Term
Esophagus lies from what vertebrae to what organ? |
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Definition
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Term
What are the contents of the oral cavity? |
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Definition
Lips, cheeks, gums, teeth, palate (hard, soft, uvula), tongue |
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Term
What are the contents of the oral cavity? |
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Definition
Lips, cheeks, gums, teeth, palate (hard, soft, uvula), tongue |
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Term
What are tge 3 kinds of mucosa in the oral cavity? |
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Definition
Lining (non keratinized), Masticatory (keratinized or non-keratinized), Specialized (taste bunds) |
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Term
What are the core of lips? |
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Definition
Skeletal muscle, lacks glands thus why we require chapstick |
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Term
What is the difference between lips and cheeks? |
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Definition
Cheeks lack vermillion, a darkly staining region in the middle |
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Term
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Definition
Masticatory mucosa that is not keratinized but is thick, forms barrier between tooth and oral cavity |
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Term
What defines the hard palate? |
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Definition
Keratinized masticatory epithelium |
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Term
What are the glands of the hard palate? |
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Definition
Oral side has seromucosal gland and nasal side has nasal glands |
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Term
What forms rugae ridges in the hard palate that connects it firmly to the bony core? |
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Definition
Lamina propria via dense connective tissue |
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Term
What defines the soft palate? |
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Definition
Respiratory and masticatory epithelium with seromucous glands but no bone |
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Term
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Definition
Similar to soft palate but only has nonkeratinized epithelium |
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Term
What are the divisions of the tongue? |
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Definition
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Term
What is in the anterior tongue? |
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Definition
Filiform, fungiform, and circumvallate papillae, only fungiform and circumvallate have taste buds |
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Term
What is within the posterior tongue? |
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Definition
Smooth and uneven due to presence of lymph nodes, contains lingual tonsils, crypts, tonsils, and waldeyer's tonsillar ring |
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Term
Where does tonsillitis begin? |
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Definition
Infection of posterior tongue |
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Term
What are the 3 parts of the pharynx? |
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Definition
Nasopharynx, oropharynx, laryngopharynx |
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Term
What are characteristics of the nasopharynx? |
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Definition
Respiratory with ciliated pseudostratified epithelium |
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Term
What are the characteristics of the oropharynx? |
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Definition
Digestive and speech with nonkeratinized stratified squamous |
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Term
What are the characteristics of the laryngopharynx? |
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Definition
Speech involved with same epithelium (bootom is C6) |
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Term
What are the functional layers of the digestive system distal to the pharynx? |
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Definition
Mucosa, submucosa, muscularis externa, serosa/adventitia |
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Term
What controls movement as well as allowing CNS innervation in the GI? |
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Definition
Myenteric (Auerbach) and submucosal (Meissner) plexuses |
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Term
What are the 4 types of epithelia in the GI? |
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Definition
Protective, secretory, absorptive, and absorptive/protective |
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Term
What makes up protective epithelial cells in the GI? |
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Definition
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Term
What makes up secretory epithelial cells in the GI? |
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Definition
Simple columnar with goblet cells |
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Term
What makes up absorptive epithelial cells in the GI? |
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Definition
Simple columnar with goblet cells and microvilli |
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Term
What is the shape of the esophageal lumen? |
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Definition
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Term
What makes up the upper 1/3 of the esophagus? |
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Definition
Musculara externis layer with skeletal muscle |
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Term
What makes up the middle 1/3 of the esophagus? |
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Definition
Mixed skeletal/smooth muscle |
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Term
What makes up the distal 1/3 of the esophagus? |
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Definition
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Term
Describe the epithelia and contents of the esophagus |
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Definition
Protective, submucosa has glands, blood vessels, nerves, and lymph structures |
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Term
What kind of tissue change occurs at the gastroesophageal junction? |
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Definition
Abrupt change from stratified squamous to simple columnar |
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Term
How can damage occur at the gastroesophageal junction? |
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Definition
Site of heart burn, lacks anatomical sphincter but does have a muscular sphincter |
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Term
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Definition
Longitudinal folds that allows for distention, disappears upon distention, seen in the stomach, etc. |
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Term
What are the 4 anatomical areas of the stomach? |
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Definition
Fundus, cardia, body, pyloris |
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Term
Describe features of the epithelial cells of the stomach |
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Definition
No villi but does have straight glands that secrete gastric juice to convert food to chime |
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Term
What are the cell types of the fundus and body of the stomach? |
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Definition
Superficial to deep are surface cells for bicarbonate secretion, mucous cells secreting soluble mucous, parietal cells secreting HCL, stem cells for regeneration, chief cells |
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Term
