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25 Cards in this Set

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  • Back

Describe the healthy eating plate

- plenty of fruit andvegetables – approximately 1/3

- plenty of starchy food(wholegrain when possible) – approximately 1/3

- small amount of milkand dairy – approximately 1/9

- small amount ofnon-dairy protein (meat, fish , eggs, beans etc) – approximately1/9

- small amount of food ordrinks high in fat and/or sugar – approximately 1/10

Give 4 examples of starch foods

wholegrainbread, whole wheat pasta, brown rice and wholegrain breakfast cereals

What are the organs of the digestive tract?

mouth,most of the pharynx, oesophagus, stomach, small intestine and largeintestine

List 6 accessory organs for digestion

teeth,the tongue, salivary glands, the liver, gallbladder and pancreas

Describe the 5 functions of the digestive tract

(1)ingestion: eating

(2)secretion: i.e. GI tract secretes water, acid, buffers and enzymes

(3)mixing and propulsion: contraction and relaxation of smooth musclemixes food and secretions toward the anus. This is called motility

(4)digestion: chemical (e.g. hydrolysis of macromolecules by enzymesfrom the salivary glands, tongue, stomach, pancreas, and smallintestine) and mechanical (e.g. chewing and peristalsis)

(5)defecation: release of wastes, indigestible substances, bacteria,cells and undigested substances through the anus

What are the three stages of swallowing?

(1) voluntary stage(bolus passed into the oropharynx),

(2) pharyngeal stage (boluspassed involuntarily through the pharynx into the oesophagus, and

(3)oesophageal stage (bolus passed from the oesophagus into the stomach

Describe the stomach's role in digestion

- acts as a mixingchamber and holding resevoir- at regular intervals,the stomach releases small amounts of material into the duedenum

- digestion of starchesand triglycerides continues in the stomach, while the digestion ofproteins begins

- stomach is composed offour regions: cardia, fundus, body and pyloric part

- the fundus is in thesuperior region of the stomach and is involve in storing gasesproduced through digestion

- the body is the centralregion

- the pylorus has threeregions: the pyloric antrum (connects to the body), the pyloric canal(the middle region) and the pylorus (connects to the duodenum)

- the stomach containscolumns of secretory cells called gastric glands, which empty intogastric pits. The gastic glands are composed of thee types ofexocrine gland cell: mucous neck cells, chief cells and parietalcells.

- mucous neck cells (andsurface mucuous cells) secrete mucous.

- parietal cells produceintrinsic factor – needed for absorption of vitamin B12 andhydrochloric acid

- chief cells secretepepsinogen - which, when activated to pepsin, catabolises proteins -and gastric lipase, which catabolises triglycerides into fatty acidsand monoglycerides

- the collectivesubstance produced from these gastric glands is called gastric juice

- the gastric glands alsosecrete an enteroendocrine cell, called the G-cell, which secretesthe hormone gastrin into the bloodstream. Gastrin has many functions:stimulates parietal cells and chief cells, contracts the loweroesophageal sphincter, increases motility in the stomach, and relaxesthe pyloric sphincter

Draw and label the stomach

Describe the role of the pancreas in digestion

- pancreas connects tothe duodenum by two ducts

- it delivers pancreaticjuice to assist with absorption

- some of the enzymes inpancreatic juice include; pancreatic amylase (digests starch);trypsin, chymotrypsin, carboxypeptidase and elastase (digest proteinsinto peptides); pancreatic lipase (triglyceride catabolisation); andribonuclease and deoxyribonuclease (nucleic acids)

- protein-digestingenzymes are kept in a deactivated form to prevent digestion of thepancreas. Trypsinogen is activated at the brush border of the smallintestine by enterokinase

What does bile consist of?

What is its function?

- water, bile salts,cholesterol, a phospholipid called lecithin, bile pigments, and ions

- bile salts are composedof mainly sodium salts and potassium salts, and have a role inemulsification – breaking down large lipid globules into smalllipid globules. Breaking lipid globules down increases surface areafor pancreatic lipase to act on triglycerides

what are the components of the small intestine?

- divided into duodenum(starts at pyloric sphincter), jejunum (longest region of the smallintestine) and ileum (joins large intestine at the ileocecalsphincter

How is mechanical digestion achieved in the small intestine?

- there are two types ofmechanical movement in the small intestine: segmentations, and typeof peristalsis called migrating motility complexes

- segmentation is enabledby smooth muscle fibres. It involves localised contractions which mixthe chyme with the digestive juices, and allow it to come intocontact with the mucosa. Segmentation does not propel the chymethrough the small intestine.

- the Migrating MotilityComplex (MMC) is a type of peristalsis which moves the chyme from thestomach, through the small intestine.

How are the following chemically digested in the small intestine;




nucleic acids

carbohydrates:m pancreatic amylase, alpha-dextrinase, sucrase, lactase and maltase

proteins: trypsin, chymotrypsin,carboxypeptidase and elastase

lipids: pancreatic lipase

nucleic acid: ribonucleases anddeoxyribonucleases

What are the different phases of digestion?

