Term
| what is the MAIN fx of the digestive system |
|
Definition
| - transfer nutrients, water, and electrolytes from ingested food into body's internal environment |
|
|
Term
| what are the four basic processes which help acheive the main fx of the digestive system |
|
Definition
- motility
- secretion
- digestion
- absorption |
|
|
Term
|
Definition
| - muscular contractions that mix and move contents forward in digestive tract |
|
|
Term
|
Definition
| - transfer of digestive juices (made by multiple exocrine glands) into digestive tract; water and electrolytes are picked up from blood which req. energy |
|
|
Term
|
Definition
| - chemical change (hydrolysis) of large molecules (e.g. carbs, proteins, fats) into smaller, absorbable subunits (e.g. glucose, aa, lipids) |
|
|
Term
|
Definition
| - passage of products of digestion (e.g. glucose), plus water, vitamins, and electrolytes, into blood and lymph |
|
|
Term
| what 3 general digestive fxs fall under skeletal control |
|
Definition
- chewing
- swallowing
- excretion |
|
|
Term
| is the digestive tract autonomic or skeletal control? |
|
Definition
| - the digestive tract is smooth muscle therefore it maintains low levels of contraction and tone and is autonomic control |
|
|
Term
| what are the two types of digestive motility called? |
|
Definition
- propulsive movements
- mixing movements |
|
|
Term
|
Definition
| - move contents forward at various speeds |
|
|
Term
|
Definition
| - mixed with digestive juices, facilitating digestion and absorption |
|
|
Term
| what are the components and descriptions of the digestive system tract |
|
Definition
- continuous tube that consists of mouth, pharynx, esophagus, stomach, small intestine, large intestine, anus
- 15 foot long, hollow tube
- lumen continuous with external environment |
|
|
Term
| what do the "accessory organs" of the digestive system consist of? |
|
Definition
- salivary glands
- exocrine glands
- biliary system (liver and gallbladder) |
|
|
Term
| what does the motility by the mouth and salivary glands include? |
|
Definition
|
|
Term
| what does the motility by the pharynx and esophagus include? |
|
Definition
|
|
Term
| what does the motility by the stomach include? |
|
Definition
- receptive relaxation
- peristalsis |
|
|
Term
| what two digestive organs have no motility involved? |
|
Definition
- exocrine pancreas
- liver |
|
|
Term
| what does the secretion by the mouth and salivary glands include? |
|
Definition
| saliva - amylase, mucus, lysozyme |
|
|
Term
| what does the secretion by the pharynx and esophagus include? |
|
Definition
|
|
Term
| what does the secretion by the stomach include? |
|
Definition
| - gastric juice - HCL, Pepsin, Mucus, Intrinsic factor |
|
|
Term
| what does the secretion by the exocrine pancreas include? |
|
Definition
| - digestive enzymes (trypsin, chymotrypsin, carboxypeptidase, amylase, lipase) |
|
|
Term
| what does the secretion by the liver include? |
|
Definition
| - bile (bile salts, alkaline secretion, bilirubin) |
|
|
Term
| what does the digestion by the mouth and salivary glands include? |
|
Definition
|
|
Term
| what three digestive organs play no role in digestion? |
|
Definition
| pancreas, esophagus, large intestine |
|
|
Term
| what does the digestion by the stomach include? |
|
Definition
| carb continues, protein begins |
|
|
Term
| what does the digestion by the exocrine pancreas include? |
|
Definition
| - digestion of carbs, fats, proteins, nucleic acids in duodenal lumen |
|
|
Term
| what does the digestion by the liver include? |
|
Definition
| - bile salt facilitates fat digestion and absorption |
|
|
Term
| what does the absorption by the mouth and salivary glands include? |
|
Definition
| - no food; few medications |
|
|
Term
| what does the absorption by the pharynx and esophagus include? |
|
Definition
|
|
Term
| what does the absorption by the stomach include? |
|
Definition
| no food; few lipid-soluble substances (alcohol and aspirin) |
|
|
Term
| what two digestive organs have no involvement in absorption? |
|
Definition
| exocrine pancreas and liver |
|
|
Term
| what does motility by the small intestine include? |
|
Definition
| - segmentation; migrating motility complex |
|
|
Term
| what does motility by the large intestine include? |
|
Definition
| - haustral contractions, mass movements |
|
|
Term
| what does secretion by the small intestine include? |
|
Definition
| - succus entericus (mucus, salt, enzymes in brush border) |
|
|
Term
| what does digestion by the small intestine include? |
|
Definition
| - in lumen by pancreatic enzymes and bile (carbs, protein continue; fat completed) |
|
|
Term
| what does absorption by the small intestine include? |
|
Definition
| - salt and water, converting contents to feces |
|
|
Term
| what does secretion by the large intestine include? |
|
Definition
|
|
Term
| what does absorption by the large intestine include? |
|
Definition
| - salt and water, converting contents to feces |
|
|
Term
| 4 layers of the GIT wall structure |
|
Definition
| - mucosa, submucosa, muscularis externa, serosa |
|
|
Term
| the mucosa of the GIT wall |
|
Definition
- lines luminal surface
- contains the mucous membrane, lamina propria, muscularis mucosa |
|
|
Term
| mucous membrane of the mucosa in the GIT wall |
|
Definition
| - inner epithelial layer with exocrine and endocrine cells |
|
|
Term
| lamin propria of the mucosa in the GIT wall |
|
Definition
| - middle layer of connective tissue, small blood vessels, nerve fibers, lymph ducts |
|
|
Term
| muscularis mucosa of the mucosa in the GIT wall |
|
Definition
| - outer, sparse layer of smooth muscle, both circular and longitudinal; can push things forward |
|
|
Term
| submucosa of the GIT wall |
|
