Patho Ch. 14 Alterations in nutrition
How many liters if chyme a day dies the cecum recieve?
1.5 - 2
How many chews is optimal?
20
If you are obese, your BMI is in excess of ___ kg/m2.
30
What kind of cells store lipids as a key energy source when the need arises?
Adiposcytes
Most dietary fat is sitored in the body within _______ cells.
Adipose
What is energy?
Capacity to do work
Name the structures of the large intestine
Cecum appendix colon rectum
Name the structures of the large intestine
Cecum ascending colon transverse colon descending colon sigmoid colon rectum anal canal
What are the three phases of acid secretion?
Cephalic - 30% Gastric - 60% Intestinal - 10%
Name some complications of obesity
Cerebral artherosclerosis sleep apnea hyperlipoproteinemia hypoventilation HTN Left ventricular hypertrophy CAD MI Artheroscelrosis gallstones diabetes poor wound healing
Mucoswa contains numerous tubular glands called _______ responsible for mucus secretion. (think graveyard).
Crypts
When food is broken down mechanically and chemically in the GI tract and cooverted into absorbable components you are ________.
Digesting
__________ breaks down food into absorpable molecules
Digestion
T/F: In jaundice, bile flow is obstructed in the canaliculi of the hepatic lobules or in the intra or extra hepatic bile ducts
Duhhh ... true
The __________ is a muscular tube that conveys food form pharynx to stomach and has an inner circular muscle and and outer longitudinal muscle.
Esphagus
Digestion and absorption involves movements of materials through the GI tract at a rate that __________ absorption.
Facilitates
T/F: Ingestion of Iron supplements is a cause of jaundice
False
T/F: The presence of enzymes is not essential to digestion and absorption
False
T/F: The proximal half of the colon is for storage of feces and the distal half is for absorption
False other way around
T/F: Of your caloric intake: Carbs = 50-60% Fats = 10 - 20 % Proteins = 30% or less
False - Fats = 30% or less, Proteins = 10-20%
T/F: Water and undigested fiber are in their simplest form needed for absorption.
False - amino acids and water
T/F: Amino acids are are needed to build and maintain structural body tissues such as muscle, bone, bonbe matrix, and connective tissue
False - amino acids make proteins which do all that
T/F: Obesity is only caused by environmental factors and gentics does not play a role.
False - both are highly complex causes
T/F: Jandice is caused by and inrease conjugation of bilirubin
False - decrease
T/F: The bile duct and pancreatic duct empty into the ileum
False - duodenum
T/F: GI hormones funtion in the digestive tract to facilitate the absoption of essential nutrients
False - hormones stimulate GLANDS that secrete enzymes
T/F: Secretion breaks sown food into absorbable molecules
False - it aids in digestion and absorption
T/F: The stomach is capable of considerable expansion and can hold well over 5 L.
False - it can hold 2-3
T/F: Raw fruit and veggies have a cellulose covering that is digestible
False - it is indigestible
T/F: The upper esphagial sphincter is smooth muscle in a state of relaxation prior to arrival of bolus.
False - it is striated muscle controlled by vagus nerve
T/F: AN has the second highest mortality rate of any psychiatroc disorder
False - it is the highest
T/F: Motility aids in digestion and absorption
False - it propels ingested food from mouth toward rectum
T/F: GIP's action on the GI system is to increase insulation secretion from pancreatic ALPHA cells and decrease gastric HCL secretion and inhibit gastric emptying time
False - it works on the beta cells of pancreas - not alpha
T/F: The lower esphagial sphincter is striated muscle controlled by the vagus nerve.
False - its smooth muscle in a state of relaxation prior to bolus
T/F: In the mouth the molars cut and incisors grind
False - molars grind and incisors cut
T/F: Hunger or satiety is is feeling of fullness and are regulated in brain by the pituatary gland, based on digestive tract feedback.
False - regulated by hypothalmus
T/F: Food is digested and absorbed in the large intestines in the GI tract?
False - small intestines
T/F: The LI reabsorbs water and electrolytes, eliminates waste, and contains villi and microvilli
False - there are no villi present
T/F: Micronutrients are proteins, carbs, and fats
False - those are macro
T/F: Macronutients are vitamins and minerals
False - those are micro
Name some causes of altered nutriton
Genetic defects ineffective intestinal mucosa inadequate or excessive intake hypermetabolic state
What is the name of the liver cells capable of regeneration?
Hepatocytes
What are some major causes of iron deficiency anemia?
Inadequate iron intake or high iron demands Chronic hemorrhage (GI, menstrual, injury) Iron malabsorption
The _____ _______ absorbs water and electrolytes.
