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BRS GASTROENTEROLOGY > Upper GI tract > Flashcards

Upper GI tract Flashcards

(67 cards)

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1
Q

What are the different system nomeclatures? (3)

A

Gastrointestinal system vs Alimentary system vs Digestive system

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2
Q

What is digestion?

A

Digestion is the process of breaking down macromolecules to allow absorption

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3
Q

What is absorption?

A

Absorption is the process of moving nutrients & water across a membrane

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4
Q

How is ingestion, digestion, absorption and excretion linked?

A

Ingestion-> digestion-> absorption

Ingestion-> digestion-> excretion

Ingestion-> absorption

Ingestion-> excretion

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5
Q

Label this diagram of the components of the GI system.

A
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6
Q

What is the basic plan of the gut wall? e.g., oesophagus

A

Mucosa
Submucosa
Muscularis
Serosa/ Adventitia

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7
Q

what are the layers of the mucosa?

A

Epithelium
Lamina propria (loose connective tissue)
Muscularis mucosae

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8
Q

What is the submucosa?

A

Connective tissue (containing nerve plexus)

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9
Q

What is the muscularis?

A

Smooth muscle (containing nerve plexus)

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10
Q

What is the serosa/ adventitia?

A

Connective tissue +/- epithelium

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11
Q

How many teeth and what are they?

A

TEETH - 32 in total
8 incisors
4 canines
8 premolars
12 molars

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12
Q

What is the masseter muscle?

A

Largest jaw muscle responsible for biting

Several muscles control position of mandible

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13
Q

What are the salivary glands?

A

Parotid
Sublingual
Submaxillary

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14
Q

What do salivary glands do?

A

Food mixed with saliva (aqueous secretion & digestive enzymes)
Lingual lipase (fat digestion)
Salivary amylase (carbohydrate digestion)

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15
Q

Describe the muscles of the tongue.

A

Intrinsic muscles
- fine motor control & moving food

Extrinsic muscles
- gross movement of tongue (in, out, up &
down)
- Assists mechanical digestion

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16
Q

Where does the oesophagus start and end?

A

Starts at C5
Ends at T10

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17
Q

What is the function of the oesophagus?

A

Conduit for food, drink & swallowed secretions from pharynx to stomach

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18
Q

What is the epithelium of the oesophagus like (structure and function relationship)?

A

Non-keratinising
‘Wear & Tear’ lining (extremes of temp. & texture)
Lubrication – Mucus secreting glands (& saliva)

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19
Q

What is the muscle of the oesophagus like?

A

Tonically active
Swallowing centre

Skeletal and smooth muscle at lower oesophageal sphincter
Skeletal muscle at upper oesophageal sphincter

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20
Q

What is near the lower oesophageal sphincter?

A

Sub Hiatal fat ring

Zigzag (Z) line

Diaphragm

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21
Q

What muscle in the oesophagus is in charge of peristalsis?

A

Circular muscle

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22
Q

How does peristalsis work basic?

A

contract just before where the food is and relax just after where the food is?

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23
Q

What are the 2 muscle types in the oesophagus?

A

Circular and longitudinal

Skeletal/ smooth

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24
Q

How is the skeletal and smooth muscle split in the oesophagus (placement wise)?

A

Upper third is skeletal
middle third is skeletal and smooth
lower third is smooth