Definition
| - lies under mucosa; connective tissue with blood and lymph vessels and submucous nerve plexus |
|
|
Term
| muscularis externa of the GIT wall |
|
Definition
| - major smooth muscle layer, lies bt submucosa and out serosa |
|
|
Term
| what lies within the muscularis externa of the GIT wall |
|
Definition
- inner circular layer and outer longitudinal layer of muscle (contractions produce propulsive and mixing components)
- myenteric nerve plexus (bt the two smooth muscle layers) |
|
|
Term
|
Definition
| - outer connective tissue layer (continuous with mesentery (which suspends digestive tract) slong much of tract) |
|
|
Term
|
Definition
| - in the small intestine - big player for absorption bc these projections increase surface area |
|
|
Term
|
Definition
| - where new epithelial cells are generated; these cells are turned over quickly |
|
|
Term
| what four factors regulate digestive motility and secretion? |
|
Definition
- autonomous smooth muscle fx
- intrinsic nerve plexuses
- extrinsic nerves
- GI hormones
- all of these have regulatory effects and work together in a synergistic fashion |
|
|
Term
| autonomous smooth muscle fx |
|
Definition
- cells display rhythmic, spontaneous variations in membrane potentials
- inherent rate of several digestive processes (e.g. peristalsis and segmentation) depend on pacesetter cells in tract with this characteristic |
|
|
Term
|
Definition
- myenteric and submucous plexuses: the enteric nervous system, signaling GIT from w/in wall
- neurons w/in this tract release acetylcholine
- influence all facets of digestive system
- variety of neurons present: including sensory (respond to stimuli in tract) and neurons that innervate smooth muscle cells and endocrine and exocrine cells |
|
|
Term
|
Definition
- from ANS innervate digestive structures from outside the system
- modify digestive tract motility and secretion
- parasympathetic nerves signal max digestive activity |
|
|
Term
|
Definition
| - endocrine glands w/in mucosa; hormones signal digestive responses |
|
|
Term
| what are 3 types of receptors in GIT that respond to local chemical or mechanical changes |
|
Definition
- chemoreceptors (chemicals in lumen)
- mechanoreceptors (stretch or tension w/in wall)
- osmoreceptors (osmolarity of luminal contents) |
|
|
Term
| how does activation of receptors in the digestive system produce neural reflexes or secretion of hormones and how many types of neural reflexes are there? |
|
Definition
- alter activity of effector cells, smooth muscle cells and endocrine and exocrine glands
- there are two types of neural reflexes (short and long reflexes) |
|
|
Term
| what is the overall general fx of the the mouth, pharynx, and esophagus |
|
Definition
| - food moistened and lubricated by saliva, chewed to break down into smaller pieces, swallowed, and peristalsis moves it through esophagus to stomach |
|
|
Term
|
Definition
- mouth
- entrance to digestive tract
- opening formed by muscular lips
- palate separates mouth from nasal passages
- tongue consists of voluntarily controlled skeletal muscles |
|
|
Term
|
Definition
| - cavity at rear of throat |
|
|
Term
|
Definition
- muscular tube extending from pharynx to stomach
- guarded at both ends by sphincters: pharyngo-esophageal sphincter and gastroesophageal sphincter |
|
|
Term
|
Definition
- secreted by salivary glands
- contains salivary amylase
- helps keeps mouth and teeth clean
- secretion is continuous
- can be reflexively increased |
|
|
Term
|
Definition
- increased by both branches of ANS, sympathetic and parasympathetic neurons
- simple, unconditioned salivary reflex coordinated by the salivary center in medulla
- acquired, or conditioned, reflex occurs without oral stimulation |
|
|
Term
|
Definition
- chewing by the teeth
- first step in digestion
- grinds and breaks food into smaller pieces
- mixes food with saliva and stimulates taste buds |
|
|
Term
|
Definition
| - motility associatd with pharynx and esophagus |
|
|
Term
| what initiates swallowing |
|
Definition
- when food bolus exerts pressure on receptors in pharynx
- afferent impulses sent to swallowing center in medulla, triggers various swallowing responses |
|
|
Term
| how is food prevented from entering wrong passagways |
|
Definition
- closing of glottis by tilting of epiglottis: preventing food from entering respiratory tract
- elevation of uvula: preventing food from entering nasal passages |
|
|
Term
|
Definition
- swalling initiates primary peristaltic wave
- peristaltic waves push food through esophagus |
|
|
Term
| what prevents reflux of gastic contents |
|
Definition
- gastroesophageal sphincter
- unless swallowing, remains closed (contracted) |
|
|
Term
| what is the back flow of stomach contents called? |
|
Definition
|
|
Term
| what is the purpose of esophageal secretion? |
|
Definition
- mucus
- for protection
- lubricates, preventing damage by sharp objects
- protects esophageal wall from acid contents of stomach |
|
|
Term
| what are the 3 major fxs of the stomach |
|
Definition
- stores food (body)
- begins protein digestion, using HCL and enzymes
- forms chyme, sol'n of partially digested food via mixing (antrum) |
|
|
Term
|
Definition
| - necessary and helpful for absorption of vitamin B12 which is important for RBC production |
|
|
Term
|
Definition
| - fundus, body, and antrum |
|
|
Term
| fundus and body of the stomach |
|
Definition
- thin-walled, secrete mucus, HCL, and pepsinogen, intrinsic factor
- remember that the oxyntic mucosa is in the body |
|
|
Term
|
Definition
- thicker layer of smooth muscle, secretes mucus, gastrin, and small amount of pepsinogen
- remember that the pyloric gland area is in the antrum |
|
|
Term
| what is the role of the epithelial layer w/in in the stomach |