What are the features of the cardiac region of the stomach? |
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Definition
Shallow, tubular with coiled base, mostly surface mucous cells |
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Term
What are features of the pyloris? |
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Definition
Deep, base convoluted and branched, mostly mucous neck cells |
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Term
What occurs at the gastroduodenal junction? |
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Definition
Transition from glandular to villus simple columnar cells, sudden submucosa gland increase, a ring of thick inner layer muscles known as the pyloric sphincter |
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Term
How is the small intestines designed to have increased surface space? |
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Definition
Via villi, duodenum has highest concentration of villi and decreases towards the ileum. Plicae circulares are highly folded tissues in the small intestine. They also use micro vili, goblet cells, righ lamina proper, lymphocytes, smooth muscles, and lacteals |
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Term
What are crypts of liberkuhn and where are they found? |
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Definition
On simple columnar epithelium, found in duodenum and contains lots of submucosal glands |
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Term
What are the cell layers of the duodenum, superficial to deep? |
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Definition
Absorptive, goblet, DNES, mononuclear phagocyte cells |
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Term
What are crypts of lieberkuhn? |
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Definition
Long and deep invaginations of the epithelium in the small intestines |
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Term
What are located at the bottom of crypts of lieberkuhn and what is their function? |
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Definition
Paneth cells, contain antibiotic mechanisms, tumor necrosis and defensing defenses as well |
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Term
Describe the organization of the ileum |
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Definition
Plica circulares, villi, crypts of liberkuhn, lymphoid vessles, submucosa, muscularis externa, serosa |
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Term
What are Peyer's patches? |
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Definition
Large lymph node sites in the small intestines |
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Term
What are some common epithelial features of the duodenum, jejunum, and ileum? |
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Definition
brush borders, goblet cells, rich lamina proper, lymphocytes, thin basement membranes |
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Term
What is the organization of the large intestine? |
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Definition
Cecum to appendix -> ascending, transverse, descending, sigmoid colon -> rectum -> anus |
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Term
What are some differentiating features of the large intestine? |
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Definition
Teniae coli, haustra coli, appendix, anal column, anal valves, anal sinuses, and pectinate line at level of anal valves |
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Term
What kind of cells are found in the appendix? |
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Definition
Simple columnar cells with lots of goblet cells, crypts of liberkugn, lymph, right LP layer, muscularis externus |
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Term
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Definition
Longitudinal folds of smooth muscle in the anus |
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Term
What is the function of anal sinuses? |
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Definition
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Term
What is the function of anal valves? |
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Definition
Located at the ends of anal sinuses, joins anal columns |
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Term
What defines pectinate lines? |
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Definition
Stratified squamous epithelium that becomes thin, represents the border between endoderm and ectoderm |
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Term
What is located just above the pectinate line and what occurs there? |
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Definition
Ano rectal junction where the simple columnar epithelium changes to stratified squamous |
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Term
What is the hilton's white line and where is it found? |
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Definition
Inbetween the internal and external sphincter, also known as intersphincteric line. Is white and th epoint where epithelium becomes keratinized |
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Term
How do sensory neurons of the enteric system extend to structures? |
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Definition
Submucosal and myenteric IPANs or to the brain stem via the vagus nerve or sympathetics to the spinal cord |
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Term
What is contained within the smooth muscle of the gut that can cause contraction? |
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Definition
Stretch activated channels, triggers depolarization, can be attached to IPAN neuronal processes that fire action potentials to sense the stretch |
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Term
How does the enteric system sense the chemical environment? |
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Definition
Intermediary epithelial cells on the luminal surfaces of the enterocytes, sensitive to chemical changes and secretes serotonin to activate the nearby neural ends of the IPANs |
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Term
How is the myenteric (Aerbachs) plexus distributed? |
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Definition
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|
Term
How is the submucosal plexus distributed?
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|
Definition
Only in the small and large intestines |
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Term
Describe the axons of the enteric system |
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Definition
Unmyelinated, plexuses do contain glia cells but do not myelinate axons, only provides nourishment |
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Term
Which signals are exitatory? |
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Definition
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|
Term
Which signals are inhibitory? |
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Definition
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|
Term
What do enteric neurons stimulate in stomach parietal cells? |
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Definition
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Term
What stimulates secretion in exocrine glands of the gut? |
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Definition
Neurons innervating crypts of lieberkhun and parietal cells in the stomach |
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Term
What do exocrine glands of the gut secrete? |
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Definition
Cl - into the lumen, water follows osmotically |
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Term
Extrinsic is what kind of innervation? |
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Definition
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|
Term
Parasympathetic extrinsic innervation is via what? |
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Definition
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Term
Parasympathetic extrinsic innervation via the vagus or pelvic nerve use what neurotransmitter?
