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Physio Ch.15

QuestionAnswer
gi tract includes the oral cavity, pharynx, esophagus, stomach, small/large intestine
accessory organs include salivary glands, liver, gallbladder, pancreas
functions of the GI tract include digestion, secretion, absorption and motility
digestion is either mechanical (physical breakdown, no chemical change) or enzymatic hyrdolysis (individual units/monomers)
secretion happens via...and it facilitates... exocrine glands...movement
absorption goes from lumen to lymph or blood vessel
motility happens via...and does... smooth muscle...mixing and moving
oral cavity includes the teeth (mechanical digestion), tongue (mixing and initiates swallowing), saliva
saliva does...through...and it also does... enzymatic hydrolysis ...(amylase - breaks down starch)...moistening/lubrication, dissolving chemicals(taste) and antibacterial actions (lysozyme)
the pharynx and esophagus are both pathways
stomach does what stores food, dissolves it, partially digests it and absorbs water and alcohol
the stomach dissolves food/mixes it via HCl (carbohydrates and proteins)
partial digestion in the stomach does both...second one happens through.. mechanical digestion and enzymatic hydrolysis ...pepsinogen and HCl (converst pepsinogen)
absorption of water and alcohol in stomach is just a very small amount
the sections of the small intestine include the duodenum, jejunum and ileum
the duodenum does digestion, absorption and motility
digestion in the duodenum involves luminal and pancreatic enzymes
the jejunum does continued digestoin, absorption and motility
the ileum does absorption and motility
the pancreas produces... digestive enzymes and hco3 which neutralizes hcl in intestine from stomach
liver and gallbladder produce...which includes... bile...bile salts, cholesterol, bile pigments and hco3
bile salts do...and bile pigments are the... emulsifaction...waste products of RBC breakdown
large intestine does absorption of salts and water, storage of wastes and defecation
absorptive ability of GI tract basically says that the GI tract is very effecient at water conservation
GI wall structure: ...through... stomach...rectum
Actual wall structure from inside to oustide mucosa, submucosa, muscularis externa, serosa
mucosa consists of epithelium, lamina proprio and muscularis mucosa
the epithelium of the mucosa has...as well as...from... exocrine and endocrine cells...ducts..external glands
the lamina propria contains small lymph ducts and blood vessels and nerve fibers
submucosa contains larger blood and lymphatic vessels and the submucosal nerve plexus
the submucosal nerve plexus is responsible for local stimulation of mucus producing cells
muscularis externa consits of the circular muscle, myenteric nerve plexus and longitudinal muscle
the circular muscle does...and the longitudinal one does...in order to... squeezing...shortening...get more movement along the GI tract
myenteric nerve plexus is also called the...and it stimulates... muscle plexus...muscle layers
the submucosal and myenteric nerve plexi can communicate w/ eachother
serosa is the external boundary of this system
GI wall structrue specializations include the stomach and small intestine
the stomach has the...which is the... oblique muscle...3rd muscle layer in muscularis externa
the oblique muscle can contract in all directions for mixing/mechanical breakdown
the small intestine is the most...and does the important part of digestion...vast majority of food digestion
the small intestine contains plicae circulares and villi
the villi do what increase surface area for absorption of nutrients
villi also have microvilli, lateals and capillary networks
lacteals absorb fatty acids
the hepatic portal system order of stuff celiac trunk and mesenteric arteries, capillary beds, hepatic portal vein, capillary beds, hepatic vein
the celiac trunk and mesenteric arteries go to the stomach, pancreas, spleen and intestines
the capillary beds do what absorption into the blood
hepatic portal vein goes to the liver
2nd capillary beds after the hepatic portal vein include the...that do... hepatic sinuses...removal of nutrients from blood into the liver
the hepatic vein goes to the vena cavae
carbohydrates, like starch, which is made up of..., gets broken down into... glucose monomers...maltose (disaccharide) and small glucose chains
