Term
| G cells make this hormone. |
|
Definition
|
|
Term
|
Definition
| made by I cells in the Duodenum/Jejunum |
|
|
Term
| the 5 sphincters in the GI system? |
|
Definition
SES
LES/Cardiac
Pyloric Sphin
Illeocecal
Rectal/Anal Sigmoid |
|
|
Term
| 4 functions of the GI tract? |
|
Definition
1. secretiton
2. motility
3. absorption
4. excretion |
|
|
Term
| Blood supply to the GI tract is controlled by what? |
|
Definition
| Nervous system: SNS and PSNS |
|
|
Term
| 2 types of SM in the GI tract? |
|
Definition
longitudinal (located in 3 incomplete sections in the LI, fyi)
circular (acounts for the "ring like" structure of the GI tract) |
|
|
Term
| What connects the tissue in the GI tract to allow for fast, uninterrupted transfer or AP's for rhythmic contractions? |
|
Definition
|
|
Term
| What is the term for a stimulus to a muscle that transfers in all directions from that point? |
|
Definition
|
|
Term
| Does the GI tract have direct innervation from the PSNS or SNS? |
|
Definition
| NO, all innervation is done "thru passing" of nervous system near the GI system |
|
|
Term
| SNS stimulation in GI does? |
|
Definition
| inhibitory, decreases: blood flow, motility, secretions, etc. |
|
|
Term
| PSNS stimuli in the GI does? |
|
Definition
| excitatory, increases: motility, secretitons, blood flow |
|
|
Term
| What is one of the main cranial nerves associated with much of the GI systems activity? |
|
Definition
|
|
Term
| What is the name of the Gi's own nervous sustem? |
|
Definition
|
|
Term
| what are the 2 plexuses within the ENS? |
|
Definition
1. myenteric/Auerbachs
2. Submucosal/Meissners complex |
|
|
Term
| The myentreric/auerbachs plexus is located where? and controls what in the GI system? |
|
Definition
1. btwn longitudinal and circular SM
2. controls GI movements, mixing, rhythmic motions, excitatory in nature |
|
|
Term
| myentreric/auerbachs plexus secretes what inhibitory transmitter? and what does it do? |
|
Definition
1. vasoactive intestinal polypetide
2. inhibits the pyloric sphincter when foods needs to empty into the duodenum |
|
|
Term
| The Submucosal plexus/Meissners complex is located where? and what is its main funx? |
|
Definition
1. btwn submucosa and circular SM layer
2. controls GI secretion, absorption, and local Blood flow |
|
|
Term
| how many estimated neurons are inthe GI system? |
|
Definition
|
|
Term
| NTMs associated with the ENS? |
|
Definition
| ACh, NE, epi, ATP, 5HT, Dop, CCK, Sub P, VIP, Somatostatin, Bombesin... |
|
|
Term
| _______ is the term for propulsive movement that is stimulated by distention in the GI tract. |
|
Definition
| peristalsis or peristaltic waves |
|
|
Term
| What plexus must be intact for peristalsis to occur? |
|
Definition
| myenteric/auerbachs plexus |
|
|
Term
| What does Atropine do to the GI tract? |
|
Definition
| paralyzation of the cholinergic nerve endings or the myenteric/auerbachs plexus |
|
|
Term
| When the GI tract relaxes downstream form a mass of food being moved forward is called? |
|
Definition
|
|
Term
|
Definition
| the combination of the myentric relfex and the direction of peristalsis = food moving out your ass!! |
|
|
Term
| _____ tough connective tissue that forms the outer layer of GI tract. |
|
Definition
|
|
Term
| Immediatly proximal to serosal layer is the _______ that is oriented up and down the GI tract. (is excitable) |
|
Definition
|
|
Term
| _____ is the 3rd layer of the GI tract and contract in a circular motion. |
|
Definition
|
|
Term
| ______ layer just below the submucosal layer moving inward thru the layers. |
|
Definition
|
|
Term
| The inner most layer of tissue within the GI system, these cells are active at all times. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Where can these slow waves actually cause contractions? |
|
Definition
|
|
Term
| What must occur for a contraction to happen on the BER? |
|
Definition
| spike potentials (Ca++ moving into SM) |
|
|
Term
| what ions accounts for the BER? |
|
Definition
|
|
Term
| Normal resting membrane potential #? |
|
Definition
|
|
Term
| Slow waves account for what? |
|
Definition
| the rythm/rate that contractions CAN occur but only if spike potentials occur. |
|
|
Term
| Spike potentials can be stimulated by? (3) |
|
Definition
|
|
Term
| Hyperpolarization of the slow waves occurs from what NTMs? |
|
Definition
|
|
Term
| What is the name of the "pacemaker cells" in the GI system? |
|
Definition
| interstitial cells of Cajal |
|
|
Term
| If all the nervous system is cut away from the GI tract will it still funx? |
|
Definition
|
|
Term
| Spike potential threshold is what mV? |
|
Definition
|
|
Term
| BER cycles in the stomach? (this is the MAX rate contraction can occur, and the only place that contractions occur from slow waves) |
|
Definition
|
|
Term
BER cycles in the Duodenum?
(this is the MAX rate contraction CAN occur but only if spikes happen) |
|
Definition
|
|
Term
BER cycles in the jejunum?
(this is the MAX rate contraction CAN occur but only if spikes happen) |
|
Definition
|
|
Term
BER cycles in the Illeum?
(this is the MAX rate contraction CAN occur but only if spikes happen) |
|
Definition
|
|
Term
BER cycles in the Cecum?
