AnP CH. 23 Hw and Quiz Houzen

Red blood cells contain the protein

Hemoglobin

Gastric activity may be initiated before food even enters the mouth.

True

Gastrin from the gastric mucosa plays a major role in activating stomach motility and secretion

True

When swallowing, the epiglottis covers the larynx

True

Mrs. Fender's prolonged clotting times and excessive bruising are related. Referring to normal physiological functioning of the liver, why do these two things happen when alcohol damages hepatocytes?

When damaged, hepatocytes can't produce normal levels of clotting factors, resulting in prolonged bleeding and more bruising.

How is Mrs. Fender's jaundice related to her liver cirrhosis?

her damaged liver is not capable of removing and processing bilirubin from the bloodstream

The __________ circulation drains all of the organs of the digestive system.

hepatic portal

The mechanical and chemical receptors that control digestive activity are located ________.

in the walls of the digestive tract organs

What stomach secretion is needed to produce mature erythrocytes?

intrinsic factor

A common sign of liver disease is

jaundice

Parasympathetic input decreases digestive tract motility and secretion.

False

The liver further converts it into ____________, which is stored in the ___________.

1. Bile 2. Gall bladder

Bile functions

1. Bile functions to emulsify fats. 2. Bile is both a digestive secretion and a means of excreting certain substances. 3. Bile functions to carry bilirubin to the intestine for disposal.

Contraction of the ___________ forces the _______ into the _______________, where it emulsifies fats and aids in their digestion.

1. Gall bladder 2. bile 3. duodenum

Woman gets sick after eating fatty foods. Whites of her eyes are yellow, Tenderness on right side of abdomen. BP and HR normal. Based on this initial assessment, what organs do you think might be involved in this woman's illness, and why? Choose the two most likely organs involved in her illness.

1. Liver, because of the yellow coloration in her eyes, which indicates that the liver is not processing bilirubin. 2. Gall bladder, because it stores bile and might be related to the bilirubin buildup in her blood.

Mrs. Fender suffers from ascites - the severe abdominal edema associated with advanced liver disease. Which of the following factors can contribute to the ascites? (more than one may be correct)

1. Low albumin production by the damaged liver reduces the osmotic pressure of the blood, allowing greater loss of fluid into the tissues. 2. Scarring in the liver constricts the portal veins, increasing the hydrostatic pressure, and forcing fluid out of the upstream vessels.

characteristics of the stomach?

1. The stomach mucosa is folded into rugae. 2. The stomach has three layers of muscle in the muscularis tunic. 3. The stomach produces a double-layered coat of alkaline mucus.

Pancreatic juice consists of (more than one is possible):

1. digestive enzymes 2. bicarbonate solution

Which of the choices below correctly describe the events occuring during the intestinal phase of gastric digestion. (more than one may be correct)

1. inhibitory reflexes slow gastric activity and emptying 2. secretin and CCK from the duodenum stimulate release of bile and pancreatic juices into the small intestine

Food absorption in the GI tract.

1. most absorption of food molecules occurs in the small intestine 2. the ultimate goal of all physical and chemical processes of digestion is to allow absorption of nutrients 3. simple columnar epithelial cells of the mucosa provide the absorptive surface 4. food absorption is enhanced by the large surface area of the GI tract

true statements of the alimentary canal:

1. most of its regulation is intrinsic 2. the autonomic nervous system plays a role in its activity 3.its wall is formed from four tissue layers

Stimuli that promote gastric motility include

1. peptides and increased pH in the stomach 2. distension of the stomach 3. smelling food

Activities of the large intestine are

1. propels feces toward the anus 2. absorption of vitamins produced by local bacterial flora 3. absorption of water and electrolytes

factors that helps create the stomach mucosal barrier?

1. replacing of damaged epithelial mucosa cells 2.tight junctions of epithelial mucosa cells 3. thick coating of bicarbonate-rich mucus

Which of the following statements about the hormones of the GI tract is true? (may be more than one)

1. the hormones are secreted into the bloodstream by enteroendocrine cells which are scattered in the mucosa of the GI tract 2. the hormones stimulate activities that support the function of the GI tract organ from which they are released

Peritoneal membranes and mesenteries of the abdominal cavity have all the following functions.