|
Definition
| - invaginates into the mucosa, increasing SA and creating glands |
|
|
Term
|
Definition
- cells at the opening of glands
- secrete thin, watery alkaline mucus
- line pits and entrance of glands
- stimulated mechaically
- fx is protection |
|
|
Term
| what are some examples of cells lining glands? |
|
Definition
- cheif cells
- parietal cells
- others |
|
|
Term
| 4 aspects of gastric motility |
|
Definition
- filling
- storage
- mixing
- emptying |
|
|
Term
| filling in respects to gastric motility |
|
Definition
| - can accommodate 20-fold increase in volume by receptive relaxation |
|
|
Term
|
Definition
| - reflexice relaxation of stomach as it receives food |
|
|
Term
| storage in respects to gastric motility |
|
Definition
- in fundus and body
- pacesetter cells in fundus generate slow-wave potentials that swwp down stomach (3/min)
- weak contractions in fundus and body bc thin muscle here; ideal for storage |
|
|
Term
| mixing in regards to gastric motility |
|
Definition
- in antrum
- peristaltic movements are much stronger bc walls are thick and muscular |
|
|
Term
|
Definition
- peristaltic action in stomach drives chyme from stomach into small intestine
- increased gastric motility by distension of stomach; fluidity of stomach contents
- increased by: signaling by vagus nerve and hormone gastrin (intrinsic nervous) |
|
|
Term
| what four factors control gastrin emptying |
|
Definition
| - fat, acid, hypertonicity, and distension |
|
|
Term
| what prevents gastric emptying |
|
Definition
| - undigested fat, unneutralized acid, increase in osmolarity, distension |
|
|
Term
| what inhibits gastric emptying |
|
Definition
| - neural (intrinsic/extrinsic reflexes) or hormonal response (secretin and CCk: inhibitory enterogastrones) |
|
|
Term
|
Definition
- forced expulsion of gastric contents through mouth
- stomach does not actively participate in vomiting
- force by contraction of respiratory medulla
- severe vomiting can lead to dehydration and circulatory problems
- coordinated by vomiting center in medulla |
|
|
Term
| what parts of the GIT are relaxed during vomiting? |
|
Definition
| - stomach, esophagus, associated sphincters |
|
|
Term
|
Definition
- tactile stimulation
- irritation/distension of stomach and duodenum
- elevated intracranial pressure
- chemical agents
- psychogenic factors |
|
|
Term
|
Definition
- secrete pepsinogen
- line gastric glands
- numerous
- stimulated by gastrin and ACh
- fx is to begin protein digest (active) |
|
|
Term
|
Definition
- secrete HCL and intrinsic factor
- line gastric glands
- fewer
- stimulated by ACh, gastrin, and histamine
- fx is to activated pepsinogen, etc., vitamin B12 |
|
|
Term
| where do glands w/in the stomach act? |
|
Definition
| - locally (unlike endocrine) |
|
|
Term
|
Definition
- secreted by glands located at base of gastric pits
- 2L of gastric juice is secreted daily |
|
|
Term
| what are the three types of gastric exocrine cells in oxyntic mucosa |
|
Definition
- mucous cells
- cheif cells
- parietal cells |
|
|
Term
| where are exocrine secretions released? |
|
Definition
|
|
Term
| 3 types of cells involved in endocrine and paracrine secretions |
|
Definition
- Enterochromaffin-like (ECL) cells
- G cells
- D cells |
|
|
Term
|
Definition
- in oxyntic mucosa
- secrete paracrine
- histamine secreted
- stimulated by ACh and gastrin
- fx is to stimulate parietal cells |
|
|
Term
|
Definition
- in PGA
- secrete hormone
- gastrin secreted
- stimulated by protein products, ACh
- fx is to stimulate parietal, chief, ECL cells |
|
|
Term
|
Definition
- in PGA; stimulated by acid
- but more numerous in duodenum
- fx is to inhibit parietal, G, ECL cells
- secrete paracrine
- somatostatin secreted |
|
|
Term
|
Definition
|
|
Term
|
Definition
- secreted by parietal cells
- low pH (as low as 2) in stomach
converts inactive pepsinogen into active pepsin, initiating protein digestion
- denatures proteins (uncoiling from tretiary structure)
- breakdown of connective tissue and muscle fibers
- kills most microorganisms
- mucus lining on gastric mucosa surface is protective
- mechanical injury
- self-digestion (pepsinogen)
- alkaline, neutralizing HCL near gastric lining |
|
|
Term
| cellular metabolism process in parietal cells |
|
Definition
| 1. carbonic anhydrase; 2. easy dissociation; 3. K+ primary active transport ATPase pump; 4. Cl- in, bicarbonate out -> secondary active transport; 5. Cl- into lumen by simple Cl- channel - STUDY SLIDE |
|
|
Term
|
Definition
- HCL initiates pepsinogen to pepsin
- pepsin catalyzes pepsinogen making more of itself |
|
|
Term
| 4 chemical messengers that influence secretion of gastric juice |
|
Definition
- ACh
- Gastrin
- Histamine
- Somatostatin |
|
|
Term
| how does ACh influence secretion of gastric juice |
|
Definition
- from intrinsic nerve plexuses, stimulates parietal and chief cells
- released in response to short reflexes and vagal stimulation |
|
|
Term
| how does gastrin influence secretion of gastric juice |
|
Definition
- from G cells, stimulates parietal and chief cells
- released in response to: ACh and protein products in lumen |
|
|
Term
| how does histamine influence secretion of gastric juice |
|
Definition
- from ECL cells, acts locally on parietal cells increasing HCL release
- released in response to: gastrin and ACh |
|
|
Term
| how does somatostatin influence secretion of gastric juice |
|
Definition
- from D cells, locally inhibits secretions from parietal, G, and ECL cells
- released in response to: acid |
|
|
Term
| three phases that control gastric secretion |
|
Definition
- cephalic phase
- gastric phase
- intestinal phase |
|
|
Term
|
Definition
- stimuli from head (seeing, smelling, etc.)
