GI

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Author:
catitasilva
ID:
123166
Filename:
GI
Updated:
2011-12-12 17:56:06
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GI
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GI
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  1. Actions of the following:
    Secretin
    CCK
    G1P
    GLP1 & YY
    • Secretin: dec. H+, inc. panc & biliary HCO3-; S cells
    • CCK: inc. pancreatic secretions (enzymes & HCO3-)
    • G1P: dec. H+ & inc. insulin
    • GLP1 & YY: ileal brake
  2. Small Intestine:
    Mucosal Layers?
    • Mucosa:
    • villi - enterocytes & goblet cells
    • crypts - paneth, stem & EEC (S, G, I, D, EC)
    • Submucosa: duodenum (brunner's glands), ileum (peyer's patch)
    • Muscularis Externa
    • Serosa & Adventitia
  3. Secretions of EEC?
    • S: secretin
    • G: gastrin
    • I: CCK
    • D: somatostatin
    • EC: serotonin
  4. SI sites of nutrient absorption:
    duodenum
    jejunum
    ileum
    • duodenum: Fe, Ca, K
    • jejunum: carbs(d), fats & proteins (d & i)
    • ileum: B12 & bile salt
  5. Small Intestine amplifications?
    • placae circularis
    • valvulae conniventes
    • villi
    • microvilli (brush border)
  6. Control of blood flow in Small Intestine?
    • SANS: vasoconstriction
    • Sensory C fibers: vasodilation; capsaicin sensitive & nociceptors
  7. Carbohydrate digestion in Small Intestine:
    Enzymes
    • amylase(luminal): salivary & pancreatic
    • maltase-glucoamylase (BB): maltose > glc
    • sucrase-isomaltase (BB): sucrose > glc + frc
    • lactase(BB): lactose > glc + gal
  8. Carbohydrate digestion absorption transporters?
    • SGLT1: glucose/galactose (lument to enterocyte)
    • GLUT2: glucose/galactose (enterocyte to blood)
    • GLUT5: fructose (lumen to blood)

    • Na/K ATPase pump needed
  9. Protein digestion enzymes?
    • gastric: pepsin
    • SI lumen: trypsin, chymotrypsin, carboxypeptidase A & B, elastase
    • SI BB: amino peptidase, oligopeptidase & dipeptidyl peptidase

    proline or glycine = slow digestion
  10. Protein absorption? Mechanism transporters?
    • absorb free aa, di & tri peptides; tris=kinetic advantage
    • Luminal side:
    • SLC: aa (Na+ co transport)
    • PEP T1: dis & tris (H+ cotransport) w/ NHE (Na/H antiporter)

    • Capillary side:
    • SLC: aa
    • Na/K ATPase
  11. Fat digestion enzymes?
    • lingual lipase
    • gastric lipase
    • pancreatic lipase (small intestine)
    • lipase & colipase (BB)
    • lipoprotein lipase (chylomicron)
  12. Micelle Formation
    products of lipid digestion (TG & phospholipids) are emulsified (bile acids) along w/fat soluble vitamins and made into micelles
  13. Fat absorption?
    • micelles come into contact w/BB & FA, MG & cholesterol diffuse across membrane
    • Re-esterified w/apoproteins --> chylomicrons
    • Exocytosis: lacteal >> lymph vessels>> thoracic duct >> bloodstream >> liver
  14. STEATORRHEA
    • fat malabsorption due to:
    • liver & biliary tract (impaired bile & HCO3- secretion)
    • pancrease (reduced HCO3- secretion or lipase deficiency)
    • endocrine (dec. chylomicron intake)
  15. Beta lipoproteinemia
    decrease chylomicron synthesis
  16. Crohn's Disease
    reduced bile acid absorption - dec. in bile pool
  17. Celiac Disease
    loss of intestinal surface area
  18. Breast Milk...mmmm
    • SCFA
    • passive diffusion
  19. Ca2+ absorption
    • Ca2+ channel (luminal)
    • calbindin (intracellular)
    • Na/Calbindin anti transporter
    • Na/K pump
  20. Water Absorption
    • Proximal SI: coupled w/Na-H & nutrient
    • Ileum: NaCl absorption (Na/H & Cl/HCO3-)
    • initially high permeability-hypertonic meal
    • isosmotic in SI & gallbladder
    • reduced permeability in colon, feces hypertonic
  21. Na+ Absorption
    • SI: Na/Glc (SGLT), Na/AA (SLC), Na/H (NHE)
    • Colon: passive diffusion; aldosterone
  22. Cl- Absorption
    • passive diffusion (paracellular)
    • Na/Cl co transport
    • Cl/HCO3- exchanger
  23. K+ absorption & secretion
    • dietary K+ absorbed in SI
    • K+ secreted in colon
    • stimulated by aldosterone
    • diarrhea - hypokalemia (over secretion)

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