Physio Practice Exam

What are the four components of the digestive system

What is the difference between propulsive movements and mixing movements?

What are the four major tissue layers of the digestive tract?

Describe the layers of the mucosa:

Describe submucosa, muscularis externa, and serosa.

How are digestive motility and secretion regulated?

Describe digestive process (beginning in mouth)

Describe control of salivary secretion mechanism
Describe swallowing reflex
--------prevents air from entering esophagus
--------prevents reflux of gastric contents
-------barrier between stomach and duodenum
Three main functions of the stomach:
1.
2.
3.
--------secretes somatostatin
--------secretes hydrochloric acid and intrinsic factor
-------secretes pepsinogen
-------secretes alkaline mucus

--------secretes histamine

List five major function of hydrochloric acid in digestive process.

1.
2.
3.
4.
5.
---------increased secretion of HCl and pepsinogen that occurs in response to stimuli
acting in the head (nose, mouth, brain)

-----food in stomach, presence of protein increases gastric secretions

------inhibitory phase, shut off form duodenum

Describe mechanism for cephalic phase of gastric secretion

How do the components of the gastric mucosal barrier enable the stomach to
contain acid without injuring itself?
-------secrete insulin and glucagon
---------breaks down polysaccharides
---------only enzyme that can digest fat

Describe how the pancreas is controlled hormonally.

Non-digestive functions of the liver:

1.
2.

3.
4.
5.
6.
7.
Describe blood flow in the liver: The liver receives blood from two sources:
1. Arterial blood (delivered by hepatic artery). Arterial blood provides the livers
O2 supply and carries blood-borne metabolites for hepatic processing.
2. Venous blood (carried by the hepatic portal vein). Venous blood draining the
digestive tract is carried to liver for processing and storage of newly absorbed
nutrients.
**Blood leaves the liver via the hepatic vein
bile salts-----secreted by liver between meals. Stored in gallbladder, convert large
fat globules into a liquid emulsion.

Describe circulation of bile salts: Secreted bile salts consist of 95% old, recycled bile
salts and 5% newly synthesized bile salts. 95% of bile salts are reabsorbed by
terminal ileum. Reabsorbed bile salts are recycled by enterohepatic circulation. 5%
of bile salts are lost in feces.

Small intestine------majority of digestion and absorption occurs here, particularly in

the duodenum and jejunum.
----------juice secreted by small intestine that does not contain any digestive
enzymes

Describe mechanism by which carbohydrates are absorbed: The dietary

polysaccharides starch and glycogen are converted into the disaccharide maltose
through the action of salivary and pancreatic amylase. Maltose and the dietary
disaccharides (lactose, sucrose) are converted to their respective monosaccharides
by the disaccharides (maltase, lactase, sucrase) located in the brush borders of the
small-intestine epithelial cells. Glucose and galactose (monosacs) are absorbed into
the epithelial cells by Na+ and energy-dependent secondary active transport (via
the symporter SGLT) located at the luminal membrane. The monosaccharide

fructose enters the cell by passive facilitated diffusion via GLUT-5. Glucose,
galactose, and fructose exit the cell at the basal membrane by passive facilitated
diffusion via GLUT-2. These monosaccharides enter the blood by simple diffusion.

Describe how protein is absorbed: Dietary and endogenous proteins are hydrolyzed
into their constituent amino acids and a few small peptide fragments by gastric
pepsin and the pancreatic proteolytic enzymes. Many small peptides are converted
into their respective amino acids by the aminopeptidases located in the brush
borders of the small-intestine epithelial cells. AAs are absorbed into the epithelial
cells by means of Na+ and energy-dependent secondary active transport via a
symporter. Various AAs are transported by carriers specific for them. Some small
peptides are absorbed by a different type of symporter driven by H+, Na+, and
energy-dependent tertiary active transport. Most absorbed small peptides are
broken down into their AAs by intraceullular peptidases. AAs exit the cell at the
basal membrane via various passive carriers. AAs enter the blood by simple
diffusion (a small percentage of di and tripeptides also enter the blood intact).

Describe how dietary fat is absorbed: dietary fat (in form of large fat globules) is
emulsified by detergent action of bile salts into a suspension of smaller fat
droplets (increases SA available for attack by pancreatic lipase). Lipase hydrolyzes
triglycerides into monglycerides and free fatty acids. These water-insoluble products
are carried to the luminal surface of the small-intestine epithelial cells within watersoluble micelles, which are formed by bile salts and other bile constituents. When a
micelle approaches the absorptive epithelial surface, the monoglycerides and faty
acids leave the micelle and passively diffuse through the lipid bilayer of the luminal
membranes. The monoglycerides and the free fatty acids are resynthesized into
triglycerides inside the epithelial cells. These triglycerides aggregate and are coated
with a layer of lipoprotein from the ER to form water-soluble chylomicrons.
Chlyomicrons are extruded through the basal membrane of the cells by exocytosis.
Chylomicrons are unable to cross the basement membrane of the capillaries, so
instead they enter the lymphatic vessels, the central lacteals.

