| Term 
 | Definition 
 
        | liver hepatocytes and biliary duct cholangiocytes |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Na, K, Ca (positive ions), bile acids, lecithin, bilde pigments, cholesterol |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ATP and glutathione Proteins such as biliary glycoproteins (mucins) and serum immunoglobulins Steriod hormones and their various metabolites Drugs, toxins, and heavy metals Amino acids, peptides and Vitamins |  | 
        |  | 
        
        | Term 
 
        | bile canaliculi eventually becomes |  | Definition 
 
        | hepatic bile ducts which ends in a common hepatic duct |  | 
        |  | 
        
        | Term 
 
        | Common bile duct picks up the main pancreatic duct at |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Ring of circular smooth muscle that is the exit of the biliary system immediately before entering the duodenum |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Gallbladder's lateral walls are relatively impermeable to_____ leading to the standing osmotic gradient |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | potent amphipathic organic acid detergents made from cholesterol, with pKa's near neutral and usually associated with sodium as bile salts |  | 
        |  | 
        
        | Term 
 
        | Hepatocytes conjugate bile acids with ____ or _____ thereby lowering the pKa of the conjugated bile acids |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | cholic acid and chenodeoxycholic acid directly synthesized from cholesterol |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | formed by the action of intestinal bacteria on the primary bile acids (rmove OH) 3.5 grams |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | formed when lecithin enters a micelle |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | occur when micelles enter the duodenum and pick up the hydrophobic components of the diet and products of lipid digestion (FFA's, 2MG) |  | 
        |  | 
        
        | Term 
 
        | lipid soluble contents of micelles are absorbed via |  | Definition 
 
        | the unstirred layer on the microvilli surface of the epithelium of the mid-jejunum |  | 
        |  | 
        
        | Term 
 
        | non lipid soluble contents of micelles are absorbed via |  | Definition 
 
        | across apical membrane of ileal enterocytes via either a Na-independent transporter protein, OATP1B1, or a 2:1 Na-BS cotransporter alpha and betat and the ATPase transporter, MRP3 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | reticuloendothelial cells located throughout vasculature |  | 
        |  | 
        
        | Term 
 
        | pump used to transfer bilirubin into the cell |  | Definition 
 
        | OATP1B1 (also carries BS) |  | 
        |  | 
        
        | Term 
 
        | Chemoreceptors that sense toxins, and trigger vomiting are located |  | Definition 
 
        | near the floor of the fourth ventricle of the brain and in the gastric and duodenal mucosa |  | 
        |  | 
        
        | Term 
 
        | Bilirubin conjugated with two glucuronic acids in the SER of a hepatocyte to form |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Bilirubin diglucuronice (BRDB) is actively pumped out of the hepatocyte and into the bile canaliculi by: |  | Definition 
 
        | multidrug-resistance related protein 2 (MRP2) |  | 
        |  | 
        
        | Term 
 
        | Gives urine and feces their color |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | accumulation of >1.5 mg% total bilirubin in blood |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | excessive bilirubin production overwhelming the capacity of a healthy liver to take up and conjugate the BS |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | results from a decrease in functional liver cells (e.g intoxication or infection of the liver as with hepatitis virus) making it unable to handle the normal load of BS |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | obstruction in the biliary tact (eg cholelithiasis) with pressure back up and regurgitation of conjugated BS out of the biliary tract and into the blood |  | 
        |  | 
        
        | Term 
 
        | Used to import conjugated and unconjugated BS on the hepatocyte sinusoidal membrane |  | Definition 
 
        | Na-dependent, Na-taurocholate-co-transporting polypeptide=NTCP Na-independent organic anion-transporting peptide=OATP1B1 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | -hepatocyte sinusoidal membrane -apical membrane of ileal enterocytes to import BS |  | 
        |  | 
        
        | Term 
 
        | Na-independent OATP1B3 transporter imports |  | Definition 
 
        | bile jpigment, glutathione, bromosulphonphthalein and various radiopaque dyes |  | 
        |  | 
        
        | Term 
 
        | Transporters on the hepatocyte sinusoidal membrane |  | Definition 
 
        | NTCP OATP1B1 MRP3- ATP-dependent multidrug resistance-related protein 3 |  | 
        |  | 
        
        | Term 
 
        | ATP-dependent multidrug resistance-related protein 3 transports |  | Definition 
 
