Gastrointestinal Physiology Physiology 1523/1531

Practice Questions for Exam 2

Regulation of GI Function

1. A characteristic of the splanchnic circulation is that:

A. systemic arterial blood from the aorta is delivered equally to each

individual GI organ.
B. large digested proteins can easily enter into the capillaries of the
small intestine.
C. the liver can filter and remove ingested medications before they
reach the systemic circulation.
D. activating the parasympathetic nervous system will directly produce
constriction of splanchnic resistance arterioles.

2. A newly synthesized drug is found to selectively activate neurons of the

myenteric plexus. This drug could be potentially used to:

A. control the tone of the ileocecal sphincter.

B. increase mucosal blood flow within the lining of the stomach.
C. decrease hormone secretion from mucosal endocrine cells.
D. reduce the absorption of fats by lymph vessels.

3. Single-unit GI visceral smooth muscle behaves as a functional unit because:

A. gap junctions allow the electrical coupling of many smooth muscle

cells.
B. each smooth muscle cell receives individual innervation from an
autonomic nerve.
C. somatic nervous system control ensures that all fibers of the smooth
muscle unit contract simultaneously.
D. tonic contractions of GI sphincters require sustained membrane
hyperpolarization of all muscle cells.

4. Stimulation of parasympathetic efferent nerves will increase:

A. sweat production
B. heart rate.
C. skeletal muscle contraction.
D. intestinal motility.

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5. Which of the following neural reflexes can only be mediated by a long neural
reflex?

A. Gastric distension causes an increase in gastric acid (HCl) secretion.

B. An increase in motility of the ileum causes a relaxation of the
ileocecal sphincter.
C. Activation of a duodenal intrinsic primary afferent neuron (IPAN)
increases duodenal motility.
D. Stimulation of sensory receptors in the oropharynx causes relaxation
of the stomach fundus.

6. A newly discovered peptide found in the GI system has the following

characteristics:

- Does not circulate in the plasma

- Extent of local action limited by diffusion
- Binds to receptors located on nearby cells
- Released from mucosal endocrine cells

This peptide would be classified as a:

A. hormone.
B. paracrine
C. neurocrine

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Mouth and Esophagus

1. The rate of salivary secretion will be increased by a(n):

A. gastrin receptor agonist.

B. histamine H2 receptor agonist.
C. cholinergic agonist.
D. adrenergic antagonist.

2. The concentration of sodium (Na+) in the final salivary secretion will be lowest
when the:

A. flow through the salivary duct is very high (40 ml/min).

B. concentration of cholecystokinin (CCK) in the plasma is very high.
C. sympathetic nerves terminating on salivary glands release
epinephrine.
D. concentration of aldosterone in the plasma is very high.

3. During a swallow, an increased release of acetylcholine from the vagus nerve

DIRECTLY causes primary peristalsis of the:

A. smooth muscle of the esophageal body.

B. upper esophageal sphincter (UES).
C. striated muscle of the esophageal body.
D. fundus of the stomach.

4. During the act of swallowing, the lower esophageal sphincter (LES) and the
fundus of the stomach will both relax due to:

A. activation of a short reflex.

B. release of nitric oxide (NO) from enteric neurons.
C. a decrease in tonic sympathetic nerve activity.
D. inhibition of somatic motor nerve activity.

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5. In a patient with dysphagia, the lower esophageal sphincter (LES) opens

frequently in the absence of a swallow. When the sphincter opens, acidic chyme
from the stomach enters the esophagus. Distension of the esophagus by acidic
chyme can:

A. decrease the tone of the striated muscle in the lower 2/3 of the
esophagus.
B. decrease concentration of bicarbonate (HCO3-) in the final salivary
secretion.
C. activate short neural reflexes to begin secondary peristalsis.
D. activate the alpha-amylase secreted by the salivary acinar cells.

