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GI Function
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137
Physiology
Graduate
11/27/2011

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Term
Hunger determines what?
Definition
Amount of food we eat
Term
Appetite determines what?
Definition
Type of food we eat
Term
Food intake is regulated by what?
Definition
Energy expenditure
Term
Long term regulation of food intake is primarily concerned with what?
Definition
Maintenance of normal qualities of energy stores in the form of fat in the body
Term

Short term regulation of food intake is primarily concerned with what?

Definition
Preventing overeating at each meal
Term
What 3 systems regulate food intake?
Definition
CNS, Endocrine System, GI System
Term
How is the lateral hypothalmic area involved in food intake regulation?
Definition
Simulates food intake and storage of calories (hunger center)
Term
How is the ventromedial nuclei of the hypothalmus involved in food intake regulation?
Definition
Satiety Center
Term
What is the function of the Melanocortin Pathway?
Definition
A hypothalmic pathway that increases metabolism and inhibits food intake
Term
What is the function of the neuropeptide Y - mediated pathway?
Definition
A hypothalmic pathway that stimulates food intake and decreases metabolism (hunger signals)
Term

Leptin has what clinical effect on appetite and metabolism?

Definition
Decreasd Appetite, increased Metabolism
Term

CCK has what clinical effects?

Definition
Decreased appetite, decreased gastric emptying
Term

PYY has what clinical effect on appetite and metabolism?

Definition
Decreased appetite, increased metabolism
Term
Which part of the GI tract prevents pulmonary aspiration?
Definition
Oral Cavity
Term
Which part of the GI tract prevents gastric reflux?
Definition
Esophagus
Term
Which part of the GI tract is the major site of nutrient digestion and absorption and the site of synthesis of GI regulatory hormones?
Definition
Small Intestines
Term
What are the four general processes in the GI tract?
Definition
Motility, Secretion, Digestion, Absorption
Term
What produces Cholecystokinin?
Definition
I cells in the duodenum and jejunum and neurons in the ileum and colon
Term
What produces gastric inhibitory peptide?
Definition
K cells in duodenum and jejunum
Term
What produces Gastrin?
Definition
G cells in the antrum of the stomach
Term
What stimulates the release of Gastrin?
Definition
Vagal nerve endings
Term
What produces Guanylin?
Definition
Ileum and Colon
Term
What produces Motilin?
Definition
M cells in duodenum and jejunum
Term
What are the effects of Cholecystokinin?
Definition
Pancreatic enzyme secretion, gallbladder contraction
Term
What are the effects of Gastric Inhibitory Peptide?
Definition
Decreased fluid absorption, insulin release, decreased gastric motility and emptying
Term
What are the effects of Gastrin?
Definition
Increased H+ secretion, increased Pepsinogen secretion
Term
Whare the effects of Guanylin?
Definition
Increased fluid absorption and increased smooth muscle contraction
Term
What are the effects of Motilin?
Definition
Increased GI motility and initiates the migrating motor complex
Term
What are the effects of Neurotensin?
Definition
Vasoactive stimulation of histamine release
Term
What exhibits Extrinsic control of GI functions?
Definition
CNS and Autonomic NS
Term
What exhibits Intrinsic control of GI functions?
Definition
Enteric NS
Term
What is the role of the CNS in regulation of GI functions?
Definition
Appetite/Hunger, cephalic phase of digestion, voluntary muscles of the GI tract (mouth, upper 1/3 esophagus, pharynx, external anal sphincter), pain, defecation
Term
What effects do Parasympathetic nerves generally have on the GI tract
Definition
Excitatory effect (increased motility, secretion, blood flow)
Term

What effects do Sympathetic nerves generally have on the GI tract

Definition

Inhibitory effect (Vasoconstriction, Decreased GI motility, Decreased secretion activity)

Term
Which major neurotransmitter of the enteric NS is excitatory?
Definition
Ach
Term
Which major neurotransmitter of the enteric NS is inhibitory?
Definition
Norepinephrine
Term
Which non-peptide neurotransmitters of the enteric NS are inhibitory?
Definition
ATP and NO
Term
What are the peptide neurotransmitters of the enteric NS?
Definition
Vasoactive Intestinal Peptide (VIP), Substance P
Term
What do short reflexes in the GI control?
Definition
Secretion, Peristalsis, Mixing Contraction
Term
What controls short reflexes in the GI tract?
Definition
Enteric NS
Term

What do long reflexes in the GI control?