starch is broken down by...which comes from.. enzyme amylase..salivary glands and pancreas
other carbohydrates are broken down by...from the....and they have... brush border enzymes...small intestine...microvilli
brush border enzymes break down...into... disaccharides and oligosaccharides...monosaccharides
the monosaccharides get absorbed into epithelial cells and then into the blood stream
absorption of carbohydrates happens in the...via a... small intestine..transcellular pathway
monosaccharides require...and...through...into... facilitated diffusion...2ndary active transport w/ na (energy)...luminal membrane...epithelial cells
monosaccharides also require...out of the... facilitated diffusion...basolateral membrane into the blood stream
proteins are...which get broken down into...then into... long polymers of amino acids..peptide fragments...amino acids
stomach breaks down proteins into..via... peptide fragments...pepsinogen > pepsin
pepsin is not necessary for protein digestion
pancreas breaks...into... trypsin and chymotrypsin...peptide fragments
the pancreas also breaks down..into... carboxypeptidase...free amino acids
small intestine breaks down...into... aminopeptidases...free amino acids
absorption of proteins happens in the...via a.. small intestine..transcellular pathway
the small intestine can do all of the breakdown and absorption w/o the stomach
absorption of amino acids requires...through...into... 2ndary active transport w/ na...luminal membrane...epithelial cell
dipeptides and tripeptides require...through...into... 2ndary active transport w/ h...luminal membrane...epithelial cells
di and tripeptides are broken down to...within the... amino acids...epithelial cell
amino acids require...out of... facilitated diffusion...basolateral membranes
proteins can also undergo endo and exocytosis
the normal ingest fat is called...and it gets broken down into...through triglyceride...monoglyceride and 2 fatty acids...lipase from the pancreas (mainly) or also the mouth and stomach (small portions)
fatty acids are hydrophobic
emulsification keeps fat droplets from re-joining (and thus decreasing the surface area)
emulsification involves is the..of fat droplets and it happens in the... mechanical disruption ...pyloris of stomach and duodenum
emulsifying agents prevent...and include... reaggregation...phospholipids, bile salts (from liver and are amphipathic) in bile
absorption of fats occurs in the..via a... small intestine...transcellular pathway
absorption of fats involves...which is when.. .micelle formation...bile salts surround non-polar fatty acids
the micelle formation keeps constant equilibrium of forming and breaking down
luminal membrane is where free fatty acid diffusion into the epithelial cell occurs
once inside the epithelial cell,...forms chylomicrons
chylomicron formation involves the... endoplasmic reticulum and golig apparatus (reforms triglycerides) and exocytosis (of the triglycerides)
lacteal abosrtion involves... diffusion of triglyercides, then it goes into the blood stream
vitamins are...and are stored in... fat soluble...adipose tissue
vitamins follow fatty acid path
vitamins are also...so they sort of act like... water solube..nutrients
vitamins that are water soluble involve the most...through... absorption...diffusion and mediated transport into bloodstream
vitamin b12 must have...in order to be absorbed... intrisnic factor (protein)
intrinsic factor decreases..which leads to... the ability to produce RBCs...pernicious anemia
intrinsic factor gets recognized by specific receptors in the ileum
vitamin b12 and intrinsic factor go through endocytosis
the stomach absorbs some...but the small intestine.. water....absorbs most of the water
water follows...in the small intestine ions (na/k atpase pump)
large intestine does what it absorbs the leftover unabsorbed water
iron is a...and it goes from the..via... mineral...lumen to epithelial cell..active transport (specific transporter)
iron in the epithelial cell: some iron is bound to...and is... ferritin...stored
iron in the epithelial cell: some iron moves to...where it binds to... blood..transferrin for transport in plasma
GI regulation: stimuli for regulation include strech or distension of external muscularis, chyme osmolarity, chyme acidity and chyme concentration of digestive products