- increase seretion of HCL and pepsinogen extrinsic nerve activity via vagal nerve activity |
|
|
Term
|
Definition
- stimuli in stomach (e.g. proteins)
- initiate gastric secretions via intrinsic nerve plexuses and extrinsic vagal pathway
- caffeine/alcohol are stimuli for gastric phase and a lot of HCL secretion is the result |
|
|
Term
|
Definition
- inhibitory
- shuts off flow of gastric juices via factors in duodenum (e.g. fat, acid, etc.) |
|
|
Term
|
Definition
- continues in stomach body
- food not mixed with gastric secretions in body of stomach
- salivary amylase continues to work in internal mass of food
- no fat digested yet |
|
|
Term
|
Definition
- begins in antrum
- food mixed with HCL and pepsin here
- no fats digested yet |
|
|
Term
| what does the stomach absorb |
|
Definition
| - OH (lipid soluble) and aspirin (weak acid, lipid soluble here), but not food |
|
|
Term
| what protects the stomach lining from gastric secretions |
|
Definition
- gastric mucosal barrier
- alkylin so it neutralizes
- mucosal membrane is almost impermeable to H ions |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| aqueous alkaline fluid (NaHCO3-) |
|
|
Term
| enzymes of the exocrine pancreas |
|
Definition
- proteolytic enzymes (tripsin, chymotrypsin, and carboxypeptidase)
- pancreatic amylase: converts starch to disaccharides)
- pancreatic lipaseL: hydrolyzes dietary lipids |
|
|
Term
|
Definition
- hormones, insulin, and glucagon
- islets of langerhans |
|
|
Term
| pancreatic enzymes: trypsin and chymotrypsin |
|
Definition
- protein substrate
- fx is to make peptides from proteins |
|
|
Term
| pancreatic enzymes: carboxypeptidase |
|
Definition
- protein substrate
- fx is to remove last aa from carboxy end of peptide |
|
|
Term
| pancreatic enzyme: lipase |
|
Definition
- fat substrate
- fx is to convert triglycerides into fatty acids and monoglycerides |
|
|
Term
| pancreatic enzyme: pancreatic amylase |
|
Definition
- polysaccharide substrate
- fx is to convert polysaccharides into glucose and maltose |
|
|
Term
| pancreatic enzymes: RNAse and DNAse |
|
Definition
- nuclei acid substrate
- fx is to convert nucleic acids into nucleotides |
|
|
Term
|
Definition
- bile secretion
- metabolic processing of nutrients (such as drugs and hormones)
- detoxifies or degrades body wastes
- synthesizes plasma proteins, glucose, clotting factors
- stores: glycogen, fats, iron, copper, vitamins
- activated vitamin D
- removes bacteria and worn-out RBCs (kupffer cells: resident macrophages)
- excretes cholesterol and bilirubin
- converts ammonia to urea
- converts fatty acids to ketones |
|
|
Term
| hepatic portal system of the liver |
|
Definition
- blood enters liver from digestive tract via hepatic portal system
- portal vein breaks into capillary network, the liver sinusoids |
|
|
Term
|
Definition
- functional units of the liver
- hexagonal arrangements of tissue surrounding central vein
- lobules delineated by vascular and bile channels (hepatocytes continuously secrete bile into these channels)
- bile channels from lobules converge to form common bile duct (duct transports bile from liver to duodenum) |
|
|
Term
| when and where is bile stored |
|
Definition
- stored in gallbladder bt meals
- after a meal, liver and gallbladder secrete bile into small intestine for fat digestion |
|
|
Term
|
Definition
- an aq. alkaline fluid that contains bile salts, cholesterol, lecithin
- bicarbonate ion which neutralizes acid in duodenum
- waste products (e.g. bilirubin) which es excreted via GIT |
|
|
Term
|
Definition
| - stabilize fat; aid gat digestion and absorption |
|
|
Term
|
Definition
- cholesterol derivatives
- recycled through enterohepatic circulation |
|
|
Term
| how does bile emulsify fat |
|
Definition
- fat globules broken into smaller droplets
- increases surface area, facilitates enzymatic attack
- pancreatic lipase anchored to fat droplets by polypeptide colipase (colipase is necessary) |
|
|
Term
| what happens when bile salts are absorbed to surface of small fat droplets |
|
Definition
- prevent the droplets from recoalescing
- most potent stimulus for increased bile secretion from the liver |
|
|
Term
|
Definition
- negatively charged outside H2O-soluble portion (a carboxyl group at the end of a glycine or taurine chain)
- lipid-soluble portion inside (derived from cholesterol)
- 4-8 nm in diameter
- STUDY SLIDES |
|
|
Term
|
Definition
- waste product excreted in bile from breakdown of Hb
- good indication of liver fx (high bilirubin = low fx) |
|
|
Term
| by what mechanisms does bile secretion occur? |
|
Definition
| - chemical, hormonal, and neural |
|
|
Term
|
Definition
- any substance that increases bile secretion
- pancreas |
|
|
Term
| chemical mechanism by which bile secretion occurs |
|
Definition
|
|
Term
| hormonal mechanism by which bile secretion occurs |
|
Definition
|
|
Term
| neural mechanisms by which bile secretion occurs |
|
Definition
- vagus nerve
- from the liver (NOT THE GALLBLADDER) |
|
|
Term
| what are the fxs of the gallbladder |
|
Definition
- stores and concentrates bile
- stored bt meals
- emptied during meals
- gallstones possible |
|
|
Term
|
Definition
| - secretion of CCk stimulates gall bladder contraction, relaxation of sphincter of Oddi, and bile release into duodenum therefore CCK release triggered by chyme reaching small intestine (fat especially potent trigger) then enterohepatic then liver stimulation of bile salts etc etc |
|
|
Term
| what occurs in the small intestine |
|
Definition
- most digestion and absorption
- before this only slight digestion of carbs, proteins (stomach) and NO fat; absorption has slightly occurred but not absorption of nutrients |
|
|
Term
| three segments of the small intestine |
|
Definition
| duodenum, jejunum, and ileum |
|
|
Term
| motility via segmentation in the small intestine |
|
Definition
- mixes and slowly propels chyme
- segmentation contractions: initiated by BER cells (lower contractions at the ileum)
- circular smooth muscle responsiveness: influences by distension of the intestine, gastrin, and extrinsic nerve activity |
|
|
Term
|
Definition
| - part of GIT that is doing most of the contracting and relaxing |
|
|
Term
| frequency of contractions in the small intestine |
|
Definition
- changes
- most frequent in duodenum(12/min) least frequent in ileum (9/min) this helps with absorption
- a lot of mixing
- need to push things forward not back therefore more contractions in duodeum than in ileum
- movement bt duodenum, jejunum, and ileum takes approx. 4 hrs |
|
|
Term
| migrating motility complex of the small intestine |
|
Definition
- weak, repetitive peristaltic waves
- move a short distance then die otu then picked up again
