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Git Phy
Git Phy
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Motility:
Ingestion:
Taking food into the mouth. Chewing the food and mixing it with saliva. Swallowing the food. Rhythmic wave-like contractions that move food through GI tract.
Mastication:
Deglutition:
Peristalsis:
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(continued)
Secretion:
Exocrine:
HCl, H20, HC03-, bile, lipase, pepsin, amylase, trypsin, elastase, and histamine are secreted into the lumen of the GI tract. Stomach and small intestine secrete hormones to help regulate the GI system.
Endocrine:
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(continued)
Digestion:
Breakdown of food particles into subunits (chemical structure change). Process of the passage of digestion (chemical subunits) into the blood or lymph. Temporary storage and elimination of indigestible food.
Absorption:
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Layers of GI Tract
Composed of 4 tunics:
Mucosa. Submucosa.
Muscularis. Serosa.
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Mucosa
Consists of simple columnar epithelium. Thin layer of connective tissue containing lymph nodules. Thin layer of smooth muscle responsible for the folds.
Lamina propria:
Muscularis mucosae:
Goblet cells:
Secrete mucus.
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Submucosa
Thick, highly vascular layer of connective tissue. Absorbed molecules enter the blood and lymphatic vessels. Submucosal plexus (Meissners plexus):
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Muscularis
Responsible for segmental contractions and peristaltic movement through the GI tract.
Inner circular layer of smooth muscle. Outer longitudinal layer of smooth muscle.
Contractions of these layers move food through the tract; pulverize and mix the food. Myenteric plexus located between the 2 muscle layers. Major nerve supply to GI tract.
Fibers and ganglia from both sympathetic and parasympathetic nervous systems.
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Serosa
Binding and protective outer layer. Consists of areolar connective tissue covered with simple squamous epithelium.
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Vagus and spinal nerves: Stimulate motility and GI secretions. Postganglionic sympathetic fibers that pass through submucosal and myenteric plexuses and innervate GI tract: Reduce peristalsis and secretory activity.
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(continued)
Sites where parasympathetic fibers synapse with postganglionic neurons that innervate smooth muscle. Local regulation of the GI tract. Molecules acting locally. Secreted by the mucosa.
Paracrine secretion:
Hormonal secretion:
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Mastication (chewing):
Deglutition (swallowing):
Cannot be stopped.
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(continued)
Involuntary muscular contractions and relaxations in the mouth, pharynx, larynx, and esophagus are coordinated by the swallowing center in the medulla. Esophagus:
Upper third contains skeletal muscle. Middle third contains a mixture of skeletal and smooth muscle. Terminal portion contains only smooth muscle.
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Esophagus
Peristalsis:
Insert 18.4a
Circular smooth muscle contract behind, relaxes in front of the bolus. Followed by longitudinal contraction (shortening) of smooth muscle.
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Stomach
Functions of the stomach: Stores food. Initiates digestion of proteins. Kills bacteria. Moves food (chyme) into intestine.
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Stomach
(continued)
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Stomach
(continued)
Gastric mucosa has gastric pits in the folds. Cells that line the folds deeper in the mucosa, are gastric glands.
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Gastric Glands
Goblet cells: mucus. Parietal cells: HCl and intrinsic factor. Chief cells: pepsinogen. Enterochromaffin-like cells (ECL): histamine and serotonin. G cells: gastrin. D cells: somatostatin. Stomach: ghrelin.
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HCl Production
Parietal cells secrete H+ into gastric lumen by primary active transport, through H+/ K+ ATPase pump. Parietal cells basolateral membrane takes in Cl- against its electrochemical gradient, by coupling its transport with HC03-.
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HCl Production
(continued)
Histamine:
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HCl Functions
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Proteins partially digested by pepsin. Carbohydrate digestion by salivary amylase is soon inactivated by acidity. Alcohol and aspirin are the only commonly ingested substances absorbed.
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Peptic ulcers:
Erosions of the mucous membranes of the stomach or duodenum produced by action of HCl.
Ulcers of the duodenum are produced by excessive gastric acid secretions. Bacterium that resides in GI tract that may produce ulcers. Histamine released by tissue damage and inflammation stimulate further acid secretion.
Zollinger-Ellison syndrome:
Helicobacter pylori:
Acute gastritis:
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Parietal and chief cells impermeable to HCl. Alkaline mucus contains HC03-. Tight junctions between adjacent epithelial cells. Rapid rate of cell division (entire epithelium replaced in 3 days). Prostaglandins inhibit gastric secretions.
