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28 Cards in this Set

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  • Back
What are 4 acid-related GI diseases?
GERD, PUD (peptic ulcer disease), NSAID-induced ulcers, Stress-related ulcerations
What are the 4 GI Agents available?
Drugs for acid disease (antisecretory agents to reduce gastric acid, cytoprotective agents, antacids), Drugs for GI motility (Prokinetic agents), Drugs for N/V, Antidiarrheals
GI Physiology: The cardia near fundus has mucus producing cells. What about the body & antrum?
The body contains parietal and chief cells. The parietal cells secrete acid and intrinsic factor. The chief cells secrete pepsinogen. The antrum contains G cells, which secrete gastrin
What are the 3 main factors in acid stimulation?
Neuronal, Endocrine and Paracrine
What does neuronal stimulation produce?
Acetylcholine (ACh)
What does endocrine stimulation produce?
What does paracrine stimulation produce?
What are the 5 types of secretory cells in the stomach?
Parietal cells, ECL, G cells, Superficial epithelial cells, D cells
What do the Parietal cells in the body & fundus secrete?
What do the ECL (EnteroChromaffin-Like) cells secrete?
What do the G cells in the antrum secrete?
Gastrin, which in turn triggers the release of histamine.
What do the Superficial epithelial cells secrete?
Bicarb (HCO3-) and mucus
What do the D cells in the antrum secrete?
Somatostatin, which inhibits gastrin secretion
The activation of HCl secretion relies on a combination of neurocrine - endocrine and paracrine events. What 2 types of drugs can we use to block the secretion of HCl?
H-2 receptor blockers and H/K ATPase pump inhibitors
What are the 2 phases of gastric secretion?
The cephalic phase, which is initiated by the brain (vagus nerve to the medulla oblongata). The gastric phase, initiated by gastric, or physical/food in stomach events.
GI innervation and motility is controlled by what 2 systems?
The parasympathetic and sympathetic. They balance each other out. The parasympathetic helps the digestive process (rest & digest), and the sympathetic inhibits the digestive process.
GI structure and function serve what 2 types of movement?
Propulsion and mixing
What something is eaten and swallowed the esophagus utilizes a peristaltic wave action to get the food down to the:
lower esophageal sphincter (LES), which is normally constricted until it catches the wave and relaxes to allow passage of food.
The LES constricts again to protect the lower esophagus and “traps the food” before it enters the stomach. In the stomach:
peristaltic contractions move and mix food with gastric secretions.
The pyloric sphincter maintains constant tonic constriction and allows water/fluid to pass constantly to the duodenum (?) Gastric emptying is the time & process required to empty the stomach. What regulates it?
Signals from the stomach and duodenum. It also depends on what you ate - fat takes longer to pass.
HCl (hydrochloric acid) is secreted by the parietal cells which first need to be stimulated by:
ACh, gastrin and histamine.
Pepsinogen is secreted from peptic and mucous cells. ONLY in the presence of:
HCl does pepsinogen convert to pepsin. Pepsin is the problem. It’s irritating, and only forms in the presence of pepsinogen and HCl. In an acidic pH it’s now a proteolytic enzyme.
What is feedback inhibition?
The gastric pH increases (becomes more basic) during the digestive process. Feedback inhibition occurs when pH reaches 3-4 (HCl is 1-2 pH)
What 4 physiological properties does the GI tract have as intrinsic protection?
Mucous/bicarb. Gastric blood flow. Cell turnover. Prostaglandin E2.
How does mucous and bicarb offer intrinsic protection?
Mucous provides a barrier, and the bicarb neutralizes acid.
How does gastric blood flow offer intrinsic protection?
It pulls acid away and into the bloodstream, where its neutralized quickly.
How does cell turnover offer intrinsic protection?
there’s continuous cellular replacement. (This is not the case with patients on chemo - they have reduced cell turnover)
How does Prostaglandin E2 offer intrinsic protection?
It’s a protective prostaglandin, secreted by mucosal cells when the pH is less than 3. It inhibits acid secretion.