Digestive system(6-8)

1.Hormones of git( Gastrin ,secretin, cck pZ)

Causes of secretion, site of action and function

2.Factors affecting saliva secretion

3. Regulation of hcl secretion

4.Amount, ph ,composition and regulation of digestive juice (GASTRIC juice)

5.Cho, protein, fat digestion absorption and malabsorption

6.Bile, micelli and emulcification

7.Compositon of bile

8. liver function

9.fx of large gut

10. gastric emptying

11. Factors affecting fe absorption

12. Absorption of water and electrolytes

13.absorption of ca, bile, b12 in different part of intestine

Ghrelin
 LOCAL HORMONES OF GIT

Polypeptide in nature (amino acid less than 100)

Secreted by nerve cells and gland cells in mucosa

Act in paracrine fashion

A. Gastrin family : gastrin ,cholecystokinin(CCK-PZ)

B. Secretin family: secretin glucagon glicentin vip gip

SBA: Gastrin: Stimulates pepsin secretion.

Ach and cCk contracts- gall bladder.

Ghrelin
hormone Origin Stimulus Action
Gastrin Antram G cell. Products of protein digestion Stimulates gastric acid
Suppressed by acid and secretion
somatostatin Stimulates growth of
gastrointestinal mucosa
insulin release
somatostatin Throughout Gl tract & Fat ingestion Inhibits gastrin and insulin
secretion
Decreases acid secretion
Inhibits pancreatic secretion
Fat ingestion

Cholecystokinin Duodenum and Products of protein simulates pancreatic enzyme

Jejunum( S cell) digestion secretion
Fat and fatty acids Suppressed Gallbladder contraction
by trypsin Sphincter of Oddi relaxation
Decreases gastric acid
secretion
Reduces gastric emptying
Regulates pancreatic growth

secretion Duodenum and Duodenal acid simulates pancreatic fluid and

Jejunum( S cell) Fatty acids bicarbonate secretion - Ductal
Decrease acid secretion
Reduce gastric emptying
Motilin Duodenum, small Fasting Regulates peristaltic activity,
intestine and colon Dietary fat including,
(Mo cells) migrating motor complexes
(MMC)

GIP Duodenum( K cells) and Glucose and fat Stimulates insulin release (also
jejunum known as
Glucose and fat
glucose-dependent insulin-
trophic
polypeptide)
Inhibits acid secretion

VIP Nerve fibers Unknown Vasodilator

throughout GI tract Smooth muscle relaxation
Water and electrolyte
secretion

Ghrelin Stomach Fasting. Stimulates appetite, acid

Inhibited by eating secretion and gastric emptying

Ghrelin
Peptide YY Ileum and colon feeding. Modulates satiety - decrease
appetite.

Amylin Pancreatic islet B-cells feeding. Glycemic control

Stimuli that increase gastrin secretion:

Luminal: Peptides ad amino acids, Distention

Neural: Increased vagal discharge Vid GRP

Blood borne: Calcium, Epinephrine

Stimuli that inhibit Gastrin secretion:

Luminal: Acid, Somatostatin

Blood borne:

Secretin, GIP, VIP, Glucagon, Calcitonin

SBA - Ghelin the onty hormone which increase apelte.

Leptin- Ioss appetite.

In Acetle cholecystitis pain due to -CCK. - SBA.

Ghrelin