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20 Cards in this Set
- Front
- Back
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Gastrin: - Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: Antrum
Action: - Gastric acid secretion - Cell growth
Stimulated by: - Vagus - Food in antrum - Gastric distention - Calcium
Inhibited by: - Antral pH < 2.0 - Somatostatin |
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Cholecystokinin (CCK): - Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: - Duodenum
Action: - Gallbladder contraction stimulates pancreatic acing cell growth - Inhibits gastric emptying
Stimulated by: - Polypeptides - Amino acids - Fat - Hydrochloride (HCl)
Inhibited by: - Chymotrypsin - Trypsin |
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Secretin: - Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: - Duodenum
Action: - Stimulates pancreatic secretion of H2O and bicarb - Bile secretion of bicarb - Pepsin secretion - Inhibits gastric acid secretion
Stimulated by: - Low pH - Intraluminal duodenal fat
Inhibited by: - High duodenal pH |
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Somatostatin: - Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: - Pancreas
Action: - Increases small bowel reabsorption of water and electrolytes - Inhibits cell growth; GI motility; GB contraction, pancreatic, biliary, and enteric secretion of gastric acid; and secretion/action of all GI hormones!
Stimulated by: - Intraluminal fat - Gastric acid duodenal mucosa - Catecholamines
Inhibited by: - Acetylcholine release |
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Pancreatic polypeptide: - Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: - Pancreas
Action: - Clinical usefulness of pancreatic polypeptide is limited to being a marker for other endocrine tumors of the pancreas
Stimulated by: - Cephalic: vagus - Gastric: reflexes - Intestinal: food in small bowel |
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Neurotension: - Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: - Small bowel/colon
Action: - Pancreatic secretion - Vasodilation - Inhibits gastric acid secretion
Stimulated by: - Fat |
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Peptide YY: - Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: - Small bowel/colon
Action: - Inhibits gastric acid secretion, pancreatic exocrine secretion, and migrating myoelectric complexes (MMCs) |
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Glucagon:
- Site of release? - Action? - Stimulated by? - Inhibited by? |
Site of release: - Small bowel/colon
Action: - Increases glycogenolysis, lipolysis, gluconeogenesis
Stimulated by: - Low serum glucose
Inhibited by: - Somatostatin |
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Motilin: - Site of release? - Action? - Stimulated by? - Inhibited by? |
Action: - Inhibits MMCs - Increases gastric emptying - Increases pepsin secretion alkaline environment
Stimulated by: - Vagus - Fat - Intraduodenal
Inhibited by: - Pancreatic polypeptide |
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How long is the Small intestine? |
Around 5-10 meters (average 6 m) |
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Ulcers: - Which ones perforate? - Which ones bleed? |
Anterior ulcers tend to perforate, causing leakage of duodenal contents into the peritoneal cavity, leading to peritonitis.
Ulcers that result in massive bleeding are posterior ulcers that have penetrated the gastroduodenal artery. |
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What might cause a person to have recurrent symptoms of SBO? |
Since the third part of the duodenum lies posterior to the SMA, compression of the SMA on the duodenum, as seen in SMA syndrome, can lead to small bowel obstruction (SBO). Although rare, this is most typically seen in thin patients who have lost the fat pad between the SMA and the duodenum, leading to recurrent symptoms of SBO. |
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How do you differentiate between the colon and small bowel? |
Plicae circulares. The colon does not have place circulares. |
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The entire small bowel is supplied by branches of what? |
SMA, except the proximal duodenum (which is supplied by branches from the celiac trunk). |
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How do you differentiate between the jejunum and ileum upon gross inspection? |
- Jejunum has larger diameter, thicker wall, and more prominent place circulares
- The jejunum has few (1 to 2) arcades with long vasa recta, and the ileum has many arcades with short vasa recta
- Ileum has fatty mesentery |
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How much fat is normally absorbed? |
> 93% of ingested fat is normally absorbed, so > 6 grams of fecal fat collected over a 24-hour time period in a diet with 100 grams of lipid ingested per day would be defined as steatorrhea. |
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What are the common causes of SBO? |
"Henry Ate Volumes In Chicago, Gaining Success Nowhere"
Hernia Adhesions Volvulus Intussusception/Ileus Crohn's disease Gallstone ileus SMA syndrome Neoplasm |
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SBO and neoplasm? |
As opposed to large bowel obstruction, SBO is rarely caused by neoplasm. If neoplasm is the cause, it is most likely secondary to extrinsic compression as opposed to intraluminal obstruction. |
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What features are associated with strangulated SBO? |
- Tenderness - Tachycardia - Fever - Markedly elevated WBC count - Acidosis with elevated lactate level
*Beware: These indicators are NOT present in 5-15% of patients with intestinal infarction, especially the elderly. |
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Drainage of small bowel? |
Bowel wall --> Mesenteric nodes --> lymphatic vessels parallel the corresponding arteries --> cistern chill (a retroperinteal structure between the aorta and IVC) --> thoracic duct (also between the aorta and IVC) --> left subclavian vein
Lymphatics participate in absorption of fat. |
