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136 Cards in this Set

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Greater Peritoneal Sac
located in the anterior, in front of all the “intraperitoneal” organs
Lesser Peritoneal Sac
located in the posterior, behind the stomach
Falciform Ligament
attaches the liver to the anterior ventral body wall; contains the Ligamentum Teres
Greater Omentum
“fatty apron” that hangs from the bottom of the stomach’s Greater Curvature
Lesser Omentum
connects both the liver & gall bladder to the stomach’s Lesser Curvature

separates the Greater & Lesser Peritoneal Sacs

contains the hepatic triad
Hepatic triad
hepatic portal vein, hepatic artery, common bile duct
Retroperitoneal Organs
located behind the posterior dorsal body wall…
• pancreas
• kidneys + adrenals
• duodenum (most of it)
• descending + sigmoid colon
• abdominal aorta
• inferior vena cava
• thoracic esophagus
Intraperitoneal Organs
those that are located totally within the peritoneal cavity…
• liver
• gall bladder
• spleen
• stomach
• jejunem + ileum
• ascending colon + cecum + appendix
• transverse colon
• abdominal esophagus
Pancreas
exocrine function = secretes enzymes for lipid & protein digestion

endocrine function = secrete insulin & glucagon hormones to regulate blood glucose

Head lies against duodenum
Tail lies against spleen & left kidney
Liver
produces bile (gall bladder stores it)
Hepatic Artery
brings oxygenated blood from the heart to the liver
Hepatic Portal Vein
brings de-oxygenated blood w/ absorbed nutrients from the small intestine to the liver
Hepatic Vein
drains the liver of its de-oxygenated blood and continues as the IVC
Gall Bladder
seen off of liver’s right lobe

secretes bile (liver produces it)
Spleen
involved in RBC & WBC formation

NO digestive function
Esophageal Hiatus
hole in the diaphragm thru which the esophagus passes from the thoracic cavity into the abdominal cavity
Cardiac Sphincter
lower esophageal sphincter that prevents regurgitation of gastric contents
Cardia of Stomach
where food enters from the esophagus

contains the Cardiac Sphincter = regulates the entrance of food into the stomach
Fundus (orad) of Stomach
a small temporary storage area where food remains unmixed w/ HCl
Body (caudad) of Stomach
where most of the mechanical & chemical digestion of chyme occurs
Pyloris (antrum) of Stomach
where food gets emptied into the duodenum

where food gets emptied into the duodenum
Rugae
longitudinal folds of the mucosa

functions to increase surface area for chemical digestion & provide a rough texture for mechanical digestion
Gastric Pits
little pores in the mucosal rugae of Stomach

Gastric glands empty their secretions (enzymes, acid, mucus) into lumen
Duodenum
C-shaped loop to accommodate the pancreas head

mixes food from the stomach w/ bile secretions from the gall bladder

Contains Brunner Glands to secrete mucous

Contains outer longitudinal and inner circular smooth muscle
Brunner Glands
located in the submucosa of duodenum instead of the lamina propria like most other glands are

Produces mucous secretion to protect duodenum from chyme acidity
What are the only places in the digestive tract that has glands in the submucosa
Duodenum and middle 1/3 of esophagus
Jejunem
primary responsibility = completion of chemical digestion

Contains Plicae Circulares to increase digestive surface area as well as Villi
Ileum
primary responsibility = completion of absorption of nutrients

Contains Peyer’s Patches = areas of lymphoid tissue

M-cells = cells of patches that signals immune system
Peyer’s Patches
Areas of lymphoid tissue that is unique to the ileum only
Large Intestine
primary function = absorption of water & vitamins

Contains:
Teniae Coli (3 longitudinal layers of muscularis externa)

Haustra (pouches)

Epiploic Appendages (fat lobules)

Goblet cells

Lymphoid tissue
Where can the highest number of goblet cells be found in the digestive tract
Large Intestine

Secrete mucus to aid in passage of fecal matter
Where cant he highest concentration of lymphoid tissue be found in the GI tract
Large Intestine

