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Git 3 Lec Notes

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13 views4 pages

Git 3 Lec Notes

Uploaded by

yapjoseantonio
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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GIT 3 Dr.

Janill Magano

Learning Outcomes:
1. Physiology of digestion
2. Mechanism of nutrient absorption
3. Application to clinical scenarios (acute pancreatitis, cholera)

PURO BULLETS LANG TO :)


Macromolecules
● CHO, CHON, Fats → different macromolecules, SAME process of breaking down

Hydrolysis
● Major reaction involved in the digestion of macromolecules
● Basta BREAKDOWN of molecules → key reaction is HYDROLYSIS
○ “Lysis with the use of H2O”

CARBOHYDRATES
● Sucrose, lactose, starches → Major sources of CHO
● Tanong! Which enzyme breaks down CHO in the mouth?
○ Sagot: Ptyalin, salivary amylase (alpha amylase)
● So si Ptyalin ay involved sa initial digestion ng carbs sa bibig
● Amylose → straight chain → alpha 1,4 glycosidic bonds
● Amylopectin → branched → alpha 1,4 and alpha 1,6 (sa branches) glycosidic bonds
Mouth - Ptyalin
● Secreted by the parotid glands
● Can only cleave alpha 1,4 glycosidic bonds
● Deactivated by HCl → due to denaturation
○ Enzyme ay protein → acidity destroys the protein conformation
● After mag-act ni ptaylin sa carbs sa bibig → shorter polysaccharides and
oligosaccharides → small intestine na next
Small intestine - Pancreatic amylase
● Also an alpha amylase
● Cleaves alpha 1,4 glycosidic bonds (within 15-30 mins upon entry of chyme to SI)
● Tanong! How are branched carbs broken down?
○ Sagot: HYDROLYSIS of disaccharides and smaller glucose polymers into
monosaccharides
● Tanong! What happens to undigested starch?
○ Sagot: Travels to COLON → acted upon by intestinal flora → FERMENTATION
→ magiging free FA and poop 💩
Sucrase
● Has the ability to cleave alpha 1-6 glycosidic bonds
● ISOMALTASE same same lang yan
● Sucrose → Glucose + Fructose
PROTEINS
● Sa carbs kanina may chemical digestion sa mouth palang, sa CHONs wala
● Mechanical digestion only sa mouth
Stomach - Pepsin
● Initial digestion of CHON

● Collagen - triple helix structure


Small Intestine

● Final digestion product of proteins → AMINO ACIDS


○ Where? Intracellular
FATS
● Neutral fats → triglycerides
● MOST of fat digestion → small intestines
Mouth - Lingual lipase
● Chemical digestion in the mouth (initial)
● Secreted by lingual serous glands at the back of the tongue
Stomach - Gastric lipase
Duodenum
● Fat + acidity → enteroendocrine (??) → CCK from I cells, Secretin from S cells
● Cholecystokinin → stimulate the gallbladder to RELEASE (NOT PRODUCE) bile and
the release of pancreatic juices
○ Ano nagprproduce? Liver diba (bile = bile salts + lecithin)
● BILE SALTS → EMULSIFICATION
○ Fat globules (malaki) → interaction with bile salt → emulsify → small fat droplets
or micelles (yung micelle it prevents reformation as in yung pagiging malaking
globule uli)
○ Recall yung fate ng micelles something to do with chylomicrons then via
lymphatics → enterohepatic circu ***
● Secretin → stimulate the pancreas to release BICARBONATE HCO3
○ Kasi yung galing sa stomach acidic chyme diba, need siyang i-alkalize para
optimal enzyme activity from duodenum onwards (cause again, sabi nga ni
doc santos, lahat ng digestive enzymes works in alkaline pH maliban sa
________)
● Pancreatic lipase PINAKAMAHALAGA
● Final product: 2 free fatty acids, 2-monoacylglycerol

CLINICAL CORRELATION: ACUTE PANCREATITIS


● Pancreas
○ Endocrine → insulin, glucagon
○ Exocrine → digestive enzymes
● Clinical manifestations: epigastric pain, (+) cullen’s sign (periumbilical hemorrhage),
(+) Gray Turner’s (sa flanks naman) → indicative of hemorrhagic pancreatitis
● Causes: (1) most common GALLSTONES (2) ALCOHOLISM

GASTROINTESTINAL ABSORPTION
● Facilitated by:
○ Folds of Kerckring
○ Villi
○ Microvilli
● ^^ Increase mucosal absorptive area or yung surface area
● Small intestine (particularly JEJUNUM) most involved in nutrient absorption
● Large intestine can absorb more water and ions, but can only absorb very few
nutrients
Absorption of Ions
● SODIUM**
● Na-K Pump - ↓ Na in the cell kasi nilalabas siya sa lumen → creates a gradient
● *Insert figure ni doc madali sundan :) temporary lang

● Aldosterone - RAAS
○ Secreted by the adrenal glands. Ano specifically? Yung G sa GFR na pnemonic
ni doc di ko rin sure pero here ata siya:
■ Glomerulosa (outer) → ALDOSTERONE
■ Fasciculata (middle) → cortisol
■ Reticularis (innermost) → sex hormones
● Aldosterone may role sa absorption of sodium and reabsorption of chloride
○ Mag-asawa si sodium at chloride always sila related and magkasama, and si
water lagi rin kumakabit sa kanila.
● Reabsorption of chloride → HCO3 release → Mixes with H+ → carbonic acids → CO2 +
H20 (thru action of carbonic anhydrase) → expire thru respiration
● Very young epithelial cells → release of chloride (?), where as old epithelial naman for
reabsorption of chloride → maintains balance
● CLINICAL CORRELATION: CHOLERA
○ Cholera toxin → damages something related ata sa chloride transporter →
nagkakaproblem with chloride reabsorption → rice-watery diarrhea
○ Hindi bloody diarrhea kasi hindi yung cells ang mismong dinadame, yung
transponsporter lang kaya nagkakaloss of fluids and electrolytes → severe
dehydration
● Parathyroid hormone di ko nanote pero nabanggit
○ Kidneys
○ Bones
○ Intestines → Vit D → Calcium absorption
● Sugars
○ For every 2 sodium, 1 glucose
○ GLUT 5 → Fructose
○ SGLT 1 → Glucose
○ SGLT 2 → Galactose (Kidneys)
○ Silang lahat nageexit paracellularly via GLUT 2
● Proteins
○ Dipeptide, tripeptide enters (saan? haha) via a transporter**
● Fats
○ Bitbit nga ng micelles → papasok sa cell → endplasmic reticulum → si
2-monoacylglycerol and 2 free FA magiging (1) triglyceride uli (2) chylomicrons
(APO B-48, APO B-100) sa intestinal mucosal cells then papasok sa lymphatics
then systemic circu
○ Tanong! Ano daw yung responsible for triglyceride digestion in the small
intestines? Sagot: pancreatic lipase

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