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74 Cards in this Set
- Front
- Back
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What are Peyer's patches?
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Unencapsulated lymphoid tissue in lamina propria and submucosa of SI
Contain specialized M cells that take up Ag |
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What do B-cells stimulated in Peyer's differentiate into?
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IgA secreting plasma cells that live in lamina propria
IgA gets secreted across epithelium to handle intraluminal Ag |
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Which salivary gland is the most serous? most mucinous?
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Parotid is most serous
Sublingual is most mucinous |
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Fxns of Saliva?
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1. alpha-amylase begins starch digestion
2. Bicarb neutralizes oral bacterial acids maintaining dental health 3. Mucins lubricate food 4. Antibacterial secretory products 5. GF's promote epithelial renewal |
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how do salivary (alpha) amylases get inactivated?
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low pH in stomach
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what are mucins?
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glycoproteins
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What stimulates Salivary Secretion?
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SANS:
T1-T3 superior cervical ganglion PANS: facial and glossopharyngeal nerves |
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How does low flow rate and high flow rate change saliva?
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Low flow rate allows more time to reabsorb water--->hypotonic
High flow rate--->closer to isotonic |
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What can be damaged during Parotid gland surgery?
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CN VII (facial)
it runs right through it |
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What are Brunner's Glands? fxn? location?
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Duodenal Submucosal (only GI submucosal gland) that secretes alkaline mucus to neutralize acid from stomach
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Pathologic sign w/ Brunner's Glands?
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Hypertrophy seen w/ PUD
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Who are the 8 GI hormones?
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Gastrin
Cholecystokinin Secretin Somatostatin GIP (glucose-dependent insulinotropic peptide) VIP (vasoactive intestinal polypeptide) Nitric Oxide Motilin |
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Source of GI hormones?
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Gastrin : G cells in antrum
Cholecystokinin : I cells in duo and jeju Secretin : S cells in duo Somatostatin : D cells in pancreatic islets and GI mucosa) GIP : K cells in duo and jeju VIP : PANS ganglia in sphincters, gallbladder, and SI Nitric Oxide Motilin : SI |
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Fxns of Gastrin?
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Inc Gastric acid secretion
Inc Growth of gastric mucosa Inc gastric motility |
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Regulation of Gastrin?
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Inc by stomach distention, AA's, peptides, vagal stimulation
Dec by stomach pH < 1.5 |
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2 most potent AA's for gastrin secretion?
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Tryptophan
Phenylalanine |
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Pathologic condition involved Inc gastrin?
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Z-E
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Fxns of Cholecystokinin?
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Inc pancreatic secretions
Inc gallbladder contractions Dec gastric emptying |
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Regulation of Cholecystokinin?
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Inc by FA's and AA's
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What does Cholecystokinin do during Cholelithiasis?
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Causes the increased pain after eating fatty foods
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Fxns of Secretin?
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Inc pancreatic bicarb secretion
Dec gastric acid secretion Inc bile secretion |
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Regulation of Secretin/
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Inc by acid and FA's in duodenal lumen
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GI Fxns of Somatostatin?
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Dec gastric acid and pepsinogen secretion
Dec pancreatic and SI fluid secretion Dec gallbladder contraction Dec insulin and glucagon release |
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Regulation of Somatostatin?
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Inc by acid
Dec by vagal stimulation |
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When is somatostain used pharmicolgically?
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VIPoma
Carcinoid tumors |
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Fxns of GIP?
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Exocrine: dec gastric acid secretion
Endocrine: inc insulin release |
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Regulation of GIP?
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Inc by FA's, AA's, and oral Glucose
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Fxn's of VIP?
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Inc intestinal water and electrolyte secretion
Inc relaxation of intestinal smooth muscle and sphincters |
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Regulation of VIP?
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Inc by distention and vagal stimulation
Dec by adrenergic input so it promotes digestion |
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What's up with a VIPoma?
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non-alpha, non-beta cell pancreatic islet cell tumor that secretes VIP
Sx: copious diarrhea |
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GI Fxns of NO?
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Inc smooth muscle relaxation INCLUDING LES
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What is loss of NO secretion implicated in?
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Achalasia (megaesophagus)
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Fxn's of Motilin?
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Produces Migrating Motor Complexes
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Regulation of Motilin?
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Inc in the fasting state
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4 upper GI secretory Products?
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Intrinsic Factor
Gastric Acid Pepsin HCO3 |
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Sources for upper GI secretory products
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IF: Parietal cells (stomach)
Gastric Acid: Parietal cells (stomach) Pepsin: Chief Cells (stomach) BiCarb: Mucosal Cells (stomach, duo) and Brunner's Glands (duo) |
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Fxn of IF?