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Small Intestine
Each villus is a fold in the mucosa. Covered with columnar epithelial cells interspersed with goblet cells. Epithelial cells at the tips of villi are exfoliated and replaced by mitosis in crypt of Lieberkuhn. Lamina propria contain lymphocytes, capillaries, and central lacteal.
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Carbohydrates, amino acids, lipids, iron, and Ca2+. Bile salts, vitamin B12, electrolytes, and H20.
Ileum:
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Intestinal Enzymes
Microvilli contain brush border enzymes that are not secreted into the lumen.
Brush border enzymes remain attached to the cell membrane with their active sites exposed to the chyme.
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Peristalsis:
Slow movement. Pressure at the pyloric end of small intestine is greater than at the distal end.
Segmentation:
Major contractile activity of the small intestine. Contraction of circular smooth muscle.
Mix chyme.
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Occur automatically in response to endogenous pacemaker activity. Rhythm of contractions is paced by graded depolarizations called slow waves.
Slow waves produced by interstitial cells of Cajal. Slow waves spread from 1 smooth muscle cell to another through nexuses.
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When slow waves above threshold, it triggers APs by opening of VG Ca2+ channels. Inward flow of Ca2+:
Produces the upward depolarization phase. Stimulates contraction of smooth muscle. VG K+ channels open.
Repolarization:
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Large Intestine
Absorbs H20, electrolytes, several vitamin B complexes, vitamin K, and folic acid.
Intestinal microbiota produce significant amounts of folic acid and vitamin K. Bacteria ferment indigestible molecules to produce short-chain fatty acids.
Guanylin stimulates secretion of Cl- and H20, and inhibits absorption of Na+ (minor pathway).
Minor pathway.
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Small intestine:
Absorption of H20 occurs passively as a result of the osmotic gradient created by active transport.
Large intestine:
Absorption of H20 occurs passively as a result of the osmotic gradient created by active transport of Na+ and Cl-.
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Defecation
Waste material passes to the rectum. Occurs when rectal pressure rises and external anal sphincter relaxes. Defecation reflex:
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Structure of Liver
Hepatocytes form hepatic plates that are 12 cells thick. Arranged into functional units called lobules. More permeable than other capillaries.
Contains phagocytic Kupffer cells. Secretes bile into bile canaliculi, which are drained by bile ducts.
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Structure of Liver
(continued)
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Products of digestion that are absorbed are delivered to the liver. Capillaries drain into the hepatic portal vein, which carries blood to liver.
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Enterohepatic Circulation
Many compounds can be absorbed through small intestine and enter hepatic portal blood. Variety of exogenous compounds are secreted by the liver into the bile ducts.
Can excrete these compounds into the intestine with the bile.
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The liver produces and secretes 2501500 ml of bile/day. Bile pigment (bilirubin) is produced in spleen, bone marrow, and liver.
Free bilirubin combines with glucuronic acid and forms conjugated bilirubin.
Secreted into bile. Urobilogen is absorbed by intestine and enters the hepatic vein.
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Major pathway of cholesterol breakdown in the body. Cholic acid. Chenodeoxycholic acid.
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Liver can remove hormones, drugs, and other biologically active molecules from the blood by:
Excretion into the bile. Phagocytosis by Kupffer cells. Chemical alteration of the molecules.
Ammonia is produced by deamination of amino acids in the liver. Liver converts it into urea.
Excreted in urine.
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(continued)
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Contains enzymes required to convert free fatty acids into ketone bodies.
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Albumin and most of the plasma globulins (except immunoglobulins) are produced by the liver. Albumin:
Globulins:
Transport cholesterol and hormones. Inhibit trypsin. Produce blood clotting factors I, II, III, V, VII, IX, XI.
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Gallbladder
Sac-like organ attached to the inferior surface of the liver. Stores and concentrates bile. When gallbladder fills with bile, it expands.
Contraction of the muscularis layer of the gallbladder, ejects bile into the common bile duct into duodenum.
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Pancreas
Exocrine:
Acini:
Endocrine:
Islets of Langerhans:
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Pancreatic Juice
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Pancreatic Juice
Complete digestion of food requires action of both pancreatic and brush border enzymes.
Most pancreatic enzymes are produced as zymogens. Trypsin (when activated by enterokinase) triggers the activation of other pancreatic enzymes.
Fig. 18.29
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Neural and endocrine mechanisms modify the activity of the GI system. GI tract is both an endocrine gland, and a target for the action of hormones.