1.hold abdominal organs in place and reduce kinking 2. provide conduits for blood vessels, lymphatics and nerves to reach organs 3. provide lubrication and reduce friction of movement of organs

Why might a gallstone affect the pancreas?

A gallstone that blocks the hepatopancreatic ampulla (ampulla of Vater) will block the release of digestive enzymes from the pancreas.

Digestive problems that may result from Mrs. Fender's liver cirrhosis include

An inability to digest and absorb dietary fats.

Which vitamin requires intrinsic factor in order to be absorbed?

B12

When red blood cells are old or injured, the spleen breaks them down and converts the heme from their hemoglobin into

Bilirubin

In the stomach, HCl secretions convert pepsinogen to the active enzyme pepsin. What cells in the gastric pits produce pepsinogen?

Chief

function carried out by the liver include

Functions are: 1. storing glucose as glycogen 2. gluconeogenesis 3. producing bile

Parietal cells of the stomach secrete

HCl and intrinsic factor

Roles of the villi of the small intestine include

Correct roles: 1. they increase surface area for absorption of nutrients 2. their microvilli provide brush border enzymes for digestion 3. each contains a lacteal for fat absorption

All of the following reasons can explain why most peptic ulcers, like Mr. Volpe's, occur in duodenum

Correct statements: 1. Bicarbonate-rich pancreatic juice is secreted after the acidic chyme enters the duodenum. 2. The duodenum is the anatomical structure nearest to the stomach's outlet. 3. The chyme coming from the stomach is very acidic.

After her surgery to remove her gallbladder and clear the obstructed bile duct, the woman recovered uneventfully, and her pancreatitis resolved. Now she wants to know what this surgery has done to her ability to produce bile and digest food. What is the answer?

Her liver will still make bile, but she will have a limited ability to store it (the bile duct may stretch to take on some of this role), so she may not be able to process large amounts of fat in a single meal.

Mr. Volpe's duodenal ulcer pain is relieved immediately by food, which binds up the stomach acid and slows gastric emptying, but returns 2-4 hours later. Which of the following explanations is most likely?

It takes 2-4 hours for the acidic chyme to move from the stomach into the duodenum.

Dr. Lorraine explains to Mr. Volpe that H. pylori overwhelms the duodenal buffering capacity. How does the duodenum buffer the acidic gastric chyme?

Secretion of bicarbonate-rich mucus and release of alkaline pancreatic juice into the duodenum

The nurse asked whether she has noticed a change in her stools. The woman answered that they were hard to flush (they float) and kind of gray-looking. Why did the nurse ask about stools?

Someone with difficulty converting bilirubin into bile will have trouble digesting fats, and they will go out in the stool.

The nurse noticed the following: She was pale, sweating, and had cool, clammy skin. Her heart rate was high and so was her blood pressure. She had no detectible bowel sounds. What part of the autonomic system was activated in this patient?

Sympathetic system because severe pain activates the fight or flight response, which has all the effects she exhibits.

Why does liver dysfunction, such as cirrhosis, lead to hyperglycemia?

The liver is unable to take up glucose from the blood and store it as glycogen.

Which of the following statements are NOT true?

The most common cause of hepatitis is alcoholism. True statements: 1. The most common cause of gastric ulcers is infection by Helicobacter pylori. 2. Acute appendicitis is often accompanied by nausea and vomiting. 3. Hiatal hernia is a protrusion of the stomach upward through the diaphragm.

Mucosae of all GI regions from the stomach through the colon secrete

alkaline mucus

Both the liver and pancreas release __________ into the duodenum, which act to ___________ .

alkaline secretions......protect the duodenal mucosa from stomach acid.

The function of intrinsic factor is to

allow vitamin B12 absorption

Mr. Volpe indicates he has epigastric pain, which leads Dr. Lorraine to consider several organs in that region. Which of the following organs is NOT a likely culprit since it is not in the epigastric region?

appendix

Considering the components of bile, ___________ emulsify fats and is recycled, and ___________ is a waste product of RBC degradation that is eliminated.

bile salts.... bilirubin

Brush border enzymes are

bound to the microvilli of the simple columnar epithelium in the duodenum.

The function of the hepatic portal circulation is to

bring nutrients from the intestine to the liver for processing and storage deliver absorbed nutrients directly to the liver for processing and storage

The __________ controls the entry of food into the stomach.

cardiac (gastroesophageal) sphincter

The function of gastrin is to

cause parietal and chief cells to secrete their products

Pepsinogen, an inactive digestive enzyme, is secreted by the ________.

chief cells of the stomach

When you eat fat, the cells of your small intestine release the hormone

cholecystokinin

The substance that stimulates secretion of bile and pancreatic juice is

cholecystokinin (CCK)

Acinar cells of the pancreas secrete

digestive enzymes

Gastric juice does not typically cause a burning sensation within the stomach. But reflux of this gastric juice into the esophagus can cause a burning sensation. One reason why this occurs is that the esophagus ______.

does not secrete a thick alkaline mucus capable of protecting against stomach acid

The __________ is the first segment of the small intestine

duodenum

The processing of fats in the duodenum requires bile to

emulsify the fat.

Which of the following is an essential role played by large intestine bacteria?

fermentation of indigestible carbohydrates

What other organ in Mrs. Fender's right upper quadrant, besides the liver, must be considered when investigating her abdominal pain?

gallbladder

G cells of the stomach secrete

gastrin

Digestion and absorption of which of the following would be affected the most if the liver were severely damaged?

lipids

This organ is the first to receive the blood-borne products of digestion?

liver

Most of the secretions promoting digestion of food in the small intestine come from the

liver and pancreas.

Which layer of the alimentary canal is constructed from either stratified squamous or simple columnar epithelium?

mucosa

Which layer of the alimentary canal is responsible for segmentation and peristalsis?

muscularis externa

What is a major function of pancreatic juice?

neutralizing chyme entering the small intestine from the stomach

In Mr. Volpe's case, H. pylori degraded his duodenal lining, leaving it vulnerable to the stomach HCl. What other constituent of gastric juice is harmful to a damaged duodenal wall?

pepsin

Which of the following GI hormones is the "natural antacid", promoting secretion of bicarbonate from the pancreas and liver, and reducing stomach acid secretion?

secretin

Dr. Lorraine explains to Mr. Volpe that the H. pylori often causes excess stomach acid secretion. All of the following mechanisms normally increase gastric acid secretion EXCEPT ________.

secretin and CCK

Secretion of pancreatic juices and enzymes is largely under the control of

secretin and CCK

These two hormones are generally released in response to the same stimuli and together they cause secretion from the liver, gallbladder and pancreas. They are:

secretin and CCK (cholecystokinin)

Intestinal enteroendocrine cells secrete

secretin, CCK

The structural feature within the liver that allows for large volumes of blood to flow slowly through it, increasing time for processing of blood contents, is the

sinusoids

The major site of nutrient digestion and absorption is the _________.

small intestine

The alimentary canal is innervated by all of the following except the __________, resulting in complex control of GI function.

somatic nervous system

In a patient suffering from untreated infection-induced peritonitis, an infection in the visceral peritoneum immediately ______.

spreads directly to the parietal peritoneum

The hormone gastrin is secreted by enteroendocrine cells called G cells in the gastric pits of the stomach. Gastrin functions to (you will need to refer to your textbook):

stimulate release of HCl and enzymes from the gastric glands.

Gastrin is a hormone released by the gastric mucosa that is responsible for ______________

stimulating release of stomach acid and pepsinogen

Nervous control of gastric secretion is provided by ________.

the vagus nerve and enteric plexus

Thinking about, seeing, or smelling food can stimulate salivation and gastric juice secretion by way of input from

the vagus nerves

Dr. Lorraine is suspicious of a peptic ulcer, which is a disruption in the stomach or duodenal mucosa extending through its muscularis layer. The primary function of the mucosa is _________.

to provide a protective barrier

Mr. Volpe's one-year follow-up endoscopy shows a healed duodenal wall (no more ulcer). What distinctive feature is now visible on the surface of the duodenal mucosa?

villi with a brush border