- occurs bt meals, when segmentation ceases
- "internal housekeeper": sweeps intestine clean bt meals after segmentation
- motilin |
|
|
Term
|
Definition
| - hormone secreted by endocrine cells of small intestine regulates migrating motility complex |
|
|
Term
|
Definition
- bt the small and large intestine
- prevents contamination of small intestine by colonic bacteria |
|
|
Term
| does the small intestine secrete digestive enzymes into lumen |
|
Definition
|
|
Term
| where does the pancreas secrete enzymes to |
|
Definition
|
|
Term
| what are completely digested in the small intestine lumen |
|
Definition
| - monoglycerides and free fatty acids, but proteins and carbs need further digestion |
|
|
Term
| what do exocrine gland cells secrete |
|
Definition
- aq. salt and mucus sol'n called "succus entericus"
- provides protection and lubrication in small intestine
- lots of H2O for hydrolysis a key part of digestion |
|
|
Term
| what do the enzymes produced by the small intestine do |
|
Definition
| - act intracellularly at brush border to complete digestion |
|
|
Term
|
Definition
| - special, hairlike projections (microvilli) on epithelial cells of small intestine |
|
|
Term
| what 3 categories of membrane-bound enzymes are found in the plasma membrane of the brush border |
|
Definition
- enterokinase
- dissacharides
- aminopeptidases |
|
|
Term
| enterokinases of the plasma membrane of the brush borders |
|
Definition
| - activates pancreatic enzyme, trypsinogen (precursor) |
|
|
Term
| dissacharidases of the plasma membrane of the brush borders |
|
Definition
- maltase, sucrase, lactase
- complete carb digestion |
|
|
Term
| aminopeptidases of the plasma membrane of the brush borders |
|
Definition
| - hydrolyze small peptide fragments into aa components |
|
|
Term
| which cells of the small intestine play an important role in transport mechanisms |
|
Definition
| - epithelial cells - have a wide variety of transport mechanisms |
|
|
Term
| how does energy-dependent Na+ transport absorption drive passive water absorption |
|
Definition
- sodium pumped from lumen into interstitial fluid; then enters capillaries by diffusion
- sodium transport creates osmotic pressure; water follows sodium |
|
|
Term
| how are carbs and proteins absorbed |
|
Definition
| - by secondary active transport |
|
|
Term
|
Definition
| - passive facilitated diffusion |
|
|
Term
| how are aa and small peptides absorbed |
|
Definition
| - secondary active transport (a lot of different carriers) |
|
|
Term
| how are glucose and galactose absorbed |
|
Definition
| - secondary active transport; co-transported with sodium |
|
|
Term
| how are vitamins absorbed |
|
Definition
- mainly passive
- water-soluble vitamins absorbed with water
- fat-solube vitamins absorbed in micelles |
|
|
Term
| how are iron and calcium absorption regulated |
|
Definition
- only part of ingested iron can be absorbed
- some absorbed iron immediately transported to blood
- transferrin carries some iron to bone marrow (RBCs)
- excess iron stored in ferritin pool
- unused iron lost in feces (excreted) |
|
|
Term
|
Definition
- active transport
- approx 2/3 of ingested calcium absorbed; remaining 1/3 eliminated |
|
|
Term
| how do nutrients immediately pass through the liver for processing |
|
Definition
- venules leaving small intestine villi(and from rest of GIT) empty into the hepatic portal vein; hepatic portal vein carries blood and all absorbed contents to liver
- products of digestion subject to metabolic processing
- any absorbed toxic substances detoxified |
|
|
Term
|
Definition
- mainly drying and storage organ
- most digestion and absorption already accomplished small intestine
- colon receives indifestible food, unabsorbed biliar components, and any remaining fluid
- colon extracts water and salt and eliminates feces |
|
|
Term
| haustral contractions of large intestine |
|
Definition
- slowly shuffle colonic contents back and forth (similar to small intestine by MUCH SLOWER)
- initiated by autonomous rhythmic contractions of smooth muscle in wall of large intestine
- not propulsive, simply for mixing |
|
|
Term
| mass movements of the large intestine |
|
Definition
- propel colonic contents long distances
- drive feces into distal part of large intestine
- material stored here until eliminated by defecation
- primarily occur via gastrocolic reflux (stomach in the colon; "stomach talking to colon" by gastrin) |
|
|
Term
| mechanism by which the defecation reflex eliminates feces |
|
Definition
- fecal material entering rectum stimulates stretch receptors of rectal walls
- causes relaxation of internal anal sphincter smooth muscle (autonomic control)
- causes rectal and sigmoid colon to contract vigorously
- if external anal sphincter (skeletal muscle, voluntary control) also relaxed, defecation occurs (obviously being voluntary, this sphincter can be contacted, preventing defecation; delayed defecation, rectal wall relaxes, removing defecation urge until next mass movement |
|
|
Term
|
Definition
- subjective sensation from stimulation of medullary vomiting center
- often precedes or accompanies vomiting |
|
|
Term
| different types of manifestation of GI disorders |
|
Definition
- anorexia
- nausea
- vomiting
- GI bleeding |
|
|
Term
| what results from GI bleeding |
|
Definition
|
|
Term
|
Definition
- disease/trauma to GIT
- blood vessel abnormalities
- blood clotting disorders |
|
|
Term
|
Definition
|
|
Term
|
Definition
| - black, tarry stool because blood not fresh; it has been acted upon by digestive enzymes |
|
|
Term
|
Definition
- type of melena
- hidden in stools; detected only via chemcial test |
|
|
Term
| various types of esophagus disorders |
|
Definition
- dysphagia
- esophageal diverticulum
- esophageal tears
- gastroesophageal reflux disease (GERD) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| - outpouching of esophageal wall |
|
|
Term
|
Definition
- malory-weiss syndrome
- often associated with alcoholism |
|
|
Term
|
Definition
| - 3-7% of US population (1985); 2002 - 20% had reflux sxs (NOT GERD) |
|
|
Term
|
Definition
| - 1,000 deaths (1984-88); rate is low (1/100,000) not very significant; morbidity bigger issue |
|
|
Term
|
Definition
- only know risk factors; no definite determine of cause
- hiatal hernia
- OH use
- overweight
- pregnancy
- smoking
- certain foods |
|
|
Term
|
Definition
| - upper part of stomach (aka fundus) is above the diaphragm |
|
|
Term
|
Definition
- H+/K+ ATPase
- proton pump |
|
|
Term
| what are 3 stimuli of the H+/K+ ATPase |
|
Definition
- histamine; external
- gastrin
- vagus nerve (produces ACh); external |
|
|
Term
|
Definition
- impaired esophageal clearance (LES stays open)
- transient LES relaxation
- delayed gastric emptying