        | organic solutes into the hepatocyte (MRP3 is also on the BLM of ileal enterocytes where it exports BS out of the cell and into the body) |  | 
        |  | 
        
        | Term 
 
        | Transporters that transport from the hepatocyte to the canliculi |  | Definition 
 
        | BSEP MRP2 MDR1 MDR3 (all are ATPases belonging to the ATP binding cassette) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | monovalent BS (bile salt export protein) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | divalent BS, bile prgment, glutathione, cystic fibrosis transmembrane conductance regulator, bromosulphonphthalein and various radiopaque dyes |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | organic cations and xenobiotics |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | phospholipids like lecithin |  | 
        |  | 
        
        | Term 
 
        | 
 
The  cholangiocyte basolateral membrane (BLM) contains: |  | Definition 
 
        |       
A) a Na +-hydrogen exchanger 1 (NHE 1) that exports H+ in exchange for Na+ entry.
B) a Na +- HCO3
-   co-transporter.
C) a Na +- K+-2Cl- co-transporter.
D) the usual K + channel. |  | 
        |  | 
        
        | Term 
 
        | Cholangiocyte canalicular membrane contains |  | Definition 
 
        | CFTR Cl channel Ca activated Cl channel AE2 |  | 
        |  | 
        
        | Term 
 
        | AE2 funciton on canlicular membrane |  | Definition 
 
        | exports HCO3 being driven by the Cl gradient thereby alkalinizing the bile |  | 
        |  | 
        
        | Term 
 
        | Apical transporters typically generate what kind of gradient |  | Definition 
 
        | -6 mV with a negative lumen |  | 
        |  | 
        
        | Term 
 
        | Importers of BS in ileum enterocytes on apical membrane |  | Definition 
 
        | OATP1B1 ASBT (electroenic apical sodium dependent BS trasporter) |  | 
        |  | 
        
        | Term 
 
        | Exporters of BS on the basolateral membrane of ileum enterocytes |  | Definition 
 
        | MRP3 the heterodimeric organic solute transporter alpha and beta, OSTalpha and beta |  | 
        |  | 
        
        | Term 
 
        | Substances that stimulate bile flow |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Secretin affect on bile flow |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | The release of ATP into the bile vy cholangiocytes activates |  | Definition 
 
        | purinergic P2 (P2Y2) receptors on the cholangiocyte surface that results in an increase in intracellular Ca through a mechanism involving conventional or novel PKC Elevated Ca opens Ca activated Cl channels |  | 
        |  | 
        
        | Term 
 
        | Cl exchanges for HCO3 bile to cholangiocytes via |  | Definition 
 
        | AE2 exchanger results in dilution and alkalinixation of the bile |  | 
        |  | 
        
        | Term 
 
        | ATP released by shear of flow affect on bile flow |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Cephalic phase of digestion stimulus |  | Definition 
 
        | taste and smell of food, food in mouth and pharynx |  | 
        |  | 
        
        | Term 
 
        | CCK secreted in the stomach by fat digestion acitvation does what involving bile? |  | Definition 
 
        | 
causes the gallbladder to contract strongly, increases common bile duct peristalsis and further relaxation of the sphincter of Oddi |  | 
        |  | 
        
        | Term 
 
        | Acid in chyme evokes the release of _____ from duodenal enteroendocrine cells |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | increased bicardbonate secretion from all the pancreatic and common bile duct epithelial cells and the walls of the small intestine |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | 
as bile acids are actively absorbed in the ilium, the elevated blood levels stimulate further bile secretion by hepatocytes |  | 
        |  | 
        
        | Term 
 
        | Higher blood bile acids act in an inhibitory fashion on |  | Definition 
 
        | the first enzyme (7-alpha hydroxylase) in the conversion of cholesterol into bile acids |  | 
        |  | 
        
        | Term 
 
        | Mediating factor of intestinal digestion |  | Definition 
 
        | cholecystekinin Secretin High concentration of bile acids in portal blood |  | 
        |  | 
        
        | Term 
 
        | Mdiating factor in interdigestive period |  | Definition 
 
        | low concentration of bile acids in portal blood |  | 
        |  | 
        
        | Term 
 
        | Stimulus of intestinal digestion |  | Definition 
 
        | fat digestion products in duodenum Acid in duodenum Absorption of bile acids in the distal part of ileum |  | 
        |  | 
        
        | Term 
 
        | Stimulus of interdigestive period of digestion |  | Definition 
 
        | low rate of release of bile to duodenum |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | MRP2 mediates organic anion export of |  | Definition 
 
