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136 Cards in this Set
- Front
- Back
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Greater Peritoneal Sac
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located in the anterior, in front of all the “intraperitoneal” organs
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Lesser Peritoneal Sac
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located in the posterior, behind the stomach
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Falciform Ligament
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attaches the liver to the anterior ventral body wall; contains the Ligamentum Teres
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Greater Omentum
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“fatty apron” that hangs from the bottom of the stomach’s Greater Curvature
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Lesser Omentum
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connects both the liver & gall bladder to the stomach’s Lesser Curvature
separates the Greater & Lesser Peritoneal Sacs contains the hepatic triad |
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Hepatic triad
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hepatic portal vein, hepatic artery, common bile duct
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Retroperitoneal Organs
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located behind the posterior dorsal body wall…
• pancreas • kidneys + adrenals • duodenum (most of it) • descending + sigmoid colon • abdominal aorta • inferior vena cava • thoracic esophagus |
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Intraperitoneal Organs
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those that are located totally within the peritoneal cavity…
• liver • gall bladder • spleen • stomach • jejunem + ileum • ascending colon + cecum + appendix • transverse colon • abdominal esophagus |
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Pancreas
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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 |
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Liver
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produces bile (gall bladder stores it)
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Hepatic Artery
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brings oxygenated blood from the heart to the liver
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Hepatic Portal Vein
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brings de-oxygenated blood w/ absorbed nutrients from the small intestine to the liver
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Hepatic Vein
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drains the liver of its de-oxygenated blood and continues as the IVC
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Gall Bladder
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seen off of liver’s right lobe
secretes bile (liver produces it) |
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Spleen
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involved in RBC & WBC formation
NO digestive function |
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Esophageal Hiatus
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hole in the diaphragm thru which the esophagus passes from the thoracic cavity into the abdominal cavity
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Cardiac Sphincter
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lower esophageal sphincter that prevents regurgitation of gastric contents
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Cardia of Stomach
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where food enters from the esophagus
contains the Cardiac Sphincter = regulates the entrance of food into the stomach |
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Fundus (orad) of Stomach
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a small temporary storage area where food remains unmixed w/ HCl
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Body (caudad) of Stomach
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where most of the mechanical & chemical digestion of chyme occurs
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Pyloris (antrum) of Stomach
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where food gets emptied into the duodenum
where food gets emptied into the duodenum |
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Rugae
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longitudinal folds of the mucosa
functions to increase surface area for chemical digestion & provide a rough texture for mechanical digestion |
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Gastric Pits
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little pores in the mucosal rugae of Stomach
Gastric glands empty their secretions (enzymes, acid, mucus) into lumen |
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Duodenum
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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 |
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Brunner Glands
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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 |
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What are the only places in the digestive tract that has glands in the submucosa
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Duodenum and middle 1/3 of esophagus
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Jejunem
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primary responsibility = completion of chemical digestion
Contains Plicae Circulares to increase digestive surface area as well as Villi |
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Ileum
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primary responsibility = completion of absorption of nutrients
Contains Peyer’s Patches = areas of lymphoid tissue M-cells = cells of patches that signals immune system |
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Peyer’s Patches
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Areas of lymphoid tissue that is unique to the ileum only
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Large Intestine
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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 |
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Where can the highest number of goblet cells be found in the digestive tract
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Large Intestine
Secrete mucus to aid in passage of fecal matter |
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Where cant he highest concentration of lymphoid tissue be found in the GI tract
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Large Intestine
Due to the enormous amounts of bacteria |
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Teniae Coli
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3 longitudinal thickened bands of the muscularis externa layer
runs along the entire length of large intestine |
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Haustra
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pouches of the large intestine due to the tension of the teniae coli
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celiac artery
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supplies foregut structures = stomach, some duodenum, liver, gall bladder, spleen
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What supplies foregut structures
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Celiac Artery
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Name foregut structures
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stomach, some duodenum, liver, gall bladder, spleen
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superior mesenteric artery
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supplies midgut structures = jejunem + ileum (mesenteric loops), ascending & transverse colon, pancreas
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what supplies midgut structures
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superior mesenteric artery
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Name midgut structures
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jejunem + ileum (mesenteric loops), ascending & transverse colon, pancreas
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inferior mesenteric artery
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supplies hindgut structures = transverse + descending + sigmoid colon, rectum
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What supplies hindgut structures
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inferior mesenteric artery
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name hindgut structures
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transverse + descending + sigmoid colon, rectum
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Phrenic arteries
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Paired
supplies diaphragm |
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Adrenal arteries
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3 Pairs because extensive vasculature is needed to transport endocrine hormones
supplies the adrenal glands |
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External Iliac
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Branch of Common Iliac
Supplies lower limbs |
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Internal Iliac
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Branch of Common Iliac
Supplies pelvic organs |
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Hepatic Portal Vein receives drainage from what structures?
