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61 Cards in this Set
- Front
- Back
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Tongue
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1 made of muscle
2 named by direction 3 verticalis 4 muscles that move tongue end w/ glossus 5 innervated CN XII 6 allows food to be mixed & assists w/ swallowing |
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Verticalis (in tongue)
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1 superior longitudinal
2 inferior longitudinal 3 transverse |
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Teeth
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upper jaw: 3m,2p,1c,2i X 2=32
lower jaw: 3m,2p,1c,2i X 2=32 64 total Fx:bite,tear,puncture & chew |
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Salivary Gland Facts
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1 Everything paired=6 glands
2 1.5 liters of saliva secreted daily |
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Salivary Gland contains...
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1 parotid gland
2 submandibular gland 3 sublingual gland |
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Salivary Gland:Parotid gland
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1 100% serous
2 mixed gland 3 largest salivary gland 4 contributes saliva when eating 5 parotid duct(stenson's duct)opening is at the upper level 2nd molar tooth. 6 innervated by parasympathetic nerves |
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Salivary Gland:Submandibular
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1 mixed (mostly serous)
2 produces daily saliva |
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Salivary Gland:Sublingual
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1 mixed (mostly mucous)
2 Sjogren disease- AI disease characterized by blue bumps under the tongue (stones in sublingual duct) |
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Esophagus
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1 Tube that moves food down to the stomach
2 Lined by stratified squamous epithelium 3 Has mucous glands 4 2 layers of muscle: outer longitudinal & inner circular 5 perstalsis- rhythmic movement to push food down |
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Concept of G.I tract
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1 Mucosa- has epithelium
2 Submucosa- blood vessels & nerves 3 Muscularis- muscle to move the food 4 Serosa- outermost layer |
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Stomach contents
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1 cardia
2 cardiac notch (incisure) 3 fundus-housed by air 4 body 5 greater curvature 6 lesser curvature-has angular notch 7 pyloric sphincter- end of stomach 8 pylorus- antrum & canal 9 duodenum |
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Stomach (internal)
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1 rugae-folds inside stomach increase surface circumfrence
2 gastric gland and pit |
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Stomach wall has ___ layers
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3 layers:outer longitudinal,inner circular &innermost is oblique
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Gastric gland & pit contents
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1 mucous barrier
2 surface mucous cells 3 gastric pit-entrance to gland 4 Surface neck mucous cell 5 parietal cells 6 chief cells(zymogenic) 7 chromaffin cells |
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Mucous barrier
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prevents acid from eating the epithelium
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Surface mucous cells
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made of simple columnar epithelium. Secrete mucous
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surface neck mucous cell
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produces plug of mucous. The plug of mucous covers the pit so the acid can’t go inside.
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Parietal cells (in body of gland) secretes:
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1 HCL (ph 1-1.3)
2 Intrinsic factor:carrier for extrinsic factor (EF or colobamin = Vit B12) |
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EF-IF Complex
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EF-IF Complex→ s.intestine→ blood→ liver(Vit.B12 stored in liver)
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Lack of IF causes...
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Vit.B12 to be excreted and leads to Pernicious Anemia (lack of IF)
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Chief Cells (zymogenic cells) secretes...
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1 Pepsinogen- inactive proteolytic enzyme In the presence of HCL, pepsinogen changes to:
* Pepsin- powerful proteolytic enzyme that digests protein |
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chromaffin cells
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located only on bottom of gland. Silver stained cell. Secretes the hormone:
1 Seratonin (5 hydroxytryptamine)- secreted into the blood & regulates blood supply to the gland |
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Vascularization of stomach
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1 lesser curvature
2 greater curvature 3 fundus |
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lesser curvature (vascularization)
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1 Lf gastric artery → stomach
2 Rt gastric artery 3 Common hepatic artery → liver stomach ii. Rt gastric artery iii. Common hepatic artery ® liver |
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greater curvature(vascularization)
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1 Lf gastroepiploic artery
2 Rt gastropepiploic artery |
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Fundus (vascularization)
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1 Short gastric artery
2 Splenic artery → spleen |
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Stomach innervation:sympathetic
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1 Constipation
2 Closure of cardiac & pyloric sphincters 3 ↓Peristalsis 4 ↑Mucus secretion |
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stomach innervation:parasympathetic
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1 Diarrhea
2 Open cardiac & pyloric sphincters 3 ↑perstalsis 4 ↑HCI secretion |
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stomach innervation: sensory
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Travel w/ sympathetic & parasympathetic fibers, associated w/ T-7 & T-8 spinal chord nerves (pain).
