BMS13-1055 Mechanisms of Gastrointestinal Motility and its control

Description

mechanism and role of saliva production • how parietal (oxyntic) cells of the stomach secrete HCl and regulating factors • other gastric secretions (pepsinogen, mucus, intrinsic factor, gastric lipase) and their regulation • the factors which govern the rates of secretion of gastrin, CCK/PZ, and secretin • source and roles of GLP-1 & GIP • main secretions of small intestine enterocytes exocrine secretions of the pancreas (composition, source, stimuli) bile formation dysfunctions
Evian Chai
Flashcards by Evian Chai, updated more than 1 year ago
Evian Chai
Created by Evian Chai about 4 years ago
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Resource summary

Question Answer
What muscles are involved in gut motility? Mainly smooth, but skeletal at critical points
What innervates the gut and what is it stimulated by? Enteric nervous system Regulated by ANS but somatic neurones affect key areas (eg. oesophagus)
How are nerves in the gut stimulated? With hormones released by cells
What is the function of sphincters/valves? Ensure correct timing and one way traffic
What 4 areas do motor neurones innervate? 1. Smooth muscle (both excitatory and inhibitory) 2. Vasomotor (intrinsic arterioles) 3. Secretomotor (cells regulating acid secretion) 4. Epithelium (enteroendocrine cells)
What do interneurons do? Many kinds, for reflexes
What types of sensory neurones are present? 1. Chemosensitive (for H+/pH) 2. Mechanoreceptors (for distension)
What does the upper/lower oesophageal sphincter do? Allows swallowing, prevents reflux
What does the pyloric sphincter do? At the base of stomach, so controls exit of food to duodenum
What does the Ileo-caecal sphincter do? Controls movement from Ileum to colon
What do the anal sphincters do? Control defecation
What are the three phases of swallowing, and what occurs in each? 1. Oral phase - tongue pushes bolus to back of mouth to trigger swallow 2. Pharyngeal phase - upper oesophagus sphincter relaxes - epiglottis closes to protect airway 3. Oesophageal phase - bolus moves down into oesophagus w aid of peristalsis and gravity
How does the muscle type and innervation of the oesophagus change as you go down? Upper 1/3: brainstem motor neurones, somatic motor neurones to striated muscle Overlap zone: both Lower 1/3: vagus nerve of ANS innervates smooth muscle
What is peristalsis? Wave like contractions for moving food down gut
Why does the oesophagus enter the stomach at an angle? So intergastric pressure squashes a wall and closes a valve like flap to achieve one way traffic
What occurs when food enters the stomach? 1. Internal ruguae flatten 2. Muscle wall relaxes via receptive relaxation by PNS/brainstem 3. Stomach wall contracts to mix contents and propel to pyloric region
What controls stomach contractions, and how do they change as you approach the pyloric region? Pacemaker cells send contractile waves Waves get stronger to increase pressure so chyme can pass through narrow sphincter
What is chyme? pulpy acidic fluid which passes from the stomach to the small intestine, consisting of gastric juices and partly digested food
What nervous system controls gastric emptying? the ANS (increased SNS/decreased PNS)
What is the feedback relationship between gastric emptying and the duodenum? Negative feedback Increased acidity/fat/AA/hypotonicity/distension increase secretion of enterogastrones Enteric neurons stimulated to decrease gastric emptying
What is the main motility in the small intestine? Segmentation as contraction of different parts lead to mixing
What makes the ileo-caecal sphincter contract? Downstream pressure/SNS
What are the two types of movement in the large intestine? 1. Haustrations: short segments where circular/longitudinal muscles contract to mix food 2. Mass movement: longer segments of circular muscle contract for bulk movement
Is the internal or external anal sphincter involuntary (PNS?) The internal The external is voluntary
Which muscles controlled by the PNS are activated when you defecate? Rectal circular muscle contracts Internal anal sphincter relaxes
Which muscles controlled voluntarily are activated during defection? External anal sphincter relaxes Levator ani contracts
How does the PNS/SNS impact gut motility? Increased PNS increases Increased SNS decreases
How does the hormone Motilin affect gut motility? Where is it released? It regulates background motility in between meals by causing SM contractions in upper small intestine Released from scattered cells in epithelium
How does the hormone Gastrin affect gut motility? It increases gastric motility when digesting a meal (initial)
How does the hormone CCK affect gut motility? Decreases gut motility in response to increased fats
How do the hormones GIP/GLP-P affect gut motility? Lowers gut motility in response to sugars Also increases insulin from pancreas
What external factors impact gut motility? 1. Diet composition -H20 retention, microbiota in gut 2. Medication 3. Age as ENS neurones degenerate
What are 5 issues related to gut motility? 1. Acid reflux 2. Malabsorption 3. Bacterial overgrowth 4. Diarrhoea 5. Constipation
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