stretch or distension of external muscularis involves....in the.. mechanoreceptors...stomach and small intestine
chyme osmolarity involves osmoreceptors
chyme acidity and chyme concentration of digestive products involve chemoreceptors
neural regulation of GI involves enteric nervous sytem and CNS reflexes
the enteric nervous system does...which involves... short reflexes...receptors > nerve plexus > effector cells
enteric nervous system does self control/regulation and communication along the entire length of plexus & between plexuses
the enteric nervous sytem includes the...that controls.... myenteric plexus...smooth muscle activity
the enteric nervous sytem also includes the..that controls... submocosal plexus...exocrine glands and secretory activity
CNS reflexes involve both... symp/para systems and long reflexes
long reflexes involve...>...>...>...>... receptors > afferent neurons > CNS > autonomic efferent neurons > effector cells
GI can also be regulated via hormones
hormones come from...in the... endocrine cells or cell clusters...stomach and small intestine epithelium
endocrine cells or cell clusters respond to...and provide... GI tract contents...feedback control of GI tract
the four major hormones are gastrin, CCK, secretin and glucose-dependent insulinotropic peptie (GIP)
gastrin is produced by the...stimulated by...and inhibited by... stomach...proteins, amino acids, peptides and parasympathetic system...acid in stomach
gastrin stimulates stomach activity (motility)
CCK is made in the...stimulated by... small intestine...chyme in the small intestine(amino acids and fatty acids)
CCK stimulates pancreas to secret enzymes, gallbladder contraction (for bile secretion)
CCK inhibits...and relaxes... stomach activity,...sphincter of Oddi
secretin is from the...and is stimulated by... small intestine...acid in small intestine
secretin stimulates...and inhibits... pancreatic hco3-, potentiates (facilitates) CCK...stomach activityq
GIP helps you get ready for...which means it does... onslot of nutrients...feed forward regulation
gip is produced by the..and it stimulates small intestine...insulin
phases include cephalic, gastric and intestinal
the cephalic phase happens in the...and is stimulated by head...sight, smell, taste, chewing
action of cephalic phase vagus nerve to GI nerve plexuses
gastric phase stimulation stretch, acidity, amino acids and peptides in stomach
action of gastric phase long (vagus) and short reflexes as well as gastrin release
intestinal phase stimulation stretch, acidity, osmolarity and digestive products
action of intestinal phase long (vagus) and short reflexes as well as secretin, cck, gip release
chewing happens via..which is... somatic motor control...conscious and a reflex
chewing does...and it has no major effect on... mechanical digestion..digestion and absorption rates
salivation happens via...which involves stimulation from... autnomic system control...para/symp systems depending on saliva type
salivation also involves..stimulation, which can either be... reflex...conditioned (sight and thought) or via chemoreceptors (smell and taste)
swallowing is also called...and it is a... deglutition...reflex
the reflex of deglutition involves pressure receptors in the pharynx and swallowing center in the medulla
deglutition has two phases oral(aware) and esophageal (unaware)
oral phase is where the..is formed, the...elevates as well as the... bolus...soft palate...larynx and epiglottis
the esophageal phase: upper esophagus is made of...lower is made of... skeletal muscle..smooth muscle (autonomic control)
during swallowing the..reflexively... upper esophageal spincter...relaxes
esophageal phase involves...between the... peristalsis...upper and lower esophageal sphincter
the lower esophageal spincter is also called..and it... upper gastric sphincter..reflexively relaxes
the body of the stomach, including the...has... fundus...gastric glands for pepsinogen and HCl production
the antrum of the stomach has..for... gastric glands...gastrin production
the gastric glands in the body of the stomach contain 5 different types of cells mucous neck cells, parietal cells, chief cells, enterochromaffin-like cells (ECL) and d cells
mucous neck cells produce mucous to protect the stomach from the acid
parietal cells produce HCl and intrisic factor
chief cells are also called...and they secrete principle cells...pepsinogen and gastric lipase
