Ucf Human Physiology Test3 Summerb Digestive

Front 1

Digestive system is supplied by 2
different plexuses (parasympathetic):
1- ?
2- ?

Back 1

1- Submucosal plexus of Meissner
2- Myenteric plexus of Auerbach

Front 2

Parasympathetic preganglionic fibers synapse in the
_______ and _______ plexuses

Back 2

-Myenteric

-submucosal

Front 3

Carries information to the lower
parts of the large intestine and
pelvic organs.

Back 3

Pelvic splanchnic nerve (S2-4)

Front 4

sends information to the esophagus, stomach, pancreas, intestine down to the upper parts of the large intestine.

Back 4

Vagus (CNX)

Front 5

Postganglionic adrenergic fibers
leave the prevertebral ganglia
and synapse in the ______
and _______ plexuses.

Back 5

myenteric and submucosal plexuses.

Front 6

All of the GI muscle is smooth muscle except?

Back 6

pharynx, upper 1/3 of the esophagus, and the external anal sphincter, all of which are striated muscle.

Front 7

are found in esophagus, gastric antrum, and small intestine which contract and relax periodically.

Back 7

Phasic contraction

Front 8

are found in lower esophageal sphincter, the orad stomach, and the ileocecal and internal anal sphincters

Back 8

Tonic contraction

Front 9

slow waves originate in the _________, which serve as the pacemaker for GI smooth muscle

Back 9

-interstitial cells of Cajal

Front 10

Are slow waves action potentials?

Back 10

no

Front 11

Slow depolarization is by _____ and slow repolarization is by _____

Back 11

Ca++

K+

Front 12

are slow waves influenced by neural or hormonal input?

Back 12

nope

Front 13

Frequency of slow waves is highest in ______ and lowest in ______

Back 13

highest = duodenum

slowest = stomach

Front 14

Spike potentials are triggered at ____mV. Resting membrane potential floats between -50 to -60 mV

Back 14

(negative)-40 mv

Front 15

Factors that accelerate the spike wave are stimulation by parasympathetic NS

Back 15

Stretching
Acetylcholine
Parasympathetic stimulation
Specific gastrointestinal hormones

Front 16

Factors that inhibit the spike wave and cause hyperpolarization?

Back 16

Norepinephrine/epinephrine
Sympathetic stimulation

Front 17

Calcium ions act through ______ as the calcium regulator to coordinate the myosin/actin filament binding

Back 17

calmodulin

Front 18

Cholecystokinin?

Back 18

from mucosa of jejunum in response to fats, increases contractility of gallbladder to release bile and concomittantly decreases stomach contractilty (hold fats still for digestion)

Front 19

Secretin?

Back 19

from mucosa of duodenum in response to acid, has a mildly inhibitory effect on GI motility to moderate acid load to small intestine

Front 20

Gastric inhibitory peptide?

Back 20

from mucosa of upper small intestine in response to fats (lesser to carbs) to decrease motor function (peristalsis) when the upper small intestine is already full!

Front 21

Defects in Meissner’s plexus lead to ?

Back 21

malabsorption

Front 22

The swallowing reflex is coordinated in the medulla by?

Back 22

by CNIX and CNX

Front 23

where does peristalsis begin?

What relaxes?

Back 23

-the pharynx

-upper esophageal sphincter relaxes

Front 24

esophagus passes through esophageal hiatus of diaphragm at the level of ?

Back 24

T10

Front 25

where esophagus enters the stomach

Back 25

Cardia

Front 26

Because the esophagus is located in the thorax, intraesophageal pressure equals ________, which is ________ atmospheric pressure

Back 26

-thoracic pressure

-lower than

Front 27

receptive relaxation of the ________ of the stomach to allow the food bolus into the stomach.

Back 27

orad region

Front 28

Gastric reflux may occur if the tone of the _________ is decreased and gastric contents reflux into the esophagus.

Back 28

lower esophageal sphincter

Front 29

retrosternal pain, neuromotor disorder of the lower esophageal sphincter (LES). Decreased cells in the myentric plexus (analogous to Hirschsprung’s disease), dysphagia for solid and liquid. Dilated proximal esophagus and aperistalsis, increased LES pressure.

Back 29

Achalasia (cardiospasm)

Front 30

Achalasia (cardiospasm)? analogous to?