        | divalent BS, BRDG, and glutathione |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | organic cations and xenobiotics |  | 
        |  | 
        
        | Term 
 
        | MDR2 on the CM of hepatocyte transports |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | HCO3 (exits) with Cl (enters) |  | 
        |  | 
        
        | Term 
 
        | OATP1B1 on apical/luminal membrane of enterocytes in the ileum brings in |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | FXR has what effect on bile salt import proteins in elevated bile salt concentrations |  | Definition 
 
        | represses bile salt important proteins, while activating the genes for the BS exporting proteins on the basolateral membrane |  | 
        |  | 
        
        | Term 
 
        | FXR reduces the potential of systemic infection by |  | Definition 
 
        | maintaining the mucosal defense barrier and protecting the lower intestinal epithelium against bacterial overgrowth |  | 
        |  | 
        
        | Term 
 
        | Reduce liver cell destruction in cholestasis by |  | Definition 
 
        | inhibition of the human cholesterol-7-alpha-hydroxylase gene promoter CYO7A1 by administration of Fibroblast Growth Factor 19 possibly via FXR |  | 
        |  | 
        
        | Term 
 
        | unabsorbed bile salts int he colon produce |  | Definition 
 
        | osmotic diarrhea, steatorrhea and loss of calcium and fat-soluble vitamins |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | 
fasciculus solitarius in the dorsolateral border of the lateral reticular formation of the medulla |  | 
        |  | 
        
        | Term 
 
        | Chemoreceptor trigger zone for vomiting located in |  | Definition 
 
        | above medulla in the area postrema on the floor of the 4th ventricle |  | 
        |  | 
        
        | Term 
 
        | During retching intrathoracic pressure is |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | During retching, intra-abdominal pressure is |  | Definition 
 
        | raised due to abdominal muscles strongly contracting |  | 
        |  | 
        
        | Term 
 
        | During retching stomach acid secretion ____ while mucus and salivary secretions _____ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Electrical stimulation of vomiting center results in |  | Definition 
 
        | projectile vomiting without retching |  | 
        |  | 
        
        | Term 
 
        | Caudal half of colon receives innervation by |  | Definition 
 
        | pelvic nerve parasympathetic preganglionic fibers |  | 
        |  | 
        
        | Term 
 
        | 
proximal colon receives sympathetic postganglionic nerve fibers from the |  | Definition 
 
        | superior mesenteric ganglion |  | 
        |  | 
        
        | Term 
 
        | the distal colon recieves sympathetic postgangionic nerve ffibers from |  | Definition 
 
        | the inferior mesenteric ganglion |  | 
        |  | 
        
        | Term 
 
        | the rectum and anal canal are innervated by sympathetic fibers from |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | The striated muscle comprising the external anal sphincter is innervated by |  | Definition 
 
        | somatic fibers in the pudendal nerves |  | 
        |  | 
        
        | Term 
 
        | During defecation muscles of the pelvic floor |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | In addition to the ENS, the defecation reflex is coordinated by: |  | Definition 
 
        | a spinal cord center which is facilitated or inhibited by the cerebral cortex |  | 
        |  | 
        
        | Term 
 
        | Gastrin influence on defecation |  | Definition 
 
        | increases motility of the ileum and relaxes the ileocecal sphincter |  | 
        |  | 
        
        | Term 
 
        | Epinephrine effect on defecation |  | Definition 
 
        | inhibits colonic motility and the prostaglandin E's decrease segmentation and increase peristalsis |  | 
        |  | 
        
        | Term 
 
        | examples of osmotic diarrhea |  | Definition 
 
        | 
 
Lactose intolerance; sea water; MgSO   4; steratorrhea; post-prandi, aldumping syndrome |  | 
        |  | 
        
        | Term 
 
        | secretor diarrhea examples |  | Definition 
 
        |   
 
Bacterial toxins e.g., cholera (cAMP mediated Cl    - secretion);
enteropathic E.coli (    ↑[Ca++] i); Gastrinoma; VIPoma |  | 
        |  | 
        
        | Term 
 
        | malabsorptive diarrhea examples |  | Definition 
 
        | bile acid malabsorption, gluten enterophathy, cholelithiasis |  | 
        |  | 
        
        | Term 
 
        | Exudative diarrhea examples |  | Definition 
 
        | 
Invasive organisms e.g., salmonella, amoeba histolytica, withinflammation and blood loss; influenza; Crohn’s Disease (ileitis);ulcerative colitis |  | 
        |  | 
        
