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GI Phys IV
Solomon 4/8/11 - 1.5 hr Guyton ch 64, 70
42
Physiology
Undergraduate 4
04/15/2011

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Term
released from distal stomach(antrum) due to the presence of

1)amino acids
2)peptides
3)or a decrease in somatostatin

released by G cells in stomach duodenum and pancreas
Definition
where and when is gastrin released, and by what cells?
Term
1)increase in histamine secretion by ECL cells
2) increase in H+ secretion by parietal cells
Definition
what does the release of gastrin stimulate?
Term
CCK is released by the proximal small intestine in the presence of
1) peptides
2) amino acids
3) and fatty acids

released by I cells in the mucosal epithelium of the duodenum
Definition
where and when is CCK released, and by what cells?
Term
1) increase in pancreatic enzyme release
2) stimulates gall-bladder contraction and bile release
Definition
what does the release of CCK stimulate?
Term
released in the proximal small intestine due to the presence of
1) H+ and
2) fatty acids

released by S cells in the duodenum crypts of Lieberkuhn
Definition
where and when is secretin released, and by what cells?
Term
increase in pancreatic/Brunner's gland secretion of
1)water and
2)bicarb

helps maintain pH
Definition
what does the release of secretin stimulate?
Term
1) lubrication
2) solvent
3) digestion
4) defense
Definition
what are the functions of saliva?
Term
mumps
Definition
viral infection of the parotid gland that used to be a common childhood illness
Term
salivary glands
Definition
the only region of the GI tract controlled EXCLUSIVELY by neuronal control vis ACh(no paracrine/hormones)
Term
occurs in acini, which secrete:
1) ptyalin (amylase)
2) mucus
3) the overall composition is similar to extracellular fluid
Definition
where does primary secretion of salivary glands occur? what is secreted in primary secretion?
Term
primary secretions are modified in the ducts of the glands

1) Na+ actively absorbed
2) Cl- passively absorbed
3) K+ actively secreted
4) HCO3- secreted (either Cl- exchange or active secretion)
Definition
where is the primary secretion modified, and how is it modified?
Term
saliva has a HIGH concentration of K+ and HCO3- (basic solution)

but LOW concentration of Na+ and Cl-

this makes it a hypotonic solution
Definition
what ions are in high concentration in saliva, which are low? why?
Term
Na+ is actively absorbed and K+ actively secreted. Excess of Na+ reabsorbtion causes a negative charge in the duct, causing Cl- to be passively reabsorbed
Definition
how is chloride absorbed passively in salivary ducts?
Term
H2O & NaHCO3- and a concentration of 135 mM to neutralize gastric H+
Definition
what do the cells of the ducts and ductules in the pancreas secrete?
Term
the pancreatic ducts join with the bile ducts and this is a common stricture site
Definition
what is important about the gross anatomy of the ducts of the pancreas?
Term
99% exocrine
1% endocrine(islets of Langerhans)
Definition
what percent of the pancreas is exocrine? endocrine?
Term
1)trypsinogen
2)chymotrypsinogen
3)carboxypeptidase
4) lipase
5) amylase
(and trypsin inhibitor?)
Definition
what do acinar cells of the pancreas secrete?
Term
the enzymes are synthesized basally in the ER and secreted to the lumen via zymogen granules
Definition
which side of pancreatic acinar cells synthesize large digestive enzymes?
Term
1) ACh (activates many cell types like salivary glands etc)
2) CCK (acts specifically on specialized acinar cells of the pancreas)
Definition
what 2 things(signal molecules) stimulate acinar cell secretion in the pancreas?
Term
carbonic anhydrase makes it from H20 + CO2 and it is actively secreted into the lumen as H+ is secreted into the blood
Definition
what enzyme makes HCO3-, and how is this secreted from the ducts cells of the pancreas?
Term
H2O and Na+ are passively absorbed from the interstitium

Cl- is transported INTO the cell via antiport with HCO3-

Cl- is then pumped out RAPIDLY via CFTR
Definition
how are H2O, Na+, Cl-, and HCO3- secreted/absrobed in duct cells?
Term
cystic fibrosis transmembrane regulator, a proteins that is an ion transporter of Cl-, a defect in the CFTR encoding gene causes cystic fibrosis

MONOGENE disease: 1 gene causes this
Definition
what is CFTR?
Term
1) abnormal sweat composition
2) decreased pulmonary and pancreatic secretions
3) autosomal recessive occurance
4) defective CFTR
5) severe coughing
Definition
what are the hallmarks of cystic fibrosis?
Term
pulmonary infection
Definition
what is the primary cause of death with cystic fibrosis?
Term
acid
Definition
___ from the stomach causes release of secretin from the duodenum.
Term
fats and amino acids
Definition
___ and ___ cause release of CCK
Term
blood stream
Definition
where do secretin and CCK go once secreted?
Term
vagal
Definition
____ stimulation causes release of enzymes into acini
Term
positive feed-forward (it won't stop until there is no more food)

ex: stomach acid->duodenum release of secretin + CCK-> blood-> release bicarb, pancreas juice, enzymes
Definition
pancreatic secretion control is ___ regulation
Term
1) secretion of bile
2) filtration and storage of blood
3) metabolism of nutrients
4) synthesis of proteins
5) metabolism of hormones & chemicals
6) storage of vitamins, iron
Definition
what are the functions of the liver?
Term
secretin

CCK
Definition
what blood stream hormone causes liver ductal secretion?

what causes gallbladder contraction and sphincter of Oddi relaxation?
Term
portal vein from the digestive tract, and from arterial blood via the hepatic arteries
Definition
how does the liver receive signaling molecules in the blood?
Term
no, it circulates through the lymph, to the thoracic duct, then gets to the blood and EVENTUALLY hits the liver as chylomicrons
Definition
does absorbed dietary fat go through the liver?
Term
1)HCO3-
2)bile acids
3)bilirubin
4)cholesterol
5)drug metabolites
Definition
what is found in bile?
Term
cholesterol
Definition
what does the liver make biles salts from?
Term
they don't get digested and come out in feces as diarrhea
Definition
if fats do not enter the intestine, where do they go?
Term
bile salts
Definition
what is critical to fat digestion and absorbtion?
Term
they are actively resorbed in the terminal ileum then travel in the blood stream to the liver

this is through the enterohepatic circulation, if blocked, there is a loss of bile salts

occurs 6-12 x per day
Definition
how are biles salts conserved? how frequently does this occur?
Term
parynchemal secretion
Definition
what do bile salts in the blood stimulate in the liver?
Term
heme breakdown makes it
Definition
why does bilirubin need to be metabolized?
Term
up to 15 times
Definition
how much does the gall bladder concentrate bile?
Term
1)unconjugated bilirubin joins albumin in the blood
2) then travesl through the hepatic sinusoids into the hepatocyte
3) the bilirubin is conjugated with glucuronide
4) it leaves the liver via the biliary system to the small intestine
5) bacterial proteases convert it to urobillinogen
6) some is taken back up by the kidney and excreted in urine, the rest (99%) exits with the feces
Definition
describe the general path of billirubin metabolism starting with intra or extra vascular hemolysis
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