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GI Phys Stomach
USCSOM Physiology: GI Lecture Part III - Stomach
Question | Answer |
---|---|
Migrating motility complex | periodic wave of contractions every 90 minutes |
What is MMC stimulated by? | motilin |
What inhibits motilin production? | eating |
What antiobiotic is a motilin receptor agonist? | erythromycin |
What is dumping syndrome? Common cause? Tx? | rapid gastric emptying, gastrectomy, smaller more frequent meals |
What is gastroparesis? Common cause? Tx? | delayed gastric emptying, chronic diabetes, muscarinic agonists and more frequent smaller meals |
What are four gastric secretions? | HCl, mucus, Intrinsic Factor, Pepsinogen |
HCl gastric secretion function? | secreted by parietal/oxyntic, activates pepsinogen, kills bacteria, breaks down connective tissue |
What is function of Intrinsic factor? | binds Vit B12 |
What happens if there is no intrinsic factor secreted? | pernicious anemia |
What is the function of pepsinogen? | a protease that is converted to pepsin by acid |
Describe Oxyntic glands. | Parietal Cells for HCl and intrinsic factor, Chief cells for pepsinogen, Mucus cells |
Describe pyloric glands. | G-cell for gastrin and mucus cells |
How much HCl is secreted daily? | 1-2L |
Severe vomiting causes loss of what two ions? | H+ and K+ |
What types of mechanisms are involved in HCl production? | carbonic anhydrase, H/K ATPase, Bicarb/Cl exchanger |
What are the three acid secreting stimulants? | Histamine, gastrin, ACh |
What is the strongest stimulant of acid secretion? | Histamine |
What stimulates histamine release in GI acid secretion? | gastrin and ACh |
What drug blocks H/K ATPase? | omeprazole |
What drugs block H2 histamine receptors? | cimetidine and ranitidine (Zantac) |
Is histamine a paracrine or endocrine hormone? | paracrine |
Is gastrin a paracrine or endocrine hormone? | endocrine |
What kind of glands secrete gastrin? | pyloric glands |
What type of drug blocks muscarinic ACh recpetors? | atropine |
What nerve stimulates ACh release? | Vagus |
What two things stimulate gastrin release? | gastrin releasing peptide (GRP); peptides/AA |
What inhibits gastrin release? | somatostatin |
What stimulates somatostatin release? | acid, low stomach pH |
What inhibits somatostatin release? | ACh |
What are the basal secretions of somatostatin and gastrin? | high somatostatin, low gastrin, bc there is a low pH |
What are the 3 phases of stimulated secretion? | Cephalic Phase, Gastric Phase, Intestinal Phase |
What stimulates the cephalic phase? | thoughts of food, conditioned reflexes, tasting/smelling food |
What is released during the cephalic phase? | GRP (bombesin) and ACh |
What is the gastric phase? | when food enters the stomach |
What are the three major components of the gastric phase? | pH, distension, peptides/amino acids |
What is the intestinal phase? | when food enters the small intestine |
What two things stimulate acid release in the intestinal phase? | enterooxyntin |
What does enterooxyntin do? in response to what? | increase acid release in response to distension of small intestine |
What hormones contribute to ending acid secretion? | secretin, gastic inhibitory peptide, GIP |
What is GIP? What does it inhibit? What does it release? What is it produced by? What is it stimulated by? | glucose-dependent insulinotropic peptide; inhibits gastrin/acid, increases insulin, produced by endocrine cells, stimulated by products of digestion |
What is mucus secretion inhibited by? | alpha-adrenergic agonsts; stress may cause ulcers |
What are two common causes for stomach ulcers? | Helicobacter pylori and NSAIDs |
How do you test for presence of H. Pylori? | Urea breath test for urease enzyme |
What is GERD? | Gastroesophageal Reflux Disease |
What are some Txs for GERD? | lifestyle changes, antacids, pro-motility drugs |
What are the 3 steps of vomiting? | nausea, retching, vomiting |
Where in the brainstem is the 'vomiting center' located? | medulla |
What things stimulated the vomiting center? | vestibular stimulation, GI chemoreceptors, visceral afferents, psychic stimuli (odors/fears) |
What types of drugs would work as anti-emetics? | muscarinic ACh receptor antagonists and dopamine receptor antagonsists |
What are the two openings to and from the stomach? | LES and pyloric sphincter |
What are the upper and lower stomach named? | Orad (upper) and Caudal (lower) |
Describe the orad stomach. | weak mm, tonically contracted, oxyntic glands |
Describe the caudal stomach. | strong mm, phasic contraction, pyloric glands |
Describe the intrinsic contractile activity of the stomach. | Interstitial cells of Cajal, slow waves, BER |
CCK is released in response to what? | fat |
Secretin is released in response to what? | acid |
Gastric inhibitory peptide is released in response to what? | food |