(this is the MAX rate contraction CAN occur but only if spikes happen) |
|
Definition
|
|
Term
BER cycles in the Sigmoid?
(this is the MAX rate contraction CAN occur but only if spikes happen) |
|
Definition
|
|
Term
GI response to catecholamines (SNS)?
SM?
sphincters?
BER?
Spikes APs? |
|
Definition
inhibit
excite
no effect
inhibit |
|
|
Term
GI response to 5HT, ACh, Hist (PSNS)?
SM?
sphincters?
BER?
Spikes APs? |
|
Definition
excite
inhibit
no effect
excite |
|
|
Term
| Blood flow increases durring GI activity, what substances released from MUCOSA cause this? (5) |
|
Definition
| CCK, vasoactive intestinal peptide, gastrin, secretin |
|
|
Term
| Blood flow increases durring GI activity, what substances released from GLANDS cause this? (2) |
|
Definition
|
|
Term
| When metab demands increase in the gut O2 levels drop and _____ increases production by 10 fold. |
|
Definition
|
|
Term
| Due to the design and arrangement of arterial and venous blood flow in the Villi, what can occur under stressful states like Shock? |
|
Definition
| no blood flow/exchange at the ends of the villi leading to ischemic death of tissue |
|
|
Term
| When SNS stimulates the GI system and constricts blood flow, ischmeic vasodilators are released and overcome the SNS constriction to return blood flow back near normal, this is called? |
|
Definition
|
|
Term
| Secretory Glands 2 general functions? |
|
Definition
1. digestive enzymes
2. mucous (lubricant/protection) |
|
|
Term
| Salivary glands secrete _____, ______, _____, to help prepare food and stick it together. |
|
Definition
|
|
Term
| What 2 digetive enzymes are secreted by the salivary glands that end up in the stomach? |
|
Definition
1. Amylase - breaks down CHO
2. Lipase - inactive when it hits stomach |
|
|
Term
| Saliva in the mouth main funxs? (5) |
|
Definition
1. help w/ speech, swallowing, taste
2. antibacterial
3. hypersalivate to noxious stimuli
4. dental health
5. secrete digestive enzymes |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
Parotid gland saliva production.
Active?
Rest? |
|
Definition
|
|
Term
Submaxillary gland saliva production.
Active?
Rest? |
|
Definition
|
|
Term
Sublingual gland saliva production.
Active?
Rest? |
|
Definition
|
|
Term
| What ion is saliva very high in, this aids in the H+ exchange later in the stomach? |
|
Definition
|
|
Term
| Organic substances in saliva? (5) |
|
Definition
mucous
Blood Antigens (A B O)
Amylase
Lysosomes
Iodine |
|
|
Term
| PSNS does what to saliva production? |
|
Definition
|
|
Term
| What nerve collection controls salivary gland funx? and what CNs? |
|
Definition
Inferior & Superior Salivary Nuclei (made up from CN VII & IX)
CN: X, VII, IX |
|
|
Term
| Vagus (X) nerve has more efferent or afferent transmissions? |
|
Definition
|
|
Term
| Autoimmune disorder where antibodies attack salivary glands and pt has no tears and dry mouth? treatment? |
|
Definition
Sjogrens Syndrome
Tx: Restasis (artifical tears/saliva) |
|
|
Term
| Formation of stones in the salivary glands? Treatment? |
|
Definition
|
|
Term
| Dry mouth, ulcers, caries, gum disease? Treatment? |
|
Definition
Xerostoma
Tx: gargle w/ medications to stimulate glands |
|
|
Term
| Viral infection of salivary glands? |
|
Definition
|
|
Term
| What CNs are excited when food hits the back of the throat? |
|
Definition
|
|
Term
| What is the area that CN's associated w/ swallowing send their afferent sensory msgs? |
|
Definition
Tractus Solitarious/Swallowing Center
CN V, IX |
|
|
Term
| Efferent CN nerves associated w/ chewing and swallowing? |
|
Definition
| V, IX, X, XII, all of these come form the swallowing center |
|
|
Term
| Phase I of swallowing is voluntary or involuntary? |
|
Definition
| voluntary, we make the decision |
|
|
Term
| How long does phase II take in the swallowing pathway? |
|
Definition
| 6 seconds, occurs btwn inspiration or experation |
|
|
Term
Phase II: Pharyngeal
sensory from CN V(trig) and CN IX(gloss) is sent to _____ which initiates all the muscle actions of this phase. |
|
Definition
|
|
Term
Phase II pharyngeal:
Afferent limb CNs? |
|
Definition
|
|
Term
Phase II pharyngeal:
Efferent limb CNs? |
|
Definition
|
|
Term
| ______ inhibits the respiratory center of the Medulla during Phase II of swallowing? |
|
Definition
|
|
Term
| What is the fancy term for swallowing? |
|
Definition
|
|
Term
| When _____________ occurs phase II of swallowing is over? |
|
Definition
| food is transported past vocal cords |
|
|
Term
| What sphincter has to relax for swallowing to occur? |
|
Definition
|
|
Term
| What type of movement propels food down the esophagus? |
|
Definition
|
|
Term
| The _____ swings back and covers the trachea during swallowing? |
|
Definition
|
|
Term
| When swallowing is not occurring what sphincter is held tightly shut so that no air enters the esophagus? |
|
Definition
|
|
Term
| Phase III: Esophageal Phase of swallowing moves food from the ____ to the _____. |
|
Definition
|
|
Term
| The Esophagus has 2 types of peristalsis? |
|
Definition
1. Primary - initiated by stretching
2. Secondary - initiated from food being in the Gi tract |
|
|
Term
| Damage to any of these CNs will impair swallowing? |