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Vitamin B12 binding protein (required for uptake into terminal ileum)
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Pathological issue w/ IF?
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Autoimmune destruction of parietal cells---> dec If---> pernicious anemia
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Fxns of gastric acid?
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Dec stomach pH
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Regulation of Gastric Acid?
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Inc by histamine, ACh, and gastrin
Dec by somatostain, GIP, PG's, and secretin |
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What is a gastrinoma?
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Gastrin secreting tumor--> continuous high levels of acid secretion--->ulcers
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Fxn of pepsin?
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Protein digestion
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Regulation of Pepsin?
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Inc by vagal stimulation and local acid
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How is pepsin made?
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Pepsinogen--->pepsin by H+
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Fxns of Bicarb?
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Neutralize acid
Prevent autodigestion |
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Regulation of HCO3?
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Increased by secretin
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How do ACh and Gastrin stimulate Acid secretion?
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Gq coupled receptors--->IP3 and Ca---> activates K/H ATPase to pump H into lumen
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How does Histamine stimulate Acid Secretion?
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H2 receptor--->cAMP --->activates K/H ATPase
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what do the pancreatic enzymes help digest
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Carbohydrates
Fats Proteins |
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what does the pancreas secrete that helps w/ carb digestion?
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alpha-amylase--> starch digestion
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what does the pancreas secrete that helps w/ Fat digestion?
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Lipase
Phospholipase A Colipase |
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what does the pancreas secrete that helps w/ Protein Digestion?
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PROTEASES:
trypsin chymotrypsin elastase carboxypeptidase |
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Who do all the pancreatic proteases get activated?
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they're all secreted as proenzymes (zymogens)
Trypsingoen--->Trypsin by Enterokinase/Enteropeptidase (from duo mucosa). Trypsin then activates all the other proenzymes (positive feedback) |
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Which enzymes are used in Carbohydrate Digestion?
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Salivary Amylase
Pancreatic Amylase Oligosaccharide hyrdolases |
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fxn of salivary amylase?
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hyrdolyzes alpha-1,4 linkages-->disaccharides
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Who are the disaccharides?
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Maltose
Maltotriose alpha-limit dextrans |
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Fxn of pancreatic amylase?
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Hydrolyze starch to oligosaccharides and disaccharides
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Location of oligosaccharide hydrolases?
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BB
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Fxn of Oligosaccharide hydrolases?
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Produce monosaccharides from oligo's and di's
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rate-limiting step of carb digestion?
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Oligosac hydrolase hydrolysis
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Who do monosaccharides get from GI lumen to blood?
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Glu and Gal are taken up by SGLT-1 (Na-dep)
Fru is taken up by facilitated diffusion via GLUT5 All are transported into blood by GLUT2 |
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How and where is Iron absorbed?
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Fe-2+
in duodenum |
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Where is Folate absorbed?
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Jejunum
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How and Where is B12 absorbed?
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Ileum w/ Bile Acids and thanks to IF
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Composition of Bile?
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Bile Salts**
Phospholipids Cholesterol** Bilirubin** Water Ions |
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For what is bile the only method to excrete it?
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cholesterol
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What are bile salts?
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Bile acids conjugated to glycine and taurine, which makes them water soluble
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Where does bilirubin come from?
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Heme metabolism
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What are the steps of bilirubin formation and excretion? location of steps too
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MACROPHAGES
RBC--->heme--->Unconjugated Bilirubin BLOODSTREAM Unconjugated Bili + Albumin = Indirect Bilirubin LIVER Uridine Glucuronyl Transferase converts Unconjugated to Conjugated = Direct Bilirubin GUT Direct Bili comes out in Bile Gut bacteria turn Direct Bili into Urobilinogen Urobilinogen is either pooped out, enters EHC, or goes to kidney In kidney, Urobilinogen--->Urobilin and is peed out |
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General characteristic of Salivary Gland Tumors?
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Benign
Parotid gland |
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Types of Salivary Tumors?
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Pleomorphic Adenoma (most common)
Warthin's Tumor Mucoepidermoid Carcinoma |
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Characteristics of Pleomorphic salivary adenomas?
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Painless, movable mass
Benign High rate of recurrence |
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Characteristics of salivary Warthin's Tumor?
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Benign
Heterotrophic salivary gland tissue trapped in LN surrounded by lympathic tissue |
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Characteristics of mucoepidermoid carcinoma?
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most common malignant tumor
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