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25
What are the stages of swallowing?
Stage 0: Oral phase Stage 1: Pharyngeal phase Stage 2: Upper oesophageal phase Stage 3: Lower oesophageal phase
26
How would you describe swallowing?
a complicated and highly coordinated event
27
As the bolus travels down the oesophagus when do the superior and inferior muscles contract and dilate (close/ open)?
Superior muscles contract Inferior muscles dilate
28
What happens during stage 0 of swallowing?
Stage 0: Oral phase - Chewing & saliva prepare bolus - Both oesophageal sphincters constricted
29
What happens during stage 1 of swallowing?
Stage 1: Pharyngeal phase - Pharyngeal musculature guides food bolus towards oesophagus - Both oesophageal sphincters open
30
What happens during stage 2 of swallowing?
Stage 2: Upper oesophageal phase - Upper sphincter closes - Superior circular muscle rings contract & inferior rings dilate - Sequential contractions of longitudinal muscle The oesophageal phase is controlled centrally
31
What happens during stage 3 of swallowing?
Stage 3: Lower oesophageal phase - Lower sphincter closes as food passes through
32
What happens/ is at the gastro-oesophageal junction? (3)
Reflux – prevented by diaphragm Epithelial transition Gastric folds - rugae
33
What are the functions of the stomach?
Breaks food into smaller particles (acid & pepsin) Holds food, releasing it in controlled steady rate into duodenum Kills parasites & certain bacteria
34
What are regions of the stomach? (5)
cardiac, pyloric, body, fundus, antrum
35
What does each section of the stomach secrete?
Cardia & Pyloric Region: Mucus only Body & Fundus: Mucus, HCl, pepsinogen Antrum: Gastrin
36
Describe the structure of tubular glands?
Simple columnar- invaginates into mucosa
37
What are the details of the layers of the gut wall? e.g., longitudinal muscle in muscularis (9)
Mucosa Submucosa Muscularis Serosa
38
How much acid does the stomach produce?
2L/ day
39
What is the concentration of the acid in the stomach?
150mM H+ (3 million x that in blood)
40
What is the pH at the epithelial surface of the stomach and the lumen?
Epithelial surface = 6-7 Lumen = 1-2
41
Describe the cells present in the different regions of the stomach.
42
What cells secrete pepsinogen?
Chief cells
43
What cells secrete HCl?
parietal cells (they can be resting or active)
44
What cells secrete mucus?
mucous neck
45
What secretes gastrin?
Enteroendocrine (they can be closed or open)
46
What are the 2 methods of stomach contraction and how much of each is split as stomach contractions?
20% is peristalsis 80% is segmentation
47
What is peristalsis?
20% stomach contractions Propels chyme towards colon More powerful as moves from LOS to pyloric sphincter ANS essential
48
What is segmentation?
80% stomach contractions Weaker Fluid chyme towards Pyloric sphincter Solid chyme pushed back to body Stretching activates enteric NS
49
What are chief cells?
Gastric Chief Cell - Protein-secreting epithelial cell - Abundant RER - Golgi packaging and modifying for export - Masses of apical secretion granules - Secretes pepsinogen
50
What are resting parietal cells?
Parietal Cell: Resting - Many mitochondria (requires lots of ATP) - Internal canaliculi (secretory surface) - Cytoplasmic tubulovesicles (contain H+/K+ ATPase)
51
what are secreting parietal cells?
Microvilli project into canaliculi Tubulovesicles fuse with membrane
52
What is inside parietal cells?
53
What is the role of pepsinogen?
Pepsinogen and HCl form pepsin pepsin is used to break/ digest proteins
54
What is gastrin?
Pyloric antrum Reaches parietal cell via systemic circulation Stimulated by distention, small peptides & amino acids, stimulation of vagus nerves Acts on receptors on parietal cell Stimulate histamine release from chromaffin cells (lamina propia)
55
What are the phases of gastric secretion?
Cephalic phase Gastric phase Intestinal phase
56
Describe the first phase of gastric secretion?
Cephalic phase Thought, sight, smell and taste of food stimulates gastric secretion Vagus nerve activates parietal cells through ACh to trigger the whole cascade
57
Describe the gastric phase of gastric secretion?
Food in stomach activates the stretch- (distension) and chemo-receptors (pH of food chemicals) - G cells secrete gastrin which stimulates HCl secretion Signals sent to and from the brain via vagus nerve to activate the secretion of acid
58
Describe the intestinal phase of gastric secretion.
Once the chyme with pH less than 2 reaches the duodenum Signal is transmitted by the vagus nerve and this causes secretion of hormones that inhibit the secretion of gastric HCl and pepsin too These hormones are Gastric inhibitory peptide, Cholecystokinin and Secretin
59
Give a summary of gastric secretion.
60
What drugs reduce acid secretion?
ranitidine and omeprazole
61
How do omeprazole and ranitidine work?
Ranitidine is a competitive inhibitor of histamine H2-receptors. The reversible inhibition of H2-receptors in gastric parietal cells results in a reduction in both gastric acid volume and concentration. Leading to less H+ being formed inside the cell. Omeprazole is a proton pump inhibitor that inhibits secretion of gastric acid by irreversibly blocking the enzyme system of hydrogen/potassium adenosine triphosphatase, the “proton pump” of the gastric parietal cell.
62
Which vertabrae does the oesophagus lie between?
C5 to T10
63
What are the controls of motility and acid secretion in the stomach?
Local control Nervous control Gut hormone control
64
Describe the process of HCl secretion from parietal cell.
65
What triggers production and secretion of HCl from parietal cells?
Histamine acting on H2 histamine receptors on parietal cells - ACh - gastrin ECL (endocrine cells in stomach) cells secrete histamine in response to gastrin stimulation, and histamine acts on the H2 receptor of parietal cell, which provide a stronger stimulus for parietal cell acid secretion than direct gastrin action.
66
What cells make gastrin?
pyloric antrum by G cells - gastrin is a local peptide hormone - stimulates histamine release from chromaffin cells (lamina propria) which triggers HCl secretion
67
When is pepsinogen cleaved?
Pepsinogen is secreted via chief cells and is cleaved at low pH (HCl) into pepsin to digest proteins

BRS GASTROENTEROLOGY (25 decks)

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