STRUCTURE AND FUNCTION OF THE GUT Flashcards Preview

GASTRO-INTESTINAL MEDICINE AND HEPATOLOGY > STRUCTURE AND FUNCTION OF THE GUT > Flashcards

Flashcards in STRUCTURE AND FUNCTION OF THE GUT Deck (115):
1

What is the cell type that lines the entire mouth?

Stratified squamous epithelial cells

2

How many teeth do adults normally have?

32

3

How many teeth do children normally have?

20 deciduous teeth

4

Where do the teeth arise from?

Alveolar bone

5

Where on the tongue are the receptors for sweet foods found?

Towards the front

6

Where on the tongue are the receptors for salty foods found?

Anterior middle portion

7

Where on the tongue are the receptors for sour foods found?

Posterior middle portion

8

Where on the tongue are the receptors for bitter food found?

Towards the back

9

What attached the anterior part of the tongue to the floor of the mouth?

The Frenulum

10

What are the roles of saliva?

Lubricate food to aid swallowing
Begin digestion of starches (amylase)
Break down of fats to help tongue analyse fragments (Lipases)
Antibacterial enzymes

11

How much saliva an adult produce per day?

1500 ml, most is swallowed and recycled

12

What is the enzyme found in the saliva which starts the breakdown of starch?

Alpha amylase

13

What are the names of the three main salivary glands found in the mouth?

Parotid gland
Submandibular gland
Sublingual gland

14

Which salivary gland in the mouth produces the highest percentage of saliva?

The submandibular gland - 70%

15

What is the specific role of the parotid gland?

Produces watery secretions lacking mucus
Secretes the alpha amylase

16

What is the specific role of the submandibular gland?

Secretes mucolipoproteins

17

Is saliva isotonic, hypertonic or hypotonic?

Hypotonic

18

What is the oesophageal hiatus?

The point where the oesophagues passes through the diaphragm and hence enters the abdomen

19

What proportion of the oesophagus is made of striated muscle?

The upper third

20

What proportion of the oesophagus is made of smooth muscle?

Lower two thirds

21

At what spinal level does the oesophageal hiatus sit?

T10

22

What is the name of the oesophageal sphincter that closes off the entrance to the stomach?

Cardio sphincter or lower oesophageal sphincter

23

Which nerve controls the sphincters of the oesophagus?

Vagus nerve

24

Describe the nervous pathway of swallowing.

Sensory endings in the mouth signal presence of food
Sends signal to nucleus of the tractus solitarius (solitary tract, NTS)
Activates motor neurones in nucleus ambiguus
Controls muscles of soft palate, larynx and epiglottis

25

What is the capacity of the average adult stomach?

4 Litres

26

What do we call the superior part of the stomach where the bolus enters?

The fundus

27

What is the name of the folds in the stomach that allow it to expand?

Rugae

28

What are the functions of the stomach?

Temporary storage of food
Mechanical breakdown of food
Pepsin digestion of proteins
Controlled passage of chyme into small intestine
Secretion of intrinsic factor

29

What is chyme?

The name used for the semi-digested material which is passed on from the stomach to the small intestine.

30

What is the role of intrinsic factor?

It protects vitamin B12 from the very low pH of the stomach. It is absorbed with the vitamin in the ileum.

31

What is the name of the additional muscle layer in the stomach wall not found in other parts of the GI tract? What is its function?

Inner oblique muscle
Churn up the food

32

What is the primary barrier which prevents the digestive enzymes from digesting the stomach wall?

A very thick layer of mucus

33

Which cells secrete gastrin from the stomach wall?

G cells

34

Which cells secrete HCl from the stomach wall?

Parietal (oxyntic) cells

35

Which cells secrete intrinsic factor from the stomach wall?

Parietal (oxyntic) cells

36

What are pepsinogens and which cells are responsible for secreting them from the stomach wall?

Pepsinogens are inactive precursors of pepsin secreted from the chief cells (or peptic cells)

37

What is the role of gastrin?