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- inferior mesenteric vein
- superior mesenteric vein - splenic veins - gastric veins |
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major pelvis
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AKA false pelvis
contains ONLY the sigmoid colon |
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minor pelvis
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AKA true pelvis
contains everything else but Sigmoid Colon (Ex: sexual organs) |
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What is the autonomic innervation to foregut
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Sympathetic - Celiac Ganglion
Parasympathetic - Vagus |
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What is the autonomic innervation to midgut
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Sympathetic - Superior Mesenteric Ganglion
Parasympathetic - Vagus |
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What is the autonomic innervation to hindgut
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Sympathetic - Inferior Mesenteric Ganglion
Parasympathetic - Pelvic Splanchnic Nerve |
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epithelium of oral cavity, oropharynx, upper esophagus, anal canal
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Stratified squamous
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epithelium of stomach, small & large intestines
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Simple columna
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WHich layer is the thickest in the esophagus
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Muscularis Interna layer of Mucosa
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Which layer is substituted by an elastic layer in the oropharynx
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Muscularis Interna layer of Mucosa
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WHere is the Meissner Plexus found
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Found in Submucosa layer
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Meissner Plexus
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innervates the smooth muscles of the muscularis interna up above to squeeze glands & move villi
Found in Submucosa layer |
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Muscularis Externa
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Contains
Inner circular layer Outer longitudinal layer Auerbach's Plexus |
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Auerbach's Plexus
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located in b/t the layers of muscle in Muscularis Externa layer
innervates Muscularis Externa for contractions for peristalsis |
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Oropharynx
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MUCOSA
stratified squamous epithelium Dense elastic layer replaced muscularis interna SUBMUCOSA missing MUSCULARIS EXTERNA Skeletal muscle ADVENTITIA |
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Esophagus
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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 |
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What layers contributes to the esophagus's longitudinal folds
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Mucosa and Submucosa
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Stomach
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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 |
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Surface Mucous Cells of Stomach
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Taller simple columnar cells
Forms thick mucus for lubrication & protection against abrasion |
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Neck Mucous Cells of Stomach
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Shorter simple columnar cells
secretes a thinner, more soluble mucus for lubrication & protection against acid attack |
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Parietal Cells
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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 |
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Castle’s Gastric Intrinsic Factor
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Secretes by Parietal cells
for absorption of Vitamin-B12 in colon Deficiency of cells/factor leads to pernicious anemia |
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Chief Cells
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Located in Stomach
serous granular cells secretes Pepsinogen to digest proteins Secretes Renin to digest milk proteins |
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Pepsinogen
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Secreted by Chief Cells
Activated by HCl into Pepsin Digests proteins |
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Renin
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Secreted by Chief cells
Digests milk proteins |
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Argentaffin Cells
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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 |
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G-cell
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Argentaffin Cells in Stomach
Stimulated by protein, distension, feeding Produces: Gastrin to stimulate Parietal cells Promote gastric motility, decreases emptying Promote mucosal cell growth |
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Gastrin
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Secreted by G-cells
Stimulates Parietal cells to secrete HCL Promotes Gastrin motility |
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A-cell
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Argentaffin Cells in Stomach
Secretes Enteroglucagon to increase blood glucose |
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Enteroglucagon
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Secreted by A-cells
Increases blood gluocose lvels Same function as hepatic glucagon |
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D-Cell
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Argentaffin Cells in Stomach
Stimulated by Acid Secretes Somatostatin to inhibit G-cell |
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Somatostatin
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Produced by D-cells
Inhibits G-cell secretion of Gastrin Therefore lowers HCl and decreases acidity of stomach |
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EC Cell
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Argentaffin Cells in Stomach
Secretes Serotonin to stimulate Muscularis Interna |
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Serotonin
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Secretes by EC-cells
Stimulates Muscularis Interna to squeeze glands in Lamina Propria and move villi back and forth Increases gastric motility |
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ECL Cell
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Argentaffin Cells of Stomach
Stimulated by Gastrin Secretes Histamine to increase Gastric secretions |
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APUD Cell
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Argentaffin Cells of Stomach
Decarboxylates A.A to make digestive hormonese |
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Pit:Gland Ratio of Stomach
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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) |
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Gland Position of Stomach
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Cardia and body have straight glands
Pyloris has convoluted glands |
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What area of the stomach has the widest lumen
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Pyloris
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What structures increase surface area of the small intestine
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Plicae Circularis
Villi Microvilli (Straited border) |
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Crypts of Lieberkuhn
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Dips between villi in Small Intestine
Lined by simple columnar cells, EC cells and Paneth cells |
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What is the core of Plicae Circularis
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Submucosa
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What is the core of Villi
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Lamina Propria
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How does large intestine differ from small intestine
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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 |
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Anal Canal
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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) |
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Histamine
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Secretes by ECL Cell
Stimulates Gastric Secretions |
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I Cells
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Cells of Small Intestine