ECL produce histamine (paracrine agent)
d cells produce somatostatin releasing cells
antrum includes 3 types of cells mucous neck cells (mucous), chief cells (pepsinogen) and G cells (gastrin)
HCl secretion involves...in the... h/k atpase pump..parietal cell luminal membrane
h/k atpase pumps do h into lumen and k into cell
HCl secretion also involves...in the... hco3-/cl- counter transport..basal membrane
hco3-/cl- counter transport does what hco3- to blood (why vomitting increasing ph) and cl- to the cell
lastly, HCl secretion ivolves...in the... cl and k leak channels in paritel cell luminal membrane
cl and k leak into lumen
regulation of h/k atpase pumps involves the...into.. insertion of pumps...parietal cell luminal membrane
which three hormones stimulate the insertion of h/k atpase pumps into parietal cell luminal membrane gastrin, histamine, ACh
gastrin is a...that stimulates during the... hormone...cephalic phase (vagus) and gastric phase (short/long relfexes)
histamine is a...that... paracrine agent...potentiates gastrin and ACh
histamine stimulates during the cephalic phase (vagus) and gastric phase (short/long reflexes)
ACh is a...that stimulates during the... neurotransmitter...cephalic phase (vagus) and gastric phase (short/long relfexes)
somatostatin...the insertion of h/katpase pumps inhibits
somatostatin is a...that is stimulated by...and it does... paracrine agent...^ [HCl]...negative feedback
regulation of h/k atpase pummps: stimulation occurs during both the... cephalic phase (long reflex) and gastric phase (long and short reflexes)
regulation of h/k atpase pumps: inhibition occurs during the...and provides... gastric phase..negative feedback (^ [HCl] and somatostatin)
regulation of h/k atpase pumps during the intestinal phase involves monitoring an ^ [HCl] in duodenum > dec gastric secretions
regulation of h/k atpase pumps: ^ distension of duodenum > ... dec gastric secretions
regulation of h/k atpase pumps: ^ [amino acids & fatty acids] in duodenum > ... dec gastric secretions
the intestinal phase of h/k atpase pump regulation involves long and short reflexes and hormones (secretin and cck)
regulation of pepsin involves pepsinogen secretion, pepsin production and pepsin inactvation
the stimulatory pathways of HCl production also stimulates pepsinogen secretion
zymogens are the...and they can't... inactive forms of enzymes...damage the cell
pepsin production happens when...and it requires... pepsinogen...low pH (HCl)
pepsin production is a...that means.. positive feedback loop...pepsin stimulates conversion of pepsinogen to pepsin
pepsin inactivation happens in the...and it involves dumping... duodenum...bicarb into the intestine to neutralize it
gastric motility has...which happens during the...and relaxation of the stomach occurs... receptive relaxation...cephalic phase (vagus)...before food arrives
gastric motility involves...whihc is the...and it is stimulated by... peristalsis...sequential contraction of muscles...presence of food
peristalsis puts...but most is... small amounts of food into duodenum (via pyloric sphincter)...returned to the body for further mixing
peristaltic rhythm is controlled autonomically
peristalic rhythm involves...that produce... smooth muscle pacemaker cells...slow waves (3/min basic electrical rhythm)
smooth muscle pacemaker cells only need...and there is only a small.. a few action potentials...^ muscle tension
peristaltic rhythm w/ an additional stimulus and membrane depolarization via...so there are more...and larger... excitatory neural and hormonal input...action potentials...^ muscle tension
gastric emptying happens during both the gastric and intestinal phases
the gastric phase for gastric emptying increases...>... stomach distension > ^ rate of emptying of chyme
the intestinal phase for gastric emptying increases....>....why is this beneficial? ^ duodenal distension, fat content, acidity, hypertonic solutions > dec rate of emptying chyme (neg feedback to slow down stomach)....more mixing chyme w/ enzymes and bicarb and more time for digestion/absorption
pancreatic secretions are...from... exocrine secretions...pancreatic acini
pancreatic secretions include hco3- (buffer), zymogens (trypsinogen, chymorypsin, elastase) and lipase, amylase, ribonuclease and deoxyribonuclease
pancreatic secretions are stimulated by secretin and CCK