- cephalic: anticipatory response todigestion

- gastric: occurs in the stomach

- intestinal: begins when chyme enters the small intestine

Define eating disorder

persistentdisturbance of eating or eating-related behaviour resulting inaltered consumption or absorption of food, that significantly impairsphysical health or psychosocial function.

List the 5 eating disorders

AnorexiaNervosa (AN)

Bulimia Nervosa (BN)

EatingDisorder Not Otherwise Specified (EDNOS)

Pica ( appetitefor non-nutritive substances e.g. paper, clay, metal and chalk)

Ruminationdisorder (regurgitating and re-chewing food)

Summarise anorexia nervosa

-marked by weight loss due to food avoidance

-often associated with binging, purging (vomiting, laxatives, enemasetc) or excessive exercise

-distorted body image – despite often profound emaciation (extremeweight loss) – while still feeling overweight and fearful of weightgain

List presentations and sequelae of anorexia nervosa

-often accompanied by anxiety and depression

-may present with lanugo (fine, downy hair) on back, forearms andcheeks

-has a range of sequelae – both psychological (e.g. anxiety anddepression) and physical e.g.cardiac (ECG abnormalities and arrhythmias),haematological (anaemia (reduced RBCs), thrombocytopaenia (reducedplatelets) and leukopaenia (reduced WBCs)),endocrine (delay or arrest of puberty, reduced growth, amenorrhea(absence of menstruation) and sick euthyroid state (low serum thyroidhormones)),metabolic (uraemia (blood in urine), renal calculi (kidney stones),osteoporosis (brittle, fragile bones)) andgastrointestinal (constipation, abnormal liver function).

Discuss the aetiology of AN

- unknown though likelyinvolves environmental, psychological and genetic factors

- rarely occurs beforepuberty or after 40

- more common in woman:10:1

- more common inaffluent, westernised societies

- often associated with astressful life event e.g. leaving home, parental divorce etc

- those with anxiety orcompulsive disorders are at greater risk

- there is associationswith cultural stresses of being thin, and in some casessports-related stresses

- concordance rates ofmonzygotic twins are higher than that of dizygotic twins, suggestingpartially genetic aetiological basis

- most will achieveremission within 5 years. Death rate is ~5% per decade

How is AN diagnosed?

(A) dietary intake belowthat of requirements, resulting in significantly low body weight forage sex, expected development and physical health.

(B) intense fear ofweight gain and becoming “fat”, or behaviour which preventsweight, despite significantly low weight

(C) disturbed body imageor shape and persistent lack of recognition of the seriousness of thecurrent low weight

What are the 2 subtypes of AN?

Restrictingtype: when weight loss isaccomplished by dieting, fasting and/or excessive exercise, withoutbinging or purging (over period of three months).

Bingeeating/purging type: whenindividuals had engaged in recurrent purging or binge eating (overperiod of three months)

Summarise bulimia nervosa

- usually at or nearnormal weight

- can occur but is lesscommon in obese individuals

- display disorderedeating and have a morbid fear of fatness

- associated withrecurrent eating binges, often followed by purging behaviour

-occurs in similar proportions toAN, though patients are less likely to seek help

Give 9 presentations of BN

- recurrent self-inducedvomiting is associated with pitted teeth (erosion and decay)

– dueto gastric acid- Russell's signs on knuckles

- callouses due to mechanical sheer when inducing vomiting

-parotid gland enlargement –enlargement of salivary glands

- dental and oesophagealcomplications

- electrolyteabnormalities

- arrhythmias

- renal problems

- amenorrhea is common infemales. Causes are unclear as it can be associated with weight,nutrition of emotional stress

- disturbed fluid andelectrolyte balance

Discuss the aetiology of BN

- unknown though likelyinvolves environmental, psychological and genetic factors

- more common in woman:10:1

- rarely occurs beforepuberty or after 40

- possible familialassociation – 4 times more likely if a close family member has/hadBN

- more common inaffluent, westernised societies

- often associated with astressful life event e.g. difficult upbringing, sexual abuse

- low self-esteem,depression and stress are factors which can lead to BN

- those with anxiety orcompulsive disorders are at greater risk

- there is associationswith cultural/social stresses of being thin, and in some casessports-related stresses

How is BN diagnosed

(A) Recurrent episodes ofbinge eating

- eating, within adiscrete amount of time (e.g. 2 hours), an amount much larger thanwould be considered normal.

- sense of lack ofcontrol during binge eating periods

(B) Recurrentinappropriate behavioural to counter weight gain – e.g. vomiting,laxatives, diuretics etc

(C) Binge eating andcompensatory behaviour occur ~ once a week for three months

(D) Opinions of one'sself is disproportionately related to body shape and weight

(E) Disturbances do notoccur during episodes of AN