- decreased LES tone - BIGGEST CAUSE
- impaired tissue resistance
- decreased salivation |
|
|
Term
| why does decreased salivation cause GERD |
|
Definition
| - bc saliva contains amylase and bicarbonate therefore it is protective on way to stomach (but not in) |
|
|
Term
| 3 reasons why stomach is protected against acid |
|
Definition
- impermeability to HCL
- tight junctions between cells
- cells lining gastric mucosa (including those lining gastric pits and glands) |
|
|
Term
|
Definition
|
|
Term
| why does bending, stooping, lying down, and eating increase heart burn |
|
Definition
| - because the contents are moved up and press on the sphincter |
|
|
Term
|
Definition
- regurgitation of food
- dyspepsia
- aspiration
- laryngitis
- cough
- recurrent pneumonia
- asthma
- dental erosions |
|
|
Term
| which of the atypical sxs of GERD should you seek medical attn for |
|
Definition
| - dysphasia, choking, odynophagia, GI bleeding, weight loss, chest pain |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
- esophagitis
- esophageal strictures
- ulceration, bleeding, perforation
- barrett's esophagus |
|
|
Term
|
Definition
- inflammation
- most common pathologic manifestation |
|
|
Term
|
Definition
- fibrosis and narrowing; elasticity lost therefore peristalsis
- fibrosis occurs bc trying to repair wounds |
|
|
Term
|
Definition
- conversion of squamous to columnar epithelium
- 30-100x increased risk for developing esophageal adenocarcinoma |
|
|
Term
|
Definition
| - normal epithelial cells |
|
|
Term
|
Definition
| - abnormal epithelial cells; better at protection from acid |
|
|
Term
|
Definition
- history of sxs (lifestyle changes and drugs for acid reduction; if no relief of sxs in 4-6 wks then proceed to following)
- barium swallow radiograph for nernias and narrowning by not esophagitis
- upper endoscopy
- ambulatory pH monitoring (sends signal to monitor pH) |
|
|
Term
|
Definition
- relieve sxs
- heal esophageal lesions/esophagitis
- maintain sx-and disease-free state; prevent recurrence
- provide cost effective management
- prevent complications |
|
|
Term
| two approaches to GERD tx |
|
Definition
- decrease reflux
- reduce acid |
|
|
Term
|
Definition
- lifestyle modification
- prokinetic (promotility) agents
- surgery (nissen fundoplication) |
|
|
Term
| what is nissen fundoplication |
|
Definition
| - moving fundus around lower esophagous to improve tone to regulate sphincter (i.e. if it is always open, etc) |
|
|
Term
|
Definition
- antacids
- histamine H2 receptors antagonists
- proton pump inhibitors (PPI) |
|
|
Term
| lifestyle modifications to improve GERD |
|
Definition
- not much evidence supporting these
- elevate head of bed
- avoid tight fitting clothing
- weight loss
- avoid triggers that decrease LES tone (dependent upon person; can be food, caffeine, OH, smoking, Ca2+ channel blockers)
- avoid large meals
- avoid lying down after meals |
|
|
Term
|
Definition
- PUD
- erosion of the upper GIT |
|
|
Term
|
Definition
- gastric ulcers
- duodenal ulcers |
|
|
Term
|
Definition
- Helicobacter pylori infection (main cause of both types of ulcers; can be treated with antibiotics)
- chronic NSAIDS, ASA (more gastric ulcers than duodenal; no tx) |
|
|
Term
| which type of ulcer is most common in PUD |
|
Definition
|
|
Term
| are men or women more likey to get PUD |
|
Definition
|
|
Term
|
Definition
- sudden and severe
- abdominal pain (burning, gnawing, especially when stomach empty)
- nausea, vomiting
- weight loss
- fatigue
- hearburn, indigestion, belching
- vomiting blood
- bloody or tarry stools |
|
|
Term
| five complications of PUD |
|
Definition
- hemorrhage
- anemia
- hypovolemic shock
- obstruction
- perforation |
|
|
Term
|
Definition
- sudden and severe or slow and chronic
- coffee ground emesis (vomit that looks like coffee grounds)
- hematemesis
- melena
- hematochezia (blood in stool; visibly red) |
|
|
Term
|
Definition
- low amount of blood
- slow and chronic PUD complication |
|
|
Term
|
Definition
- catastrophic loss of blood
- sudden and severe complication of PUD |
|
|
Term
|
Definition
- sudden severe history
- hypochromic microcytic anemia
- endoscopy
- h.pylori test: serologic or breath
- tagged RBC scan |
|
|
Term
|
Definition
- H.pylori: antibiotics
- acid blockers and PPIs
- stop NSAIDS/ASA
- surgery for severe bleeding |
|
|
Term
| zollinger-ellison syndrome |
|
Definition
- gastrin-secreting tumor (gastrinoma) therefore uncontrolled HCL production and secretion
- massive H+ production, ulcer is inevitable |
|
|
Term
| signs and sxs of zollinger-ellison syndrome |
|
Definition
- peptic ulcers
- diarrhea
- malabsorption
- often in pancreas and duodenum |
|
|
Term
| dx of zollinger-ellison syndrome |
|
Definition
- abnormal gatrin concentration
- abnormal stomach acid concentration
- scan for tumors |
|
|
Term
| tx of zollinger-ellison syndrome |
|
Definition
- PPI
- localize tumor and recept it (bc most are malignant); good things is that tumors are often slow growing and pts can live for a long time with a tumor |
|
|
Term
| what type of stress causes stress ulcers |
|
Definition
- physiologic stress
- these ulcers are generalized inflammation and superficial ulceration |
|
|
Term
| etiology of stress ulcers |
|
Definition
- mucosal hypoperfusion and ischemia
- acidosis, decreased motility, bile salts |
|
|
Term
| who is at risk for stress ulcers and why |
|
Definition
- hospital ICU pts
- bc mechanical intubation, burns, major trauma, sepsis, severe liver failure |
|
|
Term
|
Definition
- determine underlying cause
- reduce acid intake |
|
|
Term
| two related inflammatory intestinal disorders |
|
Definition
- chron's disease
- ulcerative colitis |
|
|
Term
| prevalence of chron's and ulcerative colitis |
|
Definition
- 7/100,000 for chrons disease
- 10-15/100,000 for ulcerative colitis |
|
|
Term
| etiology of inflammatory bowel disease |
|
Definition
- unknown
- genetic predisposition, environment, psychogenic |
|
|
Term
| which of the two types of imflammatory bowel syndrome is most likely develop cancer |
|
Definition
| - ulcerative colitis because the bleeding is uncontrolled and may change the cell type which is more likely to cause cancer |
|
|
Term
| which parts of the GIT does chrons disease affect? |
|
Definition
- small intestine, large intestine
- mostly the ileum and the colon |
|
|
Term
| what are the characteristics of chrons disease |
|
Definition
- sharply demarcated, granulomatous lesions surrounded by normal mucosa
- patchy (skip lesions)
- surface fissures and crevices ("cobblestone")
- submucosal edema
- smooth muscle usually spared (normal) |
|
|
Term
|
Definition
| - one channel extending from one region to another that normally wouldn't be there |
|
|
Term
