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Gastro-Intestinal
Final
164
Other
Graduate
12/09/2012

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Cards

Term
The Digestive System is a portal for
Definition
nutrients from the environment to gain access to the circulatory system
Term
Before nutrients can gain access into the circulatory system foodstuffs must first be
Definition
reduced to very simple molecules by a combination of mechanical and enzymatic degradation 
Term
foodstuffs are reduced to very simple molecules by a combination of
Definition
mechanical and enzymatic degredation 
Term
Once foodstuffs are reduced to very simple molecules through mechanical and enzymatic degradation, the resulting __________, ____________, __________, are transported across the ________________________ into the blood
Definition

sugars, amino acids, fatty acids

lining of the intestine 

Term
What are the 7 parts of the simple overview of the GI tract? 
Definition
mouth, esophagus, stomach, liver, pancreas, small intestine, Large intestine
Term
Food are broken down ____________ by ____________ and _______________ is added a lubricant
Definition
mechanically, mastication, saliva 
Term
In most species saliva contains ______________
Definition
amylase
Term
amylase
Definition
an enzyme that digests starch
Term
_______________ is digested by amylase which is an enzyme
Definition
starch
Term
______________ is the first step in the digestive process
Definition
mastication
Term
When food is masticated it is broken down into small pieces resulting in a massive increase of _______________________ for __________________ to work
Definition
surface area, digestive enzymes
Term
Mastication helps to ____________ food and transform it into _______________________ to______________.
Definition
soften, a size conducive to swallowing 
Term
Food is _____________________ with saliva
Definition
lubricated
Term
Saliva is produced in and secreted from:___________________
Definition
saliva glands
Term
_____________ cells in the glands secrete a fluid that contains water, electrolytes, mucus, and enzymes into collecting ducts 
Definition
Ancini
Term

Ancini cells secrete fluid that contains:  

 

WEME

Definition
water, electrolytes, mucus, and enzymes into collecting ducts 
Term
In the collecting ducts (where ancini cells drop off fluid that is WEME) the composition of secreted fluid is _________________ (__________ reabsorbed, _________ is secreted)
Definition
altered, sodium, potassium
Term
the composition of secreted fluids is altered in the collecting ducts: sodium is __________ and potassium is ___________________
Definition
reabsorbed, secreted 
Term
Parotid Glands produce
Definition

serous watery secretion

 

 

Term
Submaxillary Glands produce
Definition
a mix of serous and mucus secretion
Term
Sublingual Glands produce
Definition
primarily mucus secretion 
Term
Saliva is effective for ______________ masticated food into a slippery bolus that should __________ easily through the esophagus w/o _____________ to the esophageal mucosa 
Definition
binding, slide, damage 
Term
Saliva coats the ________  ____________  and __________ mucosa and food does not touch the __________ ________ of the ________
Definition
oral, pharyngeal, esophageal mucosa, epithelial cells of the lining 
Term
Saliva ____________ dry food
Definition
solubilizes 
Term
Dry food is solubilized by
Definition
saliva
Term
taste requires that the molecules in food be 
Definition
solubilized
Term
saliva constantly flushes the oral cavity of ______________ and keeps the mouth ____________
Definition
food debris, relatively clean
Term
flow of saliva diminishes during ___________ allows populations of _______________
Definition
sleep, bacteria morning breath
Term
saliva also contains: _____________ that ______ bacteria and prevents overgrowth of oral microbial populations
Definition
lysozmes, lyses
Term
saliva helps to initiate _____________ digestion
Definition
starch
Term
in order for starch to be digested: the serous acinar cells secrete ______________ which begins to digest starch into ____________
Definition
amylase, maltose
Term
what cells secrete amylase which begins to digest starch into maltose?
Definition
serous acinar cells 
Term
T/F amylase is never present in carnivores or cattle
Definition
false: sometimes
Term
What is the conduit from the mouth to the stomach? 
Definition
esophagus 
Term
___________ conduit from the mouth to the stomach
Definition
esophagus 
Term
T/F there is absorption of nutrients in the esophagus 
Definition
False
Term
T/F the esophageal mucosa does contain mucus glands that are expressed as food boluses distend the esophagus and help with lubrication
Definition
True
Term
How many types of peristalsis can the esophagus do? 
Definition
primary, secondary, tertiary 
Term
T/F there wont be a third peristaltic wave, you have to trigger another swallow to get primary and secondary again
Definition
True
Term
What part of the GI tract is routinely exposed to rough abrasive foodstuffs, like fragments of bone, fibrous plant leaves, hot and cold temperatures, variations from very hot liquids to ice
Definition
esophagus 
Term
The esophagus is lined with what kind of epithelium? 
Definition
stratified squamous
Term
T/F stratified squamous epithelium lines the esophagus and is one of the strongest tissues in the body
Definition
True
Term
T/F The lower esophageal sphincter opens to allow foods from the pharynx into the esophagus
Definition
False: Upper Esophageal Sphincter 
Term
T/F The lower esophageal sphincter is a strong ring of muscles at the bottom of the esophagus which relaxes to allow food into the stomach
Definition
True
Term
T/F The UES and LES are always in tonic contraction
Definition
False, they lose their tonic contraction when a bolus is swallowed and ready to pass! (tricky!)
Term
Name the two parts of the stomach
Definition
fundus, antrum
Term
Part of the stomach where food enters from the esophagus and where it stays until it is ground into small fragments by digestive enzymes
Definition
fundus 
Term
T/F food stays in the fundus until it is ground into small fragments by digestive enzymes
Definition
True 
Term
The part of the stomach that is the grinder where food is churned back and forth until spurts of liquid with particles of food are passed through the pylorus
Definition
Antrum
Term
Four Basic Functions of Stomach
Definition