Stimulates the release of acid from the parietal cells.

38

What are the components of gastric juice?

Salts
Water
HCl
Pepsinogens
Intrinsic factor

39

What are the three ions channels/transporters found on the lumen side of the parietal cells, used in the secretion of acid?

Proton pump - K+ in for H+ out - active transport
K+ and Cl- co-transporter - passive transport
Cl- channel

40

Where do the protons used to make acid come from?

Water

41

How are the OH- ions, made as a by product of acid secretion, dealt with?

They are deposited in the blood as bicarbonate.

42

What is the pH of the blood in the gastric vein? What do we call this?

"Alkaline tide"

43

What is the pH in the lumen of the stomach?

pH ~ 1.3

44

What are the roles of stomach acid?

Denatures connective tissue and muscle fibres of meat

Combines with calcium and iron in the food to form soluble salts that can be digested

Activates inactive pepsinogens

Optimizes pH for pepsins

Kills germs

45

What do we call pepsinogens wrapped up in membrane-bound granules?

Zymogens

46

Does the stomach secrete lipase?

Yes, however not much fat digestion occurs in the stomach

47

What is secreted with the mucus to prevent the digestion of the stomach wall?

Bicarbonate to shield wall from acid

48

What prevents stomach acid from getting under the epithelium?

Tight junctions

49

What increases mucus production?

Prostaglandins increase mucus production and increase blood flow to the mucosa, bringing bicarbonate with it.

50

How much gastric juice is made in the adult stomach on an average day of eating?

2-3 litres

51

What are the three phases that regulate gastric secretion?

Cephalic phase
Gastric phase
Intestinal phase

52

What triggers the cephalic phase of gastric secretion?

Smell, sight, taste of food, chewing

53

What transmits the signal in the cephalic phase?

Vagus nerve

54

What triggers the gastric phase of the gastric secretion?

Distension of the stomach

55

What triggers the intestinal phase of gastric secretion?

Protein digestion products in the duodenum

56

What inhibits gastric secretion?

Low pH
Intestinal phase - Secretion of secretin, CCK and GIP

57

What are the two parts of the stomach's motor system?

Proximal motor unit
Distal motor unit

58

How does the stomach churn up and mix the contents?

Through a peristaltic wave mainly from the distal motor unit

59

What are the three parts of the small intestine?

Duodenum
Jejunum
Ileum

60

What is the average length of the small intestine in an adult?

4 metres

61

What is the average width of the small intestine in an adult?

2.5 cm

62

What are the main two functions of the small intestine?

Digestion
Absorption

63

What is particular about the folds in the small intestine in terms of how the chyme is passed through?

The folds force the chyme to take a spiral pathway

64

What is the brush border of the small intestine?

The wall of the small intestine contains villi, which themselves have microvilli. These microvilli increase surface area and are sometimes referred to as the brush border.

65

What is the name of the glands found in between the villi in the small intestine?

Crypts of Lieberkuhn

66

How far do the Crypts of Lieberkuhn extend through the wall of the small intestine?

Down to the muscularis mucosa

67

What do the endocrine cells of the Crypts of Lieberkuhn in the small intestine produce?

Secretin
Somatostatin
Entereroglucagon
Serotonin (5-HT)

68

What is the pH of the fluid secreted into the lumen of the small intestine?

Alkaline

69

What stimulates the secretion of secretin in the small intestine?

Low pH

70

What stimulates the secretion of cholecystokinin in the small intestine?

Fat digestion products

71

What is the length of the duodenum?

25 cm

72

Is the duodenum contained within mesentery?

No

73

Other than the chyme, what else enters the duodenum?

Bile
Pancreatic juices

74

What is the name of the sphincter that separates the duodenum from the bile and pancreatic ducts?

Sphincter of Oddi

75

How does the duodenum protect itself from the bile and the pancreatic juices?

It secretes an alkaline mucus

76

Are the jejunum and ileum supported by mesentry?

Yes.

77

What is the arterial supply to the jejunum and ileum?