        | Term 
 
        | Excess motor activity diarrhea examples |  | Definition 
 
        | IBS, bacterial action on unabsorbed long-chain fatty acids, stress |  | 
        |  | 
        
        | Term 
 
        | Results of chronic diarrhea |  | Definition 
 
        | dehydration, hypokalemia, and acidosis, loss of water soluble vitamins, possible loss of Ca and fat soluble vitamins |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | absence of ENS in the internal anal sphincter and often rectum |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | outpouchings of the mucosa through the muscular wall of the colon maybe due to chronic high intraluminal pressure |  | 
        |  | 
        
        | Term 
 
        | Mucosal transporters in jejunum and ileum |  | Definition 
 
        | NHE- Na and H antiport Na and gluc (a.a.) symport K and Cl symport H20 |  | 
        |  | 
        
        | Term 
 
        | Serosal transporters in jejunum and ileum |  | Definition 
 
        | Na and K ATP dependent antiport facilitated gluc (a.a) transporter Facilitated Cl transporter H20 |  | 
        |  | 
        
        | Term 
 
        | Mucosal transporters in ileum and colonbut not jejunum |  | Definition 
 
        | HCO3 and Cl antiport Epithelial Na channel |  | 
        |  | 
        
        | Term 
 
        | Serosal transporter in ileum and colon but not jejunum |  | Definition 
 
        | NBC transporter- HCO3 and Na antiport |  | 
        |  | 
        
        | Term 
 
        | Colon does not have which transporter |  | Definition 
 
        | Na and gluc (a.a.) symport |  | 
        |  | 
        
        | Term 
 
        | Colon does have which transporter that the small intestine does not |  | Definition 
 
        | K and H antiport ATP dependent |  | 
        |  | 
        
        | Term 
 
        | Myenteric plexus is the same as: |  | Definition 
 
        | Auerbach's plexus (motor control of the longitudinal and circular muscles) |  | 
        |  | 
        
        | Term 
 
        | Parietal cell the same as: |  | Definition 
 
        | Oxyntic cell (secretes stomach acid) |  | 
        |  | 
        
        | Term 
 
        | Gastrin-releasing peptide is the same as |  | Definition 
 
        | GRP or bombesin (vagal mediator of gastrin release) |  | 
        |  | 
        
        | Term 
 
        | isomaltase is the same as |  | Definition 
 
        | alpha-limit dextrinase (exzyme at the surface of small intestine brush border) |  | 
        |  | 
        
        | Term 
 
        | fastric inhitory peptide is the same as |  | Definition 
 
        | glucose insulatropic peptide (during the intestinal phase of digestion these block acid secretion and increase insulin release) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increase acid increase acid sec mucosa |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increase in bicarbonate and enzyme gallbladder contract decrease in gastric emptying decrease in appetite increase in insulin |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increase of bicarbonate and fluid decrease in acid increase in cAMP via activation of AC |  | 
        |  | 
        
        | Term 
 
        | Effect of GIP (gastric inhibitory peptide) |  | Definition 
 
        | decrease in acid increase in insulin |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increase intestinal secretions Relaxes smooth muscle |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | decrease acid decrease gastrin sec decrease insulin |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | Neurocrines involved in GI control |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Paracrines involved in GI control |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | antral contractions block |  | Definition 
 
        | gastric parietal cell and production of gastrin |  | 
        |  | 
        
        | Term 
 
        | dipeptidyl peptidase reduces ____ to _____ |  | Definition 
 
        | oligopeptides to dipeptides |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | Iron absorption highest in: |  | Definition 
 
        | duodenum and first part of jejunum |  | 
        |  | 
        
        | Term 
 
        | Iron primarily absorbed in what form? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | In blood iron is bound to: |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | abnormal iron accumulation that exceeds iron excretory capacity |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | genetic defect producing iron accumulation in vital organs, most seriously in the heart causing cardiomyopathy |  | 
        |  | 
        
        | Term 
 
        | Vitamin B12 is carried around circulatory system by |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Most to least salivary secretions at high flow rate |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Most to least gastric secretions at high flow rate |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Most to least pancreatic secretions at full flow rates |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | absorption is regulated by diet except for |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | crypt cells mature and migrate toward tip of vilus to become |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | jejunum is important site for absorption of |  | Definition 
 | 
        |  |