Back 30

retrosternal pain, neuromotor disorder of the lower esophageal sphincter (LES). Decreased cells in the myentric plexus (analogous to Hirschsprung’s disease), dysphagia for solid and liquid. Dilated proximal esophagus and aperistalsis, increased LES pressure.

Front 31

Esophageal atresia?

Back 31

when distal end of the esophagus is closed.

Front 32

Tracheoesophageal fistula?

Back 32

when there is a hole
(connection) between esophagus and the trachea.
Milk from the newborn esophagus finds its way into the
respiratory tract causing severe respiratory problems.

Front 33

Malignancy is frequently at transition between ______.

Back 33

epithelia

Front 34

Sliding hiatus hernia (A)?

Back 34

when abdominal part of the esophagus and cardia and even
part of the fundus slide up through the esophageal hiatus.

Front 35

Main symptom of Sliding hiatus hernia (A)?

Back 35

*Regurgitation and heart burn

Front 36

Paraesophageal hiatus hernia (B)?

Back 36

Cardia doesn’t move but part of the fundus and peritoneum passes through the esophageal hiatus.

Front 37

Main symptom of Paraesophageal hiatus hernia (B)?

Back 37

Usually no regurgitation

Front 38

In most cases, the operation performed to correct gastroesophageal reflux is a procedure called ?

Back 38

fundoplication.

Front 39

fundoplication?

Back 39

The upper portion of the stomach (the fundus) is wrapped (plicated)
around the lower portion of the esophagus and anchored securely below the diaphragm.

Front 40

Orad region?

Caudad region?

Back 40

orad = top half

caudad = bottom half

Front 41

Chief cells?

Back 41

in body/fundus, produce pepsinogen

Front 42

Parietal cells ?

Back 42

in body/fundus, produce HCl and the intrinsic factor for VitB12 absorption in the ileum.

Front 43

Vit B12 is absorbed using IF in the?

Back 43

ileum

Front 44

*Gastrin

Back 44

is produced by G cells mainly in pyloric antrum
stimulate acid secretion and growth of parietal cells

Front 45

*Secretin

Back 45

via duodenum inhibits HCl secretion

Front 46

pepsinogen

Back 46

is a protein-splitting enzyme activated by HCl of the stomach into pepsin to break the food.

Front 47

*Endocrine cells of mucous membrane (1.2% of all) ?

Back 47

mainly in antrum, produce: histamine, somatostatin,
gastrin, serotonin.

Front 48

**Zollinger-Ellison syndrome?

Back 48

gastrin secretion by non-beta cells of the pancreas (multiple ulcers in stomach)

Front 49

Secretion of gastric juice: 2 phases?

Back 49

Nervous and Gastric phase

Front 50

Nervous secretion?

Back 50

by vagus nerve, activated by
taste, smell and sight (even if stomach is empty).

Front 51

Gastric (digestive) phase secretion?

Back 51

stimulated by food ingestion.

Front 52

Enterochromaffin-like (ECL) cells are found in ?

Back 52

the stomach and intestine

Front 53

Enterochromaffin-like (ECL) cells function?

Back 53

secrete histamine and 5-hydrooxytryptamine (serotonin) as paracrine regulators of the GI tract

Front 54

G cells?

Back 54

secrete the hormone gastrin into the blood

Front 55

D cells?

Back 55

secrete the hormone somatostatin

Front 56

_____ mediates receptive relaxation

Back 56

CCK

Front 57

________ are contractions that occur at 90-minute intervals
to clear the stomach of residual food (even during fasting).

Back 57

Migrating myoelectric complex

Front 58

______ mediates Migrating myoelectric complex Contractions.

Back 58

Motilin

Front 59

The rate of gastric emptying is fastest when the stomach contents are ?

Back 59

isotonic

Front 60

____ inhibits gastric emptying (increases gastric emptying time) by release of _____.

Back 60

Fat inhibits gastric emptying (increases gastric emptying time) by release of CCK.

Front 61

H+ in the duodenum________ gastric emptying via direct neural reflexes

Back 61

inhibits

Front 62

Parasympathetic innervation of the stomach:

Back 62

are the ant and post vagus trunks, giving the anterior and posterior gastric (Latarget) nerves

Front 63

Sympathetic innervation mostly come from __________ nerves
which synapse in the ______
ganglion. Postganglionic fibers
innervate the stomach.

Back 63

-splanchnic nerves (also from upper lumbar)

-Celiac

Front 64

Sympathetic nerves inhibit peristalsis and gastric secretion and cause pyloric ______. They also convey pain.

