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Semester 3: Gastrointestinal > Session 2 > Flashcards

Session 2 Flashcards

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1
Q

What are the mechanisms that the gut is controlled by?

A
  • Autonomic nervous system
  • Enteric nervous system
  • Hormones and paracrine substances
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2
Q

What two neurons make up the pathway for the autonomic nervous system?

A
  • Pre-ganglionic

- Post ganglionic

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3
Q

What is released by all pre-ganglionic fibres?

A

Ach

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4
Q

Which vertebral level does the sympathetic pass through?

A

T5-L3

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5
Q

What do the sympathetic nerves form?

A

Form the presynaptic splanchnic nerves

  • Greater (T5-9)
  • Lesser (T10-11)
  • Least (T12)
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6
Q

Which ganglia do the splanchnic nerves synapse with?

A

Prevertebral ganglia

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7
Q

What is the main parasympathetic supply to the gut?

A

Vagus nerve

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8
Q

What is another parasympathetic nerve supply to the gut?

A

Pelvic splanchnic nerves

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9
Q

What do the post ganglionic fibres release in the parasympathetic system?

A
  • Acetylcholine

- Peptides (Gastrin releasing peptide, Vaso-inhibitiory peptide)

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10
Q

What do the preganglionic fibres of the parasymathetic nervous system synapse with?

A

Walls of the viscera

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11
Q

What does the parasympaticic nervous system innervate?

A

Smooth muscle/endocrine and secretory

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12
Q

What is the enteric nervous system?

A
  • Division of the nervous system

- Can operate independently but also has extensive connection with the ANS

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13
Q

Where does the enteric nervous exist from and to?

A

Oesophagus to Anus

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14
Q

What are the 2 main plexuses of the enteric nervous system?

A
  • Submucosal (Meissner’s)

- Myenteric (Auerbach’s)

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15
Q

What does meissner’s plexus control?

A
  • Secretions

- Blood flow

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16
Q

What does the myenteric plexus control?

A

Motility

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17
Q

How are hormones delivered to the area they are needed?

A
  • Peptides are related from endocrine cells
  • They enter into the portal circulation
  • They pass through the liver
  • They enter systemic circulation
  • They are delivered to the region needed which is pretty close to where they were released from
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18
Q

What are the paracrine secretions in the stomach?

A
  • Peptide released by endocrine cells

- Act in local environment and diffuse a short distance

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19
Q

Describe the production and function of somatostatin?

A
  • Produced by D cells in Antrum of stomach
  • Present in pancreas as well
  • Stimulated by H+ in stomach lumen
  • Inhibit G cells
  • Inhibit histamine release
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20
Q

What is the process of neurocine secretions in the gut?

A
  • Peptides released by neurones in the GI tract

- Released after action potential

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21
Q

How is Gastrin releasing peptide released and the function of it?

A
  • Neurocine secretion

- Increase release of Gastrin from G cells

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22
Q

The gastrin family
A. What releases them?
B. What is their function?

A

A. G cells in Antrum of stomach

B. Increase in gastric secretion

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23
Q

Cholecystokinin
A. What releases them?
B. What is their function?

A

A. I cells in duodenum and jejunum
B. Increases pancreatic/gallbladder secretions. they are stimulated by fat and proteins which triggers the gall bladder to contract and pancreas to be stimulated.

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24
Q

Secretin
A. What releases them?
B. What is their function?

A

A. S cells in the duodenum after being stimulated by H+ and fatty acids
B.Increase the HCO3 from pancreas/gallbladder and decreases gastric acid secretion