Superior mesenteric artery

78

What is particular about the mucosal thickness of the jejunum and ileum?

As you move distally, there is a gradual reduction in the mucosal thickness

79

Is the pancreas an endocrine or an exocrine gland?

Both

80

What are the endocrine functions of the pancreas?

Secretion of insulin and glucagon

81

What cells secrete digestive enzymes from the pancreas?

The acinar cells

82

Innervation of the endocrine islets of the pancreas is supplied by what?

Parasympathetic vagal nerve

83

What is the role of the duct cells in the exocrine ducts?

Regulated by secretin, they release a HCO3- rich secretion which is added to the enzyme and Cl- rich secretion from the acinar cell above.

84

What are the enzymes released from the pancreas that are responsible for the digestion of protein?

Trypsin
Chymotrypsin
Elastase
Carboxypeptidase

85

What is the enzyme released from the pancreas that is responsible for the digestion of sugars?

Amylase

86

What are the enzymes released from the pancreas that are responsible for the digestion of oils and fats?

Lipase
Colipase
Phospholipase
Cholesterol esterase

87

What is the major activator of most of the enzymes released from the pancreas?

Trypsin

88

What is the zymogen of trypsin?

Trypsinogen

89

What emulsifies fat before digestion?

Bile

90

What is the enzyme used as the catalyst in bicarbonate ion production?

Carbonic anhydrase

91

How are bicarbonate ions secreted into the lumen of the pancreatic ducts?

Cl- exchanger

92

How are the protons left behind as a by product of bicarbonate ion production removed from the cell?

Na+ ions are countertransported at the non-lumenal side.

93

What regulates the secretion of the aqueous component of pancreatic juices?

cAMP

94

What is the first part of the large intestine?

The caecum

95

How much passes into the large intestine everyday in the average healthy adult?

About 500 ml

96

What are taeniae coli?

Thickened bands of longitudinal muscle

97

What are haustra?

Pockets formed by the smooth muscle action of the taeniae coli.

98

What is the function of the large intestine?

Storage of residues before elimination
Secretion of mucus to lubricate faeces
Absorption of remaining water and electrolytes

99

Where in the GI tract is most of the water reabsorbed?

The small intestine

100

How much water is reabsorbed in the large intestine?

400-1000 ml

101

What happens if the large intestine fails to reabsorb the water?

Diarrhoea

102

How does re-absorption by the large intestine occur?

Sodium ions actively taken up, under control of aldosterone.

103

What otherwise indigestible things are digested by flora in the large intestine?

Some carbohydrates and lipids

104

Give an example of an aerobic microbe found in the flora of the large intestine.

Enterobacter aerogenes

105

Give an example of an anaerobic microbe found in the flora of the large intestine.

Clostridium perfringens
Bacteroides fragilis

106

How do microbes naturally found in the flora of the large intestine contribute to the bilirubin cycle?

Convert bilirubin into non-pigmented urobilinogens.

107

What are the vitamins synthesized by the microbes naturally found in the flora of the large intestine?

Vitamin K
Biotin
Vitamin B12
Folic acid
Thiamine

108

Why might antibiotics lead to an increased risk of bleeding?

Vitamin K synthesized by microbes naturally found in the flora of the large intestine is a cofactor in the production of blood clotting factors.

109

How long does stuff end up staying in the large bowel in an average adult?

16-20 hours

110

What muscle layer contracts in the mixing movements of the large intestine?

Circular muscle

111

Which parts of the large intestine have peristaltic movements occur and different points throughout the day?

The transverse colon and descending colon

112

What is a mass movement of the large bowel?

Portion of the colon that contracts is longer than a normal peristaltic wave. Material is moved out of the proximal colon. When the mass movement happens in the descending colon we experience the need to defecate.

113

Does the rectum normally contain anything?

No, not unless we need to defecate.

114

Which sphincter in the rectum is under voluntary control?

The external anal sphincter

115

What controls the internal anal sphincter?

Sympathetic inhibitory fibres of the autonomic system