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Stomach

1. The volume of gastric acid secretion (HCl) will be the greatest when gastric
parietal cells are stimulated by:

A. somatostatin and cholecystokinin (CCK).

B. gastrin and acetylcholine.
C. prostaglandins and motilin.
D. histamine and secretin.

----- Use the following information to answer the next two questions. -----

A patient has a gastrin-secreting tumor in their pancreas (Zollinger-Ellison

Syndrome). During both the digestive and interdigestive periods, the plasma
concentration of gastrin in this patient is very high.

2. While fasting, a sample of digestive secretions was taken from the duodenal
lumen of this patient. The pH of this sample was 1.3. At this pH:

A. exopeptidases are digesting protein into amino acids.

B. release of secretin from S cells is very low.
C. pepsin is digesting protein into peptides.
D. active bicarbonate secretion by hepatic ductal cells is very low.

3. In this patient, there will be a decrease in the secretion of:

A. HCl from parietal cells.

B. gastrin from G cells.
C. histamine from ECL cells.
D. somatostatin from D cells.

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4. In secretion of HCl from the gastric parietal cells, the H+:

A. secretion is followed by active H2O secretion.

B. is exchanged for K+ by an ATPase.
C. catalyzes the reaction of CO2 and H2O.
D. is secreted into the duodenal lumen.

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5. A patient has taken high doses of a nonsteroidal anti-inflammatory drug (NSAID)

for many weeks. As a result, the patient's:

A. plasma concentration of secretin will be lower than normal.

B. volume of HCl secreted by parietal cells will be less than normal.
C. conversion of pepsinogen into pepsin will be slower than normal.
D. gastric mucosal barrier (GMB) will be weaker and thinner than
normal.

6. During the digestive period, the rate of gastric emptying is increased by:

A. acidic chyme in the duodenal lumen.

B. peptides in the gastric lumen.
C. stimulation of sympathetic nerves innervating the orad stomach.
D. a low plasma concentration of motilin.

7. Peristaltic contractions of the caudad stomach:

A. allow for ingestion of large amounts of food with little change in

gastric pressure.
B. emulsify complex carbohydrates in the chyme.
C. force particles through the pylorus according to size.
D. increase water and electrolyte absorption by the gastric
enterocytes.

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Small and Large Intestine

1. During the interdigestive period, the motility pattern in the small intestine is:

A. mass movements.
B. haustral shuttling.
C. the migrating motility complex (MMC).
D. segmentation and peristalsis.

2. During phase 1 of the migrating motility complex (MMC):

A. at least 50% of the slow waves produce action potentials.

B. there are no phasic contractions of the small intestine.
C. the plasma concentration of motilin is maximal.
D. all sphincters of the GI tract relax.

3. During phase 3 of the migrating motor complex (MMC) the:

A. plasma concentration of motilin is at its highest.

B. frequency of the slow waves is increased.
C. frequency of phasic contractions is decreased.
D. enteric neurons do not release neurotransmitter.

4. During the defecation reflex, distension of the rectum by a mass movement

causes:

A. an increase in plasma concentration of gastrin.

B. constriction of the internal anal sphincter.
C. decreased haustral propulsion in the rectum.
D. activation of rectal parasympathetic afferent neurons.

5. A patient taking an opioid agonist for pain management might experience

constipation because of a decrease in the:

A. amplitude of action potentials in parasympathetic nerves

innervating the colon.
B. frequency of the slow wave (BER) of smooth muscle of the colon.
C. percent of slow waves associated with contractions in the colon.
D. sympathetic nerve activity to the colon.