Back 64

contraction

Front 65

The GI paracrines are ?

Back 65

somatostatin and histamine.

Front 66

Somatostatin?

Back 66

-Is secreted by cells throughout the GI tract in response to H+ in the lumen.
-Inhibits the release of all GI hormones.
-Inhibits gastric H+ secretion.

Front 67

Somatostatin secretion is ________ by vagal stimulation.

Back 67

inhibited

Front 68

histamine?

Back 68

Is secreted by mast cells of the gastric mucosa.
Increases gastric H+ secretion directly and by potentiating vagal stimulation and effect of gastrin

Front 69

gastrin?

Back 69

1- increased H+ secretion by the gastric parietal cells.
2- stimulates growth of gastric mucosa by stimulating the synthesis of RNA and new protein. Patients with gastrin-secreting tumors have hypertrophy and hyperplasia of the gastric mucosa.

Front 70

Stimuli for gastrin?

Back 70

amino acids
distention of the stomach
vagal stimulation

Front 71

the most potent stimuli for gastrin secretion are ?

Back 71

phenylalanin and tryptophan

Front 72

_______ in the lumen of the stomach inhibits gastrin release

Back 72

H+ in the lumen of the stomach inhibits gastrin release

Front 73

Zollinger- Ellison syndrome (gastrinoma)

Back 73

Occurs when gastrin is secreted by non-β- cell tumors of the pancreas.

Front 74

CCK is homologous to?

Back 74

gastrin

Front 75

5 actions of CCK

Back 75

1- stimulates contraction of gallbladder and simultaneously causes relaxation of the sphincter of Oddi for secretion of bile.
2- stimulates pancreatic enzyme secretion.
3- potentiates secretin-induced stimulation of pancreatic HCO3- secretion.
4- stimulates growth of the exocrine pancreas.
5- Inhibits gastric emptying. Thus, meals containing fat stimulate the secretion of CCK, which slows gastric emptying to allow more time for intestinal digestion and absorption.

Front 76

What secretes CCK?

Back 76

I cells

Front 77

CCK is released from the I cells of the duodenal and jejunal mucosa by?

Back 77

a- small peptides and amino acids
b- fatty acids and monoglycerides.

Front 78

Do triglycerides stimulate the release of CCK

Back 78

Triglycerides do not stimulate the release of CCK because they cannot cross intestinal cell membranes.

Front 79

Secretin is homologous to ?

Back 79

Secretin is homologous to glucagon, fourteen of the twenty-seven amino acids in secretin are the same as those in glucagon.

Front 80

Actions of Secretin?

Back 80

1- stimulates pancreatic HCO3- secretion and increases growth of exocrine pancreas.
2- stimulates HCO3- and H2O secretion by the liver, and increases bile production.
3- inhibits H+ secretion by gastric parietal cells.

Front 81

Secretin is released by?

Back 81

S-cells of the duodenum

Front 82

Stimuli for secretin release

Back 82

a- H+ in the lumen of the duodenum
b- Fatty acids in the lumen of the duodenum

Front 83

Gastric Inhibitory Peptide (GIP) is homologous to?

Back 83

secretin and glucogon

Front 84

Actions of GIP?

Back 84

1- stimulates insulin release.

2- inhibits H+ secretion by gastric parietal cells

Front 85

_____ glucose is more effective than _______ glucose in causing insulin release and, therefore, glucose utilization.

Back 85

oral glucose is more effective than intravenous glucose

Front 86

GIP is released by ?

Back 86

duodenum and jejunum.

Front 87

GIP is the only GI hormone that is released in response to ?

Back 87

fat, protein, and carbohydrate.

Front 88

Salivary glands?

Back 88

Parotid gland, Submandibular gland, and Sublingual gland

Front 89

Salivary glands receive parasympathetic innervation from superior and inferior salivatory nuclei, through CN __ and CN ___.

Back 89

CN VII and CN IX.

aka facial and glossopharangeal

Front 90

Inflammation of the parotid gland is notably caused by ?

Back 90

Mumps virus (myxovirus).

Front 91

What does mumps surpress?

Back 91

Sex hormones = infertility

Front 92

initial triglyceride digestion is by ________.

Back 92

lingual lipase

Front 93

Saliva has high?

Saliva has low?

tonicity?