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Gastric motility and secretion are automatic. Waves of contraction are initiated spontaneously by pacesetter cells. Extrinsic control of gastric function is divided into 3 phases:
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Cephalic Phase
Stimulated by sight, smell, and taste of food. Activation of vagus: Stimulates chief cells to secrete pepsinogen. Directly stimulates G cells to secrete gastrin. Directly stimulates ECL cells to secrete histamine. Indirectly stimulates parietal cells to secrete HCl.
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Gastric Phase
Arrival of food in stomach stimulates the gastric phase. Gastric secretion stimulated by:
Distension. Chemical nature of chyme (amino acids and short polypeptides). Stimulates G cells to secrete gastrin. Stimulates chief cells to secrete pepsinogen. Stimulates ECL cells to secrete histamine. Histamine stimulates secretin of HCl. Positive feedback effect.
As more HCl and pepsinogen are secreted, more polypeptides and amino acids are released.
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Gastric Phase
(continued)
HCl secretion decreases if pH < 2.5. At pH of 1.0, gastrin secretion ceases. D cells stimulate secretion of somatostatin. Paracrine regulator to inhibit secretion of gastrin.
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Intestinal Phase
Inhibits gastric activity when chyme enters the small intestine. Arrival of chyme increases osmolality and distension.
Inhibits gastric motility and secretion. In the presence of fat, enterogasterone inhibits gastric motility and secretion.
Hormone secretion:
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Submucosal and myenteric plexuses contain 100 million neurons. Include preganglionic parasympathetic axons, ganglion cell bodies, postganglionic sympathetic axons; and afferent intrinsic and extrinsic sensory neurons.
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(continued)
Peristalsis: ACh and substance P stimulate smooth muscle contraction above the bolus. NO, VIP, and ATP stimulate smooth muscle relaxation below the bolus.
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Serotonin (5-HT):
Stimulates intrinsic afferents, which send impulses into intrinsic nervous system; and activates motor neurons. Stimulates contraction of the duodenum and stomach antrum. Activates guanylate cyclase, stimulating the production of cGMP.
Motilin:
Guanylin:
Uroguanylin:
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Intestinal Reflexes
Intrinsic and extrinsic regulation controlled by intrinsic and paracrine regulators. Gastroileal reflex:
Increased gastric activity causes increased motility of ileum and movement of chyme through ileocecal sphincter. Distension of ileum, decreases gastric motility. Overdistension in 1 segment, causes relaxation throughout the rest of intestine.
Ileogastric reflex:
Intestino-intestinal reflex:
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Secretion of pancreatic juice and bile is stimulated by: Secretin: Occurs in response to duodenal pH < 4.5. Stimulates production of HC03 by pancreas. Stimulates the liver to secrete HC03 into the bile. CCK: Occurs in response to fat and protein content of chyme in duodenum. Stimulates the production of pancreatic enzymes. Enhances secretin. Stimulates contraction of the sphincter of Oddi.
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Salivary amylase:
Begins starch digestion. Digests starch to oligosaccharides. Oligosaccharides hydrolyzed by brush border enzymes.
Pancreatic amylase:
Glucose is transported by secondary active transport with Na+ into the capillaries.
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Digestion begins in the stomach when pepsin digests proteins to form polypeptides. In the duodenum and jejunum:
Endopeptidases cleave peptide bonds in the interior of the polypeptide: Trypsin. Chymotrypsin. Elastase. Exopeptidases cleave peptide bonds from the ends of the polypeptide: Carboxypeptidase. Aminopeptidase.
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Free amino acids absorbed by cotransport with Na+. Dipeptides and tripeptides transported by secondary active transport using a H+ gradient to transport them into the cytoplasm. Hydrolyzed into free amino acids and then secreted into the blood.
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Arrival of lipids in the duodenum serves as a stimulus for secretion of bile. Emulsification:
Bile salt micelles are secreted into duodenum to break up fat droplets.
Pancreatic lipase and colipase hydrolyze triglycerides to free fatty acids and monglycerides.
Colipase coats the emulsification droplets and anchors the lipase enzyme to them. Form micelles and move to brush border.
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Free fatty acids, monoglycerides, and lysolecithin leave micelles and enter into epithelial cells.
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Transport of Lipids
In blood, lipoprotein lipase hydrolyzes triglycerides to free fatty acids and glycerol for use in cells. Remnants containing cholesterol are taken to the liver.
Form VLDLs which take triglycerides to cells. Once triglycerides are removed, VLDLs are converted to LDLs.
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Absorption of Fat