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6. A 53-year old female went to a GI clinic complaining of having problems

defecating. The intensities of tonic contractions of the internal and external anal
sphincters were recorded from the patient. When the rectum was distended by a
balloon, the internal anal sphincter immediately relaxed but the tone of the external
anal sphincter did not change. These results suggest the patient has damage to
the:

A. enteric neurons.
B. vagus nerve.
C. pudendal nerve.
D. sympathetic nerves.

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Liver, Gallbladder and Pancreas

1. The rate of pancreatic acinar cell secretion will be decreased by:

A. secretin.
B. norepinephrine.
C. acetylcholine.
D. cholecystokinin (CCK).

2. A high plasma concentration of cholecystokinin (CCK) will increase:

A. the secretion of bile into the duodenal lumen.

B. the rate of salivary secretion.
C. the rate of gastric emptying.
D. bicarbonate secretion by the hepatic ductal cells.

3. A patient presents with jaundice. The plasma concentration of conjugated

bilirubin is above the normal range. The plasma concentration of unconjugated
bilirubin is within the normal range. The best explanation for elevated plasma levels
of conjugated bilirubin is:

A. defect in excretion of bile into bile duct.

B. increased bilirubin production.
C. defect in glucuronyltransferase activity.
D. decrease in formation of secondary bile acids.

4. A patient is taking a medication that increases the concentration of bile acids in

the portal blood. As a result the:

A. secretion of bile by the liver will be decreased.

B. micelle formation in the gallbladder will be decreased.
C. synthesis of new bile acids by hepatocytes will be decreased.
D. digestion of dietary triglycerides will be impaired.

5. Destruction of the enterocytes of the ileum will INCREASE the excretion of:

A. glucose.
B. bile acids.
C. micelles.
D. bilirubin.
E. short-chain free fatty acids.

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6. A hormone has the following characteristics:

- inhibits gastric acid (HCl) secretion

- inhibits peristaltic contractions of the small intestine
- increases the intensity of tonic contractions of the pylorus
- decreases gastric emptying

This hormone is:

A. motilin.
B. secretin.
C. somatostatin.
D. gastrin.

7. During the digestive period, the rate of salivary gland secretion increases, gastic
acid (HCl) secretion increases, the gallbladder contracts, and pancreatic
secretions increase. In a fasting person, all of these digestive functions would also
occur after systemic administration of a/an:

A. nicotinic neural (Nn) receptor antagonist.

B. muscarinic receptor agonist.
C. nicotinic muscle (Nm) receptor agonist.
D. adrenergic receptor antagonist.

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Digestion and Absorption

1. The final end products of lactose digestion are:

A. glucose and maltose.

B. oligosaccharides.
C. glucose and galactose.
D. glucose and fructose.

2. Inside the enterocyte, triglyceride is:

A. packaged inside a chylomicron.

B. incorporated into a micelle.
C. digested by lipase in the presence of colipase.
D. emulsified by secondary bile acids.

3. A high plasma concentration of aldosterone will increase the absorption of:

A. glucose in the small intestine.

B. chloride in the small intestine.
C. sodium in the colon.
D. secondary bile acids in the colon.

4. In a normal, healthy human, oligopeptides in the lumen of the duodenum can be

digested by:

A. endopeptidases.
B. alpha-amylase.
C. carbonic anhydrase.
D. cytoplasmic peptidases.

5. Brush border enzymes participate in the digestion of:

A. oligosaccharides.
B. triglycerides.
C. vitamin B12.
D. amino acids.

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6. A patient has a disease that destroys most enterocytes of the ileum. As a result,
the patient has difficulty digesting and absorbing:

A. long-chain free fatty acids.

B. bilirubin.
C. secondary bile acids.
D. short-chain free fatty acids.

7. Micelles are involved in the absorption of:

A. bilirubin.
B. bile acids (salts).
C. short-chain free fatty acids.
D. long-chain free fatty acids.

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Answer Key

Q# Regulation Mouth and Stomach Small Liver, Digestion

of GI Esophagus and GB, and and
Function Large Pancreas Absorption
Intestine
1 C C B C B C
2 A D C B A A
3 A C B A A C
4 D B B D C A
5 D C D C B A
6 B B C B A
7 C B D

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NOTES:

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