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Stomach clinical applications
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1 gastritis
2 peptic ulcer 3 stomach carcinoma |
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gastritis
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inflammation of intestinal lining (epithelium) of stomach caused by excessive alcohol intake or excessive intake of spices.
i. Epigastric pain aggravated by eating. |
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peptic ulcer
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erosion of mucosa of GI tract that is in contact w/ acid. Caused by bacteria called H.Pylori
i. Epigastric pain on an empty stomach. Relieved by food, antacids or vomiting ii. Commonly in lesser curvature iii. Ulcer in greater curvature can turn into stomach cancer |
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stomach carcinoma(cancer)
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linked by excessive intake of nitrites or packaged meats, over time.
i. Patients over 40 y.o ii. Blood in stool iii. Commonly in greater curvature iv. #1 carcinogenic product = bacon |
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Biliary Tract contents
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1 Hepatic Ducts (2)
2 Common hepatic duct- when two hepatic ducts join 3 Cystic Duct- attached to gallbladder 4 Common bile duct- where the cystic duct & common hepatic duct meet 5 Main pancreatic duct 6 Ampulla of Vater 7 Duodenal Papilla (Sphincter of Oddi) |
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Bile
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secreted by hepatocytes, it drains into the gallbladder for storage. Bile emulsifies fat for better absorption by the s. intestine
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Bile facts
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1 99.9% of fat is absorbed by the s. intestine wall → blood w/ out expenditure of energy
2 0.01% 3 Bile represents the exocrine function of the liver. 4 Bile secreted from liver is alkaline 5 Bile made of cholesterol + fatty acids 6 Bile eliminates cholesterol through the stool 7 Bile gives stool green/yellow color w/ out it, stool is white = fat comes out (Steatorrhea) 8 Bile sitting too long in the GB w/ out coming out may precipitate |
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Gallbladder
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1 Presence of fat in stomach or duodenum makes the gallbladder contract
2 Fx of GB wall is to take the bicarbonate ions away made by acid (bicarbonate ions turn into gallstones |
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Steatorrhea
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fatty stool caused by stone in common bile duct
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Classic features of patient w/ GB stone (6 “F” patient)
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1 Female
2 40 y.o 3 Fertile 4 Fair complexion 5 Fat 6 Flatulance |
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Gallstones caused by....