|
Definition
|
|
Term
| ______, which is gerneral muscle weakness that can progress to paralysis will impair swallowing? |
|
Definition
|
|
Term
| Posion from improperly canned foods that can cause paralysis and impair swallowing? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Deep anestehsia can impair swallowing by? |
|
Definition
| paralyzing epiglottis and laryngeal reflexes, usually only an issue when pt vomits |
|
|
Term
| Esophagus muscle in the upper 1/3 is? |
|
Definition
|
|
Term
| Muscle in the esophagus in the lower 2/3 is? |
|
Definition
|
|
Term
| Term for inability to swallow? |
|
Definition
|
|
Term
| AChlasia (inability to swallow) is a result of what sphincter not opening? |
|
Definition
|
|
Term
|
Definition
| change in normal lining of esophagus r/t reflux and usually forewarning to CA |
|
|
Term
| Hiatal Hernia occurs when the esophagus and sometimes the LES get stuck btwn? |
|
Definition
|
|
Term
| Landmark for anatomy of the stomach located at the notch on the greater curvature side of the stomach? |
|
Definition
| Angular Notch/Incusuria Angularis |
|
|
Term
| Folds of the stomach that increase surface area? |
|
Definition
|
|
Term
| Folds in the stomach that allow pathways that fluid and substances move down are called? |
|
Definition
| Magenstrasse (stomach street) |
|
|
Term
| Area of the stomach from the Fundus to the angular notch? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Sphincter that empties from the stomach into the SI? |
|
Definition
|
|
Term
| Upper portion of the stomach? |
|
Definition
|
|
Term
| SNS stimulation of the stomach only increase one thing? |
|
Definition
|
|
Term
| What type substances are absorbed in the stomach? |
|
Definition
| very lipid soluble, EtOH, ASA |
|
|
Term
| Pacemaker of the stomach? |
|
Definition
|
|
Term
| What is important to know about the "pacemaker" of the stomach when food is being processed? |
|
Definition
| it moves up the wall of the stomach above the food to allow greater full contractions of the stomach down thru the contents (mixing) |
|
|
Term
| What 2 ways are proteins broken down in the stomach? |
|
Definition
1. Acid hydrolysis
2. Pepsin (once pH is above 3.0) |
|
|
Term
| what 2 ways are lipids broken down in the stomach? |
|
Definition
1. ACid hydrolysis
2. Lipase |
|
|
Term
| What 2 ways are sugars broken down in the stomach? |
|
Definition
|
|
Term
| How long does it take the stomach to digest 1 meal? |
|
Definition
|
|
Term
| What 3 things must occur for the pyloric sphincter to open and allow stomach emptying? |
|
Definition
1. ~300 osmo
2. fluidity of paste (chyme)
3. pH 4-5 |
|
|
Term
| Accelerated stomach emptying occurs from? (4) |
|
Definition
hyptotonic
liguid
high sugar/starch
high food volume |
|
|
Term
| Intermediate stomach emptying occurs from? (3) |
|
Definition
isotonic
high protein
semi solid foods |
|
|
Term
| decreased stomach emptying occurs from? (3) |
|
Definition
hypertonic
high fats
solid foods |
|
|
Term
| The oxyntic gland/cells are located? |
|
Definition
| fundus & antrum of stomach |
|
|
Term
| There are 2 types of mucous cells in the stomach, what are they? |
|
Definition
mucous cells - outer barrier of mucous
mucous neck cells - mucous to protect pits of the onxytic gland |
|
|
Term
| What type of cell in the stomach produces acid, and is part of the oxyntic gland? |
|
Definition
| oxyntic cell/parietal cell |
|
|
Term
| The oxyntic cell/parietal cell produces 2 things? |
|
Definition
|
|
Term
| The oxyntic/parietal cells in the stoamch produce intrinsic factor, what does it do? |
|
Definition
| Protein binds with Vitamin B12 to form Transcobalamin |
|
|
Term
| How is Vitamin B12 stored throughout the body? (what is the name of the complex) |
|
Definition
|
|
Term
| Vitamin B12 is associated with the stimulation of _______ maturation. |
|
Definition
|
|
Term
| What is Vitamin B12 deficiency called? |
|
Definition
|
|
Term
| What do the RBCs look like in a person with Pernicious Anemia? |
|
Definition
|
|
Term
| Peptic/Chief cells are located where in the stomach? |
|
Definition
Oxyntic Gland
Fundus & Corpus |
|
|
Term
| Peptic/cheif cells release what in the stomach? |
|
Definition
|
|
Term
| What activates Pepsinogen in the stomach? |
|
Definition
|
|
Term
| Pepsiongen's optimal pH for breaking down proteins is _____? What pH does it stop working at? |
|
Definition
1. 1.8 - 3.5 (book numbers)
2. >5.0 |
|
|
Term
| Pepsinogen is released in response to _____ NTM associated with CN X? |
|
Definition
|
|
Term
| Pepsinogen is released in response to _____ coming in contact with ____ cells in the rugae? |
|
Definition
| 1. HCL acid 2. peptic cells (oxyntic gland) |
|
|
Term
| When you eat food, the pH in the stomach does what? |
|
Definition
|
|
Term
| Peptic/Cheif cells release 2 enzymes? |
|
Definition
1. pepsinogen - breakdown proteins
2. lipase - breakdown lipids/fats |
|
|
Term
| Pyloric Gland is located where in the stomach? |
|
Definition
| antrum (bottom of stomach) |
|
|
Term
| Pyloric Gland has 1 type of cell in it, what is it and what enzyme does it mainly release? |
|
Definition
|
|
Term