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Definition
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Term
Postganglionic neurons of the parasympathetic fibers are located where? |
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Definition
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Term
Parasympathetic signals generally have what effect in the GI? |
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Definition
Increased peristalsis and secretory responses |
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Term
How do parasympathetic postganglionic fibers arrive in the GI? |
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Definition
Paravertebral or prevertebral ganglia |
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Term
What kind of chemoreceptors do sympathetic fibers in the GI use? |
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Definition
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Term
What are intestinofugal neurons? |
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Definition
Neuron with cell body located within intestine that when stimulated, relays signal to prevertebral sympathetic ganglia, modulates secretory inhibitors and motility inhibitors |
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Term
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Definition
Waves of depolarization in the GI, do not contract unless the depolarization reaches the threshold level to make a spike in depolarization |
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Term
What creates slow waves in the GI? |
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Definition
Intrinsic Interstitial Cells of Cajal |
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Term
Describe the function of intrinsic interstitial cells of cajal |
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Definition
Pacemaker cells, non-neuronal, excitatory and inhibitory, found between muscles and the neural cells, creates slow waves |
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Term
What does a bolus of food entering the intestine activate? |
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Definition
IPANs, sends signals via ascending neurons to contract and the descending neurons to relax so food moves through the tract |
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Term
What controls the upper 1/3 of skeletal muscle in the GI? |
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Definition
Somatic neurons, however enteric neurons do form synapses on the motor endplate and appear to modulate synaptic activity |
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Term
What innervates expansion of the stomach? |
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Definition
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Term
What regulates peristalsis and amplitude of gastric movement? |
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Definition
Peristalsis = vagal, amplitude = enteric regulation |
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Term
Distention triggers what? |
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Definition
IPANs to stimulate descending neurons which activate secretory cells as well as vasodilators and CL- secretion |
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Term
What is the response to noxious stimulants such as cholera toxin? |
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Definition
Mass serotonin release that further activates IPANs and stimulates excessive Cl- secretion leading to diarrhea and massive fluid loss, releases serotonin by L-channels |
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Term
What controls GI sphincters? |
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Definition
Enteric except lower esophageal sphincter (vagus) and external anal sphincter (somatic-voluntary) |
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Term
What controls the sphincter of Oddi and what is its function? |
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Definition
Enteric system, regulates passage of bile from the gallbladder and pancreas into duodenum, located at the major duodenal papilla |
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Term
Infants suffering from severe constipations from failure of neurons to innervate distal bowel, leading to absence of ganglia in distal bowel and large distention of proximal bowel describes what disease? |
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Definition
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Term
High frequency of bowel movement, abdominal pain and altered bowel motility that fluctuates from constipation to diarrhea, possibly caused by hyperactivity of sensory fibers, and lacking any effective treatment describes what disease? |
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Definition
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Term
Numerous cells contain opoid receptors, mainly excitatory cellls have opiod receptors, but a decrease in cholinergic release by motor neurons describes what? |
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Definition
Opiod induced dysfunction, exogenous opoids given for pain management, inhibits propulsion of food bolus in the intestines |
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Term
Food intake is ultimately regulated by what? |
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Definition
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Term
How does the hypothalamus of the CNS affect food intake? |
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Definition
Along with nucleus tractus (brainstem) and other centers such as the amygdala, provides feedback control of appetite |
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Term
How does the lateral hypothalamic area affect appetite? |
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Definition
Stimulates food intake and calorie storage, active via the neuropeptide Y pathway |
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Term
How does ventromedial nuclei affect appetite? |
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Definition
Satiety center, limits food intake, active via the melanocortin pathway |
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Term
How does the endocrine system affect appetite? |
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Definition
Insulin and leptin regulates food intake, decreases appetite and increases metabolism |
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Term
How does the enteric and autonomic nervous system regulate appetite? |
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Definition
CCK, ghrelin, and peptide YY are gastric hormones, Ghrelin increases appetite, decreases metabolism, CCK and PYY decrease appetite |
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Term
What is the definition of digestion? |
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Definition
The chemical and enzymatic breakdown of complex ingested nutrients into simpler molecules |
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Term
What is the definition of absorption? |
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Definition
Movement of digested and other nutrients out of the GI lumen into the blood, regulates water, electrolytes, and other digestive products |
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Term
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Definition
Peristalsis and the mixing movements of the GI |
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Term
Where is the myenteric plexus located cross-sectionally? |
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Definition
Between longitudinal and circular muscle |
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Term
Where is the submucosal plexus located cross-sectionally?