1. serves as short-term storage reservoir 

2. substantial enzymatic digestion initiated particularly of proteins

3. contractions of gastric smooth muscle grind foodstuffs with gastric secretions, resulting in liquefaction of food (prerequisite of delivery of ingesta to small intestine)

4. as food is liquified slowly released into the small intestine for further processing

Term
the stomach serves as a ___________________, allowing a rather large meal to be consumed quickly and dealt with later
Definition
short-term storage reservoir 
Term
in the stomach, substantial enzymatic digestion is initiated particularly of __________________
Definition
proteins
Term
the _________________ contracts to grind food with gastric secretions which results in ___________________
Definition
gastric smooth muscle, liquefaction of food
Term
what is a prerequisite for delivery of the ingesta to the small intestine
Definition
liquefaction of food 
Term
Contractions of gastric smooth muscle serve two basic functions: 
Definition

1. ingested food is crushed, ground and mixed, liquefying it to form what is chyme

2. chyme is forced through the pyloric canal into the small intestine a process called gastric emptying 

Term
chyme is produced by 
Definition
contractions of the gastric smooth muscles by grinding and mixing with gastric secretions
Term
T/F Chyme is liquefyed
Definition
true
Term
Gastric Emptying
Definition
chyme is forced through the pyloric canal into small intestine
Term

Name the four secretory products of the gastric epithelium

 