| Gastrin release in the stomach is associated with what CN stimulation? |
|
Definition
|
|
Term
| Gastrin in the stomach has 6 main effects? |
|
Definition
1. stimulate HCL
2. Stimulate/activate Pepsin
3. increase motility in jejunum
4. increase mixing of stomach
5. stimulates pancreatic enzymes
6. stimulate ECL cells to release histamine (this is important in HCL acid production) |
|
|
Term
| Gastrin stimulates the release of pancreatic enzymes (3)? |
|
Definition
1. amylase - CHO breakdown
2. lipase - lipid/fat breakdown
3. trypsin - protein breakdown |
|
|
Term
| What are the 3 things that must be present in the stomach for OPTIMAL HCL- acid production? |
|
Definition
1. Histamine (ECL cell activation)
2. ACh
3. Gastrin |
|
|
Term
| If the 3 components needed for HCL acid production are not present will HCL acid still be made? |
|
Definition
|
|
Term
| The ____ pump in the parietal cell that produces the _____ ion needed for HCL acid? |
|
Definition
| 1. H/K ATPase pump 2. H+ ions pumped into stomach |
|
|
Term
| What is the catalyst that speeds conversion of H2O and CO2 in the parietal cell? |
|
Definition
|
|
Term
| What is the main ion driving the concentration gradient for H+ to move into the stomach? |
|
Definition
|
|
Term
| Where does the extra K+ come from in the stomach to provide exchange w/ H+ by the H/K ATPase pump? |
|
Definition
|
|
Term
| What type of barrier exists on the Parietal cell that prevents back flow of H+ into the cell? |
|
Definition
| mucous layer, if this layer is impaired then ulcers can occur |
|
|
Term
| Name the 3 phases of HCL acid secretion? |
|
Definition
1. Cephalic phase
2. Gastric phase
3. Small Intestine phase |
|
|
Term
| Explain what the main driving force of the Cephaic phase1 of HCL acid production? |
|
Definition
| thinking about food or Blood Sugar is low, this occurs before any food is ingested |
|
|
Term
| Explain what the main driving force of the Gastric phase2 of HCL acid prodcution? |
|
Definition
food enters stomach
1. vagovagal reflex stimulated
2. ENS reflex stimulated
3. Gastrin released |
|
|
Term
| Explain what the main driving force of the Small intestine phase3 of HCL acid prodcution? |
|
Definition
food enters Duodenum
gastrin released @ dudenal mucosa, stimulates HCL acid secretion |
|
|
Term
| Phase 1, 2, & 3 produce how much in % of HCL acid in the stomach? |
|
Definition
|
|
Term
| Gastrin released during Cephalic phase1 of HCL acid production causes mixing and contraction of an empty stomach, the noises heard are called? |
|
Definition
|
|
Term
| The main thing that inhibts HCL acid production? (very general) |
|
Definition
| food entering the Duodenum (SI) |
|
|
Term
| What are the enzymes released when food enters SI that inhibits HCL acid production? (4) |
|
Definition
1. secretin
2. GIP
3. VIP
4. somastatin |
|
|
Term
| HCL acid OVER production results in? |
|
Definition
|
|
Term
| Causes of over production of HCL acid in the stomach? (5) |
|
Definition
1. Type A personality
2. ZES (zolinger ellisoe Syndrome
3. H pylori
4. poor blood supply
5. poor/impaired mucous production |
|
|
Term
| Name the 3 common places/locations in the GI system where ulcers occur? |
|
Definition
1. Cardiac/LES
2. antrum (bottom of stomach) (most common)
3. Pyloris/duodenum SI |
|
|
Term
| HCL acid underproduction is associated with chronic ______? |
|
Definition
|
|
Term
| What are common causes of chronic gastritis leading to under production of HCL acid? |
|
Definition
1. ASA
2. EtOH
3. stomach CA
4. infection of parietal cells |
|
|
Term
| NO HCl- acid production/present? |
|
Definition
|
|
Term
| very minimal HCL- acid present/produced? |
|
Definition
|
|
Term
| What CNs are associated with vomiting reflex? |
|
Definition
|
|
Term
| What are the 3 main complications of vomiting? explain each |
|
Definition
1. loss of H2O - dehydration
2. loss of HCL - metabolic alkalosis
3. loss of K - weakness, hypoK+ |
|
|
Term
| Enterochromaffin Like Cells (MAST), aka ECL cells, release what? |
|
Definition
|
|
Term
| Enterochromaffin Like Cells (MAST), aka ECL cells, are located where? |
|
Definition
| sparsely throughout the gastric mucosa |
|
|
Term
| What are the anatomical structures in the SI that drastically increase surface area for absorption? |
|
Definition
1. Valvulae Conniventes (Folds of Kercring)
2. Macrovili
3. Microvili |
|
|
Term
| What enzymes cover the macrovilli in the SI? (4) |
|
Definition
1. Sucrase - sugars
2. Lactase - lactose
3. Maltase - maltose
4. Enterokinase - activates trypsinogen
5. |
|
|
Term
| What % of fats are drained into the lymph system from the macrovilli? |
|
Definition
|
|
Term
| What is the protein-like sturucture covering the villi in the SI that are composed of many digestive enzymes? |
|
Definition
|
|
Term
| What type of movements occur in the SI? |
|
Definition
| segmentation/myogenic contraction (NOT peristalsis) |
|
|
Term
| What is the purpose of "chopping" up the chyme within the SI by myogenic/segmentation? |
|
Definition
|
|
Term
| Peristalsis in the SI is stimulated by? |
|
Definition
vagus nerve
GI hormones
stretch receptors |
|
|
Term
| Peristaltic Rush is activated by? (2) |
|
Definition