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fatty diets, crash diets (fasting), by taking lithogenic hormone (type of estrogen that promotes gallstone formation)
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Liver & Pancreas Similarities
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1 Arise from embryonic stage from the primitive gut
2 Mixed glands (exocrine and endocrine). 3 Share common terminal duct 4 Target organs of each other (**blood sugar homeostasis) |
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Endocrine/exocrine fx = hormone → blood
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1 Exocrine → secretion → duct → cavity (i.e stomach)
2 Endocrine = ductless system (secretion → blood) |
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Exocrine requires
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ducts
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endocrine have
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no ducts
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liver (exocrine/endocrine)
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1 Exocrine fx- bile secretion
2 Endocrine fx- release of glucose (converted from glycogen <stored sugar>) → blood *Liver stores glycogen, converts it to glucose → blood* *Proteins made by liver end w/ (-in…albumin, globulin etc) |
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pancreas (exocrine/endocrine)
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1 Exocrine fx- secretes digestive enzymes (-ase)
2 Endocrine fx *Insulin- hypoglycemic agent (brings ↓ blood sugar) *Glucagon- hyperglycemic agent (brings ↑ blood sugar) *Blood sugar must be between 90mg/100ml |
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How Pancreas controls blood sugar level (homeostasis)
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1 ↑Blood sugar level → beta cell of pancreas ~~>insulin →blood → body cells take up more glucose + liver takes up glucose and stores it as glycogen = blood glucose ↓
2 ↓ Blood sugar level → alpha cells of pancreas ~~> glucagons →blood → liver breaks down glycogen and releases glucose to the blood → blood glucose level ↑ |
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DM Type 1 (IDDM)
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3 Skinny Body
4 Req. insulin shot 5 Frequent complications 6 Diabetic retinopathy a Diabetic nephopathy b Diabetic neuropathy c Diabetic cardiovascular problems *Arteriosclerosis *Hypertension d Ketoacidosis e Gangrene |
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DM Type 2 (NIDDM)
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1 Older adults
2 Caused by bad diet 3 Overweight 4 Managed by diet, if not successful, insulin shot req. 5 May have complications |
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DM Classic Signs 3 “P”s
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1 Polyphagia
2 Polydypsia 3 Polyuria |
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Liver features
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1 4 lobes
2 falciform ligament-membrane between Rt. Lobe & Lf. Lobe 3 Round ligament of the liver (Ligamentum teres hepatis) 4 Porta Hepatis (gate of liver) |
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liver lobes
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1 Rt. Lobe- largest lobe
2 Lf. Lobe 3 Quadrate lobe (square)- next to GB 4 Caudate lobe (tail)- smallest lobe, next to IVC |
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Round ligament of the liver (Ligamentum teres hepatis)
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housed by Falciform ligament
1 Before birth Round ligament of liver was the Lf. Umbilical vein, which carries the blood from the placenta to the child, bypassing the liver (so mother can have clean blood) |
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Porta Hepatis (gate of liver)
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houses:
a. Portal vein b. Hepatic artery c. Common bile duct d. Autonomic nerves (3) & lymph vessels |
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Hepatic veins are __ found in the Porta Hepatis because...
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1 NOT
2 they begin in the liver and drain the blood into the IVC. |
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liver innervation (symp)
*fight or flight |
1 Liver will convert glycogen (stored sugar) into glucose = blood sugar ↑(hyperglycemia)
1 If in danger the blood passing through the liver must increase to carry all the sugar out of the muscle = ↑ blood flow |
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liver innervation (para)
*digestion |
1 Travels w/ Vagus nerve (CN X)
2 Bile secretion 3 Enterogastrone reflex- triggered by presence of fat in the stomach or duodenum = controls GB contraction |
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liver innervation (sensory)
*pain |
1 Pain in Rt. Side of back, costal area or Rt. Shoulder if liver or GB is diseased
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Pancreas parts
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1 Held by duodenum
2 Head 3 Neck 4 Body 5 Tail 6 Uncinated process (trigger)- covered by blood vessels (superior mesenteric vessels) 7 Superior Mesenteric Vessels- cover the uncinated process 8 Main pancreatic duct 9 Accessory pancreatic duct |
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Pancreas:Endocrine Function (to maintain BS homeostasis)
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1 Beta cells secrete insulin to lower blood sugar
a. Secreted when blood sugar is high b. Deficiency of insulin = diabetes mellitus 2 Alpha cells secrete glucagon to elevate blood sugar a. Secreted when blood sugar is low 3 Normal blood glucose level = 90mg/100ml a.180-200 = borderline diabetes b.200+ = diabetic c.< 60 = hypoglycemic |
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Pancreas:Exocrine Function (digestive enzyme “-ase”)
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1 ↑Amylase in blood = pancreatitis (caused by alcoholism)
2 Bicarbonate ion fluid- it neutralizes the chyme (an acid that comes from stomach and goes down the duodenum) |