MAPH

Definition

1. mucus

2. acid

3. proteases

4. hormones

Term
T/F Mucus is pepsinogen that is activated by stomach acid into the active protease pepsin, which is largely responsible for the stomach's ability to initiate digestion of proteins
Definition
False: Proteases
Term
Mucus
Definition
Bicarbonate rich mucus coats and lubricates the gastric surface and serves an important role in protecting the epithelium from acid and other chemical insults 
Term
Acid
Definition
hydrochloric acid is important for activation of pepsinogen and inactivation of ingested microorganisms such as bacteria 
Term
T/F Hydrochloric acid actives pepsinogen 
Definition
True
Term
T/F Hydrochloric Acid inactivates ingested microorganisms such as bacteria
Definition
True
Term
Proteases
Definition
Pepsinogen is activated by stomach acid into active protease pepsin, which is largely responsible for the stomach's ability to initiate digestion of proteins
Term
What is largely responsible for the stomach's ability to initiate digestion of proteins? 
Definition
protease pepsin (pepsinogen activated by stomach acid into this)
Term
Hormones
Definition
Gastrin is a peptide that is important in control of acid secretion and gastric motility
Term
_____________  a hormone that is important in control of acid secretion and gastric motility
Definition
gastrin
Term
T/F the stomach absorbs very few substances, except small amounts of lipid soluble compounds: aspirin, other non-steroidal anti-flammatory drugs, ethanol
Definition
True
Term
The stomach can absorb small amounts of lipid-soluble compounds: ___________, ______________, __________
Definition
aspirin, non-steroidal anti-inflammatory drugs, ethanol
Term
aspirin, non-steriodal anti-inflammatory drugs, and ethanol are substances well-recongized to cause
Definition
gastric irritation, gastritis, gastric ulcers
Term
foodstuffs arrive in the small intestine already:
Definition
mechanically broken down and reduced to liquid by mastication and grinding in the stomach
Term
once in the small intestine ingesta (macromolecular aggregates) are exposed to _______________ and ________________ which enables digestion to molecules capable or almost capable of being absorbed 
Definition
pancreatic enzymes and bile
Term
pancreatic enzymes and bile in the small intestine allow digestion to molecules capable or almost capable of being _________________
Definition
absorbed
Term
______________ floods into the small intestine from the stomach
Definition
chyme
Term
when chyme is passed to small intestine acid must be ____________________________ to prevent damage to the _____________________
Definition
quickly and efficiently neutralized, duodenal mucosa
Term
when chyme is passed into small intestine _____________________________, must be broken down much further before their constituents can be absorbed through the mucosa into the blood
Definition
macromolecular nutrients, proteins, fats, and starch must be broken down
Term
The _______________ helps to quickly and efficiently neutralize acid, and breakdown macromolecular nutrients, proteins, fats, and starch 
Definition
Term
insufficient secretion of pancreatic juice leads to starvation even if the animal is consuming adequate quantities of high quality food T/F
Definition
True
Term
Before constituents can be absorbed through the mucosa into the blood marcomolecular nutrients, proteins, fats, and starch must be
Definition
broken down
Term
____________ is an endocrine organ
Definition
pancreas
Term
major hormones that pancreas secretes: 
Definition
insulin and glucagon
Term
_____________ and __________ play a vital role in carbohydrate and lipid metabolism, absolutely necessary for maintaining normal blood concentrations of glucose
Definition
insulin and glucagon
Term
_______________ is the largest gland in the body and performs and astonishingly large number of tasks 
Definition
liver
Term
because the liver is so complex __________ disease has widespread effects on virtually all other organ systems 
Definition
hepatic 
Term
the liver secretes _______________ into the ______________ where they assume a critical role in the digestion and absorption of dietary lipids 
Definition
bile acids, small intestine 
Term
Bile
Definition
complex fluid, containing water, electrolytes, battery of organic materials including bile acids, cholesterol, phospholipids, and bilirubin that flows through the biliary tract into the small intestine 
Term
What are the two fundamental functions of bile in all species? 
Definition

1. bile contains bile acids, critical for digestion and absorption of fats and fat-soluble vitamins in the small intestine 

2. many waste products, including bilirubin, are eliminated from the body by secretion into bile and elimination in feces 

Term
final stages of digestion occur on the ________________________
Definition
surface of the small intestine epithelium
Term
net effect of passage through the small intestine is ____________ of most water, electrolytes, and essentially all dietary organic materials
Definition
absorption 
Term
the small intestine not only provides nutrients to the body but plays a critical role in ___________ and __________________
Definition
water and acid base balance
Term
how long is the small intestine
Definition
20 feet long
Term
T/F the small intestine is the longest section of the digestive tube and consists of three segments forming a passage from the pylorus to the large intestine
Definition
True
Term
What are the three sections of the small intestine 
Definition
duodenum, jejunum, Ileum
Term
Duodenum
Definition
a short section that receives secretions from the pancreas and liver via the pancreatic and common bile ducts
Term
What section of the small intestine receives secretions from the pancreas and liver via the pancreatic and common bile ducts
Definition
duodenum 
Term
Considered to be roughly 40% of the small intestine 
Definition
Jejunum
Term
Empties into the large intestine, considered 60% of the intestine of man
Definition
Ileum
Term
the role of the jejunum is to _____________
Definition
absorb nutrients that come down from above
Term
ultra tiny frond extend out from the lining called villi through which nutrients move into the blood stream located in what part of small intestine
Definition
jejunum 
Term
final portion of small intestine 
Definition
Ileum
Term
main function is to absorb vitam b-12, bile salts and whatever products of digestions that were not absorbed by the jejunum 
Definition
Ileum
Term
final portion of the digestive tract and location of the terminal phases of digestion
Definition
large intestine
Term
cecum (large intestine)
Definition
blind-ended pouch that in humans carries a worm-like extension called the vermiform appendix  (large intestine)
Term
colon (large intestine)
Definition
constitutes the majority of the length of the large intestine 
Term
rectum (large intestine)
Definition
short, terminal segment of the digestive tube, continuous, with that anal canal 
Term
Name the three segments of the large intestine: 
Definition
cecum, colon, rectum
Term
3 main processes of the large intestine
Definition

