GI secretions

Question	Answer
Does osmolality increase or decrease with an increase in flow rate	increase
With a low flow rate do you have more or less time to modify slaiva	more
Which flow rate would give you the highest pH, high rate or low rate	high rate
Are both parasympathetic and sympathetic nervous systems used in the salivary secretion	Yes
What does aldosterone do to Na reabsorbtion and K secretion	increases both
What does ADH do to Na reabsorbtion	increases it
If you increase cell activity, what else will you accomplish	increaseing vasodilator metabolites
In the salivary duct, which ions or compounds are being absorbed into the duct	HCO3- and K+
In the salivary duct, which ions are being reabsorbed into the interstitium	Na, H20 and Cl-
What nuerotransmitter does the sympathetic nervous system use to create salivary secretions	NE
What enzyme is released by ductal cells that eventually causes increased capillary permiability and vasodilation	Kallikrein
What is the main contributer to H+ concentration in the lumen of the stomach	Proton Pump
Does the proton pump require ATP	Yes
What is the ion exchanged with H+ in the proton pump	K (potassium)
The Cl that is excreted aling with the H+ originally comes from where	Interstitial Space
What is the mechanism that bring Cl into the parietal cell to be able to be excreted into the lumen	Cl/HCO3- exchanger
What is the shift of HCO3- from the partieal cell into the interstial space refered to as	Alkaline tide
Where does the H+ in the parietal cell come from	dissociation from H20 or H2CO3
High secretory rate yeilds high or low amounts of K+ and Na+	LOW
Which molecules act to stimulate the parietal cell in the direct pathway	ACh, gastrin, abd histimine
What molecules work to stimulate the parietal cell in the indirect pathway	ACh, gastrin, and histimine, but keep in mind the ECL cell is also stimulated so that it secretes histimine to activate the parietal cell
What are PPI's	Proton pump inhibitors. Work to limit acid sectretion in the stomach
What mechanisms/treatments are avaiable for hyperacidity	vagoitmy, antacids, PPI's, H2 blockers (zantec and tagament,
What is the main nerve in the cephalic phase	VAGUS VAGUS VAGUS
Name the four physiological events of cephalic phase	1. Vagus stimulates parietal cell (ACh)2. Vagus stimulates G-cell (GRP) (stimulates ECL and parietal)3. Stimulates ECL cell (ACh)4. Stimulates D-Cell (ACh, inhibits somatostatin)
On what cell is there an inhibiting of an inhibitor	D-cell
What causes excretion of H+ by the parietal cell in the gastric phase	distention of food in the stomach, local and long relflexes, and finally stimulation of parietal cells
What percent of acid secretion does the gastric phase account for	50-60%
What stimulates the release of H+ from parietal cells in the intestinal cell	Protein digestion prducts, entero-oxyntin, absorbed amino acids and gastrin
What percent of H+ secretion does the intestinal phase make up	5-10%
What does somatostatin inhibit	G-cells and parietal cells
What stimulates secretin	acid
Fatty acids cause the release of what protein that acts to inhibit g-cells and parietal cells	GIP
How else do fatty acids work to inhibit the parietal cell	through local relexes
Name two other minor inhibitors of parietal cell	CCK and PGE2
What causes pesinogen to be converted to pepsin	H+ or acid
High levels of what can inhibit Gastrin	Acid
What is PUD	peptic ulcer disease, defined as a break in the mucosal surface >5mm
What are the two functions of the mucosal layer in the stomach	1. Diffusion barrier for H+2. Traps HCO3-
An inflammatory response in the stomach may be caused by what	H+ leaking through the mucosal layer and cause the release of histimine
How does H. Pylori produce an inflammation in the stomach	Inhibits somatostatin and makes excess NH4
Intrinsic factor is essential for the uptake of what vitamin	B12
What is the only essential secretion of the stomach	IF (intrinsic factor)
Acinar cells secrete what	pancreatic enzymes
What are the four general types of enzymes	Amylases, lipases, proteases, nucleases
What do ductal and centroacinar cells secrete	Na+ and HCO3-
In the pancreatic ductal cell, what is the main exchanger used to move HCO3- into the lumen	HCO3-/Cl- exchanger
Where is 90% of the HCO3- in the pancreatic juice coming from	plasma
How is cAMP linked to secretin	Secretin activates adenylate cyclase, which releaes cAMP. This causes PKA to phosphorylate CFTR channels and release Cl- into the lumen
In the pancreas, H+ is moved from the ductal cell to the blood by what mechanism	Na+/H+ exchanger
In the pancreas, the flood of H+ into the blood is called what?	Acid tide
What pulls Na+ through tight junctions in the pancreatic ductal cells	negative lumen
What does the rate of HCO3- depend on	The availability of luminal Cl-
What follows as Na+ moves down its gradient	H20
The faliure of the CFTR channel to function results in what occuring	The lack of Na+ being pulled into the lumen and thus a lack of H20. This causes thick secretiosn which become stuck in the lungs and unabel to be moved out
Pancreatic secretion has an osmolality similar to what	plasma
What are the three controllers fo pancreatic secretion	CCK, secretin, and vagovagal reflexes
What effect does the sympathetic nervous system have on pancreatic secretion	None or inhibitory
What neurotranmitter is used to cause secretions from the ductal and acinar cells	ACh
In what phase does distention cause vagovagal reflexes to occur	Gastric
What are the three main "actors" in the intestinal phase	CCK, Vagus, and secretin
What action does CCK have in the intestinal phase	causes secretions from the ductal and acinar cells
which two cell types will secretin inhibit	G-cells and Parietal cells
During the intestinal phase, the products from protein and lipid breakdown do what	stimulate a vagovagal relfex to trigger acinar cells to secrete
An absence of Cl- exchanger channels on the apical side of the ductal cell will result in a loss of secretion of what	HCO3-
Where are primary bile acids made	Liver
What process takes place to change primary bile acids to secondary bile acids	dehydroxylation (makes bile acids more soluable)
synthesis of bile acids help to rid what compound from the body	cholesterol
At the pH of the intestines, are conjugated bile acids water or fat soluable	water
What structures do bile acids form around fats	micelles
if you have a large return of bile acids to the liver, does the rate of synthesis increase, decrease or stay the same	decreases
Deconjugated/dehydroxylated bile salts are absorbed actively or passively	passivley
Which type of bile acid is absorbed actively	conjugated or more hydrophilic ones
What percentage of bile salts are returned to the liver	90%
If you increase the rate of return of bile salts to the liver, does the rate of release of secretin increase, decrease or stay the same	increase
While HCO3- is being secreted, which ions/electrolytes are being absorbed and secreted	Na+, Cl- and H20
Does billirubin become conugated or uncojugated in the liver	conjugated
Is conugated billirubin direct or indirect	direct

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