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25
Gastric inhibitory polypeptide A. What releases them? B. What is their function?
A. Cells in the duodenum and jejenum when stimulated by sugars, amino acids and fatty acids B. Increase insulin and decreases gastric acid secretion
26
What are some symptoms of appendicitis?
- Central abdominal pain - Nausea - Anorexia - Slightly raised temperature - Pain arises in the right iliac fossa
27
What is the cause of central abdominal pain in appendicitis?
- Blocked appendix becomes inflamed and increased in size - The viscera gets distended - Visceral peritoneum becomes involved - Visceral afferents accompany sympathetic motor fibre - The nerves goes back to the spinal sensory ganglia - The appendix is at the level of T10-T11 and so the body direct the pain to the T10-T11 area so pain in the midline which is vague
28
Why does pain arise in the right iliac fossa?
- The parietal peritoneum becomes involved | - Pain can be localised
29
What are other pain type associated with the abdominal structures?
Gallstones - Right upper quadrant/right shoulder tip Back pain- pancreatitis/AAA Restrosternal pain - Oesophagus
30
How does motility in the GI tract occur?
-Contraction and relaxation of the GI tract
31
What are the areas of the GI tract that don't have smooth muscle?
- Pharynx - Upper 1/3 of oesaphagus - External anal sphincter
32
What is the purpose of the muscle in the GI tract?
- Moving things along - Mix contents - Grind contents
33
What are the types of smooth muscles in the GI tract?
- Circular muscle | - Longitudinal muscle
34
What is peristalsis used for?
-Propel contents in one direction. There is contract proximal to content and relaxation distal
35
What is the segmentation contractions used for?
- Contraction splits contents and then relaxes | - To and fro movement that mix contents
36
What are mass movement used for in the GI tract?
-Occurs in the distal colon to rapidly move contents into the rectum.
37
How does the sympathetic nervous system affect motility?
-Reduces motility
38
How does the parasympathetic nervous system affect motility?
-Increases motility
39
What are the risks involved with GI surgery?
Paralytic ileum | -Leads to a functional blockage due to loss of GI contractility
40
What is achalasia?
Failure of the lower oesophageal sphincter eleading to dyspagia
41
What is Hirschsprung's disease?
Lack of myenteric and submucosal plexus so results in.a functional obstruction. -Newborns can't pass their first poo
42
What are the types of secretions associated with GI tract?
- Water - Acid - Alkali - Enzymes - Mucus - Waste products - Emulsifiers - Intrinsic Factors
43
Where are secretions made from in the GI tracts?
- Saliva - Gastric - Intestinal - Liver - Pancreatic
44
What is the function of stomach acid?
- Innate barrier to infection - Prepares proteins for digestion - Activates enzymes
45
What is the function of HCO3?
-To neutralise the acid
46
What are the 3 factors that make up the fluid balance in the GI tract?
- Ingested material - Secretions from the gut - Absorption
47
Where are the waste products secreted from in the GI tract?
-Mainly done in the liver through bile. Things such as cholesterol and bilirubin
48
What is the functions of bile salts?
Increase the surface area of lipid in order to - Aid digestion by lipases - Allow lipid breakdown products to be transported in the gut
49
What is the function of mucus?
- Protects against acidic environment in stomach - Protects against bacteria in small intestine through its antibacterial compounds - Habours bacteria in large intestine while still operating them from epithelium - Lubricates - Contain bicarbonate which forms an alkaline mucus layer which prevents acid coming into contact with the epithelium
50
What are the secretion of enzymes used for?
- Proteases for proteins - Lipases for fat - Amylases for carbohydrates
51
Where can the secretions come from?
- Acini of salivary glands - Gastric glands - Brunner's glands - Intestinal glands - Acini of exocrine pancreas - Hepatocytes - Goblet cells
52
How can things be made small enough to absorb?
- Mechanical breakdown | - Chemical digestion
53
How is the large surface for absorption created?
- Permanent folds - VIlli - Micrvilli
54
What are the effects of things that affect the absorptive process?
- Diarrhoea - Malnutrition - Anemia
55
How is water absorpbed?
Water is absorbed using osmotic gradients created by electrolytes and nutrients
56
What does the peritoneal cavity normally contain?
A small amount of fluid
57
Where does the lesser sac lie?
Behind the stomach
58
Where is the greater sac?
All the space that isn't the lesser sac
59
What are the boundaries of the lesser sac?
Anterior wall: Lesser momentum, Anterior 2 layers Greater omentum, Back of the stomach Posterior wall: Posterior 2 layers of Greater omentum, transverse colon, Ascending colon, upper surface of the pancreas, left suprarenal gland and upper end of left kidney
60
What are the 2 area that abnormal fluid can collect in a man?
- Rectovesicular pouch | - Paramesenteric gutter
61
What is the peritoneal pouch that is only found in a woman?
Rectouterine pouch
62
What are the signs and symptoms of peritonitis?
- Feeling sick - High temperature - Lack of appetite - Not passing urine

Semester 3: Gastrointestinal (6 decks)

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