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4. major hormones, peptides, and neurotransmitters 5. enteric nervous system and splanchnic circulation 6. Organization of the wall of the intestine into functional layers 7. structure of intestinal villi and crypts 8. Regulation of salivary secretion parasympathetic nervous system ACh, acetylcholine. 9. Anatomy of the stomach 10. Structure of a gastric glandfrom the fundusand body of the stomach 11. ECL (enterochromaffin-like) cells
13. Contents of Normal Gastric Juice (Fasting State )
14. Anions: Cl, HPO4 2, SO4 2 15. Pepsins 16. Lipase 17. Mucus 18. Intrinsic factor 19. Intrinsic factor absorptionof vitamin B12 20. Regulation of gastric acid and pepsin secretion (SST somatostatin ) 21. Parietal cell receptors 22. Ion transport proteins of parietal cells 23. Clinical Box 1Peptic Ulcer Disease
24. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)
26. Clinical Box 1 Peptic Ulcer Disease
omeprazole(proton pump inhibitor )
27. NSAID -induced ulcers
28. PANCREATIC SECRETION 29. Principal Digestive Enzymes ( )
30. Pepsins Proteins Polypeptides
31. TrypsinProteinsPolypeptides 32. LipaseTriglyceridesMonoglycerides, fatty acids 33. AmylaseStarchDextrins, maltotriose, maltose 34. Liver, gallbladder , and pancreas 35. Human bile acids 36. Lipid digestionand passage to intestinal mucosa 37. circulation of bile acids 38. Daily Water Turnover (mL) in the Gastrointestinal Tract
39. Endogenous secretions7000
41. Pancreas1500
42. Reabsorbed 8800
43. NaCl absorption in the small intestine and colon 44. Sodium absorption in the colon 45. Chloride secretion in the small intestine and colon 46. Lubiprostone ( )
47. Clinical Box2 A40 y/o male patient with Epigastric pain for 1 day
48. Pain was severe; moving would aggravate ; bending forward relieved pain 49. Vomiting 50. Clinical Box2 Acute pancreatitis( )
51. Amylase1627 IU/L(normal < 200 IU/L) 52. Admission diagnosis :ACUTE PANCREATITIS 53. Clinical Box2 Acute pancreatitis ( )
54. ASSOCIATED FACTORS( )
56. Polypeptides in Gastrointestinal Tract
57. Sites of production of the five gastrointestinal hormones along the length of the gastrointestinal tract 58. GLP-1 (glucagon -like peptide 1) ( ) 59. MOTILIN -Migrating motor complexes (MMCs) 60. ENTERIC NERVOUS SYSTEM
and middle circular muscle layers
and the mucosa 61. ENTERIC NERVOUS SYSTEM
63. ENTERIC NERVOUS SYSTEM
64. acetylcholine, norepinephrine, serotonin,-aminobutyrate (GABA), the gases NO and CO, peptides 65. Some of these peptides also act in a paracrinefashion or enter the bloodstream , becoming hormones 66. most of them are also found in the brain 67. EXTRINSIC INNERVATION
69. GASTROINTESTINAL (SPLANCHNIC) CIRCULATION 70. SUMMARY
71. Hormones and paracrine factors are released from enteroendocrine cells in response to signals coincident with the intake of meals. 72. SUMMARY Brain gut axis
73. SUMMARY Portal system
74. The majority of its venous outflow does not return directly to the heart, but rather is directed initially to the liver via the portal vein. 75. Reference