________ is a rare disorder of the esophagus characterized by impaired ability to push food down toward the stomach (peristalsis), failure of the ring-shaped muscle at the bottom of the esophagus, the lower esophageal sphincter (LES, AKA cardiac sphincter), to relax. Manifests as: dysphagia, regurgitation, chest pain

___________: the formation of gallstones in the gall bladder while ____________ is inflammation of the gall bladder.

___________ is the general name for a common condition that causes small bulges or sacs to form in the wall of the large intestine.

______________: a condition that affects the stomach muscles and prevents proper stomach emptying.

___________: an intestinal infection marked by diarrhea, cramps, nausea, vomiting, and fever.

___________: is rapid gastric emptying due to a surgery that removed part of your stomach.

______________: a type of nerve damage that can occur with diabetes.

____________: an intestinal disorder causing pain in the belly, gas, diarrhea, and constipation.

________: abnormal veins in the lower part of the tube running from the throat to the stomach. Usually develop when blood flow to the liver is blocked. They often occur in people with advanced liver disease.

__________________: deep intraoral lip laceration that needs repair.

Sepsis can result from ____________________ against pathogens in the environment, including bacterial colon.

Chronically, GI disease can be complicated by ____________________. These occur because many primary GI diseases result in malabsorption.

Select the GI tract wall mucosa components

The submucosa contains larger blood and lymphatic vessels and a nerve plexus of the enteric nervous system, termed the submucosal nerve (Meissner) plexus. This nerve plexus ___________________________.

The _________________ is composed of an inner circular and an outer longitudinal layer of smooth muscle and is responsible for the motility of the GI tract. Between these muscle layers lies the myenteric nerve plexus, a division of the enteric nervous system that regulates motility.

The serosa is an outer sheath of _________________ and connective tissues, where larger nerves and blood vessels travel in a bed of connective and adipose tissue.

Simple diffusion is passive transport of ______________ across a concentration or electric gradient.

Facilitated diffusion is passive transport of ______________ utilizing channels or transporters (water is polar and absorbed by special water channels called "aquaporins." Fructose I spoiler and is absorbed by the glucose transporter GLUTS.

Na/K ATPase pump hydrolyzes ATP and use the energy directly to drive 3 Na ions outside and 2 K ions inside (against concentration gradients). This unequal transport of ions generates a transmembrane potential (negative inside; ie, transport is electrogenic)

No ATP hydrolysis by the transporter. Instead, the transport depends on an electrochemical gradient generated by a neighbor primary active transport. For example, glucose is absorbed against a concentration gradient across the apical membrane of epithelial cells in the small intestine by secondary active transport with Na ions by the SGLT1 transporter. Two Na+ ions are transported down their electrochemical gradient (generated by the Na+-K+ ATPase), dragging with them one glucose molecule.

_______: sodium-dependent glucose transporter. It is a cotransporter.

transport occurs by fusion of membrane vesicles with the plasma membrane resulting in uptake into epithelial cells

transport occurs by pinching off membrane vesicles from the plasma membrane resulting in export out of the epithelial cells

______________ (specific populations of dendritic cells and macrophages) extend processes that interact with the intestinal epithelial barrier to sense the luminal environment.

_____________________ include Peyer's patches and isolated lymphoid follicles located throughout the intestine. These also play important roles in immune surveillance.

Select the parts of the lamina propria

Innate immunity and GIT: the secretion of ________ (gastric acid) and ________ to neutralize and flush away potentially damaging bacteria and macromolecules

Innate immunity and GIT: the _____________ between epithelial cells prevent the secretions from ingressing into tissues

Innate immunity and GIT- ______ is secreted by specialized goblet cells. The mucus forms a protective layer over the epithelial cells. Paneth cells are specialized cells in the small intestine that produce and secrete lysozyme and alpha-defensins (antibacterial peptide) that contribute to defense.

The enteric nervous system (ENS) can regulate the GI tract _________________________________. For this reason, it is often called the "little brain." Enteric neurons use many neurotransmitters, most notably neuropeptides.

An enteric neuron has its cell body within the wall of the GI tract and is thus __________ to the gut.

The ENS comprises a series of ganglionated nerve plexuses that extend from the esophagus to the rectum and are organized into two principle components: They myenteric or __________, plexus, which is sandwiched between the layers of the muscularis externa. The submucosal or __________ plexus, which lies in the submucosa.

In ______________, as a result of enteric nervous system defects, the body of the esophagus is quiet and the lower sphincter is contracted, making ingestion of food difficult or impossible.

__________ have cell bodies outside the gut wall

GI hormones are invariably peptides, and many of these peptides are present not only in endocrine cells but also in the nerves of the enteric system and CNS. Thus, they have dual functions as ____________________.

Which of the following inhibits the release of most other peptide hormones (ie gastrin)?

Which of the following increases mucus and bicarbonate secretion from gastric mucosa?

Which of the following stimulates gastric acid secretion?