1. irritation from toxic substances
2. overactive vagus nerve |
|
|
Term
| What is the characteristics of Peristaltic Rush? |
|
Definition
| longer perstaltic contractions 20-30cm long that overloads the LI and leads to EXPLOSIVE diarrhea |
|
|
Term
| What is the purpose of anti-perstalsis, and where does it occur in the SI? |
|
Definition
1. allows further mixing of chyme by contracting against the pyloris
2. duodenum |
|
|
Term
| Where is anti-peristalsis also occurring in the LI? and why? |
|
Definition
1. Colon
2. allows further reabsorption of water |
|
|
Term
| CCK is release in response to high fat meals and does what? |
|
Definition
1.contract gall-bladder to inject extra bile into duodenum
2. decrease stomach contractions
3. increase pancreatic enzyme secretion
4. increase bile secretion from Liver |
|
|
Term
| Secretin is released from what part of the GI system? What causes its release? |
|
Definition
1. S cells of Duodenum
2. stimulates pancreas to secrete HCO3 to bring pH back up so it doesn't eat up the SI |
|
|
Term
| GIP (gastric inhibitory peptide) main funx is to do what? |
|
Definition
| negative feedback enzyme for the GI system to stop HCL acid production |
|
|
Term
| Motilin is released from where in the GI system? what does it stimulate? |
|
Definition
1. Duodenum
2. increase SI motility (secreted when food enters the duodenum) |
|
|
Term
| As the GI system decends the nervous system becomes less involved and ______ control dominates. |
|
Definition
|
|
Term
| Where does the cellular activity occur in the SI tissue? |
|
Definition
|
|
Term
| X-section of SI tisssue would characteristically look like? |
|
Definition
| there is almost no lumen because the infoldings take up most of the lumen. |
|
|
Term
| What do mucous goblet cells secrete in the SI? |
|
Definition
| large amounts of mucous to protect mucosa |
|
|
Term
| Where is the Brunners Gland found? |
|
Definition
| first few inches of Duodenum |
|
|
Term
| What is the main role of the Brunners Gland? |
|
Definition
| secrete large amounts of mucous to protect the duodenum from HCL acid spilling into the SI |
|
|
Term
| SI reflex _______ pushes food from the SI to the colon and occurs primarily from the ENS. |
|
Definition
|
|
Term
| The _______ relfex causes peristalsis to occur in the LI and pushes feces out the rectum to allow for new food to be ingested. |
|
Definition
|
|
Term
| What is the general term for malabsorption in the SI? |
|
Definition
|
|
Term
| Celiacs disease/Non-tropical Sprue is characterized by? |
|
Definition
| gluten sensitivity, that causes irritation, inflammation, and sloughing off of the intestinal cells. |
|
|
Term
| Tropical Sprue is characterized by? |
|
Definition
| inflammation in the SI to viral/bacterial infection aka "montezuma's revenge" |
|
|
Term
| Blind Loop Syndrome is characterized by what? |
|
Definition
| stapling of area of the GI tract and this area became ischemic and died leading to sepsis and death |
|
|
Term
| Dumping Syndrome is characteristic of what type of surgery? |
|
Definition
| gastrectomy or surgical removal of Duodenum |
|
|
Term
| What causes the hypoglycemia associated with dumping syndrome? |
|
Definition
| rapid absorption of sugars elevates BS and pancreas rapidly releases insulin to drop BS |
|
|
Term
| What causes the hypotension/dizziness/syncope/shock-like states with dumping syndrome? |
|
Definition
| high osmo in the intestines draws large volumes of H2O into GI system as it trys to makes the contents isotonic but is unsuccessful.. |
|
|
Term
| Cholera is caused by what bacteria? |
|
Definition
|
|
Term
| Where does the cholera bacteria endotoxins illicit their effects? |
|
Definition
| Crypts of Lieberkuhn (between the villi) |
|
|
Term
| Cholera binds to what in the intestinal cells causing a large amount of Cl- shifting? |
|
Definition
| ATPase pump - causing Cl- to shift rapidly and Na+ follows w/ H2O too fast and this leads to unending diarrhea |
|
|
Term
|
Definition
|
|
Term
| Pancreatic Cholera is similar to the bacteria form, but this type is caused by? |
|
Definition
| CA/Tumor secreting VIP (vasoactive intestinal peptide) |
|
|
Term
| Obstruction at the Pylorus has what kind of vomit? |
|
Definition
|
|
Term
| Obstruction at the duodenum or below has what kind of vomit? |
|
Definition
|
|
Term
| Low obstruction of the GI system causes? |
|
Definition
| constipation and much less vomiting |
|
|
Term
| What are the 2 ancillary organs of the GI system? |
|
Definition
|
|
Term
| The pancreas's exocrine properties are secreted into _______. |
|
Definition
| ductal systems then into blood (as opposed to the endocrine going straight into the blood) |
|
|
Term
| The exocrine portion of the Pancreas is made up of what type of cells? |
|
Definition
| pancreatic acini (island) cells |
|
|
Term
| The pancreatic acini cells secrete enzymes in response to what substances released from the duodenum? (2) |
|
Definition
1. secretin - increases HCO3 release
2. CCK - increases in response to high fat meal |
|
|
Term
| The most common pancreatic enzymes are?(3) |
|
Definition
| 1. amylase - breaks CHO 2. lipase - breaks Lipids 3. Trypsin Family (all breakdown protein - Elastase, carboxypeptidase) |
