swallowing and peristaltic wave Flashcards Preview

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Flashcards in swallowing and peristaltic wave Deck (25):
1

UES

- neurogenic
- skeletal muscle
- constriction
- primary peristaltic wave (swallowing)
- anatomic sphincter that is anatomically controlled

2

LES

- myogenic
- smooth muscle
- relaxation by VIP
- not anatomically controlled
- functional

3

LES

- is sensitive to
- nicotine
- alcohol
- chocolate
- caffeine

4

case:
joey chestnut
68 hotdogs in 10 minutes

- LES
- receptive relaxation (inhibited by atropine)
- vagally mediated response (vagus nerve)

5

case of hotdog eating contest

- neostigmine
- physostigmine
- edrophonium (tensilon and elon)
ALL INCREASES ACH, GI MOTILITY (receptive relaxation)

6

swallowing

- is a reflex controlled from the brain stem

7

case:
stroke patient damage to CN IX and X

- aspiration pneumonia from loss of gag reflex
- difficulty swallowing

8

basic electrical rhythm 3/min (BER)

- pacemaker
- force increases not the frequency

9

PARASYMPATHETIC (vagal stimulation)
major force

- ACh increase
- GRP (gastrin releasing peptide) increase
- causing distension/stretch

10

case of DM for 15 years
presented with bloating abdominal distention

- diabetic gastroparesis
- low ACh mechanism
- parasympathetic
- won't feel the gastric distension/stretch due to neuropathy

11

duodenum

- fat (CCK) GIP
- acid (Secretin)
- distension
- osmolarity (hyper)
ALL CAUSE INHIBITS GASTRIC MOTILITY

12

stretch of duodenum

- inhibits motility

13

leaves the stomach fastest

- normal saline ( no fats, CHO, CHON, acid)
- same osmolality as blood
- normal osmolality
- it won't stretch the duodenum much

14

pills with gatorade gastric emptying time

- 20 mins

15

gatorade vs water

- water replacement can cause hypokalemic and hyponatremic
- leaves the stomach longer and take much energy to the athlete

16

gatorade

- has water with normal pH
- with salt, K, Na, sugar
- osmolality is closer to physiologic
- leaves the stomach fast
- rapidly absorbed
- does not distend the stomach

17

gastric motility stimulation

- PARASYMPATHETIC
- via ACh and gastrin release
- local distension
- DIABETIC GASTRICPARESIS INHIBITS THIS PROCESS
- treatment METROCLOPROMIDE (reglan) increases GI motility and ERYTHROMYCIN side effect vomiting diarrhea too much motility increases GI motility

18

gastric motility inhibition

- low pH of the stomach inhibits release of gastrin
- feedback from duodenal overload (neuronal and hormonal)

19

stomach emptying

- normal saline > liquids > CHO > Protein > Fat (has a lot of calories)

20

stretch of the cecum

- closes the ileocecal valve

21

stretch of the duodenum

- closes the pyloric sphincter

22

stretch of the ileum

- opes the ileocecal valve

23

half the volume of stool is (migrating myoelectric complex)
increase activity

- GI epithelial cells
- cleans every 5 days
- irritable bowel syndrome (IBS)

24

diabetic gastroparesis

- too little activity of the migrating myoelectric activity

25

case:
patient develops diarrhea abdominal pain constipation

- IBS
- hyperactivity of motilin
- increase activity of migrating myoelectric activity
- 90 - 120 mins
- stopped by meal, interrupted by meals