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Physio Ch.15
| Question | Answer |
|---|---|
| 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 |
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