Back 93

-high K+ and HCO3- concentration

-low Na+ and Cl- concentration

-hypotonicity

Front 94

At low saliva flow rate composition?

Back 94

Everything's concentration is "low" except K+ is high

Front 95

At high saliva flow rate?

Back 95

the composition of saliva is closest to that of plasma.

Front 96

Cholinergic receptors on acinar and ductal cells of salivary gland are _________

Back 96

muscarinic

Front 97

The second messengers for salivary glans are ?

Back 97

-IP3 and Ca2+

inositol 1,4,5-triphosphate (IP3) and increased intracellular [Ca++].

Front 98

Atropine effect on salivary glands?

Back 98

inhibit the production of saliva and cause dry mouth

Front 99

Effect of sympathetic on salivary glands?

Second messenger?

Back 99

-increases growth of gland

-B2 receptor with cAMP

Front 100

another name for parietal cells?

Back 100

Oxyntic glands

Front 101

In parietal cells, H+ is secreted into the lumen of the stomach by the ?

Back 101

H+/K+ pump (H+/K+-ATPase)

Front 102

vomiting causes?

Back 102

no acid in stomach = HCO3- stays in blood and isn't secreted by pancreas to neutralize stomach acid = metabolic acidosis

Front 103

IF is a co-secretion product with HCl, so destruction of parietal cells (e.g., gastritis) leads to ____ and ____

Back 103

achlorhydria and pernicious anemia

Front 104

Direct pathway of H+?

Indirect Pathway?

Back 104

-vagas nerve innervates parietal cells

-vagas nerve innvervates g-cells which release GRP and cause H+ secretion

Front 105

Which pathway does atropine block? So is acid secretion ever blocked completely?

Back 105

direct

no

Front 106

How do you block both pathways?

Back 106

vagotomy

Front 107

The 2nd messenger for histamine is ______

H2 receptor-blocking drug?

Back 107

-cAMP

-cimetidine

Front 108

cimetidine also blocks?

Back 108

also blocks histamine’s potentiation of Ach effects

Front 109

What inhibits gastric H+ secretion?

The hormonal mediators are ?

Back 109

-pH < 3 and chyme in the duodenum

-GIP (released by fatty acids in the duodenum) and secretin (released by H+ in the duodenum)

Front 110

Helicobacter pylori has high ______ activity and converts urea to NH4+, which damages the gastric mucosa.

Back 110

urease

Front 111

In gastric ulcers, H+ secretion is ________

Gastrin levels are __________

Back 111

-H+ is decreased

-Gastrin is increased

Front 112

Duodenal ulcers are ______ common than gastric ulcers

Back 112

more common

Front 113

Effect of duodenal ulcers?

Back 113

everything is increased

Front 114

Menetrier’s disease?

hypertrophic or atrophic?

Back 114

Hypertrophic gastritis giant rugal folds simulating cancer.

Atrophic = protein loss

Front 115

The duodenum secretes the hormone ____________, that inhibits stomach peristalsis

Back 115

enterogastrone

Front 116

enterogastrone?

Back 116

secreted by duodenum - t inhibits stomach peristalsis

Front 117

__________ of the duodenum has a common opening for the common bile duct (CBD)
and the main pancreatic duct in its postero-medial wall, called?

Back 117

-2nd or descending

-major duodenal papill

Front 118

The common opening is dilated and forms the hepatopancreatic ampulla of ____ which is surrounded by the ampullary ___________

Back 118

-ampulla of Vater

-sphincter of Oddi

Front 119

Gastroileal reflex is mediated by ?

Back 119

-the ANS and by Gastrin

Front 120

Presence of food in the stomach triggers increased peristalsis in the
ileum and relaxation of the ileocecal sphincter. Known as?

Back 120

Gastroileal reflex

Front 121

Functions of the Ileocecal Valve?

Back 121

Prevent backflow of fecal contents

Front 122

Illocecal valve function in appendicitis?

Back 122

may culminate in additional abdominal pain over the RUQ inflammation and reflux and vomiting

Front 123

Peristaltic rush

Back 123

the normally weak peristalsis action become more powerful and rapid.

Front 124

Is the migrating motor complex (MMC)

Back 124

no

Front 125

most colonic water absorption occurs in the ?

Back 125

proximal colon

Front 126

Composition and characteristics of pancreatic secretion:

Na and K?

Back 126

- high volume

- same Na+ and K+ concentrations as plasma

Front 127

Composition and characteristics of pancreatic secretion:

HCO3?