Describe how iron is absorbed: only a portion of ingested iron is in a form that can
be absorbed (either heme iron or ferrous iron (Fe2+). Iron is absorbed across the
luminal membrane of small-intestine epithelial cells by different energy-dependent
carriers for heme and Fe2+. Dietary iron that is absorbed into the SI epithelial cells
and is immediately needed for RBC production is transferred into the blood by
ferroportin (membrane iron transporter). In the blood, the absorbed iron is carried to
the bone marrow bound to transferrin (plasma protein carrier). Absorbed dietary
iron that is not immediately needed is sotred in the epithelial cells as ferritin which

cannot be transferred into the blood. This unused iron is lost in the feces as the
ferritin-containing epithelial cells are sloughed. Dietary iron that was not absorbed is
also lost in the feces.
Taeniae coli--------longitudinal bands of muscle in LI
Haustra ------------poubhes or sacs; circular smooth muscle layer in LI
Haustral contractions ------------ main motility in LI
Large intestine---------------contains indigestible food residues, unabsorbed biliary
components and remaining fluid
Colon -------extracts more water and salt from contents of LI.
Feces-------what remains to be eliminated after colon
Gastrocolic reflex -------------mediated from stomach to colon by gastrin and by
autonomic nerves; most evident after first meal of the day, and is often followed by
urge to defecate.
Defecation reflex ---------prescence of food in the stomach + presence of chime in
the duodenum stimulates mass movement in large intestine/colon stimulates
local defecation reflexes and parasympathetic controlled defecation reflexes
causes internal anal sphincter to relax rectum and sigmoid colon contract -
external anal sphincter (voluntary control)
Peptide hormones and catecholamines are hydrophilic hormones
Steroids and thyroid hormone are lipophilic hormones
List six major functions of the endocrine system:
1. .
2. .
3. .
4. .
5. .
6. .
--------produces melanin; secretes melatonin; affects reproductive development and
daily physiologic cycles.
---------hormone of darkness; secretion falls to low levels during daylight; helps keep
bodys circadian rhyms in synchrony w/ light-dark cycle, promotes sleep, influences

reproductive activity (incl. onset of puberty), acts as antioxidant to remove free

radicals, enhances immunity
------- produce HGH, ADH, and gonadotropins; controls growth of bones and muscles,
increases reabsorption of H2O in kidneys, and controls development of ovaries and
testes
--------produces thyroxine; controls rate of metabolism and rate that glucose is used
up in respiration; promotes growth. Follicular cells; lumen filled with colloid serves
as extracellular storage site for thyroid hormone
----secrete peptide hormone calcitonin
----------produces adrenaline; prepares the body for emergencies; increases heart
rate + depth of breathing, raises blood sugar level so more glucose is available for
respiration, diverts blood from gut to limbs
------------- produces insulin and glucagon; converts excess glucose into glycogen in
liver, convers glycogen back to glucose in liver
-------produces estrogen and progesterone; controls ovulation and secondary sexual
characteristics, prepares the uterus lining for receiving an embryo
----------produce testosterone; control sperm production and secondary sexual
characteristics
-----------thymosin; promotes production and maturation of white blood cells
Tropic hormone----------regulates hormone secretion by another endocrine gland
Plasma concentration is determined by (5):
1. .
2. .
3. .
4. .
5. .
---------------lobe of hypothalamus; consists of nervous tissue
---------------lobe of hypothalamus; consists of glandular epithelial tissue
paraventricular nucleus axons neuronal terminals in posterior pituitary
posterior pituitary
-------stimulates uterine contractions and milk ejection during breast feeding

