OST 575 - Exam #2 Questions And Correct
Answers
Why is the mesentery more than just a hammock? - answertransmits blood supply to organ it is
holding up and allows venous blood to leave
What major organ is sitting retroperitoneal to all the visceral intraperitoneal organs? -
answerdescending ab...
Why is the mesentery more than just a hammock? - answer✔transmits blood supply to organ it is
holding up and allows venous blood to leave
What major organ is sitting retroperitoneal to all the visceral intraperitoneal organs? -
answer✔descending abdominal aorta and IVC
What is the blood supply of the small intestine (ileum, jejunum), ascending colon, cecum and
appendix? - answer✔Superior mesenteric artery
What is the blood supply of the transverse colon, descending colon, sigmoid colon, and UPPER
2/3 of the rectum? - answer✔inferior mesenteric artery
What is the drainage of the bowel? - answer✔all drains into portal vein
What are the organs that are RETROperitoneal? - answer✔SAD PUCKER
S--> Suprarenal (adrenal glands)
A--> Aorta and IVC
D--> Duodenum (2nd-4th)
P--> Pancreas
U--> Ureters
C--> Colon (descending and ascending)
K--> Kidneys
E--> Esophagus (thoracic portion
R--> Rectum
What do all bowel lymphatics drain into? - answer✔chyle cisterna
What is the location of THE mesentery relative to spinal level? - answer✔L2-L4 level
What is the location of the sigmoid MESOcolon relative to spinal level? - answer✔Sacrum level
What parts of the Large colon are locked in place because they are retroperitoneal? -
answer✔ascending and descending colon
What part of the rectum venous drainage goes to the portal system and what goes to systemic
venous return? - answer✔Superior, middle rectal vein = portal system
Inferior rectal vein = systemic venous return
What is the rectum site of anastomoses? - answer✔Superior rectal vein
Inferior and middle rectal veins
What is the arterial supply of the different parts of the rectum? - answer✔Above pectinate line =
Superior and middle rectal arteries *from Inferior mesenteric Artery*
Below pectinate line = Inferior rectal artery *from the internal iliac artery*
What is the lymphatic drainage of the different parts of the rectum? - answer✔Above pectinate
line = internal iliac lymph nodes
Below pectinate line = superficial inguinal lymph nodes
What is the innervation of the different parts of the rectum? - answer✔Above pectinate line =
Visceral motor and sensory innervation
Below pectinate line = Somatic motor and sensory innervation (extremely painful area)
What type of hemorrhoid is extremely painful and which is more of a dull pain? -
answer✔EXTREMELY painful = external hemorrhoid (below pectinate line)
Dull pain = internal hemorrhoid (above pectinate line)
What is the only region of the small intestine that reabsorbs bile and B12? - answer✔Ileum
What does gastric lipase originate from? - answer✔chief cells
What stimulate gastric lipase secretion from chief cells? - answer✔ACh
gastrin
pH = 2-6
What does secretion of secretin stimulate release of? - answer✔stimulates pancreatic duct
secretion of *bicarbonate*
What is the optimal pH of the duodenum for co-lipase-pancreatic lipase activity? - answer✔6.5
(increases due to secretin)
What does secretion of CCK stimulate release of? - answer✔Stimulates enzyme secretion by
acinar cells
gallbladder contraction
*relaxation of Oddi's sphincter to release bile*
Where is CCK secreted from? - answer✔duodenal endocrine cells
What are the primary bile acids made by? - answer✔liver
What are the secondary bile acids made by? - answer✔formed from intestinal bacteria
What is the effect of the polar, ionized molecule property of bile acids? - answer✔high solubility
in water at intestinal pH
no passive absorption in biliary tract
limited passive absorption in small intestine
What is the effect of the amidation with glycine or taurine property of bile acids? -
answer✔resistance to hydrolysis by pancreatic enzymes
decreases passive uptake
What is the optimal pH for pancreatic lipase to be active? - answer✔pH 8-9
OR
pH 6-7 (with bile salts)
What inhibits pancreatic lipase binding ability at water-oil interfaces? - answer✔bile salts that
coat the oil droplets
What is co-lipase secreted by? activated by? - answer✔secreted by pancreas
activated by TRYPSIN
What is the function of co-lipase? - answer✔binds to lipid droplets and anchors lipase to bile salt
coated fat droplet
What lipase catalyzes the hydrolysis of carboxyl ester bonds in acylglycerols as well as other
dietary fats like cholesterol esters, fat-soluble vitamin esters, and phospholipids? - answer✔bile
salt-activated lipase
What are some pathophysiologic causes of insufficient lipase? - answer✔celiac sprue (impaired
release of CCK in mucosal disease)
Chronic pancreatitis (insufficient lipase secretion from pancreas)
Zollinger-Ellison syndrome (inactivation of lipase by low pH)
What is one of the first problems that needs to be overcome to effectively get lipids absorbed in
the small intestine? - answer✔Must go through the *unstirred water layer (UWL)* that is a major
permeability layer
What increases/decreased the Unstirred water layer thickness? - answer✔FAST FLOW
decreases unstirred water layer thickness
How do bile acids aid in the absorption of lipids once they reach the intestinal lumen? -
answer✔form micelles that markedly increase solubility of lipid
What protects cellular organs from toxic effects of high levels of free fatty acids in the enterocyte
cells? - answer✔Fatty acid binding proteins that carry lipids to smooth ER to be resynthesized
What are the chylomicron apo proteins? - answer✔B-48
A-IV
A-I
(gain Apo CII and E during trip)
How do chylomicrons enter circulation? - answer✔via intestinal lacteals and lymphatic system
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