Large intestine
If the villi increase the area, what further increases the surface area?
Microvilli [brush border] fringe the villi to further increase surface area.
Carbohydrates are to ________, as proteins are to ________, as lipids are to _____________.
Monosaccharides amino acids fatty acids and glycerol
The 4 major activities of the GI tract
Motility Secretion Digestion Absorption
T/F: A mass movement is a type of peristalsis that may occur with regularity (like after bfast) and moves feces 10-20 cm at a time and occut in a series of 10-30 mins. It also removes water and electrolytes and places feces into rectum
My god that's true
How many non essential and essential amino acids are there?
Nine - essential 11 - non
Overnutrition
Obesity Vitamin/mineral toxcity
What will a person with iron deficiency anemia look like and present with?
Often asymptomatic, but if manifest symptoms will experience: Pallor of the skin and mucous membranes Fatigue, weakness, lightheadedness, syncope Breathlessness, palpitations, tachycardia Headache Pica (compulsion to eat ice, or non-food substances, ie. dirt , clay)
What organ is behind the stomach and it's digestive enzymes work with bile from the liver in heloing absorption?
Pancreas
Which system incerases gut activity and therfore increases blood flow?
Parasym
Which sytem increases activity of the GI tract via the VAGUS nerve and relaxes internal anal sphincter for defecation and dilates the BVs.
Parasympathetic
The movement of food to stomach is __________. and is caused by a reflex.
Peristalsis
The reason food passes through quickly is because of ___________.
Peristalsis
What is nutrition?
Process of ingestion and untilization of nutrients for energy
There are many function of the liver. Can you name some of them?
Protein synthesis (albumin, prothrombin) Bile formation and secretion (digestion and absorption of fats) Detox of drugs and and steroids Lipoprotein synthesis (protein with a lipid component: the principal means of transporting lipids in the blood ... EX = HDL and LDL transport lipid in the blood) Carbohydrate metabolism Urea formation from ammonium
What is a persitalic movement?
Results in the squeezing of circular fiber contraction. Movements are rhythmic, propulsive movements and promotes the propulsion of stool.
___________ is made of water, bicarbonate, chloride, potassium, mucous and _______ amylase.
Saliva salivary
Name some different types of lipids
Simple lipids or fats - fatty acids and glycerol Compound lipids or lipoids - phospholipids, lipoproteins, and glycolipids Sterols - cholesterol and bile salts
Within the digestive system, what organ is in the upper left quadrant of the abdominal cavity just behind the stomach and under the diaphragm?
Spleen
Why is stool brown?
Sterobilin or bile pigment
What does the hormone cholecystokinin (CCK) in the duodenum do?
Stimulates contraction of the gall bladder stimulates secretion of pancreatic enzymes slows gastric emptying
What does the hormone secretin in the duodenum do?
Stimulates secretion of bicarbonate containing solution by pancreas and bile from the liver and also inhibits gastric emptying time
Adipose cells contain __________ fats and accumulate around body tissues and within body cavities and are used when _______ is needed.
Storage Energy
Whci system directly decreases blood flow and works with anxiety, fear vigourous exercise and hypotension?
Symp
Which nervous system provides strong stimulation that can inhibit GI activity. It can inhibit GI secretion and motor activity and contract GI sphincters and BV's.
Sympathetic
How does peristalsis work?
The distension of the GI tract causes a contraction of the circular muscle layer above the distension and a relaxation of the muscle below it. The vagus efferent fibers and ENS produce this contraction Produces a wave of contraction that moves in the direction of oral or anal This reflex occurs anywhere from esphagus to anus
Why is the small intestione the ideal site for absorption of nutrients? Think structure ...
The intestinal lining increasesw absorptive surface area
What hormones contribute to body weight asnd fat storage?
Thyroid (controls metabolism) Insulin (promotes fat storage) Leptin (made by adipocytes & signals safety)
What's the difference between a tonic movement and a rhythmic movement?
Tonic = continous and lasts for minutes to hours and occurs at sphincters Rhythmic = intermittent and responsible for mixing and moving food along digestive tract
T/F: Aneroxia Nervosa is an eating disorder characterized by refusal to maintain minimal body weight, intense fear of gaining weight, body image distortion and amenorrhea
True
T/F: Bilirubin is insoluble in plasma and attaches to plasma proteins for transport
True
T/F: Blood flow is proportional to local activity, i.e. eating a meal increases blood blow 2-3 fold for 3-6 hours
True
T/F: Chemical digestion is stimulated by mastication and breaks down food and stimulates the release of saliva
True
T/F: Digestive enzymes can only act on the surface of food particles
True
T/F: Essential nutrients must be consumed regularly in the diet b/c the body is unable to synthesize nutrients in quantities sufficient to meet its needs
True
T/F: Gastric inhibitory peptide (GIP) is stimualted for release by amino acids, fatty acids, and glucose
True
T/F: Gastrin is a hormone that stimualtes secretion of acid and pepsinogen, increases gastric blood flow, stimulates smooth muschle contraction and stimulates gastric emptying time
True
T/F: In order to digest and abosrb nutrients you must have a helath and intact GI tract epithelial lining that can resist the effects of its own digestive secretions
True
T/F: Intestinal mucosal folds slow the passage of food to provide adequate time for absorption.