secretins job when there is increased...in the doudenum is to... acidity...release more hco3-
cck's job when there are ^...in the doudenum is to... amino acids and fatty acids...enzyme release
bile secretions: contents bile salts, lecithin phospholipid, hco3-, cholesterol, bile pigments, trace metals
bile salts are...are ivoled in...and reabsorption happens by the.... emulsifying agents...enterohepatic circulation(recirculate many times during meals)...ileum to send to liver
lecithin phospholipid is an emulsifying agent
cholesterol, bile pigments and trace metals are wastes
bile pigments involve...which... stercobilin...is the brown pigment in poop
bile secretions are stimulated by cck (^ fatty acids in duodenum)
small intestine secretions involve...and...follows them ions like cl, na, hco3...water
small intestine primarily secretes...and in...there is a... cl...cycstic fibrosis...mutated cl channel
the fact that water follows ions helps lubricate
small intestine absorption involves the transport of...and there is a large net fluid... ions for reabsorption...absorption
transport of ions for reabsorption is primarily na
large net fluid reabsorption because water follows the ions
small intestine motility involves segmentation and migrating myoelectric complex
segmentation is the...and it does... diving of the intestine into overlaping longitudinal segments...movement back and forth with gradual forward progress
segmentation involves circular muscles and pacemaker cells
motility pacemaker cells in the duodenum the rate is ...and in the ileum the rate is... 12/min...9/min
motility in the small intestine allows for... mixing of chyme
migrating myoelectric complex is coordinated peristalsis from pyloris of stomach to colon
migrating myoelectric complex involves...and it begins after... long overlapping waves of peristalsis = 2 feet in length...absorption is mostly complete
migrating myoelectric complex moves..and it is the force that makes material... wastes material to colon...hit the colon's sphincter
large intestine contains the...that opens as the...and it allows... ileocecal sphincter..ileum contracts...chyme into colon
absorption in the large intestine involves fluids and bacterial digestion (fermentation) products
absorption of fluids in the large intestine involves...and...follows na active transport from lumen...water
bacterial digestion (fermentation) products include fatty acids and vitamin k
vitamin k is for production of prothrombin and other clotting factors
motility in the large intestine involves segmentation and mass movement
segmentation involves circular muscles and pacmaker cells (slow 1/30 mins)
mass movement is similar to...and it involves... peristalsis...circular and longtiduinal muscles
mass movement is diff from peristalsis because it involves two things...and is triggered by... long wave of inesnse contraction, prolonged contraction...eating (e.g. infants)
defecation happens by the... rectum, internal anal sphincter (smooth muscle) and external anal sphincter (skeletal muscle)
defecation reflex involves mass movement, distention of rectrum and conscious control
distention of rectum involves...that... mechanorecedptors...detect stretch
mechanoreceptors that detect streth produce...and... contraction of rectum and relaxation of internal anal sphincter
initially the external anal sphinter is contracted
there is continued...that increases... peristalsis in sigmoid colon...presssure in rectum
lastly the external anal sphincter relaxes
conscious control of defecation involves the...and if there is a prolonged delay of defecation > ... external sphincter...retrogarde movement of feces to sigmoid colon
valsalva maneuver involves taking a...and... deep breath...hold during effort to defecate
deep breath and hold during defecation involves increases in abdominal pressure to assist in defecation and an increase then decrease in intrathoracic pressure
increases then diecreases intrathroacic pressure > increase then decrease blood pressure
excessive strain can lead to heart attack and stroke in people w/ cardiovavscular disease
malabsorption of vitamins involves inability to absorb, nontripical sprue or perneicious anemai
nontropical sprue is also called...an it involves a loss of... celiac disease...intestinal surface area due to reaction to wheat gluten
