ABSITE Review Conference: Esophagus Stomach

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ABSITE Review Conference EsophagusStomach
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Surgical Infection

• The vagus nerve mediates which of the following
  in the setting of systemic inflammation?
• Enhanced gut motility
• Decreased protein production by the liver
• Decreased IL-10 production
• Increased heart rate to increase cardiac output

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Surgical Infection

• The vagus nerve mediates which of the following
  in the setting of systemic inflammation?
• Enhanced gut motility
• Decreased protein production by the liver
• Decreased IL-10 production
• Increased heart rate to increase cardiac output

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Surgical Infection

• Explanation The vagus nerve exerts several
  homeostatic influences, including enhancing gut
  motility, reducing heart rate, and regulating
  inflammation. Central to this pathway is the
  understanding of neurally controlled
  anti-inflammatory pathways of the vagus nerve.
  Parasympathetic nervous system activity transmits
  vagus nerve efferent signals primarily through
  the neurotransmitter acetylcholine. This neurally
  mediated anti-inflammatory pathway allows for a
  rapid response to inflammatory stimuli and also
  for the potential regulation of early
  proinflammatory mediator release, specifically
  tumor necrosis factor (TNF). Vagus nerve activity
  in the presence of systemic inflammation may
  inhibit cytokine activity and reduce injury from
  disease processes such as pancreatitis, ischemia
  and reperfusion, and hemorrhagic shock. This
  activity is primarily mediated through nicotinic
  acetylcholine receptors on immune mediator cells
  such as tissue macrophages. Furthermore, enhanced
  inflammatory profiles are observed after
  vagotomy, during stress conditions.