True
T/F: Iron is required for hemoglobin synthesis, oxygen and electron transport, and DNA synthesis
True
T/F: Iron-deficiency anemia is a problem of iron demand on red blood cell (RBC) development that cannot be met with current iron stores
True
T/F: Jaundice happens because of damage to the liver allowing bilirubin to circulate freely
True
T/F: Jaundice is caused by excessive destruction of RBC's
True
T/F: Jaundice is caused by impaired uptake of bilirubin by the liver cells
True
T/F: Saturated fatty acids have no double bonds and elevate cholsterol levels and are found in animal sources and are solid at room temp
True
T/F: The endocrine pancreas cells (islets of Langerhans) secrete insulin and glucagon into blood
True
T/F: The exocrine pancreas cells (acinar cells) release digestive juices through a duct to the duodenum to assist with digestion of straches, fats and proteins.
True
T/F: The goal of absorption is to mobe nutrients from the digestive tract to circulation in order to be used by cells
True
T/F: The hepatic portal vein brings venous blood rich in nutrients from digestive tract.
True
T/F: The liver stores glycogen and when glycogen stores are exhausted the liver than converts amino acids and glycerol to glucose
True
T/F: The mouth is used for ingestion and mastication and the esphagus is used for transport
True
T/F: The mucosal layer has direct contact with nutrients.
True
T/F: The pancreatic enzymes digest proteins, carbs and fats.
True
T/F: The proximal half of colon reduces contents of food 10 fold to 100-200 mL
True
T/F: The regulation of digestion (except chewing, swallowing, defecation) directed through hormone feedback mechanisms and the ANS.
True
T/F: The stomach initiates protein digestion
True
T/F: Triglycerides are a fatty acid and glycerol complex found readily in dietary fat
True
T/F: Unconjugated bilirubin is bilirubin with albumin
True
T/F: Unsaturated fatty acids have one or more double bonds and don't elevate blood cholsterol and are usually found in plant sources and are often liquid at room temp
True
T/F: the spleen helps to recycle old RBCs and blood borne parasites
True
T/F: After the previous process, conjugated bilirubin is now able to be exreted in the bile
True - don't you know anything???
T/F: A haustration is a type of segmentation contraction in the circular muscle that exposes fecla surface to mucosa and slowly moves feces into transverse colon over an 8 hour period.
True and I can't stop thinking about poop.
T/F: Acid reflux can cause esophagitis
True baby
T/F: In the event of a serious trauma (MI, gashing wound, microbial invasion) the spleen withh release those multitude of monocytes into the bloodstream to tackle the crisis
True true dat
What component is the largest, single one the body and is essential for all body funtions - including digestion, absorption, transportation and secretion?
Water baby
Are new studies showing that the spleen is a reservoit for huge numbers of immunce cells called monocytes?
Yes
_________ molecules include nutrients, electrolytes and H2O.
absorption
How does metabolism work?
allows chemical reactions that produce heat to maintain temp, conduct neuronal impulses, and contract muscles.
Please tell me you know that the ______ defecates.
anus
Those with clincal manifestations of ID anemia often present with pallor of skin and mucos membranes, fatigue, weakness, lightheadedness, breathlessness, palpitations, headache, tachycardia, and syncope. What are the causes? a) electrolyte imbalance b) hypoxia c) pagophagia d) excessive blood loss
b) hypoxia
The prescence of low ____ ________ or a lack of food in the GI tract induces hunger.
blood glucose
T/F: What type of anemia results from dietary deficiency, hemorrhage or increase in demands? a) sickle cell b) B12 c) Fe deficiency d) Folate deficiency
c) Iron
The four major parts of the stomach are ...
cardia fundus body pylorus
After absorption the fecal matter enter the ______ via the _______ _____.
cecum ileicecal valve (ileum)
The prescence of fat stimulates ____________ or CCK - GI hormone that contributes to satiety.
