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trueger
GI phys
70
Medical
Graduate
05/15/2006
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Term
celiac a: embryonic region
 Definition
foregut
Term
SMA: embryonic region
 Definition
midgut
Term
IMA: embryonic region
 Definition
hindgut
Term
foregut a?
 Definition
celiac aa: embryonic region
Term
midgut a?
 Definition
SMA: embryonic region
Term
hindgut a?
 Definition
IMA: embryonic region
Term
foregut->
 Definition
stomach-prox duo
liver, gallbladder, pancr
Term
midgut->
 Definition
distal duo-> prox 2/3 of trans colon
Term
hindgut->
 Definition
distal 1/3 of transverse colon-upper rectum
Term
stomach-prox duo
liver, gallbladder, pancr
embr?
 Definition
foregut->
Term
distal duo-> prox 2/3 of trans colon
embr?
 Definition
midgut->
Term
distal 1/3 of transverse colon-upper rectum
embr?
 Definition
hindgut->
Term
left gastric (PS anas)
 Definition
azygous
esoph varices
Term
sup rectal (PS anas)
 Definition
inf rectal
ext hemorrhoids
Term
paraumbilical (PS anas)
 Definition
inf epiG
caput medusa
Term
retroperitoneal (PS anas)
 Definition
renal & paravertebral
Term
myenteric plexus
 Definition
auerbachs
b/t layers of musc externa
controls motility (PS)
Term
submucosal plexus
 Definition
meissners
regs secr'ns, BF, absorbtion (PS)
b/t mucosa & inner musc wall
Term
auerbachs
b/t layers of musc externa
controls motility (PS)
 Definition
myenteric plexus
Term
meissners
regs secr'ns, BF, absorbtion (PS)
b/t mucosa & inner musc wall
 Definition
submucosal plexus
Term
brunner's glands
 Definition
submuc glands in duo
only submuc glands in GI
secrete alkaline muc: neutr gastric acid

hypertrophy in PUD
Term
peyer's patch
 Definition
unencaps lympoid tissue in LP & submuc of ileum
covered by single cub enterocytes (no gobls) interspersed w. m cells
m cells: take up Ag
stim'd b cells leave-> lymph->blood->LP of int->IgA PCs
Term
liver sinusoids
 Definition
no BM
fen'd
open into space of Disse
Term
submuc glands in duo
only submuc glands in GI
secrete alkaline muc: neutr gastric acid

hypertrophy in PUD

 Definition
brunner's glands
Term
pectinate line
 Definition
where hindgut meets ectoderm
Term
where hindgut meets ectoderm
 Definition
pectinate line
Term
int hemorroids
 Definition
above pectinate line
painless
visc innerv
BS: SRA fr IMA -> SRV->IMV->portal sys
Term
external hemorroids
 Definition
below pectinate line
painful
sq cCA
BS: IRA fr int pud a -> IRV->int pud v -> int il v -> IVC
Term
femoral triangle
 Definition
L-M: NAVEL
Term
femoral hernia
 Definition
entrance of abd contents through femoral canal
protrudes below and lateral to pubic tubercle
Term
entrance of abd contents through femoral canal
 Definition
femoral hernia
protrudes below and lateral to pubic tubercle
Term
protrudes below and lateral to pubic tubercle
 Definition
femoral hernia
entrance of abd contents through femoral canal
Term
femoral sheath
 Definition
fascial tube extending 3-4 cm below ing lig
contains fem a, fem v, and fem canal
canal contains deep ing LNs

fem n outside sheath
Term
borders of femoral triangle
 Definition
ing lig
sart m
adductor longus
Term
bird beak
 Definition
LES achalasia
s/t chagas (t cruzi)
Term
LES achalasia
s/t chagas (t cruzi)
 Definition
bird beak
Term
GI secr products
 Definition
IF
gastric acid
pepsin
bicarb
Term
IF
 Definition
stomach: parietal cells
bind B12 for abs in trm il
autoimmune destr-> chr gastritis & pern anemia
Term
gastric acid
 Definition
stomach: parietal cells
dn stom pH
reg: up w/ histamine, Ach, gastrin
dn w. somatostatin, PG, secretin
Term
pepsin
 Definition
stomach: chief cells
digest protein (pH: 1-3)
reg: up w. vagal stim
acid: pepsinogen->pepsin
Term
bicarb (GI)
 Definition
stomach & duo muc cells
neutr acid, prevent autodigestion
reg: up w. secretin
Term
saliva
 Definition
a-amylase(digest starch)
bicarb (neutr bact acids)
mucins: lube
Term
saliva stim
 Definition
SNS: T1-3 (sup cerv gangl)
PSNS: cnvii & ix