Back 127

- much higher HCO3- concentrations than plasma

Front 128

Composition and characteristics of pancreatic secretion:

tonicity?

Back 128

isotonic

Front 129

At low flow rates: the pancreas secrets an isotonic fluid that is composed mainly of ?

Back 129

Na+ and Cl-

Front 130

At high flow rates: the pancreas secrets an isotonic fluid that is composed mainly of ?

Back 130

Na+ and HCO3-

Front 131

Produce a small volume of initial pancreatic secretion, which is mainly Na+ and Cl-

Back 131

Acinar cells

Front 132

modify the initial pancreatic secretion by secreting HCO3- and absorbing Cl- via a Cl-_HCO3- exchange mechanism in the luminal membrane.

Back 132

Ductal cells

Front 133

CCK acts on pancreatic _____ cells to increase enzyme secretion (amylase, lipases, and proteases).

Back 133

acinar

Front 134

Ach is released in response to ______ _______ and ______ in the duodenal lumen.

Back 134

H+, small peptides, amino acids, and fatty acids

Front 135

Ach causes?

Back 135

Stimulates enzyme secretion by the acinar cells and, like CCK, potentiates the effect of secretin on HCO3- secretion.

Front 136

CCK effect on the galbladder

Back 136

Causes contraction of the gallbladder and relaxation of the sphincter of Oddi

Front 137

Ach effect on the galbladder

Back 137

Causes contraction of the gallbladder

Front 138

Bilirubin is generated when rbc dies, lyses hemoglobin which is phagocytosed and processed by tissue macrophages collectively known as the ?

Back 138

reticuloendothelial system

Front 139

Heme ring is “opened” to release iron -> binds _______

The remaining straight chain (four pyrrole nuclei) _______ becomes bilirubin in a couple of steps

Back 139

-transferrin

-biliverdin

Front 140

__________ excreted by the kidneys gets oxidizes in the air after it is micturated as urine and is reduced to _______ which is yellowish

Back 140

-Urobilinogen

-urobilin

Front 141

Stercobilin = ?

Back 141

brownish fecal color

Front 142

Hemolytic jaundice?

Obstructive jaundice?

Back 142

Hemolytic jaundice – increased rbc lysis

Obstructive jaundice – blockage of the bile duct or liver damage prevents bilirubin excretion to GI

Front 143

Prehepatic Jaundice

Back 143

Due to hemolytic – destruction of RBC/Hgb

Front 144

Hepatic Jaundice

Back 144

Due to obstruction of bile trees in common bile duct/cycstic duct -> bile has bilirubin
Destruction of hepatocytes -> ie hepatitis -> cirrhosis – tissue becomes fibrosis/tough

Front 145

Post hepatic jaundice

Back 145

Mostly due to obstruction of the cystic duct ie Gal stones

Front 146

hemolytic jaundice results in?

Back 146

darker/yellower foamy urine.

Front 147

obstructive jaundice results in?

Back 147

increased plasma levels of conjugated bilirubin

Front 148

Pain, nausea and vomiting and involuntary muscle guarding, Painful splinting of respiration during deep inspiration in the palpation of right upper quadrant

Back 148

Murphy’s sign

Front 149

Blood flow into the liver:

Portal vein - __ ml/min
Hepatic artery - ___ ml/min

Back 149

Portal vein - 1100 ml/min
Hepatic artery - 350 ml/min

Front 150

The _______ are specialized macrophage type cells that ingest bacteria in 1/100th of a second so the liver can effectively screen >99% of the bacterial load in the blood transit time through the liver.

Back 150

Kupffer cells

Front 151

What vitamins does the liver store? What cofactor?

Back 151

-A, D, B12

-iron

Front 152

Excess plasma Ca++ is excreted via ?

Back 152

bile

Front 153

Hemochromatosis?

Back 153

a hereditary disease causing the accumulation of iron in the body, eventually leading to liver damage.

Front 154

Wilson's disease?

Back 154

a hereditary disease which causes the body to retain copper.

Front 155

pigment stones

Back 155

Stones made from too much bilirubin in the bile

Front 156

Medical conditions that cause the liver to make too much bilirubin, such as chronic hemolytic anemia, including ________

Back 156

sickle cell anemia

Front 157

pigmented stones are caused by

Back 157

Liver cirrhosis and biliary tract infections

Front 158

Clay-colored stools notably

Back 158

gallstones