| what are the signs and sxs of chrons disease |
|
Definition
- diarrhea (if large intestine affected)
- lower right quadrant pain
- weight loss
- low grade fever
- malaise
- less belling than ulcerative colitis |
|
|
Term
| why does a person with chrons disease in the small intestine experience wt. loss? |
|
Definition
| - digestion and absorption are not normal leading to wt. loss |
|
|
Term
| what is the course of chron's disease |
|
Definition
- variable
- exaacerbation and remission |
|
|
Term
| what are some complications associated with chrons disease |
|
Definition
- fistulas
- abscesses
- infection
- obstruction
- toxic megacolon |
|
|
Term
|
Definition
- large colon with infection and inflammation
- this is very sudden and severe
- can result in perforation which can result in infection in the blood |
|
|
Term
| where does ulcerative colitis occur |
|
Definition
- begins at rectum and spreads proximally and continuously
- also in the large intestine
- primarily affects mucosal (less deep) layer but can extend into the submucosa |
|
|
Term
| what are some characteristics of ulcerative colitis |
|
Definition
- micro-hemorrhages in mucosa develop into abscesses; may become necrotic, ulcerate
- polyp-like projections from mucosa: pseudopolyps
- bowel thickens
- absolutely ulcerated, continuous, exudate |
|
|
Term
| what is the course of ulcerative colitis |
|
Definition
| - remissions and exacerbation |
|
|
Term
| what are sxs of ulcerative colitis |
|
Definition
| - diarrhea, cramping, incontinence, weakness, fatigue, rectal bleeding |
|
|
Term
| what are the three levels of severity of ulcerative colitis |
|
Definition
- mild chronic
- chronic intermittent
- acute fulminant |
|
|
Term
| mild chronic ulcerative colitis |
|
Definition
| - most common, mild diarrhea, cleeding, minimal systemic signs |
|
|
Term
| chronic intermittent ulcerative colitis |
|
Definition
| - initial attack and continues more colon involved, systemic signs |
|
|
Term
| acute fulminant ulcerative colitis |
|
Definition
- entire colon, severe bloody diarrhea, fever, acute abdominal pain
- risk for toxic megacolon and perforation
- occurs at "lightening fast speed" |
|
|
Term
| complications of ulcerative colitis |
|
Definition
- cancer
- hemorrhage
- anemia
- infection
- perforation |
|
|
Term
| dx of chrons/ulcerative colitis |
|
Definition
- sigmoidoscopy with biopsy
- CT scan w contrast to identify abscesses and fistulae |
|
|
Term
| tx for chrons/ulcerative colitis |
|
Definition
- antiinflammatory 5-ASA compounds (mesalamine, olsalazine)
- immunosuppression (corticosteroids)
- nutrition
- surgery |
|
|
Term
| what are the results for surgery if the pt has chrons disease |
|
Definition
| - since there are skip lesions, surgical removal of part of the colon does not guarantee that all of the disease has been removed and therefore the disease may occur again |
|
|
Term
| what are the results for surgery if the pt has ulcerative colitis |
|
Definition
| - since this is continuous, you can remove the part of the colon containing the disease and the person will no longer suffer from the disease and will no longer be at risk for cancer |
|
|
Term
|
Definition
- condition in which the mucosal layer of colon herniates through muscularis layer
- pouch develops bt muscle rings
- often asymptomatic and found on x-ray for other purposes |
|
|
Term
| what are two common risk factors for diverticulosis |
|
Definition
- common in western society (diet?); almost non-existent in African countries
- increases with age |
|
|
Term
|
Definition
| - complication of diverticulosis w inflammation and perforation of divericula |
|
|
Term
| what are the signs and sxs of diverticulitis |
|
Definition
- lower left quadrant pain with nausea and vomiting, tenderness
- slight fever, elevated WBC count |
|
|
Term
| what are complications of diverticulitis |
|
Definition
- abscess
- fistulae
- perforation with peritonitis, hemorrhage, obstruction |
|
|
Term
| how do you dx diverticular disease |
|
Definition
- signs and sxs
- history
- CT scan
- barium enema and x-ray (not if diverticulitis is suspected) |
|
|
Term
| tx for diverticular disease |
|
Definition
- prevent sxs and complications
- bulk diet
- treat diverticulitis with antibiotics
- surgery for complications |
|
|
Term
| what are the steps involved in bilirubin metabolism |
|
Definition
- heme broken down into biliverdin
- this is rapidly converted to free bilirubin
- binds to protein
- travels through blood to liver
- released from protein and moved into hepatocytes
- conjugated chemically to another group
- excreted into intestine
- converted into urobilinogen (large intestine)
- some used in bile
- some secreted in feces |
|
|
Term
| how does the amt. of bilirubin present relate to liver fx |
|
Definition
| - more bilirubin = decreased liver fx |
|
|
Term
| what does jaundice result from |
|
Definition
| - abnormally high accumulation of bilirubin in blood; yellowing of skin, tissues |
|
|
Term
| what is another term used when talking about jaundice |
|
Definition
|
|
Term
| what are 4 causes of high accumulation of bilirubin in the blood |
|
Definition
- excessive destruction of rbc's
- impaired uptake of bilirubin by liver cells
- decreased conjugation of bilirubin
- obstructed bile flow within (canliculi of hepatic lobules; intrahepatic or extrahepatic bile ducts) |
|
|
Term
| what is a prehepatic cause of high accumulation of bilirubin in the blood |
|
Definition
| - excessive destruction of rbcs |
|
|
Term
| what are intrahepatic causes of high accumulation of bilirubin in the blood |
|
Definition
- impaired uptake of bilirubin by liver cells
- decreased conjugation of bilirubin
- obstructed bile flow within (canliculi of hepatic lobules) |
|
|
Term
| what is a posthepatic cause of high accumulation of bilirubin in the blood |
|
Definition
| - intrahepatic or extrahepatic bile ducts |
|
|
Term
| what are 4 things tested to determine hepatobiliary fx |
|
Definition
- bilirubin
- liver enzymes
- serum protein levels (albumin)
- prothrombin time (increased PT = increased liver disfx) |
|
|
Term
| what are four liver enzymes focused on when testing hepatobiliary fx |
|
Definition
- alanine aminotransferase (ALT)
- aspartate aminotransferase (AST)
- gamma-glutamyltransferase (GGT)
- alkaline phosphatase |
|
|
Term
| what does in an increase in liver enzymes indicate? |
|
Definition
- liver damage
- amt of change does not necessarily mean a correlating amt. of liver damage |
|
|
Term
| what is the literal def of hepatitis |
|
Definition
| - inflammation of the liver |
|
|
Term
| what are causes of hepatitis |
|
Definition
- autoimmune disorders
- rxns to drugs and toxins
- secondary to other infections (malaria, monoculeosis, etc.)
