Duke PA Physiology
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| What phase is regulated by gastrin and histamine? | Gastric phase
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| Where does the gastrin bind? | Gastric receptors on parietal cells
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| What does gastrin cause? | activates proton pump
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| What does histamine cause? | paracrine secretion (regulated by gastrin) turns on proton pump
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| When does the gastric phase occur? | when food enters the stomach
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| What happens to gastrin in the intestinal phase? | decreases - secretin provides negative feedback for gastrin
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| What phase does the majority of acid output occur? | gastric phase
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| Where does secretin come from? | duodenum
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| What stimulates secretin release? | acid production
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| What innervates cephalic phase? | vagal innervation
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| What do tums do? | decrease pH by neutralizing acid in stomach - bicarb - immediate relief, titrates acid
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| What does tagamet do? | hits the histamine receptors, decreases HCl production
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| What do nexium and prilosec do? | knocks off the proton pump - stops acid production
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| What is the drug of choice for excess acid production in stomach? | nexium or prilosec
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| What are the consequences of nexium or prilosec? | loses protective function of acid against bacteria, cuts off negative feedback loop and increases gastrin levels, interferes with secretin
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| What shuts off gastrin secretion? | pH drops back down, around 2
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| What causes ulcers? | H. pylori
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| What do NSAIDS cause in the stomach? | shut off mucous barrier
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| What is the treatment for ulcers? | antibiotic, but it's hard to get it to the right spot
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| What is the name of the cell that secretes gastrin? | G cell
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| What is the G cell sensitive to? | amino acids in the lumen
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| Is gastrin a hormone? | yes
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| What does somatostatin do to gastrin? | inhibits - paracrine
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| What effect does high H+ cause on somatostatin? | cause secretion of somatostatin
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| How does secretin work? | acts as a hormone - inhibits gastrin
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| Where is somatostatin secreted? | antrum of the stomach
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| Where are the G-cells located? | antrum
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| Where does the secretin come from? | duodenum
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| What other use does nexium have? | acid reflux
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| Why would acid be damaging to the esophagus? | esophagus does not have protective mucus - constant acid wears it down
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| Can you have hyperosmotic materials in the stomach? | Yes - stomach wall does not absorb water
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| What 2 other things can turn on acid production? | alcohol and caffeine
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| Does the chyme enter the small intestine? | NO - small intestine is very sensitive to acid
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| What does the duodenum do to neutralize the acidic chyme? | secretes bicarbonate
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| Why does the chyme take so long to go from stomach to duodenum | it has to be neutralized - goes slowly
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| What role does secretin have in neutralization of acidic chyme in the duodenum? | signals pancreatic ducts to secrete bicarbonate
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| Where is bicarb secreted from to the duodenum? | pancreas
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| What does CHO trigger in the duodenum? | GLP-1 (glycogen-like peptide 1)
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| Where does GLP-1 act? | pancreas -islet
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| What does GLP-1 signal to the islet cells produce? | insulin
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| What do fats and peptides trigger in duodenum? | CCK -colecystekinin (check spelling)
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| What does CCK signal? | secretion of zyomgens (enzymes) from the pancreas
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| What do zymogens do? | degrade
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| What is the other target site of the CCK besides the pancreas? | gall bladder
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| What does the CCK signaling of the gall bladder cause? | secretion of bile
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| Where is the acinus located? | pancreas
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| What does the acinus hold? | zymogens (inactive until released into duodenum)
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| What do duct cells in the pancrease secrete? | HCO3
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| What effect would damage to the pancreas cause? | potential activation of zymogens in wrong place
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| What signals duct cells to release HCO3? | secretin
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