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Semester 3: Gastrointestinal > Session 2 > Flashcards

Session 2 Flashcards

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
Q

Gastric inhibitory polypeptide
A. What releases them?
B. What is their function?

A

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
Q

What are some symptoms of appendicitis?

A
  • Central abdominal pain
  • Nausea
  • Anorexia
  • Slightly raised temperature
  • Pain arises in the right iliac fossa
27
Q

What is the cause of central abdominal pain in appendicitis?

A
  • 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
Q

Why does pain arise in the right iliac fossa?

A
  • The parietal peritoneum becomes involved

- Pain can be localised

29
Q

What are other pain type associated with the abdominal structures?

A

Gallstones - Right upper quadrant/right shoulder tip

Back pain- pancreatitis/AAA

Restrosternal pain - Oesophagus

30
Q

How does motility in the GI tract occur?

A

-Contraction and relaxation of the GI tract

31
Q

What are the areas of the GI tract that don’t have smooth muscle?

A
  • Pharynx
  • Upper 1/3 of oesaphagus
  • External anal sphincter
32
Q

What is the purpose of the muscle in the GI tract?

A
  • Moving things along
  • Mix contents
  • Grind contents
33
Q

What are the types of smooth muscles in the GI tract?

A
  • Circular muscle

- Longitudinal muscle

34
Q

What is peristalsis used for?

A

-Propel contents in one direction. There is contract proximal to content and relaxation distal

35
Q

What is the segmentation contractions used for?

A
  • Contraction splits contents and then relaxes

- To and fro movement that mix contents

36
Q

What are mass movement used for in the GI tract?

A

-Occurs in the distal colon to rapidly move contents into the rectum.

37
Q

How does the sympathetic nervous system affect motility?

A

-Reduces motility

38
Q

How does the parasympathetic nervous system affect motility?

A

-Increases motility

39
Q

What are the risks involved with GI surgery?

A

Paralytic ileum

-Leads to a functional blockage due to loss of GI contractility

40
Q

What is achalasia?

A

Failure of the lower oesophageal sphincter eleading to dyspagia

41
Q

What is Hirschsprung’s disease?

A

Lack of myenteric and submucosal plexus so results in.a functional obstruction.
-Newborns can’t pass their first poo

42
Q

What are the types of secretions associated with GI tract?

A
  • Water
  • Acid
  • Alkali
  • Enzymes
  • Mucus
  • Waste products
  • Emulsifiers
  • Intrinsic Factors
43
Q

Where are secretions made from in the GI tracts?

A
  • Saliva
  • Gastric
  • Intestinal
  • Liver
  • Pancreatic
44
Q

What is the function of stomach acid?

A
  • Innate barrier to infection
  • Prepares proteins for digestion
  • Activates enzymes
45
Q

What is the function of HCO3?

A

-To neutralise the acid

46
Q

What are the 3 factors that make up the fluid balance in the GI tract?

A
  • Ingested material
  • Secretions from the gut
  • Absorption
47
Q

Where are the waste products secreted from in the GI tract?

A

-Mainly done in the liver through bile. Things such as cholesterol and bilirubin

48
Q

What is the functions of bile salts?

A

Increase the surface area of lipid in order to

  • Aid digestion by lipases
  • Allow lipid breakdown products to be transported in the gut
49
Q

What is the function of mucus?

A
  • 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
Q

What are the secretion of enzymes used for?

A
  • Proteases for proteins
  • Lipases for fat
  • Amylases for carbohydrates
51
Q

Where can the secretions come from?

A
  • Acini of salivary glands
  • Gastric glands
  • Brunner’s glands
  • Intestinal glands
  • Acini of exocrine pancreas
  • Hepatocytes
  • Goblet cells
52
Q

How can things be made small enough to absorb?

A
  • Mechanical breakdown

- Chemical digestion

53
Q

How is the large surface for absorption created?

A
  • Permanent folds
  • VIlli
  • Micrvilli
54
Q

What are the effects of things that affect the absorptive process?

A
  • Diarrhoea
  • Malnutrition
  • Anemia
55
Q

How is water absorpbed?

A

Water is absorbed using osmotic gradients created by electrolytes and nutrients

56
Q

What does the peritoneal cavity normally contain?

A

A small amount of fluid

57
Q

Where does the lesser sac lie?

A

Behind the stomach

58
Q

Where is the greater sac?

A

All the space that isn’t the lesser sac

59
Q

What are the boundaries of the lesser sac?

A

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
Q

What are the 2 area that abnormal fluid can collect in a man?

A
  • Rectovesicular pouch

- Paramesenteric gutter

61
Q

What is the peritoneal pouch that is only found in a woman?

A

Rectouterine pouch

62
Q

What are the signs and symptoms of peritonitis?

A
  • Feeling sick
  • High temperature
  • Lack of appetite
  • Not passing urine

Semester 3: Gastrointestinal (6 decks)

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