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A comprehensive set of test questions and answers related to upper and lower gastrointestinal (gi) peristalsis. It covers key topics such as gerd, barrett's esophagus, gastric emptying, intestinal motility, and defecation reflexes. The questions delve into the physiological mechanisms, clinical implications, and regulatory factors involved in gi function, making it a valuable resource for medical students and healthcare professionals studying gastroenterology. It explores the roles of various hormones, neural pathways, and anatomical structures in the digestive process, offering a detailed understanding of gi motility and its disorders. The document also addresses clinical conditions like gastroparesis and dumping syndrome, providing insights into their causes, symptoms, and treatments.
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What is GERD? -- Answer โโ incomplete LES closure allows stomach contents to enter the lower esophagus and damage the esophageal wall What are some complications of GERD? -- Answer โโ esophageal stricture from scar tissue, asthma resulting in aspiration, chronic sinus infections from reflux into the throat, Barrett's esophagus What is Barrett's esophagus? -- Answer โโ chronic exposure to stomach contents results in the normal stratified squamous epithelium of the esophagus being replaced with simple columnar epithelium with goblet cells (similar to intestinal lining) as esophagus tries to heal the damage What is Barrett's esophagus a risk factor for? -- Answer โโ esophageal cancer What are rugae? -- Answer โโ folds in the stomach lining What happens when food enters the stomach? -- Answer โโ receptive relaxation occurs to make room for each food bolus entering (involves the vagus) Why is receptive relaxation in the stomach considered a vagovagal reflex? -- Answer โโ sensory stretch signals are carried from the stomach to the CNS by the vagus nerve, and the vagus also conducts efferent impulses to the orad (upper stomach) to receive the food What occurs as food moves to the caudal area of the stomach? -- Answer โโ mixing of food with gastric juice
What do contractions in the stomach cause? -- Answer โโ retropulsion of contents from caudad area to orad area, which throughout mixes the food with gastric secretions What does the antral pump in the caudad area of the stomach do? -- Answer โโ propels chyme into the duodenum What are some factors that increase the rate of gastric emptying? -- Answer โโ 1) increased tone of the orad
What do segmental SI contractions do the the unstirred water layer adjacent to apical membranes of SI enterocytes? -- Answer โโ disrupt it so that chyme can gain access to the channels on the epithelial surface, which increases absorption What is a migrating motor complex (MMC)? -- Answer โโ rhythmic changes in motor and electrical activity that occur in the SI during the interdigestive (fasting) state What is the 4-phase pattern of an MMC? -- Answer โโ 1) prolonged quiescent period
What hormones stimulate intestinal motility? -- Answer โโ serotonin, prostaglandins, gastrin, CCK, and insulin What hormones inhibit intestinal motility? -- Answer โโ epinephrine, secretin, and glucagon Why do patients on SSRIs tend to have GI side effects? -- Answer โโ because increased serotonin alters gut motility What are the two functions of the ileocecal sphincter? -- Answer โโ sphincter and valve What does the sphincter function of the ileocecal sphincter do? -- Answer โโ regulates movement of ileal contents into the colon by controlling their rate of entry What does the valvular function of the ileocecal sphincter do? -- Answer โโ prevents backflow of cecal and colonic material into the SI, ensuring unidirectional movement of contents and keeping colonic bacteria in the colon What happens to the ileocecal sphincter when luminal contents cause distension or pressure on the ileal wall? -- Answer โโ the sphincter relaxes and ileal peristalsis is excited What happens to the ileocecal sphincter when luminal contents increase pressure on the colonic side? -- Answer โโ the sphincter contracts and ileal peristalsis is inhibited Which nerve innervates the proximal colon? -- Answer โโ vagus Which nerves innervate the distal colon, rectum, and anus? -- Answer โโ S2-S What are hostral contractions? -- Answer โโ contractions seen in the proximal intestine (similar to segmented contractions) that occur every 20-30 mins and further mix chyme to promote fluid/electrolyte absorption
What is secondary peristalsis in the esophageal phase of swallowing? -- Answer โโ peristalsis induced by distension of the esophagus due to local reflex signal throughout the enteric NS and the swallowing center Can secondary peristalsis in the esophagus still occur after vagotomy? -- Answer โโ yes, because even though the swallowing center would not be functioning, the enteric NS could still function and allow automatic secondary peristaltic contractions to continue What is esophageal manometry? -- Answer โโ measure of strength, muscle coordination, and pressure of the esophagus after swallowing What is the pressure like in the esophagus in between swallows? -- Answer โโ high at both the UES and LES in order to ensure that the esophagus remains clear in the absence of food (UES prevents air entry and LES prevents stomach acid entry) What is the pressure like in the esophagus during swallowing? -- Answer โโ UES pressure is lower because it relaxes, and the peristaltic wave is where we see the high pressure moving; LES and funds show low pressure, which is indicative of receptive relaxation in these regions in preparation for food bolus arrival What are the stages of GI motility? -- Answer โโ ingestion of foods/liquids, propulsion along the GI tract, breakdown into absorbable components, and removal of remaining waste products What are three functions of GI motility? -- Answer โโ 1) non-propulsive movement --
important for mixing food material