Due to the enormous amounts of bacteria
Teniae Coli
3 longitudinal thickened bands of the muscularis externa layer

runs along the entire length of large intestine
Haustra
pouches of the large intestine due to the tension of the teniae coli
celiac artery
supplies foregut structures = stomach, some duodenum, liver, gall bladder, spleen
What supplies foregut structures
Celiac Artery
Name foregut structures
stomach, some duodenum, liver, gall bladder, spleen
superior mesenteric artery
supplies midgut structures = jejunem + ileum (mesenteric loops), ascending & transverse colon, pancreas
what supplies midgut structures
superior mesenteric artery
Name midgut structures
jejunem + ileum (mesenteric loops), ascending & transverse colon, pancreas
inferior mesenteric artery
supplies hindgut structures = transverse + descending + sigmoid colon, rectum
What supplies hindgut structures
inferior mesenteric artery
name hindgut structures
transverse + descending + sigmoid colon, rectum
Phrenic arteries
Paired

supplies diaphragm
Adrenal arteries
3 Pairs because extensive vasculature is needed to transport endocrine hormones

supplies the adrenal glands
External Iliac
Branch of Common Iliac

Supplies lower limbs
Internal Iliac
Branch of Common Iliac

Supplies pelvic organs
Hepatic Portal Vein receives drainage from what structures?
- inferior mesenteric vein
- superior mesenteric vein
- splenic veins
- gastric veins
major pelvis
AKA false pelvis

contains ONLY the sigmoid colon
minor pelvis
AKA true pelvis

contains everything else but Sigmoid Colon (Ex: sexual organs)
What is the autonomic innervation to foregut
Sympathetic - Celiac Ganglion
Parasympathetic - Vagus
What is the autonomic innervation to midgut
Sympathetic - Superior Mesenteric Ganglion
Parasympathetic - Vagus
What is the autonomic innervation to hindgut
Sympathetic - Inferior Mesenteric Ganglion
Parasympathetic - Pelvic Splanchnic Nerve
epithelium of oral cavity, oropharynx, upper esophagus, anal canal
Stratified squamous
epithelium of stomach, small & large intestines
Simple columna
WHich layer is the thickest in the esophagus
Muscularis Interna layer of Mucosa
Which layer is substituted by an elastic layer in the oropharynx
Muscularis Interna layer of Mucosa
WHere is the Meissner Plexus found
Found in Submucosa layer
Meissner Plexus
innervates the smooth muscles of the muscularis interna up above to squeeze glands & move villi

Found in Submucosa layer
Muscularis Externa
Contains
Inner circular layer
Outer longitudinal layer
Auerbach's Plexus
Auerbach's Plexus
located in b/t the layers of muscle in Muscularis Externa layer

innervates Muscularis Externa for contractions for peristalsis
Oropharynx
MUCOSA
stratified squamous epithelium
Dense elastic layer replaced muscularis interna

SUBMUCOSA
missing

MUSCULARIS EXTERNA
Skeletal muscle

ADVENTITIA
Esophagus
MUCOSA
Non-keratinized stratified squamous epithelium
Langerhan Cells in Lamina Propria
Mucous Glands in Lamina Propria (Upper and Lower 1/3)
Thickest Muscularis Interna

SUBMUCOSA
Mucous glands (middle 1/3)

MUSCULARIS EXTERNA
Skeletal muscle (upper and middle 2/3)
Smooth muscle (middle and lower 2/3)

ADVENTITIA
Thoracic Esophagus

SEROSA
Abdominal Esophagus
What layers contributes to the esophagus's longitudinal folds
Mucosa and Submucosa
Stomach
MUCOSA
simple columnar epithelium
Vascular Lamina Propria
Gastric Pits
Rugae
Meissner Plexus in Muscularis Interna

SUBMUCOSA
missing

MUSCULARIS EXTERNA
3 layers of smooth muscle (inner oblique, middle circular, outer longitudinal)
Pyloric Sphincter has extra thick inner circular layer

SEROSA
Surface Mucous Cells of Stomach
Taller simple columnar cells

Forms thick mucus for lubrication & protection against abrasion
Neck Mucous Cells of Stomach
Shorter simple columnar cells

secretes a thinner, more soluble mucus for lubrication & protection against acid attack
Parietal Cells
Found in Stomach

very large, triangular/oval-shaped, eosinophilic cells w/ lots of microvilli and 40% mitochondria

secretes Castle’s Gastric Intrinsic Factor for absorption of Vitamin-B12

Produces ingredients for HCl
Castle’s Gastric Intrinsic Factor
Secretes by Parietal cells

for absorption of Vitamin-B12 in colon

Deficiency of cells/factor leads to pernicious anemia
Chief Cells
Located in Stomach

serous granular cells

secretes Pepsinogen to digest proteins

Secretes Renin to digest milk proteins
Pepsinogen
Secreted by Chief Cells

Activated by HCl into Pepsin

Digests proteins
Renin
Secreted by Chief cells

Digests milk proteins
Argentaffin Cells
Located in Stomach

stain w/ metallic silver & chromium

Includes:
G-cells - produces Gastrin
A-cells - Secretes Enteroglucagon
D-cells - Secretes Somatostatin
EC cells - Secretes Serotonin
ECL cells - Stimulates gastric secretions
APUD cells - Decarboxylates amino acids
G-cell
Argentaffin Cells in Stomach

