S1 Pharmacology > Digestive System > Flashcards

Digestive System Flashcards

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1
Q

What is the alimentary tract ?

A
  • tube extending from mouth to anus
  • muscular tube lined internally by epithelium
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2
Q

What are the functions of the alimentary tract ?

A
  • ingestion
  • processing
  • digestion
  • absorption
  • excretion
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3
Q

What is the journey through the alimentary tract ?

A
  • food
  • oral cavity
  • pharynx
  • epiglottis
  • oesophagus
  • stomach
  • duodenum
  • jejunum
  • ileum
  • caecum
  • ascending colon
  • transverse colon
  • descending colon
  • sigmoid colon
  • rectum
  • anus
  • faeces
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4
Q

What are the 4 abdominal quadrants and major organs in each ?

A
  • RUQ - liver
  • RLQ - caecum, appendix, intestine
  • LUQ- stomach
  • LLQ - intestine
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5
Q

What are the abdominal regions ?

A
  • right hypochondriac region
  • epigastric region
  • left hypochondriac region
  • right lumbar region
  • umbilical region
  • left lumbar region
  • right iliac region
  • hypogastric region
  • left iliac region
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6
Q

What are the layers of the wall of the alimentary tract ? (Refer to pic)

A
  • epithelium - inner most lining
  • lamina propria
  • muscularis mucosa
  • submucosa
  • circular muscle
  • longitudinal muscle
  • adventitia
  • serosa
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7
Q

What is the role of epithelium in mucous membrane ?

A
  • moistened by glandular secretions
  • type of epithelium differed with tissue function
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8
Q

What is the lamina propria ?

A
  • loose connective tissue
  • small blood vessels, nerve fibres, lymphatic’s
  • immune cells - e.g. macrophages + lymphocytes
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9
Q

What is the muscularis mucosa ?

A
  • thin muscle layer
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10
Q

List the 3 layer of mucosa ?

A
  • epithelium
  • lamina propria
  • muscularis mucosa
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11
Q

What is the submucosa ?

A
  • 2nd layer of connective tissue, between mucosa + main muscle layers
  • contains blood vessels, lymphatics, nerves
  • Neural tissue - SUBMUCOSAL PLEXUS which regulates contractions & glandular secretions
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12
Q

What is the muscularis externa made of ?

A
  • smooth muscle divided into 2 layers
  • inner circular layer
  • outer longitudinal layer
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13
Q

How are the layers of the muscularis externa arranged and what is their function?

A
  • circular layer is a compact spiral + longitudinal is an elongated helix
  • layers orientate in different directions
  • contractions propel materials along tract
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14
Q

What is the myenteric plexus and where is it located ?

A
  • 2nd nerve muscle plexus located between muscle layers of the muscularis external
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15
Q

What is the myentric plexus and where is it located ?

A
  • 2nd nerve muscle plexus located between muscle layers of the muscularis external
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16
Q

What covers the outside of the muscularis externa?

A
  • adventitia and/or serosa
  • Alimentary canal suspended in peritoneal cavity, covered in SEROSA
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17
Q

What is the difference between serosa + adventitia ?

A
  • serosa covers organs in the peritoneal cavity, allowing movement
  • retroperitoneal organs are covered in adventitia, but not serosa, and adventitia helps hold organ structures together.
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18
Q

What lines the oral cavity + what are it’s functions ?

A
  • lined by stratified squamous epithelium
    • Ingestion and fragmentation of food
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19
Q

Where are the small salivary glands located ?

A
  • in submucosa of oral cavity and tongue
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20
Q

What are 3 main groups of large salivary glands ?

A
  • Sublingual: beneath tongue, many ducts
  • Submandibular: floor of mouth, inner surface of mandible, ducts behind teeth
  • Parotid : Largest, empties at the 2nd Molar (gets inflamed if you have mumps)
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21
Q

What is oral drug administration ?

A
  • Given by mouth and swallowed
    • Easiest and safest method, but slow absorption
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22
Q

What is sublingual administration + limitation ?

A
  • placed under the tongue – dissolves in saliva
    • Rapid absorption, higher circulating levels
    • limitation = not for bad-tasting or irritating medications
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23
Q

What is buccal drug administrations + disadvantage ?

A
  • Placed in mouth next to cheek (tablet form)
    • Rapid absorption, higher circulating levels
    • Disadvantage -Possibility of swallowing the pill
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24
Q

How long is the oesophagus + where does it pass through ?