1. recovery of water and electrolytes from ingesta

2. formation and storage of feces

3. microbial fermentation 

Term
recovery of water and electrolytes from ingesta in the large intestine: 
Definition
by the time ingesta reaches the terminal illeum roughly 90%  of its water has been abosrbed but considerable amount of water and electrolytes like sodium and chloride remain and must be recovered by absorption in the large gut
Term
formation of feces and storage in the large intestine:
Definition
as ingesta is moved through the large intestine it is dehydrated mixed with bacteria and mucus and formed into feces, the craftmanship with which this is carried out varies amongs species 
Term
microbrial fermentation of large intestine
Definition
large intestine of all species teems with mircobrial life, those microbes produce enzymes capable of digesting many of the molecules that to vertebrates are indigestible, cellulose being a premier example, the exten and benefit of fermentation also varies greatly among species 
Term
circular folds within the colon __________ and move contents along
Definition
contract
Term
_________  __________ is just above the rectum. 
Definition
sigmoid colon
Term
in the sigmoid colon the circular folds are ________ and more ________. These folds contract vigorously and act as a _________ to regulate the stool reaching the rectum. 
Definition
deeper and frequent, brake
Term
14 common GI diseases
Definition

1. barrett's esophagus

2. esophageal strictures

3. esophageal ring

4. esophageal diverticulum

5. esophageal polyps

6. esophageal cancer

7. GERD

8. Heart burn and reflux

9. chron's disease

10. hiatus hernia 

11. diverticulosis and diverticulitis

12. irritable bowel syndrome

13. pancreatic diseases

14. hepatic diseases 

Term
heartburn is a _______________ felt behind the breastbone and sometimes in the neck and throat, caused by stomach acid refluxing or splashing into esophagus 
Definition
burning sensation
Term
__________ or __________ temporarily relieves heartburn for most people
Definition
antacid milk
Term
How does reflux occur
Definition
LES is too weak to stay contracted stomach juices seep back into esophagus 
Term
the most common causes of reflux are from: ____________________ or _______________ which cause pressure in the stomach to rise, overpowers LES muscles
Definition
eating large meal, swallowing air
Term
10 other factors that reduce the LES pressure and allow reflux:
Definition

1. nicotine

2. fried fatty foods

3. caffeine

4. citrus fruits and juices

5. peppermint and spearmint

6. alcohol

7. pregnancy

8. lying flat

9. hiatus hernia

10 certain perscription medicines 

Term

______ percent of population experience reflux daily, common

____ of pregnant women have heartburn, common rarely life threatening

severe cases can result in injury to lower esophagus that requires treatment 

Definition
10, 25, 
Term
Three tests one can use to diagnose reflux:
Definition

1. Upper GI series

2. Upper GI endoscopy 

3. Esophageal Manometry 

Term
patient drinks liquid barium and x-rays are taken of the esophagus and stomach to see how they function
Definition
Upper GI series 
Term
the patient is given a mild sedative, then an endoscope is inserted into the esophagus to visually inspect the stomach
Definition
Upper GI endoscopy
Term
this test measures the pressures within the esophagus especially the LES pressure
Definition
Esophgaeal manometry 
Term
persistent acid in lower esophagus causes _______________
Definition
tissue damage
Term
Tissue damage in the lower esophagus due to reflux can result in: 
Definition

1. chronic bleeding and anemia

2. scar formation and narrowing of lower esophagus

3. barret's esophagus can occur when reflux irritate the lower esophagus over long period of time. the stomach lining then actually grows into the esophagus. In these cases, there is a slight but definite risk of cancer developing

4. lung problems can develop when reflux results in stomach fluid being aspirated it often occurs at night when a patient is lying down. this causes wheezing bronchitis and even pneumonia 

Term
luminitis
Definition
swelling of lung tissue
Term
Reflux protocol: 8 things to do
Definition

1. eat smaller more frequent meals

2. do not lie immediately after eating, 2+ hours before going to bed

3. excess bending, exercise, girdle promote reflux

4. lose weight

5. stop smoking nicotine weakens LES

6. avoid fatty food, alcohol, coffee, nicotine, peppermint 

7. elevate head 8 to 10 inches (cinder blocks pillows)