Stimulated by protein, distension, feeding

Produces:
Gastrin to stimulate Parietal cells

Promote gastric motility, decreases emptying

Promote mucosal cell growth
Gastrin
Secreted by G-cells

Stimulates Parietal cells to secrete HCL

Promotes Gastrin motility
A-cell
Argentaffin Cells in Stomach

Secretes Enteroglucagon to increase blood glucose
Enteroglucagon
Secreted by A-cells

Increases blood gluocose lvels

Same function as hepatic glucagon
D-Cell
Argentaffin Cells in Stomach

Stimulated by Acid

Secretes Somatostatin to inhibit G-cell
Somatostatin
Produced by D-cells

Inhibits G-cell secretion of Gastrin

Therefore lowers HCl and decreases acidity of stomach
EC Cell
Argentaffin Cells in Stomach

Secretes Serotonin to stimulate Muscularis Interna
Serotonin
Secretes by EC-cells

Stimulates Muscularis Interna to squeeze glands in Lamina Propria and move villi back and forth

Increases gastric motility
ECL Cell
Argentaffin Cells of Stomach

Stimulated by Gastrin

Secretes Histamine to increase Gastric secretions
APUD Cell
Argentaffin Cells of Stomach

Decarboxylates A.A to make digestive hormonese
Pit:Gland Ratio of Stomach
cardia = 1:1 ratio (pit and gland are equal heights)

fundus + body = 1:3 ratio (pit is shorter than the gland)

pyloris = 3:1 ratio (pit is taller than the gland)
Gland Position of Stomach
Cardia and body have straight glands

Pyloris has convoluted glands
What area of the stomach has the widest lumen
Pyloris
What structures increase surface area of the small intestine
Plicae Circularis

Villi

Microvilli (Straited border)
Crypts of Lieberkuhn
Dips between villi in Small Intestine

Lined by simple columnar cells, EC cells and Paneth cells
What is the core of Plicae Circularis
Submucosa
What is the core of Villi
Lamina Propria
How does large intestine differ from small intestine
Shorter length

Wider lumne

Thicker mucosa

Thinner Lamina Propria

Purely absorption (no digestion)

No Plicae, villi, or brush border (but does have Crypts)

Tons of goblet cells and lymphatics
Anal Canal
MUCOSA
Transitions from Simple Columar to Simple squamous
Anal Columns (longitudinal folds)
No Muscularis Interna

SUBMUCOSA
Hemorrhoidal plexus of blood vessels

MUSCULARIS EXTERNA
Smooth muscle (Internal anal sphincter)
Skeletal muscle (External anal sphincter)
Histamine
Secretes by ECL Cell

Stimulates Gastric Secretions
I Cells
Cells of Small Intestine

Stimulated by Protein and Fat

Secretes Cholecystokinin to stimulate pancreas (bicarbonate) and gallbladder (bile)
Mo-Cells
Cells of Small Intestine

Stimulated by Fat and Acid

Secretes Motilin to cause GI Motility Waves
S-Cells
Cells of Small Intestine

Simulated by Acid and Fatty Acids

Secretes Secretin to stimulate Pancreas (bicarbonate), Liver (bicarbonate), and stomach (Pepsin)
Cholecystokinin (CKK)
Secreted by I-Cells

Stimulates Gallbladder to release Bile

Stimulates Pancreas to release bicarbonate
Motilin
Secreted by Mo-cells

stimulate gastric activity
Secretin
Secreted by S-cells

Regulates pH of duodenal contents via control of gastric acid secretion and buffering with bicarbonate from pancreas
VIP
Vasoactive Intestinal Peptide

Released by Nerves

Relaxes smooth muscles

Increases Interstitial Secretion

Increases Pancreatic Secretions
GRP
Gastric Releasing Protein (BOMBESIN)

Released by Nerves

Causes stimulates G-cell to increase Gastrin release
Slow Waves
oscillations in resting membrane potential of smooth muscle

AP build up slow waves to lead to Contraction

Calcium Dependent
Phasic Contraction
Short duration (seconds)

Occurs in esophagus, antrum stomach, small intestine
Tonic Contraction
long duration (up to hours)

Occurs in cardiac sphincter, pyloric sphincter, ileocecal sphincter, internal anal sphincter
pharyngoesophageal sphincter
prevents air from entering at the upper end of esophagus
gastroesophageal sphincter
prevents gastric contents from regurgitating at the lower end of esophagus
receptive relaxation
vasovagal reflex

causes the stomach muscles to relax and stretch to accommodate large volume of food
what increases contractile force & frequency?...
• Vagus parasympathetic innervation
• Gastrin
• Motilin
what decreases contractile force & frequency?...
• sympathetic innervation
• Secretin
• GIP
Where do slow waves start
At orad-caudad border