Definition
Pain and Defecation reflexes, Gastrocolic, Enterogastric, and Colonoileal reflexes, Gastric Motor and Secretory activity
Term
What electrically connect smooth muscle cells?
Definition
Gap Junctions
Term
Describe the function of Interstitial Cells of Cajal
Definition
Pacemaker cells in the caudad stomach and the intestine, generating fluctuating membrane potential as slow waves
Term
Describe Electrical Slow Waves (Basic Electrical Rhythm aka BER)
Definition
Spontaneous cycles of deporalization and repolarization of GI smooth muscle
Term
What determines the frequency of rhythmic contraction?
Definition
Frequency of the BER (Basic Electrical Rhythm)
Term
How does the frequency of the BER vary?
Definition
By region (3min in the stomach, 12min in the duodenum)
Term
What causes smooth muscle contraction?
Definition
Spikes (action potentials)
Term
What generates BERs?
Definition
Interstitial Cells of Cajal (ICC)
Term
Where is there a complete lack of slow waves?
Definition
Esophagus and proximal stomach
Term
What influences slow waves?
Definition
Body temp and metabolic activity
Term
What causes slow wave depolarization and repolarization?
Definition
NA+ influx and KA+ eflux respectively
Term
What causes depolarization and repolarization leading to contraction in the GI?
Definition
Ca 2+ influx and K+ efflux respectively
Term
What phase are slow wave action potentials leading to GI contraction associated with?
Definition
Depolarization phase
Term
What is the force of contraction in the GI directly proportional to?
Definition
Frequency of Action Potentials
Term
What are depolarizing factors that stimulate GI smooth muscle contraction?
Definition
Stretching of muscle, parasympathetic stimulation via Ach
Term
What are Hyperpolarizing factors that inhibit GI smooth muscle contraction?
Definition
Sympathetic stimulation (norepinephrine), Epinephrine
Term
What is Basal Myogenic Tone?
Definition
Tonic contraction of GI smooth muscle generated internally, NOT ASSOCIATED WITH BER, maintains continuous contraction
Term
What characterizes tonic contraction of GI smooth muscle?
Definition
Very low ATP consumption via latch mechanism
Term
What increases the intensity of contraction in Basal Myogenic Tone
Definition
Increased number of APs, increased Ca influx, partial depolarization
Term
Where is the Ileocecal Spincter?
Definition
Ileum to Colon
Term
Where is the Internal Anal Sphincter?
Definition
Rectum to Anal Canal
Term
Where is the External Anal Sphincter?
Definition
Anal Canal to External
Term
Where is the Colorectal Sphincter?
Definition
Colon to Rectum
Term
Describe the time spent in each segment of the GI tract
Definition
Mouth = 8-10s, Stomach = 1-2hrs, Feces = up to 72hrs
Term
Which patterns of muscle contractile activity are integrated within the Enteric NS?
Definition
Segmentation (mixing) and Peristalsis (propulsion)
Term
Focal contraction of the circular muscle layer describes what?
Definition
Segmentation
Term
Circular muscle contraction that spreads unidirectionally in the aborad direction describes what?
Definition
Peristalsis
Term
Parasympathetic signals have what effect on motility?
Definition
Increased Motility
Term
Sympathetic signals have what effect on motility?
Definition
Decreased motility
Term
Myogenic regulation of GI motility controls what?
Definition
Local control and contractile rhythm (BER)
Term
What controls the muscles involved in chewing?
Definition
5th Cranial Nerve
Term
Describe the pharyngeal stage of deglutition
Definition
6 seconds, airway closed, respiration stopped, initiates esophageal peristalsis
Term
Describe the esophageal stage of deglutition
Definition
8-10 seconds, primary and secondary peristalsis, relxation of lower esophageal sphincter and the stomach
Term
Aborad propulsion of food bolus into the oropharynx by the tongue describes what?
Definition
Voluntary stage of deglutition
Term
Involuntary transportation of food from the posterior mouth and pharynx into the esophagus describes what?
Definition