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|
Definition
Between muscularis mucosa and inner cicrular layer |
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Term
Parasympathetic is generally what kind of innervation? |
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Definition
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|
Term
Sympathetic is generally what kind of innervation in the GI? |
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Definition
Noradrenergic, inhibitory |
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Term
Substance P has what effect? |
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Definition
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|
Term
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Definition
Controlled from within the ENS, includes peristalsis, secretion, mixing |
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|
Term
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Definition
Controlled by CNS and ENS together, defacation reflexes, stomach and duodenum to the CNS via vagus nerve and from guit via prevertebral ganglia neurons, pain causes general inhibition of the entire GI tract |
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Term
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Definition
Secreted by I cells in the duodenum and jejunum, target is the gallbladder to secrete bile |
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|
Term
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Definition
Gastric Inhibitory Peptide, secreted by K cells in duodenum and jejunum, targets pancreas to increase insulin secretion, inhibits gastric motility and emptying |
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Term
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Definition
Secreted from G cells in antrum of stomach, targets the parietal cells o fstomach to increase H+ and pepsinogen secretion |
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Term
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Definition
Secreted by M cells in the duodenum and jejunum to increase GI motility via initiating the MMC (migrating motor complex) |
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Term
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Definition
Secreted by S cells in small intestine to increase bicarbonate secretion from pancreas and decrease gastrin secretion from the stomach |
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Term
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Definition
Increases the number of spikes, increases tension of smooth muscle |
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Term
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Definition
Downregulates peristalsis |
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Term
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Definition
Basic electrical rhythm, the spontaneous cycles of depolarization of GI smooth muscles in waves, occurs faster in the stomach than in the intestine, can trigger spikes for contractions |
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Term
Smooth muscles contract due to what? |
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Definition
Ca influx, repolarization due to K efflux |
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Term
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Definition
ICC cells, though there are NO SLOW WAVES in the esophagus and proximal stomach |
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Term
Describe rhythmic contractions of GI smooth muscle cells
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Definition
For luminal sections of the gut such as the ilium, jejunum, etc. |
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Term
Describe tonic contractions of GI smooth muscle cells
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|
Definition
Occurs at sphincters of the GI and the orad of the stomach |
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Term
Describe the pattern of GI motility |
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Definition
8-10 seconds to reach stomach, 1-2 hrs in stomach, up to 3 days as feces, smooth muscles can actively contract or relax, motility via peristalsis |
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Term
How does enteric system affect peristalsis? |
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Definition
Can achieve basic peristalsis on its own, but other system regulat its activity, ENS is the point of integration with the CNS |
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Term
Myogenic control of GI motility is what? |
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Definition
Local control, contractile rhythm establishing the BER |
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Term
What hormones affect GI motility? |
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Definition
Minor role is motilin which activates the MMC |
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Term
Chewing is a reflex of what? |
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Definition
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|
Term
What are the 3 phases of swallowing? |
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Definition
Chewing (only voluntary phase), Pharyngeal phase initiated by epithelial receptor in the pharynx, closes the trachea, inhibits respiration, Esophageal phase where UES opens, persitalsis propulsion, secondary ensures complete sweep of esophagus |
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Term
Intra-thoracic pressure is what? |
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Definition
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|
Term
Intra-abdominal pressure is what? |
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Definition
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|
Term
What is receptive relaxation? |
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Definition
Lower esophageal sphincter relaxes shortly before bolus arrives |
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Term
What is primary peristalsis? |
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Definition
Broad contractile wave controlled by the vagus nerve |
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|
Term
Describe secondary wave of peristalsis |
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Definition
In response to esophageal distention |
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|
Term
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Definition
Loss of lower esophageal relaxation, loss of esophageal peristalsis, caused by degeneration of mysenteric plexus inhibitory neurons NO and VIP, noted by bird beak esophagus |
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|
Term
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Definition
Heartburn, opposite of achalasia, hypotesnive LES regurgitates gastric juice into esophagus |
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|
Term
What are some triggers for stomach relaxation? |
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Definition