A
  • 25cm long, through diaphragm to stomach
  • contracts rhythmically toward stomach
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25
What is the role of the lower oesophageal sphincter ?
- Prevents reflux, emesis and regurgitation
26
What is the type of epithelium in the oesophagus above + below the diaphragm ?
- above diaphragm = stratified squamous epithelium - below diaphragm = columnar epithelium
27
What type of muscles are in the muscularis externa ?
- Striated muscle in upper one third - Mixture of striated and smooth muscle in middle - Smooth muscle lower one third
28
What are the main components of the lower digestive tract ?
• Stomach • Small Intestine (Duodenum, Jejunum, Ileum) • Large intestine (Caecum, Appendix, Colon, Rectum)
29
What kinds of epithelial cells are found in the lower digestive tract ?
- both absorptive & secretory
30
How is efficiency of absorption improved in the lower digestive tract ?
- improved by increasing surface area of contact between epithelia and lumen – Intrusions/folding of epithelium (villi or plicae) – Inversions (tubular structures), the lumen of which communicate with main lumen – Formation of complex glands
31
What are the main functions of the stomach ?
- Reservoir and Digestion • Mixes food it with gastric juices to form a semifluid mass called **chyme**
32
What specific processes occur in the stomach related to protein and vitamin B12?
- initiates protein break down + absorption of vitamin B12 through the release of intrinsic factor
33
How well does the stomach absorb nutrients and drugs?
- Low absorption of nutrients or drugs • Highly lipid-soluble substances e.g. alcohol and some drugs absorbed
34
What are the 4 anatomical regions of the stomach ?
– CARDIA (closest to heart) – FUNDUS (upper area) – BODY (middle portion) – PYLORUS (narrow bottom)
35
What type of epithelium lines the gastric mucosa ?
- columnar epithelium
36
What are the rugae in gastric mucosa ?
- folds in the gastric mucosa that disappear when the stomach is distended.
37
What are the gastric pits ?
- Shallow depressions on surface
38
What type of glands are found in the gastric mucosa?
• contains simple tubular gastric glands that open into the gastric pits.
39
What are the cardiac glands responsible for in the stomach ?
- mucus producing glands that provide alkaline layer
40
What are the four cell types found in the corpus-fundic glands? (CEMP)
- **Chief** (zymogenic) cells: Secrete pepsinogen (converted to pepsin at pH 2-3), gastric lipase (optimum pH 3-6), and chymosin. • **Parietal (oxyntic) cells** : Secrete gastric (hydrochloric) acid and intrinsic factor. • **Mucous neck cells** : Secrete mucus. • **Endocrine** cells: Stimulate secretion of other cell types.
41
What is the function of pyloric glands in the stomach ?
• more endocrine cells and no chief cells
42
What is Achlorhydria?
- lack of gastric acid in the stomach.
43
What is Dyspepsia ?
- Difficulty digesting food
44
What is gastritis ?
- Stomach Inflammation
45
What is Gastroenteritis ?
- Inflammation of stomach and small intestine
46
What is haematemesis ?
- Vomiting of blood
47
What is a Hiatal Hernia ?
- Protrusion of the stomach through opening in diaphragm
48
What is Eructation ?
- belching/ burping
49
What is Flatulence ?
- passing gas / farting
50
What is the main function of the small intestine ?
- digestive & absorptive functions (including drugs)
51
What are the 3 subdivisions of the small intestine ?
- Duodenum, Jejunum, Ileum
52
What are the 3 subdivisions of the small intestine ?
- Duodenum, Jejunum, Ileum
53
Where do the pancreatic + bile duct empty into in the small intestine ?
- empty into duodenum
54
What does the small intestine secrete ?
- secretes digestive enzymes, hormones and mucous
55
What are the plicae in the small intestine ?
- folds of mucosa and submucosa (increase area x3) – Permanent structures (not distension dependent) – Absent from start of duodenum and distal ileum
56
What are intestinal villi and their function?
- cover entire intestinal mucosa – Increase surface area by x10 – Main cell type – **Enterocyte** - has an absorptive function
57
What are microvilli and their role in the small intestine?
- found on enterocytes, increase area by x20
58
What are tubular glands (crypts of Lieberkuhn) in the small intestine?
- from base of villi through lamina propria to muscularis mucosae – Secretion of “intestinal juice” - **Paneth cells** at base of crypt – secretion, control of infection
59
What features of the small intestine enhance absorption?
- Rich blood supply and large absorption/ surface area
60
Where does most drug absorption occur in the small intestine?
• most drug absorption occurs in the upper portion of the small intestine
61
What does secretin do in the small intestine?
- released when chyme enters the small intestine - stimulates the release of bicarbonate from the pancreas to neutralize the chyme.
62
What happens in the duodenum during digestion and absorption?
- carbohydrates are broken down into simple sugars - proteins are broken down – fat emulsified by bile salts, broken down by pancreatic lipase into free fatty acids and monoglycerides, forming micelles for absorption – Most minerals (except. Na+, K+ and Cl-) absorbed
