1. An ulcer starts by eroding the mucosa of the G.I tract wall. What functions of digestion or reabsorption might be lost if this layer is no longer functional? What functions will be compromised if the ulcer eats through the submucosa and then the muscularis?
Absorption would not happen correctly because some of the ingested and secreted may seep out of the lumen. This could also create a pathway of entry for pathogens, if the ulcer ate its way through to the muscularis mucosa and lose some control of defecation.
2. If Zachary has a peptic ulcer affecting his stomach and or duodenum, which components of the peritoneum will be affected?
If the ulcer eats a hole into the wall of the stomach, bacteria and partially digested food can spill though the opening into the peritoneum. This will cause sever inflammation of the abdominopelvic cavity and the visceral peritoneum.
3. How can Zachary’s stomach contribute to the formation of ulcers in other parts of the G.I tract? Which cells directly participate in ulcer formation and how do they contribute to the creation of lesions in the G.I tract wall?
Zachary’s stomach contributes to the formation of ulcers in the other parts of the G.I tract by the acids that are needed to breakdown food, they are excessive and will cause the stomach to over work therefore causing surrounding parts to be over worked as well. The cells that participate in ulcer formation include: partial cells (secrete HCI) and gastric gland (acetylcholine) . The major causing factor is chronic inflammation due to helicobacter pylori that colonizes the mucosa. The immune system is unable to clear up the infection despite the appearance of antibodies, which the bacterium can cause a chronic active gastritis.
4. Why does Zachary’s G.I tract need the substance the contributes to the formation of ulcers? How is this substance secreted by cells within the gastric pits?
Zachary’s G.I tract need the substance to assist in the breakdown of food for absorption. Epithelial cells extend into the lamina where they form secretory folds called gastric glands and several of these glands open into the gastric pits and secretions from those glands flow into the pits.
5. If Zachary’s only normal digestive enzymes come back from his mouth, what substances will he be able to digest?
Zachary will only be able to digest starch because even though food is swallowed too quickly for all starches to be broken down in the mouth, salivary amylase in the swallowed food continues to act on the starches for around another hour, then the stomach acids inactivate it. Zachary can also digest triglycerides because the enzyme secreted by lingual glands in the tongue start to break down but does not activate until the bolus reaches the stomach.
6. What do you think the ultimate fate of Zachary’s pancreas would be if the hepatopancreatic ampulla continued to be blocked? What do you think would happen to the liver and then eventually to the rest of Zachary’s body?
Because of the excessive pancreatic juice and bile Zachary’s pancreas will not be able to function correctly, this will result in a blockage of the secretions that will continue to build causing further damage and inflammation. Zachary will end up with extrahephatic jaundice due to the blockage of bile drainage and he will become malnourished and lose weight.
7. What enzymes has Zachary’s body been unable to use because of the blockage of the hepatopancreatic ampulla? What are the specific molecules these enzymes work on?
Pancreatic juice and bile are the enzymes that Zachary cannot use. These enzymes work on the endocrine portion of the pancreas, they secrete the hormones glucagon and insulin.
8. Selecting one of Zachary’s symptoms of either diarrhea, fever or weight loss… explain how inflammation of one section of the small intestine could lead to that symptom?
Inflammation of the small intestine is called gastroenteritis. The symptoms that occur with this disease include diarrhea, abdominal cramps, nausea and vomiting. All of these symptoms can cause a fever and it will last anywhere from 3-7 days.
9. With Zachary’s new diet, which type of lipoprotein will decrease in circulation the most? Which type of lipoprotein do most people wish they could decrease and why? Which one do most people wish they could increase?
VLDLs will decrease with Zachary’s new diet. Most people wish they could decrease LDLs because LDL cholesterol is known as “bad” cholesterol, and people have too few LDL receptors. Their body cells remove LDL from the blood less effectively and develop fatty plague. People wish they could increase HDLs which is known as “good” cholesterol.
10. In a healthy person other molecules can be substituted into the pathways of glucose catabolism when the blood glucose level is low. What specific molecules will Zachary now have problems making during times of low glucose and what is the normal source of molecules?
Zachary will have problems making glycogen, which is mobilized and converted to glucose by gluconeogenesis when the blood glucose concentration is low. Glucose may also be produced from non-carbohydrate precursors that include: pyruvate, amino acids and glycerol. Gluconeogenesis is what maintains blood glucose concentrations, while insulin and glycogen work together to keep blood glucose normal.
11. If Zachary is no longer ingesting foods high in lipid content, how will his body continue to supply itself with phospholipids, lipoproteins and cholesterol? Without an adequate supply of lipids in the body, what process will most likely increase in his hepatocytes to ensure proper ATP production in times of low blood glucose?
Zachary’s body will continue to supply itself with phospholipids, lipoproteins and cholesterol by using the stored lipids in the adipose tissue throughout his body and his liver. Ketone bodies will increase in the hepatocytes to ensure proper ATP production.