Esophagus

M3O1. What are the organs of the GI tract?

1. mouth

2. esophagus

3. stomach

4. small/large intestine

M3O1. What are the 4 accessory organs of the GI tract?

1. liver
2. pancreas
3. gall bladder
4. salivary glands

M3O1. Muscle in the intestine that contracts the lumen smaller.

circular muscle

M3O1. Muscle that contracts to move muscle forward.

longitudinal muscle

M3O1. Muscle used to churn food for betting mixing with digestive juices and to help to break down large particles into smaller ones.

oblique muscle

M3O1. What is the nervous system control of the GI tract?

Enteric Nervous System

M3O1. Sight, smell and taste of food initiate a "_" phase of digestion in which brain activate reflex pathways

cephalic

M3O1. Postganglionic PNS nerves release AcH onto M3 receptors to initiate

Secretion and motility

M3O1. Is the Enteric Nervous System dependent on the Autonomic Nervous System?

no

M3O1. What are the 5 specialized cells that regulate control of secretion and motility?

1. Digestive enzymes
2. Mucous
3. Acid
4. Bicarbonate
5. Endocrine products

M3O2. What are the 4 main processes of the GI tract?

1. digestion
2. absorption
3. secretion
4. motility

M3O2. Solubilize food.

Digestion

M3O2. Nutrients go from lumen to blood.

Absorption

M3O2. Enzymes secreted throughout the GI tract.

Secretion

M3O2. Moves food from one area to another and mix food.

Motility

M3O3. The "little brain of the GI tract" that can coordinate activity with the ANS to regulate GI tract function

Enteric Nervous System

M3O3. Between the outer longitudinal and middle circular muscle layers.

Myenteric Plexus

M3O3. Between the middle circular layer and the mucosa.

Submucous Plexus

M3O3. Innervates the longitudinal and circular smooth muscle layer.

Myenteric Plexus

M3O3. Innervates the glandular epithelium, intestinal endocrine cells, and submucosal blood vessels.

Submucous Plexus

M3O3. Concerned primarily with motor control and motility.

Myenteric Plexus

M3O3. Primarily involved in the control of intestinal secretion.

Submucous Plexus

M3O4. What are the 4 main functions of saliva?

1. soften and moisten food
2. taste
3. defense
4. Digestion

M3O4. Lubricates food to facilitate swallowing.

Soften and moisten food

M3O4. Dissolves food so that we can taste it.

Taste

M3O4. Protection from pathogens, cell damage and self-digestion.

Defense

M3O4. Digestion of carbohydrates by amylase and fats by lipase.

Digestion of starch and some fat

M3O5. What is the role of the ANS in saliva secretion?

increased saliva production and secretion

M3O5. What branch of the ANS is involved with saliva secretion?

parasympathetic nervous system

M3O5. What neurotransmitters are involved with saliva secretion?

ACh

M3O5. What receptors are involved with saliva secretion?

Muscarinic M3 receptors

M3O6. What autoimmune antibodies are involved with Sjögren's Syndrome?

SSA and SSB

M3O6. What test detects how much saliva flows into your mouth?

Sialogram

M3O6. What test measures tear production in eyes?

Schirmer tear test

M3O6. What are the 7 signs and symptoms of Sjögren's Syndrome?

1. Dry eyes/mouth

2. Joint pain and swelling

3. Dry stuff

4. Prolonged fatigue

M3O6. What are the 3 risk factors of Sjögren's Syndrome?

1. Women
2. Over 40 years of age
3. Already have another autoimmune disease

M3O6. What are the 5 treatments of Sjögren's Syndrome?

1. Eye drops/Artificial saliva/oral rinse

2. Immunosuppressants

3. Corticosteroids

4. Muscarinic agonists

M3O6. What are the 6 counseling tips for patients with Sjögren's Syndrome?

1. ↑ household humidity

2. Stay hydrated on sugar-free liquids or water

3. Sugar-free gum or hard candies

4. Maintain good dental hygiene

5. Hand moisturizers/Saline nasal spray

M3O7. Prevent air from entering esophagus during breathing and prevent reflux into the pharynx

upper esophageal sphincter

M3O7. Prevent the reflux of gastric contents back into esophagus.

lower esophageal sphincter

M3O7. Voluntary swallowing by the somatic motor

Swallow phase 1

M3O7. Involuntary swallowing by the PNS

Swallow Phase 2

M3O7. What is the primary type of motility found in esophagus?

Peristalsis

M3O7. Little absorption happens here

• aspirin and alcohol are the exceptions

Stomach

M3O8. What do parietal cells secrete?