Pharyngeal stage of deglutition
Term
What initiates the pharyngeal stage of swollowing?
Definition
Epithelial receptor in the pharynx
Term
Involuntary propulsion of ingested foodstuff through the esophagus into the stomach describes what?
Definition
Esophageal stage of deglutition
Term
A propulsive aborad contractile wave within the esophagus that is initiated through pharyngeal receptor contact describes what?
Definition
Primary Peristalsis
Term
What controls primary peristalsis?
Definition
The Vagus Nerves along with the esophageal myenteric plexus
Term
Propulsive aborad contractile waves within the esophagus that is initiated through pharyngeal receptor contact describes what?
Definition
Primary Peristalsis
Term
What controls primary peristalsis?
Definition
Vagus nerves in connection with the esophageal myenteric plexus
Term
What sweeps the esophagus of residual food particles?
Definition
Secondary Persitalsis
Term
What controls secondary peristalsis?
Definition
Myenteric and extrinsic NS
Term
When does the lower esophageal sphincter relax?
Definition
Shortly before the peristaltic wave arrives (receptive relaxation)
Term
Loss of the lower esophageal sphincter relaxation and peristalsis of the esophagus leading to functional obstruction and progressive esophageal dilation describes what?
Definition
Achalasia
Term
Abnormalities in amplitude of swallowing contraction where >20% of swallows result in simultaneous contraction describes what?
Definition
Diffuse esophageal spasm
Term
Peristaltic contractions of increased amplitude and/or duration describes what?
Definition
Hypertensive peristalsis (nutcracker esophagus)
Term
What defines a hypertensive lower esophageal sphincter?
Definition
Increased resting pressure
Term
What defines hypotensive a lower esophageal sphincter?
Definition
Decreased resting pressure
Term
Decreased amplitude of perstaltic or nonperistaltic contractions in distal esophagus describes what?
Definition
Hypotensive peristaltic contractions (ineffective)
Term
Gastric acid reflux, weak secondary peristalsis, and low lower esophageal sphincter tone describes what?
Definition
Pyrosis (heartburn)
Term
Degeneration of the postganglionic inhibitory neurons in the myenteric plexus causing abnormalities in peristalsis and in the tone of the lower esophageal sphincter, food obstruction, and progressive esophageal dilation describes what?
Definition
Achalasia
Term
What is the vagovagal reflex?
Definition
A stretch reflex the reduces the tone in the muscular wall of the body of the stomach, initiated by food
Term
Which part of the stomach mixes and homogenizes food?
Definition
Caudad portion
Term
What controls mixing waves in the stomach
Definition
BER
Term
What controls the amount of food that leaves the stomach?
Definition
Muscle contractions of the antrum
Term
What limits the size of particles empyting from the stomach into the duodenum?
Definition
Pyloric Sphincter
Term
What kind of neural stimulation increases gastric motor activity
Definition
Parasympathetic via the vagal nerves
Term
What kind of neural stimulation decreases gastric motor activity?
Definition
Sympathetic (celiac ganglion) 
Term
What hormone increases contraction of the caudad stomach, increasing motility?
Definition
Motilin
Term
What hormones suppress stomach motility?
Definition
Somatostatin and GIP
Term
Emptying of isotonic, non-caloric fluids in the stomach is proportional to what?
Definition
Volume or distension of the stomach
Term
Which kinds of fluid empty more slowly from the stomach?
Definition
Hypertonic and hypotonic fluids empty slower than isotonic fluids
Term
What effect does pH have on the emptying of the stomach?
Definition
Lower pH = slower emptying
Term
What is the result of slower than normal gastric emptying?
Definition
Interrupts flow of nutrients, overstimulation of gastric acid, poor digestion and absorption
Term
What is the result of faster than normal gastric emptying?
Definition
