What are the five (5) phases of digestion?
1.Cephalic2.Oral3.Pharyngeal4.Esophageal5.Upper GI6.Lower GI
What nerve regulates the cephalic phaseof digestion?
The CEPHALIC PHASE Is regulatedentirely by Cranial Nerve X. This includesAll senses, touch, sound, smell, feel, andtaste all feed into the corticobulbar tract andcranial nerve X.
What effect would a vagotomy have ondigestion?
A vagatomy (removal of the vagus) wouldcause loss of all senses to the cephalic phase.
What part of the brain is responsible forall urges? What other system canoverride it?
The Limbic System is Responsible for ALL urges. This is the oldest part of the human brain.
The Cerebrum is part of the neocortex.It is able to override the LimbicSystem.
What two part of the Hypothalamusfunction in eating? Where in thehypothalamus does each reside? Whatdoes each regulate? What results fromlesions to each?
The hunger & satiety centers
The hunger center resides in the LateralHypothalamus. Stimulation of itcauses the feeling of hunger. Lesion of the hunger center causes death byANOREXIA because the urge to eat isgone.
The Satiety Center resides in theMedial Hypothalamus (Middle gets big). Stimulation causes the feeling of fullness. Lesion causes death byHYPERPHAGIA (Overeating)
How do you calculate the IDEAL BODYEIGHT for Men? Women? How isobesity defined?
Men - 106lbs for the first 5' + 5lbs for each inch after 5' + 15lbs for frame (15for medium frame, 30 for large frame)
Women - 100lbs for the first 5' + 5lbsfor each inch after 5' + 15lbs for frame(15 for medium frame, 30 for largeframe)
Obesity is a person more than 20%over their ideal weight.
What is the psychology is behindAnorexia and Bulimia, respectively?
Anorexics think they are overweightdespite being normal of below idealweight.
Bulimics are ashamed of their eatinghabbits.
What is the body type of anorexia andBulimia? What social factors aretypically seen in each? How does eachachieve their respective goals?
ANOREXics are typically slim,underweight girls trying to please their mothers. They starve themselves.
BULEMics are typical chubby girlstrying to please their boyfriends. They binge and purge (Eats and then causethemselves to vomit or defecate)
What is the pathology behind PRADER-WILLI?
Prader-Willi One of the two gnomicimprinting diseases. It is Inherited paternally and Presents with Obesity,Hypotonia, and Mental retardation. It isessentially a Lesion of the Satiety Center.
What neuro transmitters affect theSatiety and hunger centers? Do theseneuro-transmitters sitmulate of inhibitthe centers?
Both Hunger and Satiety centers areaffected by Norepinephrine (NE) andSerotonin (5-HT). 5-HT is morespecific.
These catecholamines are 80%stimulatory to the Satiety center and20% stimulatory to the Hunger center.
What drug classes are a good choice foruse in weight loss? What is the generalprinciple behind using these drugclasses? How does each class work specifically?
Amphetamines and SSRI's are a goodchoice for use in weight los.
Both set of drugs work by increasingthe amount of catecholamines in thesystem. This has the effect of stimulating the satiety center leading toa feeling of fullness.
Amphetamines cause the release of preformed catecholamines.
SSRI's inhibit the re-uptake of 5-HT atthe presynaptic terminal.
What is the main stimulant for thehunger and satiety centers? What othersubstance also stimulates hunger?
The main stimulus for the Hunger andthe Satiety center is Glucose.Decreased Glucose stimulates theHunger Center. Increased Glucose andGastric distention stimulates the SatietyCenter.
Progesterone also stimulates appetite.This is the reason women are morehungery during menses and why pregnant women want to eat.
Why should you eat small frequentmeals?
To keep blood glucose levels even. This is because if the levels are low, the hunger center fires and you eat a lot. If the glucoselevel is high, insulin kicks in and causes theglucose levels to drop and you end upeating.
What are the two phases of the stressresponse?
Phase I - is the Parasympathetic Phase.You get Increased sympathetic outflowcausing: Deification, urination,sweating, etc...
Phase II - is the Sympathetic phase.You get Increased sympathetic outflowcauses: tachycardia, HTN, mydriasis,etc...
What is the pathology of a STRESSULCER
Parasympathetic outflow causes increasedmotility of GI tract and then sympatheticoutflow cause decreased blood flow. Thiscauses the gut to produce more acid, butthen blood is shunted away from the gutand the papillae sloughs off.
What is the pathology of IRRITABLEBOWEL SYNDROME?
During stress parasympathetic causediarrhea followed by the sympatheticoutflow which causes constipation.
In what patient population do you seeCURLING ULCERS?
Stress ulcers caused in burn patients
In what patient population do you seeCUSHING ULCERS
Increased Intra cranial Pressure (ICP)
What is the Cushing Triad?
Gastrointestinal Physiology 1 of 6