low flow: hypotonic
up flow -> approach isotonic
Term
GI hormones
 Definition
gastrin
cck
secretin
somatostatin
GIP
Term
gastrin
 Definition
antral G cells
up H+, up muc growth, up gastric motility

reg: up w. stom dist'n, aa, peptides (esp trp & phe), cnx
dn w. H+ and pH <1.5

UP in zoll-ellison
Term
CCK
 Definition
I cells in duo & jej
up pancr secr'ns, GB contr'n, up growth of exocrine pancr & GB, dn gastric emptying

reg: dn by secretin & pH<1.5
up w. fat & aa

cholelith: pain w. fatty meals due to CCK
Term
secretin
 Definition
duo S cells
up pancr bicarb, dn acid secr'n

up by acid, fat & duo lumen

bicarb neutrs acid in duo, allowing pancr enzymes to fn
Term
somatostatin
 Definition
D cell in pancr islets, GI mucosa
dn gastric acid & pepsinogen, dn pancr & sm int secrn, dn GB contr, dn insulin & glucagon

reg: up w. acid, dn by CNX

inh hormone, antigrowth to allow digestion & absorption to prep for growth
Term
GIP
 Definition
k cells in duo & jej
exocrine: dn gastric H+
endocrine: up insulin

reg: up by fat, aa, oral glu (nb: only w. all 3!)

GIP: why glu load is used more rapidly if PO than IV
Term
stomach absorbs:
 Definition
etoh
Term
duo absorbs
 Definition
glu (via na-co trans)
vit a & d
fat
fe
ca
Term
prox jej absorbs
 Definition
glu, gal, monosacchs, dissachs
vit a & d
fat
protein & aa
Term
term jej absorbs
 Definition
water-sol vits
disacchs
fat
fat
prot & aa
Term
ileum absorbs
 Definition
prots & aa
vit b12
bile salts

reserve: can absorb more nutrs if necc
Term
colon absorbs
 Definition
water, K, nacl, short fats
Term
etoh absorbed where?
 Definition
stomach absorbs:
Term
glu (via na-co trans)
vit a & d
fat
fe
ca
 Definition
duo absorbs
Term
glu, gal, monosacchs, dissachs
vit a & d
fat
protein & aa
 Definition
prox jej absorbs
Term
water-sol vits
disacchs
fat
fat
prot & aa
 Definition
term jej absorbs
Term
prots & aa
vit b12
bile salts

reserve: can absorb more nutrs if necc

 Definition
ileum absorbs
Term
water, K, nacl, short fats
 Definition
colon absorbs
Term
parietal cell pump
 Definition
passive KCl excr
then H/K atpase
Term
parietal cell Rs
 Definition
H2, M3, gastrin, PG (i2 & e2)
Term
pancr enzymes
 Definition
a-amylase(digest starch)
lipase, PLA, colipase (fat digestion)
proteases (trypsin,elastase etc): secr'd as zymogens

trypsinogen act'd by enterokinase(duo brush border)
trypsin then acts others (pos feedback)
Term
pancr insuff
 Definition
seen in CF et al
malabs, steatorrhea
tx:dn fat intake, monitor ADEK defs
Term
what sugars are absorbed?
 Definition
only monos! (glu, gal, fruc)
Term
salivary amylase
 Definition
a1-4->dissachs
maltose, maltotriose, a-limit dextrans
Term
pancr amylase
 Definition
mostly in duo
starch->oligo & disacchs
Term
oligosacc hydrolases
 Definition
BB
rate lim
oligo & di -> mono sacchs
Term
direct BR
 Definition
conj'd to glucoronic acid
watersoluble
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