Download GI Tract - review anatomy of upper and lower GI tract

GI Tract
- review anatomy of upper and lower GI tract
- define GI motility, secretion, digestion, absorption, elimination
- describe the laminar histology of the GI tract: mucosa, submucosa, muscularis externa, serosa
- identify the elements of the mucosa
- describe intrinsic and extrinsic regulation of the GI tract
- define enteric nervous system
- what is the function of the enteric plexuses: myenteric and submucosal?
- what is the relationship between the ENS, ANS and endocrine system in regulating GI motility
and secretion?
- what is the structure and function of the muscularis externa throughout the GI
- what are GI tract reflexes?
- define mastication, deglutition; how does digestion of food begin in the mouth?
- describe esophageal motility; define dysphagia
- define the primary forms of GI motility: mixing, peristalsis, segmentation, clearing, etc.
- identify several forms of retrograde motility and their function
- what is the effect of autonomic innervation on motility?
- describe the anatomy of the stomach: regions, alternate names, etc.
- enumerate the functions of the stomach; define chyme; gastric emptying
- describe the importance of stomach accommodation
- what is the function of the cells of Cajal in regulating motility along the GI tract?
- describe the nature of digestion that occurs in the stomach
- what are the components and origin of ‘gastric juice’? What is the stomach pH?
- what factors regulate gastric emptying?
- how does the stomach contribute to mechanical reduction of the chyme?
- describe the gastric pits and major types of cell present in these glands. Describe parietal cell,
chief cell, enterochromaffin cells, etc.
- enumerate several hormones released from gastric pits and their functions (e.g. gastrin,
ghrelin)
- define pepsinogen; how are pepsinogens activated?
- how is HCl generated and released from the parietal cells?
- describe the importance of the carbonic anhydrase reaction. What are the products of the
reaction? How does the reaction alter the pH of the stomach lumen? What is the chloride shift?
- describe endocrine and autonomic regulation of acid secretion in the stomach. Which of the
acid secretogogues is most potent? Most abundant? By what mechanisms may acid secretion
be therapeutically reduced? E.g. antihistamines, anticholinergics, proton pump inhibitors, etc.
- describe the physiological role of the mucus-bicarbonate barrier
- is the stomach physiologically necessary? What are the reasons/risks of bariatric surgery?
Identify the importance of intrinsic factor.
- describe the anatomy/histology of the intestinal wall: plicae, villi, brush border, etc.
- what is the rate of peristalsis in the stomach, duodenum, ileum?
- identify the regions of the small intestine; define ‘law of intestine’; describe the organization of
the intestinal villus -- where is the lamina propria? What is the lacteal?
- what are intestinal crypts? What substances are released from intestinal glands?
- describe regional secretion and absorption along the small intestine -- where is B12 absorbed?
Where is pancreatic juice released?
- what is the relationship between pancreatic enzymes and brush border enzymes?
- where is bile released? What is the function of bile?
- describe intestinal activation of trypsin by enterokinase
- identify and describe the function of major classes of digestive enzymes: amylases,
peptidases, disaccharidases, etc.
- describe critical transporters present in the intestinal epithelial cell -- including Na/K pump,
NKCC transporter, secondary active transport (e.g. of H+), CFTR channel
- describe role of carbonic anhydrase reaction in the intestinal epithelium. How do the products
of this reaction alter the pH of the intestinal lumen and intestinal blood?
- identify several intestinal hormones and their functions -- e.g. secretin, CCK
- describe the anatomy of the liver and its blood supply. What is the nature of the blood
traversing the hepatic portal vein, hepatic artery, hepatic vein?
- describe the hepatic lobes and lobules. What are portal triads? Sinusoids? Central vein?
Describe the direction of blood flow through the lobules and liver.
- enumerate the various functions of the liver: e.g. role in processing portal blood, regulating
blood sugar, synthesis of essential blood proteins, enzymes, etc., processing of erythrocytes,
bile production, etc.
- describe the first pass effect and its potential effect on medication dosing
- what is the function and capacity of the gallbladder? Summarize composition and function of
bile. Define emulsification.
- define cirrhosis.
- describe the anatomy of the large intestine. Consider haustra, tenia coli, flexures of transverse
colon, rectum, anal canal, ileocecal valve, cecum, appendix, omental appendages, etc.
- discuss functions of large intestine: secretory and absorptive activity, micronutrient
metabolism, etc.
- what forms of motility are predominant in the colon?
- how does the anal canal facilitate regulation of clearing motility and elimination?
- what is the gut-biome axis? How might the colonic microflora modify behavior and mood?