63
What is absorbed in the jejunum?
• monosaccharides and amino acids are absorbed. - water-soluble vitamins are absorbed into the bloodstream. • Fat-soluble vitamins are absorbed into the lymph.
64
What is absorbed in the ileum?
– Bile salts are reabsorbed – Vitamin B12 absorption
65
How does the surface of the large intestine differ from the small intestine?
- Surface relatively smooth – no plicae or villi • Crypts of Lieberkuhn – present and longer than Small Intestine • Goblet (mucous) cells more numerous than Small Intestine
66
What are the main sections of the large intestine?
• **Caecum** (including the appendix, which contains large amounts of lymphoid tissue). • **Colon** : Ascending, Transverse, Descending, and Sigmoid. • **Rectum**: (including the anal canal, with an external anal sphincter under voluntary control).
67
What are the primary functions of the large intestine?
- Absorption of fluids and electrolytes (Na+, Cl-) • Secretion of electrolytes (K+ and HCO3-) and mucus • Bacteria synthesize vitamin K and some B vitamins • Peristalsis slow and irregular • Formation, storage and periodic elimination of faeces
68
What are the stages in defecation ?
• Faeces enters rectum • Rectum distends, stimulating mass peristalsis • Levator ani muscle relaxes • Internal and external sphincter muscles relax • Anus is pulled up and over faecal mass • Faecal mass is expelled
69
How is water absorbed ?
- a passive process driven by the transport of solutes (particularly Na+) from the lumen of the intestines to the bloodstream
70
What does an antacid do ?
- neutralises stomach acid
71
What does an antidiarrheal do ?
- control loose stools
72
What does antispasmodic do ?
- controls GI spasms
73
What does antiemetic do ?
- prevents regurgitation
74
What does cathartic do ?
- causes vomiting or relieves constipation
75
What does laxative do ?
- relieves constipation
76
What are the main characteristics of the pancreas?
- Pink/Grey organ with no distinct capsule, • retroperitoneal organ • both Exocrine and Endocrine Functionality
77
What is the endocrine function of the pancreas?
- pancreas produces and secretes insulin, glucagon, and somatostatin via the islets of Langerhans.
78
What is the exocrine function of the pancreas?
pancreas secretes digestive enzymes, including: • Trypsin, Chymotrypsin, Carboxypeptidase • Pancreatic amylase (requires HCO₃⁻, max activity at pH 7.0) • Pancreatic lipases (optimal activity pH 7.0–9.0)
79
What are the 4 main cell types in the islets of Langerhans, and what do they secrete?
• β-cells: Secrete insulin (70%), lowers BGL • α-cells: Secrete glucagon (20%), raises BGL • δ-cells: Secrete somatostatin (5%), inhibits other endocrine cells • PP/F cells: Secrete pancreatic polypeptide, inhibit bile secretion (2%)
80
What cells secrete pancreatic juice ?
- acini
81
What is the composition of pancreatic juice?
• clear, isosmotic alkaline fluid (pH 8) containing **digestive enzyme precursors**
82
Where is the bulk of the pancreatic juice and bicarbonate secreted from?
- The bulk of the fluid and bicarbonate is secreted by **intercalated duct cells**, rather than acini.
83
How are enzymes secreted in the pancreas?
• Enzymes are secreted from acinar cells as zymogen granules.
84
What induces enzyme-rich secretion from acini?
- Cholecystokinin (CCK) induces enzyme-rich secretion from acini.
85
What stimulates the secretion of bicarbonate from ductal cells?
- Secretin, released in response to pH < 3.0 in the duodenum, causes HCO₃⁻-rich secretion from ductal cells.
86
What is the role of vagal stimulation in pancreatic secretion?
• Vagal stimulation is a minor stimulus for pancreatic secretion.
87
What is the ductal system of the pancreas?
- Acini Duct (cuboidal) → Interlobular duct (columnar) → Intercalated duct (columnar) → Pancreatic Duct
88
Role of glucagon, stimulation + inhibition ?
• Secreted by α-cells of endocrine pancreas • Prevents hypoglycaemia by elevating blood glucose levels • promotes glycogenolysis & gluconeogenesis • Stimulated by cholinergic system, β-sympathetic fibres • Inhibited by glucose, insulin, somatostatin, α-sympathetic system
89
Role of insulin + degradation?
-synthesised in B cells of islets of langerhans - degraded by insulinase, primarily in the liver - increases glucose transporter activity in muscle/adipose tissue (more glucose uptake so more used, so dec glucose) - minor effect on neuronal tissue
90
What are the effects of low and high glucose levels on the body ?
- low = decreased brain activity - high = osmotic water loss, damaged blood vessels
91
What triggers the secretion of somatostatin?
• Increased blood glucose • Increased blood amino acids • Increased blood fatty acids - Increased concentrations of upper GI hormones (gastrin, secretin, CCK, VIP) in response to food intake
92
What are the actions of somatostatin ?
- inhibit insulin and glucagon secretion • Paracrine with glucagon to regulate insulin secretion • Decreases GI tract secretions and absorption • Decreased gastric acid secretion
93
What are the 3 types of gastric glands ?
- cardiac glands - corpus- fundic glands - pyloric glands
S1 Pharmacology
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