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Gastrointestinal > Stomach > Flashcards

Stomach Flashcards

(105 cards)

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1
Q

What level does the oesophagus passes through the oesophageal hiatus

A

T10

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2
Q

What does the muscle around the oesophagus hiatus function as

A

Sphincter

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3
Q

How long is the abdominal segment of the oesophagus

A

Less than 2cm

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4
Q

What is the distal oesophagus supplied by

A

Branches of the left gastric artery

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5
Q

What is the drainage of the distal oesophagus

A

Systemic system of veins

Via oesophageal veins that drains into the azygos vein

To portal venous system

Via the left gastric veins

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6
Q

What is the distal oesophagus a site of

A

Portosystemic anastomoses

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7
Q

What does the stomach chemically and mechanically break food down to

A

Chyme

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8
Q

What are the four parts of the stomach

A

Cardia
Fundus
Body
Pylorus

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9
Q

What is the oesophagus continuous with

A

Cardia of stomach

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10
Q

What is the most superior part of the stomach

A

Fundus

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11
Q

What is the largest part of the stomach

A

Body

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12
Q

What is the most distal part of the stomach

A

Pyloric part

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13
Q

What is the area of the pyloric part

A

Pyloric antrum
Pyloric canal - contains pyloric sphincter

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14
Q

What is the role of the pyloric sphincter

A

Circular smooth muscle
Regulates the passe if chyme into the duodenum

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15
Q

What is the right border of the stomach called

A

Lesser curvature

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16
Q

What is the left border of the stomach called

A

Greater curvature

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17
Q

Where does the stomach lie

A

Left upper quadrant

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18
Q

What is the stomach covered by

A

visceral peritoneum

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19
Q

What is the anterior surface of the stomach related to

A

Anterior abdominal wall
Diaphragm
Left lobe of the liver

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20
Q

What is the posterior surface of the stomach related to

A

Forms the anterior wall of the lesser sac

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21
Q

What does the lesser omentum connect

A

Lesser curvature to the liver

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22
Q

What does the free edge of lesser omentum contain

A

Hepatic artery
Hepatic portal vein
Bile duct

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23
Q

What is posterior to the free edge entrance to

A

Lesser sac

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24
Q

What does the greater omentum hang from

A

Greater curvature

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25
What is the stomach supplied by
Branches of the coeliac trunk
26
Where are G-cells located
Pyloric antra mucosa
27
What do G-cells produce
Gastrin
28
What are G-cells activated by
Vagus nerve - Ach (M3R)
29
What stimulates G-cells
Partially digested proteins
30
How does Gastrin travel
Hormone through the blood
31
Where are Parietal cells located
Fundus
32
What do parietal cells contain a lot of
Mitochondria
33
What happens with parietal cells
Mitochondria - respiration produces a lot of CO2 CO2 + H20 = H2CO3- = H+ + HCO3- H+ goes into stomach lumen HCO3- goes in to blood
34
What is the enzyme involves in the bicarbonate reaction within the parietal cells
Carbonic anhydrase
35
What do parietal cells produce
HCl
36
How is Hydrogen transported out of parietal cells
By H+K+ ATPase pump
37
What acts on parietal cells
Somatostatin - Ach + Histamines + Gastrin + PEG2 +
38
What acts on chief cells and how
Gastrin increases Ca2+ Vesicle fuses with membrane Releases pepsinogen
39
What do chief cells secrete
Pepsinogen
40
Where are the chief cells located
Fundus
41
Is pepsinogen active or inactive
Inactive
42
What is the active form of pepsinogen
Pepsin
43
How does pepsinogen become active
pH 1.8-3.5
44
What acts on chief cells
Gastrin + Histamine + Ach + Secretin +
45
When is secretin released
S-cells in duodenum To high acidic/fatty chyme
46
What to antral-D cells respond to
High H+ concentration on outside of cell
47
What do antral-D cells release
Somatostatin
48
What is the role of somatostatin
Act on G-cells Inhibit release of gastrin - to decrease pH
49
What acts on Antral-D cells
Ach - Gastrin -
50
Where are Antral-D cells located
Antrum and Body
51
What do enterochromaffin like cells secrete
Histamine
52
What acts on enterochromaffin like cells
Ach + Somatostatin - Gastrin +
53
What are the cells of the stomach
G-cells Parietal cells Chief cells Antral-D cells Enterochromaffin like cells
54
Where are enterochromaffin like cells located
Fundus Cardia
55
What cell secretes gastrin
G-cells Enteroendrocrine cells
56
What cell secretes HCL (h+ and Cl-)
Parietal cells
57
What cell secretes pepsinogen
Chief cell
58
What cell secretes somatostatin
Antral-D cells
59
What cell secretes histamine
Enterochromaffin like cells