|
|
Term
| The enzyme Lipase, realeased by the pancreas, is associated with what actions? |
|
Definition
1. break down triglycerides/fats/lipids
2. stimulate Liver to release Bile |
|
|
Term
| How much (%) of the Pancreas is exocrine and how much is endocrine? |
|
Definition
|
|
Term
| Most common cause of Pancreatitis? |
|
Definition
|
|
Term
| The 2nd most common cause of Pancreatitis? |
|
Definition
|
|
Term
| Pancreatitis can be caused by gallstones that get lodged in what area? |
|
Definition
|
|
Term
| Blockage of the Pancreas's spincter of Oddi causes what to occur? |
|
Definition
| digestive enzymes back up into Pancreas, the enzymes begin to eat away at the pancreas and infection/inflammation proceeds |
|
|
Term
| What enzyme does the Pancreas have that attempts to inhbit the digestive enzymes from eating the pancreas? |
|
Definition
| trypsin inhibitor - easily overwhelmed when blockage occurs |
|
|
Term
| What are the 3 sources of CHO in our diet? |
|
Definition
1. sucrose (sugar)
2. Lactose (milk)
3. Starches (complex CHO) |
|
|
Term
| Carbohydrate breakdown starts in the ______ with the activity of ______. |
|
Definition
|
|
Term
| Majority of CHO breakdown occurs in what are of the GI system? |
|
Definition
|
|
Term
|
Definition
| Glucose - taken up into SI > blood > Liver for processing |
|
|
Term
|
Definition
| Galactose then absorbed into cells and converted into glucose and transported to Liver |
|
|
Term
|
Definition
| Fructose is absorbed into intestine and into blood which goes straight to Liver |
|
|
Term
| Pepsin and Acid hydrolysis breaks protein down into? (3) |
|
Definition
1. protease
2. peptones
3. polypeptides |
|
|
Term
| Trypsin and Chymotrypsin further break proteins down into? |
|
Definition
|
|
Term
| Carboxypeptidase further breaks polypeptides down into? |
|
Definition
|
|
Term
| Proteolase forms elastase that breaks down? |
|
Definition
|
|
Term
| Protein breakdown pathway? |
|
Definition
| Protein > (pepsin) > Proteoses, peptones, polypeptides > (trypsin, chymotrypsin, carboxypolypeptidase, proelastase) > polypeptides + Amino Acids > (peptidases) > Amino Acids |
|
|
Term
| All amino acids are pumped across cell membrane via (ion)? |
|
Definition
|
|
Term
| Bile is produced in what organ? |
|
Definition
|
|
Term
| Bile is sotred in what organ? |
|
Definition
|
|
Term
| Bile is injected into the _____ thru the sphincter __ _______ located in the ______ which then ends up in the _______ (part of SI). |
|
Definition
1. Common bile duct
2. sphincter of Oddi
3. located in the Pappila Vater
4. Duodenum (SI) |
|
|
Term
| Bile breaksdown fats into ? |
|
Definition
|
|
Term
| The action of lecithin and bile sats breaking down fats into smaller parts and making them more soluble is called? |
|
Definition
|
|
Term
| Once fat is emulsified , pancreatic Lipase cleaves the triglycerides into? (2 pairs of things) |
|
Definition
1. 2 free fatty acids
2. 2 monoglycerides |
|
|
Term
| Bile salts form a barrier around the FFA and 2M, this barrier allows easy movement within cells, and this is called? |
|
Definition
|
|
Term
| Once the FFA and 2M are absorbed by the villi in the SI they are re-synthesized back into? |
|
Definition
|
|
Term
| The newly reformed triglycerides are taken into the ER of the cells and made into? |
|
Definition
|
|
Term
| The chylomicrons located in the ER are taken up by what system and carried back to the Liver? |
|
Definition
| lympahtics (that dump into Left subclavian vein and right lymphatic duct) |
|
|
Term
| Deficiency in bile salts ability to breakdown fats can cause stools to have a high fat content, this is called? |
|
Definition
| streattorhea (floating poo) |
|
|
Term
| Main function of the Colon is to? |
|
Definition
| reabsorb remaining Na+ and H2O from the stool |
|
|
Term
| The illeocecal valve/sphincter opens in response to? (2) |
|
Definition
|
|
Term
| The ascending Limb of the LI is located on what side of the body? |
|
Definition
|
|
Term
| The descending colon is located on what side of the body? |
|
Definition
|
|
Term
| How long is the LI tract? |
|
Definition
|
|
Term
| The incomplete longitudinal layers (3) in the LI are called? (makes up the bulges) |
|
Definition
|
|
Term
| The LI has 3 forms of movement? |
|
Definition
| 1. myogenic contractions/ haustrations 2. anti-peristalsis 3. peristalsis |
|
|
Term
| Another name for the myogenic contractions seen in the LI that account for the bulging effect durring contraction of the LI? |
|
Definition
|
|
Term
| Anti peristalsis that occurs in the LI is predominantly in the ____ portion and its purpose is? |
|
Definition
1. descending 1/3 of LI
2. reabsorb Na+ and H2O |
|
|
Term
| ___ - ____ cc/day enter the LI and ____cc/day is actually seen in the stool. |
|
Definition
1. 500-700cc/day enters
2. 150cc/day in stool |
|
|
Term
| Intestinal bacteria in the LI is called? |
|
Definition
| Normal Flora (escheria Coli) |
|
|
Term
| The final product of peristaltic rush occurring in the LI? |
|
Definition
|
|
Term
| Total amount of fluid absorbed by the LI per day? |
|
Definition
|
|
Term