TSH thyroid gland thyroid hormone (T3, T4) increased metabolic rate
ACTH adrenal cortex release cortisol metabolic actions; stress response
LH sex hormone secretion (estrogen in progesterone in females, testosterone in
males)
FSH gamete production (ova in females, sperm in males)
Growth hormone liver IGF-1 stimulates growth in bone and soft tissue
Growth hormone adipose tissue, muscle, liver metabolic actions
Prolactin mammary glands breast growth and milk secretion
Neurosecretory neurons in the hypothalamus produce hypophysiotropic hormones
(releasing and inhibiting hormones) HPH enters the hypothalamic capillaries
hypothalamic capillaries rejoin to form the hypothalamic-hypophyseal portal system
portal system branches into the capillaries of the anterior pituitary HPH control
the release of anterior pituitary hormones anterior pituitary secretes a given
hormone into these capillaries anterior pituitary capillaries rejoin to form a vein,
through which AP hormones leave for distribution throughout the body by the
systemic circulation
6 peptide hormones produced by anterior pituitary:
1.
2.
3.
4.
5.
6.
Factors that effect growth
1. Normal levels of growth-influencing hormones
2. genetic determination of an individuals maximum growth capacity
3. adequate diet
4. freedom from chronic disease and stressful environmental conditions

growth hormone ------promotes growth by stimulating livers production of

somatomedins
Insulin-like growth factor (IGF-1) ---------acts directly on bone and soft tissues;
stimulates protein synthesis, cell division, and lengthening and thickening of bones
Exercise, stress, low blood glucose, diurnal rhythm hypothalamus growthhormone releasing hormone (GHRH) anterior pituitary secrete growth hormone
liver IGF-1 increase cell division, increase protein synthesis (decrease blood
amino acids), increase bone growth. Growth hormone also increases fat break down
(increasing fatty acid concentration in blood), decreases glucose uptake by muscles
(increasing blood glucose), increases glucose output by liver (increases blood
glucose)
1. Hormones besides HGH that are essential for normal growth:
2. Thyroid hormone: growth severely stunted in kids with hypothyroidism;
hypersecretion does NOT cause excessive growth
3. Insulin: deficiency often blocks growth; hyperinsulinism often spurs excessive
growth
4. Androgens: play role in pubertal growth spurt; stimulate protein synthesis in
many organs
5. estrogens

Thyroid hormone negative feedback system:

feedback loop adrenal gland: stress + diurnal rhythm stimulate hypothalamus to

release corticotropin-releasing hormone (CRH) stimulates anterior pituitary to
release ACTH ACTH stimulates adrenal cortex to release cortisol which increases
blood glucose (by stimulating gluconeogenesis and inhibiting glucose uptake),
increase concentration of AA in blood (by stimulating protein degradation),
increasing fatty acid concentration in blood (by stimulating lipolysis)
Integrated stress response feedback loop:
Stressor stimulates hypothalamus.
1. hypothalamus stimulates posterior pituitary to secrete vasopressin
2. hypothalamus releases CRH stim. Anterior pituitary to release ACTH
stimulates adrenal cortex to secrete cortisol

3. stressor stimulates hypothalamus stimulates sympathetic nervous system

stimulates adrenal medulaa to release epinephrine. Epi stimulates
endocrine pancreas to release glucagon and inhibit insulin. Epi also
stimulates arteriolar smooth muscle vasoconstriction decrease blood
flow through kidneys increase rin increase ANG increase aldosterone
Glucose and Endocrine system: increase in blood glucose concentration (or increase
in GI hormones or elevated blood AA concentration) stimulates islet B cells to
secrete insulin decreases concentration of glucose, fatty acids, and AA in blood.
Increases fuel storage and protein synthesis.
List five functions of the skeleton:
1. support
2. protection of vital internal organs
3. Body movement (by giving attachment to muscles and providing leverage)
4. Manufacture of blood cells (bone marrow)
5. Storage for calcium and phosphate, which can be exchanged with the plasma
to maintain plasma concentrations of these electrolytes
Calcium regulation: (fast exchange) calcium is moved from the labile pool in the
bone fluid into the plasma by PTH-activated calcium pumps located in the
osteocytic-osteoblastic bone membrane. (slow exchange) calcium is moved from
the stable pool in the mineralized bone into the plasma through PTH-induced
dissolution of the bone by osteoclasts
Mechanism for calcium regulation:
-decrease plasma calcium concentration stimulates parathyroid glands to release
PTH increase [plasma calcium]
-elevated plasma calcium concentration stimulates thyroid C cells to release
calcitonin decrease {plasma calcium}

Phosphate regulation: low phosphate concentration in plasma stimulates kidneys to

release activated vitamin D increase phosphate absorption in intestine
concentration of phosphate in plasma. Low phosphate concentration in plasma
elevated plasma calcium concentration decreases release of PTH by parathyroid
glands increases phosphate reabsorption by kidneys + decreases urinary
secretion of phosphate. Simultaneously decreases calcium reabsorption by kidneys
and increases urinary secretion of calcium.