8. prescriptions weaken LES review all meds

Term
peppermint is a carmatent but produces more: 
Definition
acids 
Term
Antacids
Definition
take 30-60 minutes after eating a meal and at bedtime, liquids preferred to tablets with strongest being Maalox II Mylanta II Gelusil II, Extra Strength Riopan 
Term
Prescription meds for reflux: 
Definition
reduce or eliminate secretion of stomach acid and increase strength of LES
Term
surgery for reflux: 
Definition
fundoplication is done to tigheten the muscle within the lower esophagus and so prevent reflux of stomach acid into esophagus 
Term
Main tool to markedly reduce stomach acid
Definition
proton pump inhibitors: prilosec, prevacid, aciphex, protonix, nexium taken twice a day zantac, pepcid, axid, tagamet also available 
Term
Reglan is a drug that __________
Definition
strengthens the LES
Term
When tissue damage occurs in the esophagus because of persistent exposure to gastic acid
Definition
GERD 
Term
GERD examples (3)
Definition

1. inflammation and erythema

2. Erosion

3. deep ulceration in severe cases barret's

Term
abnormal growth of intestinal-type cells above this border into the esophagus
Definition
barret's esohpagus 
Term
since cells lining the small intestine are protected from contact with acid their growth may actually be a ____________________ in barret's esophagus
Definition
defense mechanism
Term
barret's esophagus: growth of intestinal-type cells may protect normal tissue in esophagus against further damage by 
Definition
GERD
Term
Progression of Barret's Esophagus into cancer occurs when cells develop abonormal changes known as: 
Definition
dsyplasia 
Term
Over a period of 2-5 years dysplasia may then progress to low grade then high grade dysplasia to finally ___________. Only happens in 1-5% of patients. 
Definition
cancer
Term
T/F there are medications to reverse barret's esophagus
Definition
False
Term
newer treatments of barret's esophagus involve
Definition
destruction of abnormal cells in esophagus w/o need for major surgery
Term
diaphragm is a _________________ separates the ________ from __________. When a person takes a deep breath, the dome-shaped diaphragm contracts and flattens pulling air into the lungs
Definition
sheet of muscle, lungs from abdomen
Term
the diaphragm contains a small __________ through which the ________ passes
Definition
hole, esophagus
Term
Normally the hole in the diaphragm is small and fits snugly around the esophagus calling it a 
Definition
hiatus 
Term
in a hiatal hernia the hiatus ________
Definition
weakens and enlarges
Term
T/F it is known why a hiatal hernia occurs
Definition
false
Term
In a hiatal hernia: a portion of the ___________ herniates or moves up into the chest cavity wall through the enlarge hold
Definition
stomach
Term
T/F hiatal hernias are common occuring in up to 60 % of people by age 60
Definition
true
Term
3 types of hiatal hernias
Definition

1. sliding hiatus hernia

2. fixed hiatus hernia

3. complicated or serious hiatus hernia

Term
the most common type of hiatus hernia, herniated portion of stomach slids back and forth into and out of the chest, these hernias are normally small and usually cause no problems or even symptoms
Definition
sliding hiatus hernia
Term
in this case the upper part of the stomach is caught up in the chest. even with the hernia, there may be few symptoms, however, the potential for problems in the esophagus is increased
Definition
fixed hiatus hernia
Term
complicated or serious hiatus hernia
Definition
uncommon, variety of patterns of herniation of the stomach, including cases in which the entire stomach moves up in the chest, there is a high likelihood that medical problems will occur with this hernia and that treatment frequently involving surgery be required
Term
diagnosis of hiatal hernia typically made through
Definition
upper GI study: a complementary test is gastroscopy or upper-intestinal endoscopy
Term
complications of hiatal hernia (5)
Definition

1. chronic heartburn inflammation of lower esophagus: reflux esophigitis 

2. anemia due to chronic bleeding from lower esophagus

3. scarring and narrowing of the lower esophgus causing difficulty in swallowing 

4. sleeping, stomach secretions can seep into esophagus into lungs casuing chronic cough wheeze pneumonia

5. difficulty breathing severe chest pain in elderly

Term
treatment for hiatal hernia
Definition

1. reflux protocl

2. medication for GERD

3. surgery 

Term
T/F the mere presence of hital hernia is a reason for surgery
Definition
false
Term
esophageal strictures are most often __________ and caused by acid refluxing into the lower esophagus
Definition
benign 
Term
in an esophageal stricture, the inflamed tissue breaks forming scars and causes contraction which _________________ and obstructs food into stomach
Definition
narrows
Term
Treatment for strictures (3). 
Definition

1. esophageal dilation: stretch open the narrowed or blocked portion of esophagus

2. usually perfomred with good effectiveness and no problems

3. severe complications can be excessive bleeding and or esophgeal tear 

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