They increase in velocity and amplitude as it spreads to gastroduodenal junction
Retrorepulsion
gastric contents hit upon the closed pyloric sphincter

Causes backflow & mixing
migrating motility complex
propels gastric contents + mucus into the duodenum clearing out stomach in between meals

Act of eating stops this
Enterogastric Reflex
receptors in Duodenum

Sense osmolarity, pH, lipid content, and gastric contents

Controls gastric motility and gastric emptying
migrating motor complex
NOT migrating motility complex

contractions occur throughout the length of the entire small intestine during fasting

sweeps sweep undigested material through the system
segmentation
mixing of contents b/c there is not net propulsion along the tract of small intestine
Emesis
Vomiting
What is the primary type of movement in the proximal colon
Segmentation

contents are mixed & maximally exposed to absorptive mucosa

no net movement
What is the primary type of movement in the distal colon
Segmentation

mixing, maximal exposure, absorption, not net movement
What keeps the rectum usually empty
Retrograde movement moves contents back into sigmoid colon

Allows you to administer suppository drugs
WWhen is there urge to defecate?
When rectum fills to 25% capacity due to mass peristalsis
Production of HCl
Na/K ATP pumps 3 Na out for 2 K in

Na/H exchanger pumps 1H out for 1 Na in

K/H ATPase pumps 1H out for 1 K in

Inside Parietal, bicarbonate is being created from CO2 and water

Bicarbonate/Cl exchanger pumps 1bicarbonate out into blood for 1Cl- into cell

Cloride diffuses down gradient back into lumen
It combines with H to form gastric acid
Bicarbonate
Produced by pancreas

Neutralizes acidity in duodenum
ephalic phase of gastric secretion
occurs even before food enters the stomach

Taste and smell stimulates Vagus

Vagus increased HCl secretion by direct stimulation of Parietal and releasing Bombesin
Gastric Phase of HCl Secretion
Food activates stretch mechanoreceptors

Stimulates Parietal cells to produce HCl

Stimulates G-Cells to produce Gastrin --> HCl
Cephalic Phase of Pancreatic Secretion
tasting, smelling, thinking about food can stimulate chemoreceptors of the Vagus Nerve

Causes increase of enzymatic secretions more than bicarbonate secretions
Gastric Phase of Pancreatic Secretions
distention of the stomach can stimulate mechanoreceptors of the Vagus Nerve

Affects enzymatic secretions more than bicarbonate secretions
Intestinal Phase of Pancreatic Secretions
Acidity of duodenum activates S-cells to stimulate pancreas to release bicarbonate

Fat and proteins in duodenum activates I-cells to stimulate pancreas to release enzymatic secretions
Bile
Secreted from gallbladder
Produced by liver

Required for lipid absorption

Contains bile acids, bilirubin, cholesterol, and phospholipids

Forms Micelles around insoluble components of fat digestion
Pernicious Anemia
Due to problem with absorbing Vitamin B12 due to lack of Intrinsic factor or lack of Parietal cells that make it

Seen as chronic canker sores in the mouth
Rickets
Due to problem absorbing Vit-D

Manifests as loss of supporting alveolar bone causing periodontal disease
Digestion of Carbs
Begins in mouth w/ Salivary Amylase and continues in orad part of stomach while unmixed

Stops in caudad part of stomach when food mixed denaturing enzyme

Continues in small intestine w/ Pancreatic Amylase as luminal digestion

Membrane digestion occurs at brush border
Absorption of Carbs
Only monosaccharides can be absorbed

Fructose transported via facilitated diffusion

Glucose/Galactose transported via active transport
Digestion of Proteins
Begins in caudad part of stomach w/ HCl and Pepsin

Continues in small intestine w/ Pancreatic Proteases

Endopeptidases like Trypsin breaks down Inferior Peptide bonds

Exopeptidases breaks outside peptide bonds on C-terminal end

Membrane proteases on brush border further digest polypeptides

Cytoplasmic peptidases inside cell further digest di and tripeptides into amino acids
Absorption of Proteins
Only amino acids, dipeptides, tripeptides can be absorbed

Amino acids transported via facilitated diffusion

Di and tripeptides transported via active transport (further digested inside cell)
Digestion of Lipids
Begins in stomach with churning of fat into droplets

Emulsification continues in duodenum by bile salts

Pancreatic Lipase further breaks lipids
Absorption of Lipids
Micelles form from bile salts to carry insoluble components of fat digestion

Fatty acid binding proteins carry insoluble components through cytoplasm into SER

Chylomicrons package SER products and carry to lymphatic system