________ stimulates gastric acid secretion.

_________ stimulates pancreatic bicarbonate secretion, biliary bicarbonate secretion, growth of exocrine pancreases, pepsin secretion and inhibits gastric acid secretion

________ stimulates gallbladder contraction, pancreatic enzyme and bicarbonate secretion and growth of exocrine pancreas

________ gastrin inhibitory peptide and recently changed to glucose-dependent insulinotropic peptide. Stimulates insulin release (inhibits gastric acid secretion)

________ (Glucagon like peptide) stimulates insulin secretion

___________ stimulates gastric and duodenal motility

__________ secreted by islets of Langerhans and inhibits pancreatic bicarbonate and enzyme secretion

Ingestion of caustic reagents or acid reflux cause damage to the smooth muscles and ______________.

Abnormal neural control of motility is seen in _______________.

GI motility examples for stomach- _______________ (decrease in ability to empty the food in the small intestine). A common complication for diabetes

GI motility examples for stomach- ___________: surgical transection of the vagus nerve trunks. Affects both motility and acid secretion. This is still performed sometimes as a treatment for Zollinger-Ellison syndrome (acid hypersecretion and severe peptic ulcer disease caused by a gastrin-secreting tumor)

GI motility examples for stomach- _______________: food cannot pass freely out of the stomach owing to spasmodic narrowing of the pyloric outlet caused by hypertrophy of the pyloric musculature

GI motility example for small intestine and colon-__________: abdominal pain, bloating and diarrhea alternating with constipation in the absence of detectable organic disease and structural abnormalities

Elevated acid secretion relating to an H pylori infection, increases the likelihood of developing a __________.

In the presence of an H pylori infection, _____________ (from diminished mucus secretion in some cases) is a more crucial factor in the development of gastric ulcer.

What disease is characterized by damage of the neural plexuses of the esophagus by the parasite Trypanosoma cruzi?

Over months and years, LES dysfunction results in tremendous enlargement of the esophagus holding as much as 1L of putrid, infected material and imposing a high risk of what?

Choose the symptoms of reflux

__________, a disorder in which a portion of the proximal stomach slides up into the chest cavity with upward displacement of the LES, can also contribute to the development of reflux

Reflux esophagitis can be caused by ___________ (pancreatic juice or bile refluxing through both an incompetent pyloric sphincter and a relaxed lower esophageal sphincter)

Select the hormones that increase pressure

Select the hormones that decrease pressure

Select the neural agents that increase pressure

Select the neural agents that decrease pressure

Which foods increase pressure?

Which foods decrease pressure?

Other factors that can increase pressure:

Other factors that can increase pressure:

Other factors that can decrease pressure:

Other factors that can decrease pressure:

Recurrent reflux can damage the mucosa, resulting in __________, hence the term "reflux esophagitis."

What predisposes to further reflux because the scarring that occurs with healing of the inflamed epithelium renders the LES progressively less competent as a barrier?

How is gastric ulcer distinguished from erosive gastritis?

Is there information that supports the theory that gastritis is a lesion that predisposes to the development of gastric ulcer by decreasing mucus, prostaglandin and bicarbonate secretion?

Choose the 3 ways in which motility defects have been proposed to contribute to the development of gastric ulcer

____________ may play a role in the development of gastric ulcer. Prostaglandins are known to increase mucosal blood flow as well as bicarbonate and mucus secretion and to stimulate mucosal cell repair and renewal.

Select the most notable causes of inflammation from superficial mucosal injury (shallow ulcers- unlike gastric or duodenal ulcers, in erosive gastritis the submucosa and muscular mucosa are not penetrated.

Chronic Erosive Gastritis

Etiology of __________: it is a common complication of poorly controlled diabetes mellitus (type II) with consequent autonomic neuropathy.

What kind of drugs can be used to improve to motility of the GI and therefore gastroparesis?

Why are treatments for gastroparesis not equally effective for a majority of patients even with the same initial complaints?

Select the clinical manifestations of gastroparesis

Select the option(s) containing Cholelithiasis clinical presentation

What are gallstones largely composed of?

Where is bile stored and concentrated after being produced?

Select the factors that predispose to cholelithiasis

The formation of gallstones usually requires the formation of bile whose cholesterol is ___________ its percentage solubility.

The normal processes that prevent gallstone formation probably include the fact that bile does not normally stay in the gallbladder long enough to become _________ (prone to stone formation)

_____________: inflammation of the gallbladder and the major clinical presentation of gallstones; can be acute or chronic

___________: as a consequence of an episode of acute cholecystitis, if a stone travels down the common bile duct but fails to clear the sphincter of Oddi thereby blocking the pancreatic duct

______________: inflamed gallbladder becomes infected

Diverticular Disease:

What does diverticulosis result from?

Does the incidence of diverticulosis increase or decrease with age?

Epidemiologic studies suggest that with the consumption of highly refined foods and less fiber, with a resulting _________ prevalence of chronic constipation, may be responsible for the increased prevalence of diverticular disease.

Presentation of diverticulitis: