Chapter 20
101) What does entry of the bolus into the esophagus initiate by stimulating stretch receptors? A) peristalsis B) the swallowing reflex C) the chewing reflex D) bolus formation E) receptive relaxation
A
102) What is the decrease in rugae folding within the stomach in advance of the arrival of a bolus of food called? A) receptive relaxation B) esophageal reflex relaxation C) gastric unfolding D) gastric expansion E) peristaltic relaxation
A
111) What is a mass movement? A) a peristaltic-like wave in the large intestine that propels the contents toward the rectum B) a segmentation-like wave in the large intestine that causes the elimination of contents as feces C) a peristaltic-like wave in the large intestine that causes the elimination of contents as feces D) a segmentation-like wave in the large intestine that mixes the contents E) another name for defecation
A
113) As the outermost layer of the gastrointestinal wall, which of the following secretes a lubricant to slide over other organs? A) serosa B) submucosa C) myenteric plexus D) mucosa E) muscularis externa
A
12) What membrane lines the abdominal cavity? A) peritoneum B) adventitia C) mesenteries D) mesothelium E) serosa
A
127) Which sphincter is composed of smooth muscle between the esophagus and stomach? A) lower esophageal sphincter B) pyloric sphincter C) internal anal sphincter D) upper esophageal sphincter E) sphincter of Oddi
A
133) Which cell secretes pepsinogen? A) chief cell B) acinar cell C) parietal cell D) G cell E) neck cell
A
150) What is the predominant hormone to inhibit gastric secretion and motility in response to distension of the duodenum? A) glucose-dependent insulinotropic peptide B) secretin C) gastrin D) motilin E) cholecystokinin
A
157) The stomach's lining is protected from the acidic contents of the lumen by a layer of mucus and bicarbonate called what? A) gastric mucosal barrier B) succus entericus C) prandial succus gastricus D) glycocalyx E) PGE2 inducement
A
160) What blood vessel supplies the liver with oxygenated blood? A) hepatic artery B) hepatic portal C) inferior gastric D) superior mesenteric artery E) sinusoidal system
A
170) Enterocytes secrete what protein into the lumen of the small intestine to facilitate the absorption of iron? A) transferrin B) ferritin C) ferroxidase D) hemosiderin E) siderophores
A
81) What does the secretion of leptin cause? A) decreased sensation of hunger B) increased bile secretion C) increased pancreatic secretion into the gastrointestinal tract D) decreased gastric secretion into the gastrointestinal tract E) increased motility of the gastrointestinal tract
A
82) What causes leptin secretion to increase? A) increased storage of calories in adipose cells B) increased glycogenolysis in skeletal muscle cells C) decreased synthesis of triglycerides in adipose cells D) decreased synthesis of glycogen in liver cells E) increased gluconeogenesis in liver cells
A
83) Obesity predisposes a person for development of all of the following diseases EXCEPT A) rickets. B) heart disease. C) hypertension. D) atherosclerosis. E) liver disease.
A
86) The increase in absorbed nutrients in blood will cause secretion of what hormone to increase, thereby decreasing the sensation of hunger? A) insulin B) gastrin C) cholecystokinin D) secretin E) glucagon
A
98) What causes peristalsis? A) contraction of the circular muscle layer and relaxation of the longitudinal muscle in the proximal segment coupled with the contraction of longitudinal muscle and relaxation of the circular muscle in the distal segment B) contraction of both the circular muscle layer and longitudinal muscle in the proximal segment coupled with the relaxation of both the circular muscle layer and longitudinal muscle in the distal segment C) contraction of the circular muscle layer and relaxation of the longitudinal muscle at the same segment D) relaxation of the circular muscle layer and contraction of the longitudinal muscle in the proximal segment coupled with the relaxation of longitudinal muscle and contraction of the circular muscle in the distal segment E) relaxation of the circular muscle layer and contraction of the longitudinal muscle at the same segment
A
27) To increase the absorptive efficiency of the small intestine, the surface area of the mucosa is increased by the presence of folds in the wall called ________, and projections of the cell membrane called ________. A) villi : microvilli B) rugae : lacteals C) lacteals : rugae D) microvilli : villi E) microvilli : lacteals
A
32) Blood from the intestinal capillaries drains into what blood vessel before entering the hepatic portal vein? A) mesenteric vein B) intestinal vein C) coeliac vein D) hepatic vein E) hepatic artery
A
35) Which of the following structures is NOT part of the large intestine? A) anus B) vermiform appendix C) rectum D) colon E) cecum
A
41) Which of the following secretes lipase? A) pancreas only B) salivary glands only C) liver only D) both salivary glands and pancreas E) pancreas and liver
A
44) In order to convert amino acids to gluconeogenic precursors, their ammonium ion must be removed in the liver, which is then converted to what substance, thereby making it water soluble enough to be excreted by the kidneys? A) urea B) nitrogen C) ammonia D) uric acid E) bilirubin
A
47) The flow of bile from the liver and juices from the exocrine pancreas converge at what structure? A) ampulla of Vater B) common hepatic duct C) gallbladder D) common bile duct E) bile duct
A
49) What is the functional unit of the liver? A) lobule B) bile canaliculi C) lobe D) sinusoid E) hepatocyte
A
60) Proteolytic enzymes secreted in pancreatic juice are stored in secretory cells of the pancreas as A) zymogens. B) pepsinogen. C) chylomicrons. D) limit dextrins. E) bile salts.
A
63) In order to begin the process of fat digestion, the fat globules must be A) emulsified by bile salts. B) coalesced by lipase. C) coalesced by bile salts. D) emulsified by lipases. E) emulsified by trypsin.
A
68) The products of fat degradation are absorbed in the small intestines by what transport process? A) simple diffusion B) primary active transport C) facilitated diffusion D) sodium-linked secondary active transport E) paracellular transport
A
78) Gastric-phase control of gastrointestinal function refers to its site of origin, which is what? A) the stomach B) the central nervous system C) the pancreas D) the intestines E) the colon
A
75) Carbonic anhydrase is located in which of the following digestive structures? A) salivary glands only B) lumen of the small intestine only C) parietal cells only D) both salivary glands and parietal cells E) both parietal cells and lumen of the small intestine
E
76) Which of the following substances does NOT require the interaction with a protein in the intestinal tract to be absorbed? A) sodium B) iron C) calcium D) vitamin B12 E) fat-soluble vitamins
E
77) The central component of the long reflex pathway typically involves the ________ nervous system, which acts to promote an increase in gastrointestinal activity. A) enteric B) somatic C) sympathetic D) intrinsic E) parasympathetic
E
84) A person is considered obese if their body fat composition is what percentage above normal? A) 40 B) 50 C) 30 D) 10 E) 20
E
92) In response to the presence of food within the duodenum, the increased release of what hormone will predominantly stimulate the increase of bicarbonate secretion from the exocrine pancreas? A) cholecystokinin B) insulin C) gastrin D) glucose-dependent insulinotropic peptide E) secretin
E
96) What is the main hormone that stimulates bile secretion in the liver? A) gastrin B) glucagon C) insulin D) cholecystokinin E) secretin
E
103) The peristaltic waves of the stomach will result in ________ if the pyloric sphincter is closed. A) an inhibition of further waves B) the mixing of the chyme C) some of the chyme being forced into the duodenum even D) stimulation of hormone secretion from the duodenum E) the formation of a bolus
B
106) Which of the following increases gastric motility? A) distension of the intestines B) distension of the stomach C) increased fat content in the lumen of the duodenum D) cholecystokinin and secretin E) increased osmolarity of duodenal contents
B
108) What reflex protects the small intestine by inhibiting contractions while the intestines are injured or severely distended? A) colonocolonic reflex B) intestino-intestinal reflex C) gastroileal reflex D) ileogastric reflex E) gastrocolic reflex
B
112) What is the innermost layer of the gastrointestinal wall called? A) serosa B) mucosa C) myenteric plexus D) muscularis externa E) submucosa
B
129) Where is the acid in the stomach produced? A) G cell B) parietal cell C) acinar cell D) chief cell E) neck cell
B
131) Intrinsic factor is produced where? A) acinar cell B) parietal cell C) chief cell D) neck cell E) G cell
B
135) Crypts of Lieberkühn are found in which organ? A) stomach B) small intestine C) large intestine D) pancreas E) liver
B
136) Where are the gastric pits found? A) small intestine B) stomach C) pancreas D) liver E) large intestine
B
137) The brush border is located in which organ? A) pancreas B) small intestine C) stomach D) liver E) large intestine
B
138) Sinusoids are openings where blood flows through and exchange takes place found in which of the following? A) large intestine B) liver C) pancreas D) small intestine E) stomach
B
139) Islets of Langerhans are highly vascularized bits of endocrine tissue found where? A) large intestine B) pancreas C) small intestine D) liver E) stomach
B
140) Acini are located in which of the following? A) large intestine B) pancreas C) small intestine D) liver E) stomach
B
147) Which hormone stimulates gastric secretion and motility? A) inhibin B) gastrin C) secretin D) cholecystokinin E) glucose-dependent insulinotropic peptide
B
159) Microvilli of epithelial cells in the small intestine make up what structure? A) lacteal B) brush border C) mucociliary ladder D) villi E) succus entericus
B
16) Gastric reflux occurs when material flows backwards through which of the following structures? A) glottis B) lower esophageal sphincter C) upper esophageal sphincter D) epiglottis E) pyloric sphincter
B
164) What are macrophages in the liver called? A) sinusoidal lining cells B) Kupffer cells C) sideroblasts D) giant cells E) histiocytes
B
172) What are the spontaneous graded potentials that occur in smooth muscle cells of the digestive tract called? A) segmentation B) slow waves C) intestinal phase D) basic electrical rhythm (BER) E) peristalsis
B
2) Which of the following is the correct order of the layers of the gastrointestinal tract wall, from lumen to external surface? A) serosa, muscularis externa, submucosa, mucosa B) mucosa, submucosa, muscularis externa, serosa C) serosa, mucosa, submucosa, muscularis externa D) mucosa, submucosa, serosa, muscularis externa E) submucosa, mucosa, serosa, muscularis externa
B
28) Which of the following is the correct order of the components of the small intestine, from stomach to colon? A) jejunum, ileum duodenum B) duodenum, jejunum, ileum C) ileum, jejunum, duodenum D) duodenum, ileum, jejunum E) jejunum, duodenum, ileum
B
30) What is the brush border? A) villi from epithelial cells lining the small intestine B) microvilli from epithelial cells lining the small intestine C) villi from epithelial cells lining the stomach D) villi from parietal cells E) microvilli from parietal cells
B
38) Which of the following is NOT one of the components of exocrine pancreatic secretions? A) protease B) sucrose C) amylase D) lipase E) nuclease
B
51) What are Kupffer cells? A) cells lining the crypts of Lieberkühn B) macrophages in the liver C) cells lining the pancreatic duct D) hepatocytes E) cells of the stomach that secrete hydrogen ions
B
53) Which of the following is NOT an enzyme that acts on the products of amylase digestion of glycogen and starch? A) maltase B) galactase C) glucoamylase D) dextrinase E) sucrase
B
59) What enzyme activates procarboxypeptidase? A) carboxypeptidase B) trypsin C) enterokinase D) pepsin E) aminopeptidase
B
6) What is the thin layer of smooth muscle cells whose contraction stirs the lumenal contents and promotes contact with the mucosal membrane? A) muscularis internae B) muscularis mucosae C) muscularis externae D) myenteric plexus E) serosa
B
62) Many individual amino acids enter the epithelial cells that line the lumen of the digestive tract via what transport process? A) facilitated diffusion B) sodium-linked secondary active transport C) simple diffusion D) paracellular transport E) primary active transport
B
70) Lipids are absorbed as ________ into ________. A) micelles : lacteals B) chylomicrons : lacteals C) chylomicrons : mesenteric capillaries D) micelles : mesenteric capillaries E) fatty acids and monoglycerides : mesenteric capillaries
B
79) Which of the following is NOT one of the hormones released by the gastrointestinal tract that regulates its function? A) secretin B) glucose inhibitory peptide C) gastrin D) cholecystokinin E) glucose-dependent insulinotropic peptide
B
80) Which of the following is an enterogastrone? A) epinephrine B) cholecystokinin C) gastrin D) monoglyceride E) bile
B
85) What cell type secretes resistin? A) hepatocytes only B) adipocytes and macrophages C) adipocytes only D) macrophages only E) G cells only
B
97) In the intestine, the smooth muscle cell's A) contraction requires an action potential but its force is graded by the extent of neurotransmitter released. B) contraction requires an action potential and its force is therefore graded by the frequency of action potentials. C) force of contraction is graded by the extent of depolarization for slow waves whether an action potential is generated or not. D) force of contraction is graded by the extent of depolarization for slow waves until an action potential is generated. E) contraction is stimulated by motor neurons.
B
174) Intense contractions of the antrum accompanied by relaxation of the pyloric sphincter that function to sweep the stomach clean of its contents are called the A) peristalsis. B) segmentation. C) migrating motility complex. D) receptive relaxation.
C
19) What are rugae? A) folds in the small intestine that increase the surface area for absorption B) folds in the large intestine that increase the surface area for absorption C) folds in the stomach that can flatten to expand the stomach volume D) a motility pattern of the large intestine E) a motility pattern of the stomach
C
24) Which of the following is NOT a normal function of the high acidity of the stomach? A) destroy foodborne bacteria B) denature proteins C) activate vitamin B12 D) protect against illness E) activate pepsin
C
26) What protects the stomach wall from the acidic lumenal contents? A) a layer of adipose tissue lining the gastric mucosa B) the presence of rugae C) the gastric mucosal barrier D) the gastric coat E) a layer of parietal cells
C
33) What region of the colon serves primarily as a storage depot for whatever material remains in the lumen after absorption has occurred? A) descending B) transverse C) sigmoid D) resected E) ascending
C
34) What is the primary function of the colon? A) further digest protein within the chyme B) further digest fats within the chyme C) reduce the volume of the chyme D) regulate absorption of carbohydrates and amino acids E) further absorb carbohydrates
C
45) Which of the following is NOT one of the wastes eliminated by the liver in bile? A) certain drugs B) bilirubin C) urea D) cholesterol E) trace metals
C
5) What layer of the mucosa is connective tissue that contains blood vessels and lymphatic vessels? A) mucous membrane B) serosa C) lamina propria D) muscularis mucosae E) submucosal plexus
C
64) Emulsification aids in the digestion of fats by A) beginning the process of degrading the triglycerides within the fat globule. B) increasing the number of fat globules. C) increasing the surface area of the fat globule exposed to enzymes. D) the ability of bile salts to activate lipases that digest fats. E) increasing the number of hydrophobic residues on the surface of the fat globule.
C
66) Digestion products of lipases are readily exchanged in the lumen with A) chylomicrons. B) cholesterol. C) micelles. D) low-density lipoproteins. E) polysaccharides.
C
67) Bile salts are recycled by the A) common bile duct. B) mesenteric arteries. C) enterohepatic circulation. D) biliary circulation. E) hepatic arteries.
C
10) Where do slow-wave potentials occur? A) submucosal plexus B) myenteric plexus C) muscularis mucosae D) inner circular muscle layer of the muscularis externa E) outer longitudinal muscle layer of the muscularis externa
D
107) What is the function of segmentation in the small intestines? A) releasing bile from the gall bladder B) propelling the chyme C) the opening of the pyloric valve D) mixing the chyme E) releasing pancreatic juices
D
110) What stimulates the defecation reflex? A) peristaltic contraction of the sigmoid colon B) pressure on the internal anal sphincter C) increase in osmolarity of the rectum D) distention of the rectum E) distention of the descending colon
D
115) What structure contains enterocytes and the lamina propria? A) submucosa B) myenteric plexus C) serosa D) mucosa E) muscularis externa
D
125) Which sphincter is composed of smooth muscle between the ampulla of Vater and the duodenum? A) pyloric sphincter B) ileocecal sphincter C) lower esophageal sphincter D) sphincter of Oddi E) internal anal sphincter
D
126) Which sphincter is composed of smooth muscle between the stomach and duodenum? A) lower esophageal sphincter B) internal anal sphincter C) ileocecal sphincter D) pyloric sphincter E) sphincter of Oddi
D
13) What is the technical word for chewing? A) micturition B) haustration C) segmentation D) mastication E) accommodation
D
130) Which cell secretes gastrin into the bloodstream? A) neck cell B) chief cell C) acinar cell D) G cell E) parietal cell
D
134) Rugae create greater surface area in what organ? A) small intestine B) large intestine C) pancreas D) stomach E) liver
D
14) As the food is broken into smaller pieces in the mouth, it is combined with ________ that facilitates its movement down the esophagus. A) chyme B) pancreatic juices C) gastric juices D) saliva E) amylase
D
141) Bile canaliculi are located in which organ? A) stomach B) large intestine C) pancreas D) liver E) small intestine
D
142) Which enzyme catalyzes reactions with polysaccharides? A) lipase B) chymotrypsin C) glucoamylase D) amylase E) sucrase
D
144) Straight-chain glucose polymers would require which enzyme for their catabolism? A) dextrinase B) chymotrypsin C) lipase D) amylase E) sucrase
D
149) Which hormone stimulates gall bladder contraction? A) motilin B) gastrin C) glucose-dependent insulinotropic peptide D) cholecystokinin E) secretin
D
151) Which of the following stimulates the relaxation of the sphincter of Oddi? A) motilin B) gastrin C) secretin D) cholecystokinin E) glucose-dependent insulinotropic peptide
D
152) Which of the following structures of the gastrointestinal tract has a wall structure that differs from others? A) upper third of esophagus B) external-most portion of anus C) mouth D) ileum E) pharynx
D
165) Where are the enzymes responsible for degrading disaccharides and limit dextrins located? A) ampulla of Vater B) pylorus C) endocrine pancreas D) brush border of the small intestine E) exocrine pancreas
D
166) What is a glucose polymer found in plant products that cannot be degraded within the digestive tract of humans? A) chitin B) pectin C) cellulose acetate D) cellulose E) fructose
D
167) What is the process whereby bile salts breakdown fat globules into smaller droplets? A) esterification B) digestion C) lipolysis D) emulsification E) saponification
D
168) Monoglycerides and free fatty acids that are not immediately transported into lumenal enterocytes aggregate into what type form in the lumen of the small intestines? A) VLDLs B) phospholipid bilayer C) chylomicra D) micelles E) HDLs
D
23) What do neck cells of gastric pits secrete? A) intrinsic factor B) hydrogen ions C) pepsinogen D) mucus E) gastrin
D
25) Once the chyme begins to enter the duodenum, it must first be ________ before any of the enzymes in the pancreatic juices can be activated. A) acidified B) dehydrated C) phosphorylated D) deacidified E) hydrated
D
29) A lacteal is a ________ located in ________. A) nerve : myenteric plexus B) patch of immune tissue : submucosa C) nerve : submucosal plexus D) lymphatic vessel : villus E) capillary : villus
D
31) What do the secretory cells in the crypts of Lieberkühn secrete? A) pancreatic juice B) gastric juice C) bile D) succus entericus E) intestinal juice
D
37) Which of the following is NOT one of the components of saliva? A) lysozymes B) bicarbonate ions C) amylases D) lipases E) mucus
D
4) Enterocytes of the mucous membrane of the mucosal layer are classified as ________ cells if they secrete fluids and enzymes into the lumen and ________ cells if they release hormones into the bloodstream. A) endocrine : exocrine B) exocrine : absorptive C) absorptive : endocrine D) exocrine : endocrine E) endocrine : absorptive
D
42) Which of the following is NOT one of the functions of the liver? A) secretion of bile B) synthesis and modification of hormones C) removal of aged erythrocytes D) secretion of enzymes for digestion E) synthesis of albumin
D
43) What degradation by-product of hemoglobin is removed from the blood by the liver, conjugated, and then secreted into the bile? A) lipoproteins B) iron C) urea D) bilirubin E) uric acid
D
46) Which of the following is NOT one of the hormone-related functions of the liver? A) hormone modification B) secretion of hormone-binding proteins C) hormone degradation D) hormone storage E) hormone synthesis
D
52) The enzyme amylase is able to cleave glycogen and starch into A) limit dextrins only. B) monosaccharides only. C) disaccharides only. D) both disaccharides and limit dextrins. E) both monosaccharides and disaccharides.
D
54) The absorption of glucose involves ________ across the apical membrane and ________ across the basolateral membrane. A) simple diffusion : facilitated diffusion B) facilitated diffusion : facilitated diffusion C) secondary active transport : secondary active transport D) secondary active transport : facilitated diffusion E) secondary active transport : primary active transport
D
57) The digestion of proteins begins in the ________ with the activation of the zymogen ________. A) small intestine : chymotrypsinogen B) mouth : pepsinogen C) small intestine : trypsinogen D) stomach : pepsinogen E) stomach : procarboxypeptidase
D
58) What enzyme is responsible for cleavage of the amino acid at the amine portion of the peptide fragment? A) chymotrypsin B) trypsin C) carboxypeptidase D) aminopeptidase E) enterokinase
D
71) Vitamin B12 is absorbed in the ________ through ________. A) duodenum : cotransport with sodium B) jejunum : facilitated diffusion C) jejunum : complexing with intrinsic factor D) ileum : complexing with intrinsic factor E) duodenum : facilitated diffusion
D
72) A lack of intrinsic factor can result in A) aplastic anemia. B) immune suppression. C) diarrhea. D) pernicious anemia. E) diabetes.
D
73) The absorption of sodium throughout the small intestine is driven by ________ transport and is typically linked to the absorption of ________. A) passive : bicarbonate B) active : glucose C) passive : glucose D) active : chloride E) active : bicarbonate
D
74) In the jejunum, bicarbonate is ________, while in the ileum and colon, bicarbonate is ________. A) secreted : absorbed B) absorbed : not transported in either direction C) absorbed : absorbed D) absorbed : secreted E) secreted : secreted
D
8) The enteric nervous system receives its inputs from A) autonomic neurons only. B) somatic motor neurons only. C) sensory neurons in the wall of the gastrointestinal tract only. D) both autonomic neurons and sensory neurons in the wall of the gastrointestinal tract. E) both somatic motor neurons and sensory neurons in the wall of the gastrointestinal tract.
D
87) The presence of food in the duodenum will cause secretion of what hormone to increase, thereby decreasing the sensation of hunger? A) secretin B) gastrin C) insulin D) cholecystokinin E) glucagon
D
88) ________ ions are produced within the parietal cells and transported across the apical membrane via an active transporter while, at the same time, ________ moves across the apical membrane through ion channels. A) Bicarbonate : chloride B) Hydrogen : bicarbonate C) Hydrogen : sodium D) Hydrogen : chloride E) Bicarbonate : hydrogen
D
89) Which of the following is a gastric-phase stimulus for acid secretion? A) chewing, swallowing, and the presence of protein digestion products in the lumen of the stomach B) chewing and the act of swallowing C) the presence of fat and protein digestion products in the lumen of the stomach D) distension of the stomach and the presence of protein digestion products in the lumen of the stomach E) distension of the stomach and the act of swallowing
D
9) The muscularis externa contains which of the following muscle groups? A) a muscularis mucosae, which lubricates as it contracts B) an outer longitudinal layer that requires neural input for contraction C) an inner circular layer capable of slow-wave potentials only D) both an inner circular and an outer longitudinal layer E) an inner circular and outer longitudinal layer, and a muscularis mucosae
D
90) A person taking a histamine (H2) blocker or a proton pump inhibitor to relieve excess stomach acid production often finds a return of symptoms that is worse with a missed dose. Which statement about the effects these medications have on gastrin is FALSE? A) Acid blockers have no direct effect on gastrin, but inhibit acid production through other mechanisms. B) High circulating levels of gastrin accompany acid-blocking medication use and, if interrupted, a pronounced rebound effect of excess stomach acid ensues. C) Decreased acid production inhibits inhibition of gastrin release into the bloodstream, thereby disrupting its negative feedback mechanism. D) Acid-blocking medications interrupt the negative feedback on gastrin release and are therefore self-limiting in their use. E) Return of symptoms by excess gastrin's influence on acid production stimulates further medication use, thereby leading to a chronic consumption.
D
94) The secretion of secretin is predominantly regulated by which of the following? 94) A) carbohydrate digestion products B) distention of the duodenum C) opening of the pyloric sphincter D) acid content of the duodenum E) protein digestion products and fat
D
95) Which of the following are mechanisms by which cholecystokinin (CCK) facilitates digestion of fats? A) stimulation of lipase secretion and gallbladder contraction B) stimulation of bile secretion and contraction of the sphincter of Oddi C) stimulation of lipase and bile secretion D) stimulation of gallbladder contraction and relaxation of the sphincter of Oddi E) stimulation of bile secretion and liver contraction
D
173) All of the following are factors that affect the rate of gastric emptying EXCEPT A) amount of peptides in the duodenum. B) volume of the chyme in the stomach. C) force of gastric contraction. D) composition of the chyme. E) temperature of the chyme.
E
18) The flow of chyme from the stomach to the small intestine is physically regulated by the A) gastroileal sphincter. B) epiglottis. C) lower esophageal sphincter. D) glottis. E) pyloric sphincter.
E
20) What cells secrete pepsinogen into the lumen of the stomach? A) goblet B) neck C) parietal D) G E) chief
E
21) What cells function to secrete hydrogen ions into the lumen of the stomach? A) goblet B) G C) chief D) neck E) parietal
E
22) What do parietal cells secrete? A) hydrogen ions only B) pepsinogen only C) intrinsic factor only D) both hydrogen ions and pepsinogen E) both hydrogen ions and intrinsic factor
E
3) Which of the following correctly lists the three portions of the mucosa? A) adventitia, lamina propria, muscularis externa B) muscularis mucosae, mucous membrane, submucosa C) serosa, muscularis mucosae, muscularis externa D) adventitia, muscularis externa, mucous membrane E) mucous membrane, lamina propria, muscularis mucosae
E
36) Which of the following sphincters is composed of skeletal muscle? A) pyloric sphincter only B) upper esophageal sphincter only C) external anal sphincter only D) both the pyloric and upper esophageal sphincters E) both the upper esophageal and external anal sphincters
E
39) What enzymes, secreted by the exocrine pancreas, degrade fats? A) nucleases B) amylases C) endopeptidases D) proteases E) lipases
E
40) Which of the following secretes a bicarbonate-rich fluid? A) pancreas only B) salivary glands only C) liver only D) both salivary glands and pancreas E) salivary glands, pancreas, and liver
E
48) One side of a hepatocyte faces the blood while the other faces what? A) sinusoid B) common hepatic duct C) acinar cells D) enterocyte E) bile canaliculus
E
50) What are liver sinusoids? A) the site of bile synthesis B) bile-filled cavities that exchange material with the hepatocytes C) air-filled cavities in the liver D) the pathway for bile to exit the liver E) blood-filled cavities that exchange material with the hepatocytes
E
55) Where are enzymes that breakdown disaccharides located? A) inside enterocytes B) in the lumen of the large intestine C) on the basolateral membrane of enterocytes D) in the lumen of the small intestine E) on the apical membrane of enterocytes
E
56) The absorption of fructose across the apical membrane of the lumenal epithelial cells occurs through what process? A) sodium-linked secondary active transport B) diffusion C) paracellular transport D) primary active transport E) facilitated diffusion
E
61) What enzyme cleaves trypsinogen to trypsin? A) amylase B) procarboxypeptidase C) chymotrypsin D) pepsin E) enterokinase
E
65) Pancreatic lipase degrades triglycerides into a A) monoglyceride and 1 free fatty acid. B) glycerol and 3 free fatty acids. C) diglyceride and 1 free fatty acid. D) triglyceride whose free fatty acids have been shortened 2 carbons at a time. E) monoglyceride and 2 free fatty acids.
E
7) What layer of the gastrointestinal wall is a thick layer of connective tissue that provides the gastrointestinal tract with much of its elasticity and distensibility? A) serosa B) mesentery C) peritoneum D) lamina propria E) submucosa
E
100) What does propelling food to the back of the mouth with the tongue initiate? A) the chewing reflex B) receptive relaxation C) the swallowing reflex D) bolus formation E) peristalsis
C
104) Which of the following describes events of the migrating motility complex in the stomach? A) intense antral contractions accompanied by pyloric contraction B) intense fundic contractions accompanied by pyloric contraction C) intense antral contractions accompanied by pyloric relaxation D) mild antral contractions accompanied by pyloric relaxation E) mild fundic contractions accompanied by pyloric relaxation
C
109) What reflex stimulates the motility of the ileum in response to the presence of chyme in the stomach? A) colonocolonic reflex B) gastrocolic reflex C) gastroileal reflex D) ileogastric reflex E) intestino-intestinal reflex
C
11) The ________ is a layer of epithelial cells on the outer side of the serosa that secretes a watery lubricating fluid that makes it easier for organs to slide past one another. A) mesentery B) myenteric plexus C) mesothelium D) submucosa E) endothelium
C
114) What contains the muscularis mucosae? A) myenteric plexus B) submucosa C) mucosa D) muscularis externa E) serosa
C
116) Which of the following contains the mucous membrane, but not the mesentery? A) serosa B) muscularis externa C) mucosa D) myenteric plexus E) submucosa
C
117) Which contains the smooth muscle layers for peristalsis and segmentation? A) serosa B) submucosa C) muscularis externa D) mucosa E) myenteric plexus
C
119) Where would the myenteric plexus be found? A) lamina propria B) serosa C) muscularis externa D) mucosa E) submucosa
C
123) Which sphincter is composed of skeletal muscle between the anus and external environment? A) lower esophageal sphincter B) upper esophageal sphincter C) external anal sphincter D) internal anal sphincter E) sphincter of Oddi
C
128) Which sphincter is composed of skeletal muscle between the pharynx and esophagus? A) lower esophageal sphincter B) external anal sphincter C) upper esophageal sphincter D) sphincter of Oddi E) pyloric sphincter
C
132) Mucus is secreted by which cell? A) parietal cell B) chief cell C) neck cell D) G cell E) acinar cell
C
146) Lipids are disassembled by which of the following? A) chymotrypsin B) glucoamylase C) lipase D) sucrase E) amylase
C
148) Which hormone primarily simulates pancreatic bicarbonate secretion (and enzyme secretion, to a lesser extent)? A) motilin B) cholecystokinin C) secretin D) glucose-dependent insulinotropic peptide E) gastrin
C
153) What is the correct order of the three layers of the mucosa, from innermost to outermost? A) mucosa, submucosa, serosa B) mucous membrane, lamina propria, basement membrane C) mucous membrane, lamina propria, muscularis mucosae D) muscularis mucosa, submucosa, muscularis externa E) serosa, submucosa, mucosa
C
154) In what subdivision of the four layers of the GI tract are Peyer's patches located? A) myenteric plexus of the muscularis externa B) lamina propria of the serosa C) lamina propria of the mucosa D) submucosa of the mucosa E) mucous membrane of the serosa
C
156) The G cells that line the lumen of the stomach are responsible for the secretion of what compound? A) pepsinogen B) ghrelin C) gastrin D) intrinsic factor E) HCl
C
158) What are the two sources of bicarbonate secreted into the lumen of the small intestine? A) secretin and inhibin B) secretin and glucose-dependent insulinotropic peptide C) exocrine pancreas and secretory cells in the crypts of Lieberkühn D) bile and exocrine pancreas E) both exocrine and endocrine pancreas
C
161) All of the segments of the colon are specialized for absorbing water and ions EXCEPT the A) ascending colon. B) transverse colon. C) sigmoidal colon. D) cecum. E) descending colon.
C
163) All of the following are branches of vessels found at the corners of the liver lobule EXCEPT the A) hepatic artery. B) hepatic portal vein. C) hepatic duct. D) bile duct.
C
169) For calcium to be absorbed, it must bind to a hormone-regulated brush border protein called what? A) calmodulin B) calcitrol C) calcium-binding protein (calbindin) D) vitamin D E) calciferol
C
69) Once the degradation products of triglycerides have entered the epithelial cells that line the small intestines, they A) are reassembled into triglycerides and packaged by the Golgi apparatus into micelles. B) are further degraded to glycerol and a free fatty acid, which are packaged by the Golgi apparatus into chylomicrons. C) are reassembled into triglycerides and packaged by the Golgi apparatus into chylomicrons. D) cross the basolateral membrane and enter the circulation where they will be embedded into a chylomicron. E) are reassembled into triglycerides and released into the blood where they can be incorporated into chylomicrons.
C
91) In response to the presence of food within the duodenum, the increased release of what hormone is the predominant stimulus for an increase in enzyme secretion from the exocrine pancreas? A) secretin B) glucose-dependent insulinotropic peptide C) cholecystokinin D) gastrin E) insulin
C
93) The secretion of cholecystokinin is predominantly regulated by which of the following? A) distention of the duodenum B) acid and amino acid content of the chyme C) protein digestion products and fat presence in the duodenum D) opening of the pyloric sphincter E) carbohydrate digestion products
C
99) What causes segmentation? A) relaxation of circular muscle layer and contraction of the longitudinal muscle at one segment coupled to the relaxation of longitudinal muscle and contraction of the circular muscle in the adjoining segments B) contraction of longitudinal muscle at one intestinal segment coupled with its relaxation at adjoining segments C) contraction of the circular muscle at one intestinal segment coupled with its relaxation at adjoining segments D) contraction of both the circular and longitudinal layers of muscle at one segment coupled with the relaxation of both at adjoining segments E) contraction of the circular muscle at one intestinal segment coupled with contraction of the longitudinal muscle at adjoining segments
C
1) Which of the following is NOT a basic process of the gastrointestinal system? A) digestion B) motility C) absorption D) secretion E) filtration
E
105) Where does peristalsis occur? A) esophagus only B) stomach only C) small intestine only D) stomach and small intestine only E) esophagus, stomach, and small intestine
E
118) Which of the following contains the submucosal plexus? A) muscularis externa B) myenteric plexus C) mucosa D) serosa E) submucosa
E
120) Which layer consists primarily of connective tissue which gives the gastrointestinal tract its distensibility and elasticity? A) serosa B) myenteric plexus C) muscularis externa D) mucosa E) submucosa
E
121) Which of the following structures is continuous with the mesenteries? A) muscularis externa B) mucosa C) submucosa D) myenteric plexus E) serosa
E
122) What sphincter is composed of smooth muscle between the anus and external environment? A) lower esophageal sphincter B) external anal sphincter C) sphincter of Oddi D) upper esophageal sphincter E) internal anal sphincter
E
124) Which sphincter is composed of smooth muscle between the small and large intestines? A) sphincter of Oddi B) internal anal sphincter C) lower esophageal sphincter D) upper esophageal sphincter E) ileocecal sphincter
E
143) Sucrose is the substrate for which enzyme? A) amylase B) glucoamylase C) chymotrypsin D) lipase E) sucrase
E
145) Proteins are cleaved by which enzyme? A) sucrase B) dextrinase C) lipase D) amylase E) chymotrypsin
E
15) What is a ring of skeletal muscle that regulates the movement of a bolus into the esophagus? A) pyloric sphincter B) glottis C) epiglottis D) lower esophageal sphincter E) upper esophageal sphincter
E
155) What is the portion of the enteric nervous system located within the muscularis mucosa called? A) lamellar (Pacinian) corpuscle B) bulbous (Ruffini's) corpuscle C) submucosal (Meissner's) plexus D) intrinsic nervous system E) myenteric (Auerbach's) plexus
E
162) What is the process where fecal material is removed from the body called? A) excretion B) secretion C) micturition D) elimination E) defecation
E
17) What is a mixture of food particles with gastric juice called? A) gastric secretions B) fundus C) saliva D) bolus E) chyme
E
171) Macrophages secrete what substance that may contribute to insulin resistance? A) glucose B) casein C) insulin-like growth factor (IGF-1) D) glucagon E) resistin
E