- hepatotropic viruses |
|
|
Term
| what are the 5 hepatotropic viruses |
|
Definition
- hep A virus (HAV)
- hep B virus (HBV)
- hep b assoc. delta virus (HDV)
- hep c virus (HCV)
- hep e virus (HEV) |
|
|
Term
| what are two hepatotropic virus that are enteric? |
|
Definition
- meaning from GIT
- hep a
- hep e |
|
|
Term
| what are the characteristics that determine the diff. hepatotropic viruses |
|
Definition
| - differ in mode of transmission; incubation period; mechanism; degree and chronicity of liver damage; ability to evolve into carrier state |
|
|
Term
| what is the relationship bt HBV and HDV |
|
Definition
- HDV is inactive wo HBV
- HBV can fx w or wo HDV |
|
|
Term
| what are the two mechanisms of liver injury |
|
Definition
- direct cellular injury
- induction of immune response against viral Ags
- believed extenet of inflammation and necrosis correlates with individual's immune response (prompt response during acute phase = less cell injury) |
|
|
Term
| what are the syndromes of liver injury involved by clinical course |
|
Definition
- asymptomatic infection (serology only)
- acute hepatitis
- carrier state wo apparent clincal disease or w chronic hepatitis
- chronic hepatitis w or wo progression to cirrhosis
- fulminating disease |
|
|
Term
| 3 phages of manifestations of acute viral hepatitis |
|
Definition
- prodromal or preicterus period
- icterus period
- convalescent period |
|
|
Term
| prodromal or preictreus period of acute viral hepatitis |
|
Definition
- no specific signs and sxs but person may not feel well
- no jaundice |
|
|
Term
| icterus period of acute viral hepatitis |
|
Definition
| - jaundice can be seen (not all types of hepatitis show jaundice) |
|
|
Term
| convalescent period of acute viral hepatitis |
|
Definition
| - person begins to look or feel better, virus clears (mostly with hep A) |
|
|
Term
| what occurs during the carrier state of acute viral hepatitis |
|
Definition
- no sxs but infected
- HBV, HCV, possibly HDV
- NOT HAV
- may or may not be assoc. w HEV, but HEV is relatively new so it is still unknown (currently appears not to have a carrier state) |
|
|
Term
| what classifies hepatitis as chronic |
|
Definition
- chronic inflammation of the liver of more than 3-6 months
- persistently elevated serum aminotransferase levels
- hep c most common
- may or may not see signs and sxs |
|
|
Term
| what are the causes of chronic hepatitis |
|
Definition
| - HBV, HCV, HDV, autoimmune hepatitis, drug-induced hepatitis |
|
|
Term
| what are the outcomes of chronic hepatitis |
|
Definition
- chronic liver disease, cirrhosis, hepatocellular carcinoma
- primary reason for liver transplants in adults |
|
|
Term
| clincial features of chronic hepatitis |
|
Definition
- fatigue
- malaise
- loss of appetite
- occasional jaundice
- elevated liver enzymes depend upon level of disease activity |
|
|
Term
|
Definition
- no simple, effective txs
- recombinant interferon-alpha-2b helpful (other forms of interferon also useful)
- nuceloside analog, lamivudine, during active viral replication for HBV (NOT HDV)
- liver transplant for end-stage liver disease due to chronic hepatitis (new liver often reinfected, but slow course) |
|
|
Term
|
Definition
- chronic inflammation of liver of unknown etiology (idiopathic - accounts for 10% of chronic hepatitis in US)
- circulating autoantibodies
- high serum [IgG]
- common in young girls and women |
|
|
Term
| what is hypregammaglobulinemia |
|
Definition
|
|
Term
| pathology of autoimmune hepatitis |
|
Definition
- genetically predisposed person exposed to environmental agent triggering autoimmune response
- autoimmune destruction of liver cells causes necrosis (necrotizing inflammation)
- destruction of liver cells progresses to cirrhosis
- may progress to liver failure |
|
|
Term
| presentation of autoimmune hepatitis |
|
Definition
- fatigue, malaise, jaundice
- middle-aged women with ANA
- progression is variable
- hight mortality |
|
|
Term
| dx of autoimmune hepatitis |
|
Definition
- differential dx (rule out other causes of chronic hepatitis)
- marked elevation of serum IgG
- autoAbs (ANA, anti-smooth muscle Abs, anti-LKM-1 Abs aka anti-liver kidney microsomal)
- biopsy to confirm dx |
|
|
Term
| tx of autoimmune hepatitis |
|
Definition
- corticosteroids to reduce inflammation
- this may slow progression, but may still progress to cirrhosis and liver failure (transplant) |
|
|
Term
| what develops as a result of alcohol's toxic effects on hepatocytes |
|
Definition
|
|
Term
|
Definition
- OH dehydrogenase (ADH): cytoplasm
- microsomal ethanol-oxidizing system (MEOS, member of the CYP450 system): ER
- catalase: peroxisomes
- end products: acetaldehyde, free radicals responsible for alterations that cause liver injury |
|
|
Term
| what has toxic effects on hepatocytes and liver fx |
|
Definition
|
|
Term
| what is acetyaldehyde injury correlated to |
|
Definition
- avg quantity consumed daily and duration of abuse
- age: affects OH metabolizing abilities of liver and resistance to hepatotoxic effects
- gender: women produce more acetylaldehyde than men |
|
|
Term
| Nicotinamide adenine dinucleotide (NAD) |
|
Definition
- cofactor reqd for OH metabolism
- also reqd for metabolism of pyruvates, urates, fatty acids
- OH metabolism competes for NAD (accumulation of lactic acid; impaired gluconeogenesis) |
|
|
Term
| fatty liver disease (steatosis) |
|
Definition
- fat accumulation in hepatocytes
- fat from diet, OH increases lipolysis and delivery of FFA to liver
- OH increases FA synthesis
- OH decreases oxidation of FA
- OH impairs release of lipoproteins |
|
|
Term
|
Definition
- intermediate stage bt steatosis and cirrhosis
- inflammation and necrosis of hepatocytes
- acute phase mortality |
|
|
Term
| signs and sxs of alcoholic hepatitis |
|
Definition
- hepatic tenderness, pain
- anorexia, nausea
- jaundice
- ascites |
|
|
Term
|
Definition
- result of repeated alcoholic insults to liver
- designates onset of end-stage alcoholic liver disease
- visually fine, but uniform nodules on liver suface |
|
|