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|
Term
How far apart are weak peristalsic contractions? |
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Definition
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|
Term
When emptying isotonic or non-caloric fluids, rate of gastric emptying is what? |
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Definition
Proportional to volume, hypotonic or hypertonic fluids empty more slowly |
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|
Term
Lower pH has what effect on gastric emptying? |
|
Definition
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|
Term
What is the migrating motility complex? |
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Definition
Pattern of contraction from the stomach tot he end of the small intestine during fasting, causes stomach growls after 90 minutes, initiated by motilin, contrasts with absorptive (fed) phase |
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|
Term
Rather than peristalsis, what kind of movement is in MMC? |
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Definition
Haustrations, more longitudinal |
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|
Term
The enterogastric reflex is activated by what? |
|
Definition
Intestinal receptors via distention or osmolarity changes |
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|
Term
The Iliocecal reflex is activated by what? |
|
Definition
Distention of the ileum and allows chyme to pass, distention of the colon causes sphincter to contract |
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|
Term
What causes the gastroileal reflex? |
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Definition
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|
Term
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Definition
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|
Term
When do you get sensation you need to defecate? |
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Definition
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|
Term
What intrinsic enteric input do you need to defecate? |
|
Definition
Rectospincteric reflex caused by distention of rectal sigmoid colon, causes internal anal sphincter to relax |
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|
Term
what extrinsic input do you need for defecation? |
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Definition
Parasympathetic increases urge to defecate and greatly increases peristalsic waves to further relax the internal anal sphincter |
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|
Term
What voluntary control is there of defecation? |
|
Definition
Via pudendal nerve, lets you poo |
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|
Term
What is the cephalic phase of GI secretion? |
|
Definition
Food not in GI tract yet, pavlov signals salivate for food |
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|
Term
Describe the gastric phase of GI secretion |
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Definition
Occurs mechanically via muscle distention, stimulated by caffeine and alcohol, regulated via vagus and enteric |
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|
Term
Describe the intestinal phase of GI secretion and regulation |
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Definition
Food is in the intestines, can take around 72 hrs, stimualted mainly via circulating AA produced from chyme actions, inhibited by secretion of gastrin and nervous mechanism |
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|
Term
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Definition
Water, enzymes, immunoglobins, blood group antigens, sex steroids, hypotonic due to resporption of electrolytes by salivary glands |
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|
Term
How is salivary secretion regulated? |
|
Definition
Parasympathetic stimulates, sympathetic also contributes but is more thicker and mucousy, aldosterone increases Na/K ATP in saliva glands to modulate secretion |
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|
Term
Describe electrolyte balance in saliva |
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Definition
At high flow rates, Na and CL increase in concentration, K and HCO3 stay the same, saliva is ALWAYS hypotonic |
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|
Term
Parietal cells secrete what? |
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Definition
HCl, Intrinsic factor which allows Vit B12 absorption |
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|
Term
Chief cells secrete what? |
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Definition
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|
Term
How do gastric secretions decrease luminal pH? |
|
Definition
K/H+ antitransportor, ATP dependent |
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|
Term
What stimulates gastric secretion? |
|
Definition
Ach, histamine, gastrin all via vagus nerve |
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|
Term
What downregulates H+ secretion? |
|
Definition
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|
Term
|
Definition
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|
Term
When is gastric secretin inhibited? |
|
Definition
1hr after meal, emptying into duodenum stimulates secretin secretion, inhibits gastric secretion |
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|
Term
Parietal cells secrete what? |
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Definition
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|
Term
Chief cells secrete what? |
|
Definition
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|
Term
Mucus cells secrete what? |
|
Definition
Mucus that protects the gastric epithelium from acidic stomach contents |
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|
Term
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Definition
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|
Term
How does HCl play a role in gastric digestion? |
|
Definition
Activates pepsinogen into pepsin which then activates trypsinogen into trypsin which then activates the rest of the digestive enzymes |
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|
Term
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Definition
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|
Term
When does gastric pH begin to drop after a meal? |
|
Definition
after 1hr when gastrin is at max |
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|
Term
Describe regulation of gastric H+/K+ atpase activity |
|
Definition
Pumps H+ into lumen for K+, join Cl- to form HCL |
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|
Term
Gastrin, secretin, CCK and histamines all stimulate what? |
|
Definition
Gastric secretion, histamines stimulated by Ach, inhibited by somatostatin |
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|
Term
What stimulates enterochromafin-like cells? |
|
Definition
Stimulated to release histamine via Ach via vagus nerve, inhibited by stomatostatin |
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