| Single pocket or bulge in the LI usually associated with age/poor diet/constipation? |
|
Definition
| diverticuli (inflammation of them is called Diverticultis) |
|
|
Term
| Chronic constipation is called? |
|
Definition
|
|
Term
| Genetic absence of myenteric plexus leading to a lack of peristalsis and decreased moltility most commonly seen in the LI is called? |
|
Definition
| Hirschprung's Disease (megacolon) |
|
|
Term
| Ulcerative colitis is characterized by? |
|
Definition
| inflammation primarily in rectum and descending colon |
|
|
Term
| Chron's disease is characterized by? |
|
Definition
| inflammation of entire colon and some parts of the SI |
|
|
Term
| Defecation reflex is primarily controlled by? |
|
Definition
|
|
Term
| The cortex has some control over defecation and will inhibit nerves at what level in the SC to allow some decision about when to take a crap? |
|
Definition
|
|
Term
| Defecation can also be initiated by contraction of ____ which lowers diaphragm and presses on the LI/bowel. |
|
Definition
|
|
Term
| What % of feces is water and solids? |
|
Definition
|
|
Term
| Of the Solid % of stool what makes up this portion? (4) |
|
Definition
30-35% bacteria
30-35 undigested material (cellulose)
20% fat
10-20@ inorganic material |
|
|
Term
| What is the largest organ in the body not counting the SKM system? |
|
Definition
|
|
Term
| The Liver receives what % of CO? |
|
Definition
|
|
Term
| Of the 1500ml of blood received into the Liver per min, what is the breakdown in mL to each vessel? |
|
Definition
1. 400mL/min from hepatic artery
2. 1100mL/min from portal vein |
|
|
Term
| The liver gets the 1st crack at all the absorbed materials from the GI system expect _____ which eventually ends up in the liver from lymphatic system? |
|
Definition
|
|
Term
| Name the 4 cells of the Liver? |
|
Definition
1. epithelial -leaky
2. parenchymal "hepatic" cells - filters
3. kuppfer cells - macrophages
4. mast cells - heparin is made |
|
|
Term
| The endothelial cells line the _____ of the liver and are characteristically ____. |
|
Definition
1. sinusoids
2. very leaky (allow proteins thru) |
|
|
Term
| The parenchymal "hepatic" cells of the Liver do what? |
|
Definition
filter
(filter glucose, AA, lipids, vitamins, iron....) |
|
|
Term
| The Kuppfer cells in the Liver do what? |
|
Definition
| phagocytic in nature, blood entering the liver has alot of bacteria and these cells clean the blood of all this bacteria |
|
|
Term
| Kuppfer cells use ____ to bind the bacteria and remove it from the blood. |
|
Definition
|
|
Term
| Blood flows from the _____ vein into the liver lubule and ends up in the ______ vein. |
|
Definition
portal vein
hepatic central vein |
|
|
Term
| What is the pressure at the portal vein end in the Liver? |
|
Definition
|
|
Term
| What is the pressure at the hepatic central vein? |
|
Definition
|
|
Term
| What is the structure in the Liver that arterial and venous blood flow along? |
|
Definition
|
|
Term
| what is the path/tributary that blood flows along inside the Liver lobule slowly in order to alows cells here to clean the blood? |
|
Definition
|
|
Term
| Bile made in the lubule is carried out thru closed end vessels called? |
|
Definition
|
|
Term
| what other cells located in the liver can produce bile? |
|
Definition
| parenchymal "hepatic" cells (filters) |
|
|
Term
| Bile flows in what direction compared to blood flow? |
|
Definition
| Bile flows in OPPOSITE direction to blood flow |
|
|
Term
| What is the total fluid volume entering LI? |
|
Definition
|
|
Term
| How much fluid is absorbed by the colon? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| One side of the parenchemal "hepatic" cell works to _______ the blood, while the back side of it secretes substances that make up ______. |
|
Definition
|
|
Term
| Bile flows in the opposite direction within the lobule and this closed end structure is called? |
|
Definition
|
|
Term
| How much lymph flows into circulation per min? of this amount how much is from the Liver? |
|
Definition
|
|
Term
| Area of lymph drainage that surrounds the liver cell plate within the lobule is called? |
|
Definition
|
|
Term
| List the cells that make up the Liver cell plate? (2) |
|
Definition
endothelial - leaky
parenchymal - filter |
|
|
Term
| Functions of the Liver as it pertains to glucose? (3) |
|
Definition
1. synthesis
2. storage
3. breakdown |
|
|
Term
|
Definition
|
|
Term
| List the multiple funx of the Liver? (9) |
|
Definition
1. metabolism of food stuffs
2. glucose synthesis, storage, breakdown
3. blood filtration
4. Vitamin storage
5. Blood resevior
6. makes clotting factors
7. storage of iron
8. synthesis of proteins
9. creates bile salts |
|
|
Term
| Iron in its storage form is called? |
|
Definition
|
|
Term
| Iron in its broken down form that can travel to bone marrow for RBC production? |
|
Definition
|
|
Term
| Fructose can be transformed into ______ another tpye of sugar that is used in ____. |
|
Definition
|
|
Term
| How much of stored glycogen in weight can the Liver store? muscle? |
|
Definition
|
|
Term
| What is significant about the glycogen that is sent to the muscle? |
|
Definition