Acids (HCl) and intrinsic factor (IF)

M3O8. What are the parietal cells regulated by?

acetylcholine, gastrin, and histamine

M3O8. What do ECL cells secrete?

histamine

M3O8. What are ECL cells regulated by?

acetylcholine and gastrin

M3O8. What do chief cells secrete?

pepsinogen and gastric lipase

M3O8. Endopeptidase secreted by chief found in gastric as pepsinogen

Pepsin

M3O8. What are chief cells regulated by?

acetylcholine and acid secretion

M3O8. What do mucous cells secrete?

Mucous and bicarbonate

M3O8. What are mucous cells regulated?

tonic secretion and irritation of mucosa

M3O8. What are the 2 endocrine cells?

d (delta) cells and g cells

M3O8. What do D (Delta) Cells secrete?

Somatostatin (SST)

M3O8. What are D (Delta) Cells regulated by?

acid in the stomach

M3O8. What do G Cells secrete?

gastrin

M3O8. What are G Cells regulated by?

acetylcholine, peptides, and amino acids

M3O8. Breaks down peptide bonds within a protein chain

• A-A-A-A → A-A A-A

Endopepsinogen

M3O8. Helps body breakdown fat

Lipase

M3O8. Helps body absorb B12

IF

M3O8. ↓ IF =

Pernicious anemia

M3O9. What are the 3 mechanisms that protect the stomach from self-destruction?

1. Bicarbonate excretion
2. Mucous
3. Protective prostaglandins

M3O9. Prostaglandin ___ blood flow to the area = ↓ acidity

Increase

M3O9. Prostaglandin ___ mucous and bicarbonate production

Enhancing

M3O9. Prostaglandin ___ acid secretion

Decrease

M3O10. What are the 4 functions of gastric acid?

1. Dissolve food fibers to help liquefy chyme

2. Kill bacteria and inactivate pathogens

3. Denature proteins

4. Activate pepsinogen → pepsin to digest proteins

M3O11. What enzyme is involved in gastric acid production?

Carbonic Anhydrase (CA)

M3O11. What 3 pathways increase gastric acid secretion?

1. Histamine H2 receptor

2. AcH → M3 receptor

3. Gastrin

M3O11. What are the pathways that decrease gastric acid secretion?

1. Prostaglandins (PGs)

2. Somatostatin (SST)

3. Secretin

4. CCK

M3O11. Histamine H2 receptor are ___-coupled.

Gs

M3O11. Acetylcholine M3 receptor are ___-coupled.

Gq

M3O12. What are the risk factors of Gastroesophageal Reflux Disease (GERD)?

1. Hiatal hernia

2. Peptic ulcer

3. Delayed stomach emptying

4. Certain foods

M3O12. What are the 10 foods that can contribute to Gastroesophageal Reflux Disease (GERD)?

1. Citrus
2. Chocolate
3. Caffeine
4. Alcohol
5. Fatty foods
6. Garlic
7. Onions
8. Mint
9. Spicy foods
10. Tomato-based foods

M3O12. What are the signs and symptoms of Gastroesophageal Reflux Disease (GERD)?

1. Regurgitation of acidic chyme

2. Upper abdominal pain within 1 hour after eating

3. Asthma symptoms

M3O12. What is the 3 treatment strategies for Gastroesophageal Reflux Disease (GERD)?

1. Surgery for hiatal hernia
2. lifestyle modifications
3. medications

M3O12. What are the 6 lifestyle modifications for Gastroesophageal Reflux Disease (GERD)?

1. Stop smoking
2. Eat smaller, more frequent meals
3. Lose weight
4. Avoid lying down for more than 3 hours after meals
5. Elevate head of bed
6. Avoid foods that worsen symptoms

M3O12. What 4 medications can be used to treat Gastroesophageal Reflux Disease (GERD)?

1. H2 blockers
2. Antacids
3. Proton pump inhibitors
4. Prokinetic agents that increase PNS tone

M3O13. What are the 2 risk factors of Peptic Ulcer Disease?

1. H. pylori infection

2. NSAID overuse

M3O13. What are the signs and symptoms of Peptic Ulcer Disease?

1. Decreased hemoglobin

2. Decreased hematocrit

3. Increased reticulocytes that suggest bleeding ulcer

4. Black tarry stool

M3O13. What are the 4 treatment strategies for Peptic Ulcer Disease?

1. Medications that block acid production and promote healing
2. Medications that protect the lining of your stomach and small intestine
3. Antacids that neutralize stomach acid
4. Medications to reduce acid production

M3O13. How does Helicobacter pylori resides in the stomach lining?

It makes urea that makes Ammonia to protect the bacteria from stomach acid

M3O13. What is the treatment for H. pylori-associated ulcers?

antibiotics