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Fig. 24.01
1
Describe the subdivisions and folds of
Which GIT function(s) require the mucosa? the peritoneum.
III. Peritoneum
A. Visceral
A. Ingestion B. Parietal
B. Secretion 1. “retroperitoneal” location
C. Peritoneal cavity
C. Mix and move 1. Ascites
D. Absorption D. Peritoneal folds (protection and
locating intestines)
E. B and D 1. Greater omentum
2. Lesser omentum
3. Mesentery
4. Mesocolon
5. Falciform ligament
2
These are major objectives
5. Follow food through the GIT and describe
the physical and chemical changes in each
organ.
6. Describe anatomy, histology, function and
control of motility and secretion of each
GIT organ.
7. List the various enzymes responsible for
chemical digestion, their source and action.
B. Salivary glands
1. Parotid, submandibular and
sublingual glands and ducts 3. Salivation
2. Saliva contents
a. Parasympathetic control
a. 99.5% water
b. Ions (bicarbonate, phosphate sodium and b. Stimulated by special senses
chloride) (smell, sight, taste, sound)
c. Salivary amylase to begin chemical c. Depressed by sympathetic ANS
digestion of starch (amylose)
(dry mouth)
d. Mucus
e. IgA (secretory antibodies for protection)
C. Tongue (Lingua)
1. Skeletal muscle
a. Extrinsic connect tongue to other muscles in
the pharyngeal area to maneuver food
b. Intrinsic muscles (within tongue) change it’s
shape
2. Lingual frenulum
3. Papillae
a. Sensory receptors for taste and touch
4. Lingual glands secrete water, mucous
and lingual lipase
3
Chemical digestion of what
molecules begins in the mouth?
4
Deglutition and Swallow reflex The swallow reflex does NOT
include
A. Elevation of soft palate
B. Elevation of the base of the tongue
C. Epiglottis moves inferiorly
D. Closure of upper esophageal sphincter
E. All of these are included in the reflex
Fig. 24.09
F. Esophagus
1. Modified serosa is called “adventia”
2. upper esophageal sphincter
(cricopharyngeus muscle)
3. esophageal stage of swallowing
(begins peristalsis)
4. Lower esophageal sphincter (old name:
“cardiac sphincter”)
Fig. 24.10
Peristalsis
G. Stomach
5
Fig. 24.11
Fig. 24.12a
6
Fig. 24.12b Fig. 24.12c
4. Regulation of Gastric
Activity
a. Cephalic phase
stimulated by
exteroreceptors (smell,
sight, taste) before food
enters stomach
7
So receptors responsible for
A stimulus of the gastric phase is initiating the gastric phase are
located in the
A. Increasing pH of stomach contents A. Brain
B. Increased protein contents in the stomach B. Spinal cord
C. Increased volume of the stomach C. Stomach
D. Increased buffer activity in the stomach D. Small intestine
E. All of these are gastric phase stimulants E. All of these
c) Intestinal phase, as
food enters small The intestinal phase of gastric
intestine, neural and activity is
hormonal feed back
inhibits gastric
activity A. Inhibitory by neural activity
Food entering Sm. Int. B. Excitatory by neural activity
stimulate secretion of C. Excitatory by hormonal action
hormones:
Secretin decreases D. All of these
gastric secretion E. Only B and C
Cholecystokinen
(CCK) slows stomach
emptying
8
Which gastric phase does Which gastric phases(s) does
this feedback loop this diagram describe?
