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Gastroenterology > Upper GI tract > Flashcards

Upper GI tract Flashcards

(53 cards)

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1
Q

What is digestion?

A

Process of breaking down macromolecules to allow absorption

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2
Q

What is absorption?

A

The process of moving nutrients and water across a membrane

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3
Q

What are the components of the GI system?

A 
Salivary glands 
Oesophagus
Sublingual glands
Submandibular glands
Stomach
Duodenum
Colon
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4
Q

What are the foregut structures?

A 
Liver
Pancreas
Oesophagus 
Stomach
Billary system
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5
Q

What are the midgut structures?

A

Small intestine

Part of large

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6
Q

What are the hind gut structures?

A

Colon

Rectum

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7
Q

What are the layers of the gut wall?

A

Mucosa (epithelium)
Submucosa
Musularis
Serosa/Adeventitia

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8
Q

What is the function of the mucosa?

A

Secretory and absorptive functions

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9
Q

What is the function of the submucosa?

A

Contains blood vessels and capillaries that facilitate exchange

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10
Q

What is the function of the muscularis?

A

Facilitates peristalis
Inner layer- circular muscle that constricts the bowel and divides bowel into segments so that food stays in segments for some time to prevent food rushing through

Longitudinal layer- propagates food through GI tract

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11
Q

What is the function of the serosa?

A

Connective tissue

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12
Q

Describe the numbers of teeth

A

8 incisors
4 canines
8 premolars
12 molars

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13
Q

What are the muscles in the oral cavity?

A

Masseter- largest jaw muscle
responsible for biting
Several others that control the position of mandible

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14
Q

What do the salivary glands do?

A

Secrete lipase and amylase

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15
Q

What do the tongue muscles do?

A

Propagate the food into the pharynx

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16
Q

What does the pharynx lead to?

A

Oesophagus

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17
Q

What do the intrinsic muscles of the tongue do?

A

fine motor control & moving food

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18
Q

What do the extrinsic muscles of the tongue do?

A

gross movement of tongue (in, out, up & down)

Assists mechanical digestion

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19
Q

What is the function of the oesophagus?

A

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

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20
Q

What is the structure and function relationship of the oesophageal epithelium?

A

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

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21
Q

What muscles are in the oesophagus?

A

Upper and lower oesophageal sphincter
Play a role in how food gradually moves into the oesophagus
Function not fully understood

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22
Q

What is the structure and function relationship of the oesophageal muscles?

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A

Tonically active

Swallowing centre

23
Q

What is gastro-oesophageal reflex disease?

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A

Acid refluxes into the oesophagus
‘Heart-burn’
Burning sensation

24
Q

What results from acid reflux?

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A 
Inflammation of the oesophagus 
Red streaks- oesophagitis 
After many years lining changes from squamous to columnar epithelium to protect oesophagus against acid 
"Metaplasia"- Barret's oesophagus
Pre-malignant condition
25
What should be done in a patient with barret's?
Surveillance endoscopsy every 2-3 years | To detect dysplasia
26
What is the function of the inner circular muscle?
Divided oesophagus into segments | Pushes food through
27
What is the function of the longitudial muscles?
Facilitates peristalsis
28
What are the main features of the gastro-oesophageal junction?
Reflux – prevented by diaphragm Epithelial transition Gastric folds - rugae
29
What is the diaphragmatic hiatus?
The diaphragm pinches the lower end of the oesophagus | Helps prevent acid reflux
30
How else is acid reflux prevented on a regular basis?
Angle between oesophagus and stomach is acute 2cm of oesophagus in abdo Negative pressure in thorax Positive pressure in abdo The differential keeps the 2cm in abdo in collapsed state
31
What is a hiatus hernia?
Hiatus becomes large Stomach migrates into chest Keeps gastro-oesophageal junction open Causes acid reflux
32
What is a giant hiatus hernia?
Entire stomach migrates to chest Collapsed lungs Reduced lung capacity Breathlessness
33
Why are gastric folds present?
Absorbing function Folds contains villi to increase the SA Allows for the absorption of plentiful nutrients
34
What are the 4 phases of swallowing?
0: Oral Phase 1: Pharyngeal phase 2: Upper oesophageal phase 3: Lower oesophageal phase
35
What happens during oral the phase?
Chewing & saliva prepare bolus | Both oesophageal sphincters constricted
36
What happens during the pharyngeal phase?
Pharyngeal musculature guides food bolus towards oesophagus | Both oesophageal sphincters open
37
What happens during the upper oesophageal phase?
Upper sphincter closes Superior circular muscle rings contract & inferior rings dilate Sequential contractions of longitudinal muscle
38
What happens during the lower oesophageal phase?
Lower sphincter closes as food passes through
39
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
40
What are the different parts of the stomach?
Cardia and pyloric region Body and fundus Antrum
41
How much acid is secreted by the stomach a day?
2L/day
42
What is the function of stomach acid?
Breaks down food and starts process of digestion
43
What is segmentation?
``` Keeps food in stomach 80% stomach contractions Weaker. Fluid chyme towards Pyloric sphincter Solid chyme pushed back to body Stretching activates enteric NS ```
44
What is peristalsis?
20% stomach contractions Propels chyme towards colon more powerful as moves from LOS to pyloric sphincter ANS essential
45
What are the main cells present in the stomach?
Chief cells | Parietal cells
46
What are the main features of the gastric chief cells?
Protein-secreting epithelial cell Abundant RER- involved in synthetic production of proteins Golgi packaging and modifying for export Masses of apical secretion granules Secretes pepsinogen to be converted to pepsin
47
What are the main features of the parietal cells?
Active pump Many mitochondria (requires lots of ATP) Cytoplasmic tubulovesicles (contain H+/K+ ATPase) Internal canaliculi (extend to apical surface) Tubulovesicles fuse with membrane Microvilli project into canaliculi Release HCL into lumen
48
How is HCL produced? | clarify
CO2 come from capillaries into parietal cells Mixes with H2O catalysed by carbonic anhydrase Potassium enters cell Gets secreted into gastric lumen Balance maintained by Na+ entering capillaries Potassium exchanged with H+ ion through H+/K+ ATPase pump Bicarbonic acid goes back into circulation H+ combines with CL-
49
What is the main function of HCL?
converts pepsinogen to pepsin
50
What is gastrin?
Hormone secreted by G-cells in pyloric antrum Stimulates HCL secretion from parietal cell Stimulates histamine release from chromaffin cells
51
What is a gastrinoma?
Benign tumour of gastrin producing cells Often in pancreas Presents with persistent and multiple ulcers
52
What stimulates parietal cells?
Neurostimulation: Thought, sight, smell & taste of food via vagus nerves Hormonal stimulation: pancreas secreting gastrin acts on parietal cells Local stimulation: local reflexes via neural plexus'
53
What is the function of enterohormones?
Play in a role in the enter-gastric reflex | Suppresses or enhances production of HCL and gastrin

Gastroenterology (12 decks)

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