cholecytokinin
The ________ is a gastric juice coverted into semi liquid form and is composed of HCL, pepsin and other digestive enzymes
chyme
The result of rushing food through the digestive tract is ________
diarrhea
The process by which food is broken down mechanically and chemically in the GI tract and converted into absorbable components is defined as _______________.
digestion
Clincal maifestation of AN
dry skin bradycardia hypotension hypothermic abdominal bloating constipation amennorhea brittle hair and nails peripheral cyanosis lanugo (downy hair that covers the body)
Food enters the ___________, acid stimulates secretion of _________ and pancreatic enzymes.
duodenum bile
Name the structures of the small intestine
duodenum jejunum ileum
The __________ anal structure is composed of skeletal voluntary muscle and srrounds the internal sphincter. It is controlled by nerve fibers in the pudenal nerve or ________ nervous system, providing voluntary control to relax it for defecation.
external somatic
What is a nutrient
food or liquid that supplies body with chemicals needed for metabolism
The ___________ is Attached to surface of the liver - its is a blind pouch that stores bile & concentrates bile by reabsorbing H20 from bile. Controlled by CCK & p-symp nervous system
gallbladder.
Altered metabolism or Inherited Metabolic Disorders
impaired amino acid of lipid metabolism (PKU) lysosomal storage diseases such as Tay-sachs hyperthyroidism cancer burns severe infection/fever
Undernutrition
inadequate intake altered digestion malabsorption leading to macro and micronutient deficiencies Manifestations of weight loss and muscle wasting Manifestations = Emaciated Kwashiorkor = edema in belly
The __________ anal structure is composed of smooth muscle that lies inside the anus and is contricted due to the __________ nervous system. The _________ nervous stimualtion prompts relaxation of the internal sphincter.
internal sympathetic para - symp
Increase of fat stores stimulate _______, a hormone that reduced appetite and increases energy expenditures and ultimately inreases metabolism
leptin
Bilirubin is removed from the blood (it's attached to the heme unit) by the ________and is conjugated with glucoronic acid to render it water soluble.
liver
The _________ is the largest internal organ and recieves major blood supply form ______ ______ vein.
liver hepatic portal
The role of the digestive system is to extract ________, absorb ___________, and form a chemical and pyschological barrier against ____________ introduced during food ingestion.
macronutrients digested components microorganisms
The __________ are the tiny projections on luminal membrane of each intestinal cell and give the apical region a striated appearance called a "brush border."
microvilli
The goal of digestion is to convert carbohydrates to ___________, proteins into ___________, and fats to ______ ______ and ________.
monosacchirades amino acids fatty acids - glycerol
The cells in the doudenum release __________ (think Motrin) during fasting states and cause contractions of the stomach and SI every 90 minutes and also stimulates gastric emptying.
motilin
The ______ layer of the FI tract in the innermost layer and it's cells produce _______ that lubricate and protect the inner most surface of the lumen.
mucosal mucos
What are the 4 major cells in the stomach?
mucous cells (secrete mucous and protect epithelium from stress and acid) chief cells (secrete pepsin needed to digest protein) parital cells (secrete HCL and intinsic factor nedded to activate pepsinogen) g cells (secrete gastin = responsible for controlling acid secretion and stimulating gastric motility)
The _______ layer has 2 thick layers of smooth muscle (circular and longitudinal) and facilitates movement of the contents of the GI tract. It also has a myenteric plexus to allow for neronal stimualtion.
muscularis
The ___________ or mesentry is loosley attached to the outer wall of the intestine and conncect to the serosa and supports the digestive tract. It provides a pathway for vasculat and neuronal stimulation.
peritoneum
The name for heartburn is ___________
pyrosis
The _____ ______, _______, and _______ produce digestive enzymes that help dismantle food and regulate use and storage of materials.
salivary glands pancreas liver
The ______ is the outermost covering of the GI tract
serosa
What is the primary sire for digestion and absorption?
small intesines
At the entrance and exit of esophagus are upper and lower __________.
sphincters
The __________ adds acid and mixes and the _____ ________ digests and absorbs the nutrients.
stomach small intestines
The _______ layer consists of connective tissue and contains BV's, nerve branches and structures responsible for secreting digestive enzymes.
submucosal
The _______ are the fingerlike projections of the mucosa that secrete enzymes and absorb nutrients
villi
By projecting into the lumen, the villi do what for absorption of nutrients?
villi increases the surface area
Digestion should also unleash _____ and ______ from the macronutrients (protein, carbs and fat) and seperate _____ from nutients to promote ___________ ___________.
vitamins - minerals water water absorption
Name the 4 structures of stool
water undigested fiber intestinal bacteria dietary fats