represent? A. Cephalic
A. Cephalic B. Gastric
B. Gastric C. Intestinal
C. Intestinal D. A and B
D. Neural E. B and C
E. All except D
Fig. 24.17b
9
Enteroendocrine hormones (CCK
and secretin) are
A. Inhibitory for the stomach
B. Excitatory for the pancreas
C. Excitatory for the stomach
D. A and B
E. B and C
10
Increased insulin secretion means
Secretion of glucagon:
A. Speeds systemic cell absorption of glucose A. There is increased blood glucose
B. Speeds conversion of glucose to glycogen B. Systemic cells will increase transport of
C. Increases blood glucose levels glucose
D. Increases glucose absorption from the gut C. The liver will convert glucose to glycogen
E. All of these D. Blood glucose will decrease
E. All of these
2. Liver histology
a. Hexagonal lobules
i. Hepatocytes (functional liver cells)
ii. Central vein
iii. Sinusoids
iv. Stellate reticuloendothelial cells (VanKupffer
cells or macrophages)- phagocytes to remove old
RBCs
v. Bile Canaliculi all combine to form common
hepatic duct which joins cystic duct to make
common bile duct for temporary bile storage in gall
bladder
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4. Regulation of bile secretion
J. Small Intestine
1. Anatomy
a. Begins at pyloric sphincter
Explain digestion and absorption of the four b. Duodenum is the first 25 cm
bio-macromolecules (carbohydrates, c. Jejunum is the middle one meter
proteins, lipids and nucleic acids) plus d. Ileum is the last 2 m
water, electrolytes and vitamins. e. Ends at ileocecal sphincter
f. Surface area for absorption is increased by
i. Circular folds
ii. Villi
iii.Microvilli (brush boarder on histology
sections)
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2. Histology
A. CCK
B. Gastrin
C. Insulin
D. Pancreatic amylase
E. All of these
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3. Intestinal juice and brush-boarder enzymes
5. Chemical digestion in small
a. Liquid media for absorption of digested intestine
nutrients through mucosa
a. Carbohydrate digestion
b. Most macromolecules have been hydrolyzed by
b. Polypeptide digestion
salivary, stomach and pancreatic enzymes
c. Lipid digestion
c. Remaining disaccharides, dipeptides and
nucleosides are further chemically digested to i. Bile
monomers by brush-border enzymes d. Nucleic Acid Digestion
i. Nucleosidase removes base
ii. Phosphatase removes phosphate
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7. Absorption: means all nutrients must pass
6. Regulation of motility and secretion through intestinal epithelium to reach capillaries
or lacteals
a. PSANS enteric reflex stimulated by a. Monosaccharides (from polysaccharides
and simple sugars)
i. Presence of chyme
i. Facilitated diffusion of fructose
ii. Small intestine filling (distension)
ii. Secondary active transport of glucose and
b. SANS reduces motility and secretion galactose, couples active transport of 2 Na+
c. Migrating Motility Complex (MMC) and one monosaccharide (symporter) from gut.
increased by reduction of nutrient content in iii. Facilitated transport moves
chyme (minimum of 4 hours from ingestion monosaccharides from cytoplasm into capillary
to Lg. Int.) blood
c. Lipids
i. Simple diffusion of short chain FAs (10-12 Cs) into
epithelium and then into capillaries (not many)
ii. Long chains and monoglycerides are coated with
b. Amino acids and small polypeptides (Di
bile salts to make micells, which transport them into
and Tri) enter capillaries by active epithelium, leaving bile in gut.
transport Bile is resorbed in ileum and returned to liver for
recycling (enterohepatic circulaiton)
15
Fig. 22.01
Fig. 22.03
d. Vitamin absorption
i. Fat soluble (ADEK) via micells
ii. Water soluble (Bs and C) by simple
diffusion
16
Micells Daily fluid
volumes
A. Are surrounded with bile salts
(ingested,
B. Have hydrophobic centers
secreted,
C. Transport large FAs to intestinal
absorbed and
epithelium
D. Have a polar shell
excreted by GIT)
E. All of these
K. Large Intestine
1. Anatomy 2. Large Colon Histology
a. Ileocecal valve
b. Cecum with appendix
c. Colon a. Epithelium- goblet and absorptive cells
i Ascending to right colic flexure for water absorption
ii. Transverse to left colic flexure
iii. Descending b. Three longitudinal bands (teniae coli)
iv. Sigmoid colon
d. Rectum
i. Anal canal
ii. Anus and sphincter
Internal anal sphincter (smooth muscle)
External anal sphincter (skeletal muscle)
3. Digestion in colon
a. Mechanical
i. Gastroileal and gastrocolic reflexes
ii. Haustral churning
iii. Peristalsis
b. Chemical by bacterial action
i. Remaining nutrients metabolized by
bacteria to CO2, CH4 and H gases.
(flatulence)
ii. Bilirubin to stercobilin by bacteria
iii. Bacterial production of B and K vitamins
17
The gastrocolic reflex speeds
emptying of
A. colon
B. stomach
C. ileum
D. All of these
E. None of these
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11. Who does the defecation reflex differ in infants and
adults? 12. Recognize the various
pathologic conditions of the GIT.
5. Defecation reflex
A. Dental caries and periodontal disease
a. Receptors for rectal distension
B. Peritonitis
b. Sensory impulse to sacral spinal cord
C. Mumps
c. Motor impulse and parasympathetic back for
D. Peptic ulcers
contraction of sigmoid colon, rectum and relaxation of
internal anal sphincter E. Hiatal hernia
d. Infants will defecate, “toilet training” F. GastroEsophageal Reflux Disease (GERD)
teaches control of voluntary external anal sphincter. G. pyloric stenosis
This relaxes at “the appropriate time” H. vomiting (emesis, reverse peristalsis)
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