Overwhelmed digestive and absorptive capacity of the small intestine, acidic chyme not fully buffered, poor digestion and absorption
Term
What stimulates intestinal motility?
Definition
Parasympathetic stimulation, CCK, Gastrin
Term
What do parasympathetic innervation, CCK, and Gastrin cause in order to stimulate small intestinal motility?
Definition
Spike Potentials leading to contraction
Term
What hormones inhibit small intestine motility?
Definition
Epinepherine, VIP, Secretin, Glucagon (as well as ATP and NO)
Term
What hormones stimulate small intestine motility?
Definition
Gastrin, CCK, Insulin, motilin, Serotonin
Term
What causes intestinal receptors to trigger the enterogastric reflex?
Definition
Hydrogen ions, distension, changes in osmolarity
Term
What is the effect of the enterogastric reflex?
Definition
Decreased gastric motility and slowed rate of gastric emptying, protecting the intestines from excessive acidity
Term
What activates the ileocecal reflex
Definition
Distension of the ileum
Term
What is the effect of the ileocecal reflex?
Definition
Increases motility of the ileum and relaxes the ileocecal sphincter, allows chyme to pass to the cecum, protects against reflux of colonic contents
Term
What activates the gastroileal reflex?
Definition
Distended stomach
Term
What is the result of the gastroileal reflex?
Definition
Increases ileal motility and movement through the ileocecal sphincter
Term
What part of the CNS controls vomiting?
Definition
Medulla
Term
What is the most common motility action in the large intestines?
Definition
Haustrations (segmenting contractions)
Term
What is the purpose of Haustrations (segmenting contractions in the Large Intestines)
Definition
Mixes contents with little net propulsion
Term
What kind of neural control inhibits motility in the large intestines?
Definition
Sympathetic stimulation and enteric stimulation mediated by VIP via NO
Term
What part of the large intestine is voluntarily controlled?
Definition
External Anal Sphincter
Term
What is the purpose of the gastrocolic reflex?
Definition
Stimulates gastric emptying which reflexly stimulates mass colonic movement
Term
What is the effect of the duodenalcolic reflex?
Definition
Duodenal distension increases stimulation of colonic mass movement, responsible for defecation sensation
Term
What are the boundaries of the rectum?
Definition
Internal and external anal sphincters
Term
What initiates defecation?
Definition
Rectosphincteric reflex
Term
What increases the urge to defecate by intensifying the peristaltic waves through the distal colon, rectum, and anus, allowing for the relaxation of the internal anal sphincter?
Definition
Parasympathetic reflex
Term
What nerve controls the external anal sphincter?
Definition
Pudendal nerve (CNS)
Term
What is rectal accomodation?
Definition
Constriction of the external anal sphincter delays defecation, causing the internal anal sphincter to regain tonic control until a new mass movement begins a new defecation reflex cycle
Term
How long does it take for transit through the colon?
Definition
30-40hrs
Term
The migrating motor complex is associated with what body state?
Definition
Fasting state
Term
What initiates the migrating motor complex?
Definition
Fasting >90min, Motilin
Term
What is the purpose of the migrating motor complex?
Definition
Prevents bacterial overgrowth in the gut by sweeping the gastric acid to the ileum
Term
A lack of spikes and contractions describes which phase of the migrating motor complex?
Definition
Phase 1
Term

A irregular spikes and contractions describes which phase of the migrating motor complex?

Definition
Phase 2
Term

A bursts of spikes and contractions describes which phase of the migrating motor complex?

Definition
Phase 3
Term
What is the source of hunger pangs, stomach growls?
Definition
Migrating Motor Complex in the stomach
Term
What hormones initiates the migrating motor complex in the small intestines?
Definition
Motilin in response to neural signals
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