do preganglionic fibres of Parasympathetic nervous system do

A

Synapse in walls of viscera to innervation smooth muscle/endocrine and secretory cells

107
Q

What controls sympathetic nervous system

A

T5 to L2

108
Q

how does the sympathetic nervous system pass through the paravertebral sympathetic trunk

A

Without synapsing

109
Q

Sympathetic nervous system T5-L2 forms

A

Abdominopelvic presynaptic splanchnic nerves-
Greater T5-9
Lesser T10-11
Least T12

110
Q

What do splanchnic nerves synapse with

A

Prevertebral ganglia, - coeliac, renal, superior mesenteric, inferior mesenteric and others

Mainly innervates blood vessels

111
Q

What does the vagus nerve innervation

A

Oesophagus-transverse colon

112
Q

What is pelvic nerve innervation

A

Transverse colon - anal canal

Long preganglionic fibres, extend to myenteric and submucosal plexuses, cholinergic and peptigergic

113
Q

What does parasympathetic do

A

Stimulate GI function

114
Q

Sympathetic nervous system characteristics

A

Short pre ganglionic fibres

Post ganglionic fibres extend to myenteric and submucosal plexuses- release norepinephrine

Generally inhibits GI function

115
Q

Where does enteric nervous system exist from

A

Oesophagus to anus

116
Q

What are the 2 main plexuses of enteric nervous system

A

Submucosal- (Meissner’s) in submucosa

Myenteric (Auerbach’s) in between circular and longitudinal muscle

117
Q

What are endocrine hormones

A

Peptides released from endocrine cells into portal circulation, pass through liver, enter systemic circulation

118
Q

What are paracrine hormones

A

Peptides released by endocrine cells, act in local environment, diffuse short distances

119
Q

What are neurocrine hormones

A

Peptides released by neurones in the GI tract
Released after action potential
Example- GRP (gastrin releasing peptide), increases release of gastrin from G cells

120
Q

How is gastrin released

A

G cells in antrum of stomach, increases gastric acid secretion

121
Q

what causes release of gastrin

A

Stretch, amino acids, small peptides

122
Q

How is Cholecystokinin CKK produced

A

I cells in duodenum and jejenum

Increases pancreatic/gallbladder secretions

(Stimulated by fat and protein, gall bladder contracts, pancreas stimulated, relaxes sphincter of Oddi)

123
Q

How is secretin produced

A

By S cells in duodenum, Stimulated by H+ and fatty acids, increases HCO3 from pancreas/gallbladder, decreases gastric acid secretion

124
Q

Explain action of gastric inhibitory polypeptide GIP

A

Cells in duodenum and Jejenum
Stimulated by sugars, amino acids and fatty acids
Increases insulin
Decreased gastric acid secretion

125
Q

How does somatostatin work

A

Paracrine- low pH = D cells produce it, which causes less Gastrin produced by G cells

GI (22 decks)

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