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MBChB221 Digestive > Stomach Physiology > Flashcards

Stomach Physiology Flashcards

1
Q

Incisura

A

Inflection point of the stomach

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2
Q

Lesser Curve Stomach left/right

A

Right

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3
Q

Saliva Stimulation

A

Sight, smell, taste of food

Acid in the oesophagus (predicts vomit coming up)

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4
Q

Saliva Inhibition

A

Sleep

Sympathetic ANS

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5
Q

4 Contents of Salvia

A
  1. HCO3- = Basic
  2. Mucin = Lube
  3. Amylase = Starch -> Smaller Carbs
  4. Lysozyme = Anti-bacterial
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6
Q

Antrum Role

A

Grinding mill of stomach

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7
Q

Pylorus Role Stomach

A

Regulates size of particles that pass to duodenum (must be small)

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8
Q

Osmolaloity change of contents in stomach

A

Bolus -> Chyme
= More watery

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9
Q

Control of Gastric Emptying

A

Feedback mechs from duodenum: Acid, fat, amino acids, osmolarity

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10
Q

Rapid Gastric Emptying (eg. Diarrhoea, prokinetic drugs) causes

A

Food moves too quickly through stomach = not completely digested, chyme hyperosmolar

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11
Q

Gastric Acid Functions

A
  1. Sterilises stomach
  2. Denatures proteins
  3. Absorption of B12 and Iron
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12
Q

Parietal Cell Function

A
  1. H+ Cl- ion secretion to lumen
  2. HCO3- into blood
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13
Q

Parietal Cell secretion mechanism

A

H+/K+ Proton Pump

Carbonic anhydrase needed to catalyse HCO3- production

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14
Q

Stomach pH during night

A

Lowest (1-2) as no dilution from food etc

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15
Q

Stomach pH after eating

A

Highest (5-6) as buffered and diluted

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16
Q

What protects gastric mucosa from acid

A

Mucous

Bicarbonate buffer

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17
Q

ACh Role in Regulating Gastric Acidity

A

DECREASES PH / INCREASED ACID SECRETION

Stimulates
1. Parietal Cell release HCl
2. ECL Cell release histamine = stim parietal
3. G Cell release gastrin = stim parietal and ECL

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18
Q

ECL Cells Secretion

A

Histamine

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19
Q

Histamine Role Acidity

A

Paracrine activity = stimulates Parietal Cells to release ACh

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20
Q

ECL Cell Location

A

Stomach Body

21
Q

G Cell Secretes

A

Gastrin

22
Q

G Cell Location

A

Stomach ANtrum

23
Q

Gastrin Function

A

Endocrine

Stimulates histamine release from ECL cells
Stimulates HCL release from Parietal Cells

24
Q

D Cell Secretes

A

Somatostatin

25
Q

D Cell Location

A

Antrum Stomahc

26
Q

Somatostatin Function

A

Inhibits Gastrin secretion (= decreased HCl secretion)

27
Q

3 Phases of Digestion

A
  1. Cephalic
  2. Gastric
  3. Intestinal
28
Q

Cephalic Phase

A

Thought, sight, smell of food -> ACh released by Vagus Nerve -> Stimulation of G ECL Parietal -> HCl

29
Q

Gastric Phase

A

Distension of stomach body and antrum causes acid secretion

Protein in antrum stimulates G cells -> gastrin -> HCL

30
Q

What occurs in stomach during intestinal phase of digestion

A

HCl in antrum -> D cells release somatostatin -> gastrin inhibited -> less HCl

HCl in duodenum -> Secretin -> less HCl

Proteins/fats in duodenum -> CCK -> less HCl

31
Q

Helicobacter Pylori impact on gastric acid

A

Increased secretion

32
Q

Chief Cell secretion

A

Pepsinogen

33
Q

Pepsinogen function

A

Cleaved in acid to become Pepsin

34
Q

Pepsin function

A

Hydrolysis of proteins

35
Q

How do you stop a gastric bleed

A

Must inhibit acid secretion, as otherwise acidic environment activates pepsin which destroys clot

36
Q

Prostaglandins Function

A

Protection / repair of gastric mucosa

37
Q

Are gastric ulcers pain better / wrose with food

A

Worse

38
Q

Are duodenal ulcers better / worse with food

A

Better

39
Q

Peptic Ulcer Symtpoms

A

Epigastric Pain
Bleeding -> blood in stool
Perforation
Obstruction = swelling / scarring

40
Q

Treatment of Peptic Ulcer Disease

A

Proton Pump Inhibitors

(Historically surgery to decrease acid secretion)

41
Q

Peptic Ulcer Disease Cause

A

Increased Acid
- Helicobacter pylori

Decreased prostaglandins
- Aspirin
- NSAIDs

42
Q

H pylori risk factors

A

Poor childhood living conditions

= Devleoping world, low SES, Maori

43
Q

H pylori causes

A

Break down of stomach mucous barrier -> mucosa

44
Q

Achlorhydria

A

Low/no stomach acid

45
Q

How does H pylori impact duodenum

A

H pylori -> increased gastrin -> increased acid -> gastric metallisation -> H pylori can migrate into duodenum

46
Q

Treatment for H pylori

A

First line triple therapy (antibiotics)

47
Q

Gastric Cancer Two Types

A

Intestinal
Diffuse

48
Q

Intestinal gastric adenocarcinoma

A

Antrum

Glandular pattern

49
Q

Diffuse gastric adenocarcinoma

A

Gastric Wall

No glandular formation

MBChB221 Digestive (9 decks)

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