| only the muscle can use it as energy, cannot be sent to anywhere else |
|
|
Term
| Excess glucose is transformed into ____ and sent to the tissues. |
|
Definition
|
|
Term
| Glycogen structure is a bunch of bound _____ held together by _____. |
|
Definition
|
|
Term
| _________ enzyme breaksdown glycogen into glucose int the Liver (only place this enzyme is present). |
|
Definition
|
|
Term
|
Definition
| production of glucose from non-essential AA |
|
|
Term
| What 4 main structures/organs in the body need glucose to survive? |
|
Definition
1. brain
2. retina
3. renal medulla
4. germ cells (reproductive) |
|
|
Term
| What % of food intake is fat/lipids? |
|
Definition
|
|
Term
| Beta-oxidation is the process of? |
|
Definition
| Liver breaks 2 C off of a FA and attaches it to coenzyme-A |
|
|
Term
| ACetyl CoA is _______ in water and can be further metabolized into _____ which is a much more ______ form. |
|
Definition
insoluble
acetoacetic acid
soluble |
|
|
Term
| Acetoacetic acid is commonly used in what cycle? |
|
Definition
|
|
Term
| The combination of 2 Acetyl-CoA molecules forms acetoacetic acid and this can be further broken down into ______ and _____. |
|
Definition
1. acetone
2. b-hydroxybutyric acid |
|
|
Term
| Ketosis is the conversion of _____ into energy? |
|
Definition
|
|
Term
| What % of glucose in diet is converted to fat? |
|
Definition
|
|
Term
| We cannot live without ______ metabolism. |
|
Definition
|
|
Term
| Deamination of AA is done by the removal of _____ to create _____. |
|
Definition
|
|
Term
| 2 ammonia + CO2 can be combined to form ____ & _____. |
|
Definition
| urea & H2O, which is excreted in the urine |
|
|
Term
| Transamination is the conversion of _____ into other _____ by the aid of an enzyme called ______. |
|
Definition
| AA AA transaminase enzyme |
|
|
Term
| What main plasma protein is made in the Liver? |
|
Definition
|
|
Term
| What Vitamins are stored in the Liver? |
|
Definition
|
|
Term
| Enough Vit A and D is stored in the Liver to last _____ days, and enough B12 for _____months. |
|
Definition
|
|
Term
| Vitamin K is needed for what process? |
|
Definition
|
|
Term
| Where in the SI is bile salts absorbed? |
|
Definition
|
|
Term
| Name 2 common bile salts. |
|
Definition
1. cholic acid
2. chenodeoxycholic acid |
|
|
Term
| What is the primary pigment in bile come from? |
|
Definition
|
|
Term
| name the simple pathway of RBC destruction and its pathway to excretion. |
|
Definition
| Hgb > heme > biliverdin > bilirubin (unconjegated) > conjugate bilirubin aka bilirubin diglucuronide > urobilinogen > ...urine or feces |
|
|
Term
| Conjugated bilirubin is the _____ form. |
|
Definition
|
|
Term
| what gives poop its brown color? |
|
Definition
|
|
Term
| what give urine its yellow color? |
|
Definition
|
|
Term
| The 4 F's of choleolithiasis. |
|
Definition
|
|
Term
| Common gall stones are made of ____ or ____. |
|
Definition
|
|
Term
| What are the 4 types of jaundice? |
|
Definition
hemolytic
hemolytic of newborn
erythroblastosis fetalis
obstructive |
|
|
Term
| What ratio is looked at to diagnose Liver disease? and how does this comparison show liver disease? |
|
Definition
Alb/Globulin ratio
Albumin is only made in liver and globulin is made by immune/lymph system. so if the ratio of alb drops off but globulin is normal than liver disease is evident. |
|
|
Term
| Hep A is not lethal and its incubation period is? and is commonly acquired through? |
|
Definition
15-45days
eating contaminated food/needles also |
|
|
Term
| Hep B/C is very lethal and its incubation period is? this is commonly transferred thru? |
|
Definition
4-26 weeks
dirty needles/drugs... |
|
|
Term
| Phase 2 of swallowing the first step is the apposition of ________ and approximation of _______ that closes off the nares, so that food doesnt come out the nose. |
|
Definition
1. pharyngeal wall
2. uvula & soft pallet |
|
|
Term
| Phase 2 of swallowing most important step (according to the book) is the tight approximation of _____ & ______. |
|
Definition
|
|
Term
| Pepsinogen release is strongly influenced by ______ in the stomach. |
|
Definition
|
|
Term
| Pepsinogen converts to _______ by ______ coming in contact with it. |
|
Definition
|
|
Term
| The part of the Oxynitc/Parietal cell that secretes HCL acid is? |
|
Definition
|
|
Term
| HCL acid has a pH around? |
|
Definition
|
|
Term
| THe pyloric gland located at the ______ in the stomach, has 2 types of cells ______ & ______. The ______ cell secretes ______ that comes back into the circulation and acts on another gland in the stomach called _______. |
|
Definition
1. Antrum
2. mucous & G-cells
3. G cells
4. Gastrin
5. Onxyntic Gland (to produce HCL acid) |
|
|
Term
| Saliva is made from ______ which is isotonic and when its released the saliva is ________. |
|
Definition
|
|
Term
| The ATPase pump located in parietal/oxyntic cells takes how much of our caloric expenditure to funx? |
|
Definition
|
|
Term
| Input from the ______ can activate Chemo-R from motions, driving in a car, flying in a plane, anesthesia. |
|
Definition
|
|
Term
| What drugs can initiate the Chemo-R Trigger Zone in the Medulla. |
|
Definition
|
|