Stimulated by Protein and Fat Secretes Cholecystokinin to stimulate pancreas (bicarbonate) and gallbladder (bile) |
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Mo-Cells
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Cells of Small Intestine
Stimulated by Fat and Acid Secretes Motilin to cause GI Motility Waves |
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S-Cells
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Cells of Small Intestine
Simulated by Acid and Fatty Acids Secretes Secretin to stimulate Pancreas (bicarbonate), Liver (bicarbonate), and stomach (Pepsin) |
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Cholecystokinin (CKK)
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Secreted by I-Cells
Stimulates Gallbladder to release Bile Stimulates Pancreas to release bicarbonate |
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Motilin
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Secreted by Mo-cells
stimulate gastric activity |
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Secretin
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Secreted by S-cells
Regulates pH of duodenal contents via control of gastric acid secretion and buffering with bicarbonate from pancreas |
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VIP
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Vasoactive Intestinal Peptide
Released by Nerves Relaxes smooth muscles Increases Interstitial Secretion Increases Pancreatic Secretions |
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GRP
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Gastric Releasing Protein (BOMBESIN)
Released by Nerves Causes stimulates G-cell to increase Gastrin release |
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Slow Waves
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oscillations in resting membrane potential of smooth muscle
AP build up slow waves to lead to Contraction Calcium Dependent |
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Phasic Contraction
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Short duration (seconds)
Occurs in esophagus, antrum stomach, small intestine |
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Tonic Contraction
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long duration (up to hours)
Occurs in cardiac sphincter, pyloric sphincter, ileocecal sphincter, internal anal sphincter |
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pharyngoesophageal sphincter
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prevents air from entering at the upper end of esophagus
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gastroesophageal sphincter
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prevents gastric contents from regurgitating at the lower end of esophagus
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receptive relaxation
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vasovagal reflex
causes the stomach muscles to relax and stretch to accommodate large volume of food |
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what increases contractile force & frequency?...
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• Vagus parasympathetic innervation
• Gastrin • Motilin |
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what decreases contractile force & frequency?...
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• sympathetic innervation
• Secretin • GIP |
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Where do slow waves start
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At orad-caudad border
They increase in velocity and amplitude as it spreads to gastroduodenal junction |
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Retrorepulsion
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gastric contents hit upon the closed pyloric sphincter
Causes backflow & mixing |
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migrating motility complex
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propels gastric contents + mucus into the duodenum clearing out stomach in between meals
Act of eating stops this |
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Enterogastric Reflex
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receptors in Duodenum
Sense osmolarity, pH, lipid content, and gastric contents Controls gastric motility and gastric emptying |
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migrating motor complex
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NOT migrating motility complex
contractions occur throughout the length of the entire small intestine during fasting sweeps sweep undigested material through the system |
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segmentation
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mixing of contents b/c there is not net propulsion along the tract of small intestine
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Emesis
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Vomiting
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What is the primary type of movement in the proximal colon
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Segmentation
contents are mixed & maximally exposed to absorptive mucosa no net movement |
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What is the primary type of movement in the distal colon
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Segmentation
mixing, maximal exposure, absorption, not net movement |
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What keeps the rectum usually empty
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Retrograde movement moves contents back into sigmoid colon
Allows you to administer suppository drugs |
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WWhen is there urge to defecate?
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When rectum fills to 25% capacity due to mass peristalsis
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Production of HCl
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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 |
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Bicarbonate
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Produced by pancreas
Neutralizes acidity in duodenum |
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ephalic phase of gastric secretion
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occurs even before food enters the stomach
Taste and smell stimulates Vagus Vagus increased HCl secretion by direct stimulation of Parietal and releasing Bombesin |
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Gastric Phase of HCl Secretion
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Food activates stretch mechanoreceptors
Stimulates Parietal cells to produce HCl Stimulates G-Cells to produce Gastrin --> HCl |
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Cephalic Phase of Pancreatic Secretion
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tasting, smelling, thinking about food can stimulate chemoreceptors of the Vagus Nerve
Causes increase of enzymatic secretions more than bicarbonate secretions |
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Gastric Phase of Pancreatic Secretions
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distention of the stomach can stimulate mechanoreceptors of the Vagus Nerve
Affects enzymatic secretions more than bicarbonate secretions |
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Intestinal Phase of Pancreatic Secretions
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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 |
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Bile
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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 |
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Pernicious Anemia
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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 |
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Rickets
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Due to problem absorbing Vit-D
Manifests as loss of supporting alveolar bone causing periodontal disease |
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Digestion of Carbs
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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 |
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Absorption of Carbs
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Only monosaccharides can be absorbed
Fructose transported via facilitated diffusion Glucose/Galactose transported via active transport |
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Digestion of Proteins
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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 |
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Absorption of Proteins
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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) |
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Digestion of Lipids
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Begins in stomach with churning of fat into droplets
Emulsification continues in duodenum by bile salts Pancreatic Lipase further breaks lipids |
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Absorption of Lipids
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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 |