60
What does the body of the stomach secrete
Mucus, pepsinogen and HCl
61
What does the antrum of the stomach secrete
Mucus, pepsinogen and gastrin
62
What do mucus cells secrete
Mucous
63
What cell secrete intrinsic factor
Parietal cell
64
How much hydrochloric acid is secreted a day
Approx 2 litres
65
What is gastric acid secretion dependent upon
Energy
66
What is the concentration of HCl in gastric acid
>150 mM
67
Describe the cephalic phase
Turning it on Parasympathetic NS Sight, smell, taste of food and chewing ACh released ACh acts directly on parietal cells ACh triggers release of gastrin and histamine Net effect = increased acid production
68
Describe the gastric phase
Turning it on Gastric distension, presence of peptides and amino acids Gastrin release Gastrin acts directly on parietal cells Gastrin triggers release of histamine Histamine acts directly on parietal cells Net effect = increased acid production
69
Describe what happens with proteins in the stomach
Turning it on Direct stimulus for gastrin release Proteins in lumen act as a buffer, mopping up H+ ions, causing pH to rise - decreased secretion of somatostatin - more parietal cell activity (lack of inhibition)
70
Describe the turning it off gastric phase
Low luminal pH (high H+) Directly inhibits gastric secretion Indirectly inhibits histamine release (via gastrin) Stimulates somatostatin release which inhibits parietal cell activity
71
Describe the intestinal phase
Turning it off In duodenum - duodenal distension - low luminal pH - hypertonic luminal contents - presence of amino acids and fatty acids Trigger release of enterogastrones - secretin (inhibits gastrin release, promotes somatostatin release) - CCK - cholecystokinin Short and long neural pathways - reducing Ach release
72
What is the role of secretin (interstitial phase)
Inhibits gastrin release Promotes somatostatin release
73
What is involved in the gastric acid secretion
1 PNs neurotransmitter Ach 1 hormone - gastrin 2 paracrine factors - histamine +, somatostatin - 2 key enterogastrones - secretin -, CCK -
74
What are the ways in which gastric mucosa defends itself
Alkaline mucus Tight junctions between epithelial cells Replacement of damaged cells Feedback loops
75
What is the conversion of pepsinogen dependent upon
pH
76
When is the conversion of pepsinogen to pepsin most efficient
pH <2
77
What type of feedback loop is the conversion of pepsinogen to pepsin
Positive Pepsin catalyses the reaction
78
When is pepsin active
Only at low pH Irreversible inactivation in small intestine by HCO3-
79
Is protein digestion dependent upon pepsin
No Accelerates protein digestion
80
What % does the role of pepsin in protein digestion account to
Approx. 20%
81
What does pepsin do
Breaks down collagen in meat - helps shred meat into small pieces with greater surface area for digestion
82
Describe receptive relaxation
Mediated by PNS acting on enteric nervous plexus Afferent input via Vagus nerve Nitric oxide and serotonin released by enteric nerves mediate relaxation
83
Where do peristaltic waves begin
Gastric body - weak contraction
84
Where are peristaltic waves more powerful
Gastric antrum
85
What happens to chyme
Little chyme enters duodenum Antral contents forced back towards body (mixing)
86
Describe the basic electrical rhythm for gastric motility
Frequency determined by pacemaker cells in muscularis propria 3/minute Pacemaker cells undergo slow depolarisation - repolarisation cycles Depolarisation waves transmitted through gap junctions to adjacent smooth muscle cells Do not cause significant contraction in empty stomach
87
Gastric motility what happens if there are more action potentials
The strength of smooth muscle tension and time will increase
88
What is the strength of peristaltic contractions increased by
Gastrin Gastric distension
89
What respond to gastric distension
Mechanoreceptors
90
What is the strength of peristaltic contractions decreased by
Duodenal distension Increased duodenal luminal fat Increased duodenal osmolarity Decreased luminal pH Increased sympathetic NS action Decreased parasympathetic NS action
91
Describe protease activation
Chief cell secretes pepsinogen Parietal cell secretes HCl (+ intrinsic factor) HCl facilitates the activation of pepsinogen to pepsin Pepsin breaks down proteins to peptides
92
Describe protease secretion
Chief cells produce pepsinogen Synthesised in inactive form (zymogen) Pepsinogen mediated by input from enteric NS (ACh) Secretion parallels HCl secretion Luminal activation
93
What is the blood supply to the stomach
Coeliac trunk
94
Where does the coeliac trunk leave the aorta
T12
95
What are the three branches of the coeliac trunk
Left gastric artery Common hepatic artery Splenic artery
96
Where do the left and right gastric arteries run
Lesser curvature of the stomach and anastomose with each other
97
Where does the left gastric artery arise from
Coeliac trunk
98
Where does the right gastric artery arise from
Common hepatic artery
99
Where do the left and right gastro-omental (gastroepiploic) arteries run
Greater curvature of the stomach and anastomose with each other
100
Where does the left gastro-omental artery arise from
Splenic artery
101
Where does the right gastro-omental artery arise from
Gastroduodenal artery - branch of the common hepatic artery
102
What provides parasympathetic fibre to stomach
Vagus nerve
103
What does parasympathetic stimulation to the stomach promote
Peristalsis and gastric secretion
104
What provides sympathetic fibres to the stomach
Greater splanchnic nerve
105
Where does the greater splanchnic nerve leave the spinal cord
Preganglionic fibres T5-T9

Gastrointestinal (12 decks)

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