celiac disease is basically vitamin d malabsorption
pernicious anema is a lack of...and a lack of... intrinsic factor pdocution...ileium absorption of intrinsic factor and vitamin b12
esophagues problems involve gastroesophageal reflux or heart burn
heartburn is weakened...or increased... lower esophageal sphincter...gastric pressure (mid pregnancy and large meals)
stomach ulcers constitues a lack of protective alkaline mucus secretion
la ck of protective alkaline mucus secretiions means you can't neutralize acids
ulcerscan also occur in hthe... lower esophagues 9esophageal reflux)...duodenum (lack of hco3- to neutralize acids
bleeding ulcuers involve....through... acid and pepsin digestion mucosal layer to vessels in submucosal layer
causative agents for stomach problems include (4 things) excess HCl production, alcohol, genetics and helicobactor pylori
excess hcl production can be fixed via...that inhibit... h/k atpase pump inhibitors (proton pumps)...h movement to lumen
excess hcl production can also be fixed via...that inhibits.. parietal cell histamine receptor blocker...hcl secretion
helicobacter pylori decreases your ability to maintain mucous lining
vomiting is...and retching is... bringing things up...dry heaving
vomitting involves the...center medulla oblongata vomitting
vomitting is stimulated by...in the...as well as... chemoreceptors... brain, stomach and intestines...stomach and small intestine distension, motion sickness, pain and gag reflex
motion sickness is registered in the vestibular apparatus
emetics are also called...and they are...that... syrup of ipecac...chemereceptors...triggers you to vomit
vomitting is ...of material through... retrograde movement...GI tract (stomach and duodenum and into esophagus and out)
vomitting involves a loss of fluid and h which leads to dehydration and metabolic alkalosis
gall stones are crystalizations of cholesterol
gall stones block the...which decreases two things... common bile duct..lipid digestion and absorption and it decreases fat soluble vitamin absorption
decrease in lipid digestions and absorption bec of gall stones leads to steatorrhea (inability to digest fats - no emulsifying agents)
decrease in fat soluble vitamin abosrption includes vitamins a(vision), k(clotting) ,d(ca absorption), e(antioxidant)
gall stones also lead to jaundice (bilirubin pressent in blood and then tissues)
gall stones block the pancreatic enzymes
treatment for gall stones is either cholecystectomy or lithotrypsy (ultrasound)
cholecystectomy is when you...and requires... remove the gallbladder...low fat diets
small intestine problems include a decrease in...lack of...and the symptoms are... lactase production...lactase for lactose > glucose + galactose...diarrhea and flatulance
diarrhea is increased... [solutes] (lactose) in waste material causes water rention
flatulence is when... sugars are carried to large intstine to provide food for bacteria
large intestine problems include constipation and diarrhea
constipation is the retention of feces resulting in increased water absorption
constipation is a decrease in motility of the colon
treatment for constipation include ^ dietary fiber and laxatives
^ dietary fiber means you increase distension of the colon which stimulates defecation
laxatives provide lubrication, inhibition of water reabsorption and stimulation of motility
diarrhea is ...which involves a loss of.. frequent, watery stools...salts, k, hco3, potential metabolic acidosis
diarrhea leads to decreased water reabsorption and/or increased fluid secretion into intestine
cholera and other bacteria increase secretion of cl into the lumen > water follows cl
inflammatory bowel disease affects the... mucosal layer of the GI tract
inflammatory bowel disease creates an...involves poor...and has... inappropriate immune responses to normal bacteria...tissue repair...genetic tendencies
forms of inflammatory bowel disease includee crohn's disease and ulcerative colitis
crohn's disease occurs in any part of the GI tract, mainly the ileum
ulcerative colitis occurs in the...and may produce... colon...ulcerations throughout the colon
symptoms of inflammatory bowel diease include diarrhea, blood in feces and cramping
treatment for inflammatory bowel disease include altering diet, anti-inflammatory drugs and antibiotics and removing section of diseased tissue
Created by: handrzej