digestive system ch. 23 Flashcards


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1

Where does the process of segmentation occur?

anus
small intestine
esophagus
stomach

small intestine

2

Which major process involves the removal of water from intestinal contents?

ingestion
defecation
absorption
mechanical breakdown

absorption

3

How would you classify chewing food?

digestion
propulsion
mechanical breakdown
ingestion

mechanical breakdown

4

Which of the following functions is NOT correctly matched with its description?

ingestion: intake of food nutrients
propulsion: physical breakdown of ingested food in the GI tract
absorption; passage of digested nutrients into the blood or lymph
mechanical breakdown: churning movements in the GI tract

propulsion: physical breakdown of ingested food in the GI tract

5

Which of the following is NOT a means of mechanically breaking down food?

mastication
churning
segmentation
peristalsis

peristalsis

6

Which of the following is the best illustration of the difference between metabolism and digestion?

-Metabolism comprises all of the chemical reactions preformed with in the body while digestion is only the breakdown of food within the GI tract.
-Digestion has a wide variety of chemical reactions while metabolism is restricted to only a few reaction types.
-Digestion requires enzymes for it to take place while metabolism does not necessarily need or use them.
-Digestions must happen first for metabolism to follow it.

-Metabolism comprises all of the chemical reactions preformed with in the body while digestion is only the breakdown of food within the GI tract.

7

Which of the following is least involved in the mechanical breakdown of food, digestion or absorption of nutrients?

the esophagus
the small intestine
the oral cavity
large intestine

the esophagus

8

Which of the organs listed below is involved in all of the following processes: secretion, mechanical breakdown of food, digestion and absorption?

the esophagus
the large intestines
the liver
the stomach

the stomach

9

The chemical processes of food breakdown are called ________.

ingestion
absorption
digestion
secretion

digestion

10

Peristaltic waves are ________.

-pendular movements of the gastrointestinal tract
-waves of muscular contractions that propel contents from one point to another
-segmental regions of the gastrointestinal tract
-churning movements of the gastrointestinal tract

-waves of muscular contractions that propel contents from one point to another

11

The lamina propria is composed of ________.

dense regular connective tissue
loose connective tissue
dense irregular connective tissue
reticular connective tissue

loose connective tissue

12

Chemical digestion reduces large complex molecules to simpler compounds by the process of ________.

mastication
catabolism
anabolism
fermentation

catabolism

13

When we ingest large molecules such as lipids, carbohydrates, and proteins, they must undergo catabolic reactions whereby enzymes split these molecules. This series of reactions is called ________.

absorption
secretion
digestion
mechanical breakdown

digestion

14

The mechanical and chemical receptors that control digestive activity are located ________.

in the glandular tissue that lines the organ lumen
in the oral cavity
in the walls of the tract organs
in the pons and medulla

in the walls of tract organs

15

Gastric accommodation is an example of smooth muscle plasticity.

true OR false

true

16

All the chemical and mechanical phases of digestion and mechanical breakdown from the mouth through the small intestine are directed toward changing food into forms that can pass through the epithelial cells lining the mucosa into the underlying blood and lymphatic vessels.

true OR false

true

17

Which organ of the digestive tract is the body's major digestive organ?

liver
small intestine
stomach
large intestine

small intestine

18

The major means of propulsion through the alimentary canal is peristalsis.

true OR false

true

19

Which layer of the alimentary canal is constructed from either stratified squamous or simple columnar epithelium?

mucosa
serosa
muscularis externa
submucosa

mucosa

20

Which layer of the alimentary canal is responsible for segmentation and peristalsis?

submucosa
serosa
muscularis externa
mucosa

muscularis externa

21

Which layer of the alimentary canal contains not only glands and blood vessels but also a nerve plexus that helps regulate digestive activity?

submucosa
serosa
mucosa
muscularis externa

submucosa

22

The _____ is the serous membrane that covers the abdominal organs.

omenta
visceral peritoneum
parietal peritoneum
mesentery

visceral peritoneum

23

The __________ circulation drains all of the organs of the digestive system.

peritoneal
visceral
hepatic portal
splanchnic

hepatic portal

24

In a patient suffering from untreated infection-induced peritonitis, an infection in the visceral peritoneum immediately ______.

spreads directly to the parietal peritoneum
spreads directly to the retroperitoneal organs
causes appendicitis
All of the listed responses are correct.

spreads directly to the parietal peritoneum

25

The outermost tissue layer of the alimentary canal is the __________.

muscularis
serosa
mucosa
submucosa

serosa

26

Peritoneal organs are completely covered in a serous membrane and have a dorsal and ventral mesentery.

true OR false

false

27

Select the description below that illustrates a difference between a sphincter and circular muscle.

-Sphincters are found in the proximal portion of the GI tract while circular muscle is found in the distal portions.
-Sphincters are found throughout the GI tract while circular muscle is found only in the proximal portion of the GI tract.
-A sphincter is a thickening of circular muscle that can prevent the movement of digesting materials while circular muscle is involved in propulsion digesting material.
-A sphincter is composed of smooth muscle while circular muscle is composed of skeletal muscle tissue.

A sphincter is a thickening of circular muscle that can prevent the movement of digesting materials while circular muscle is involved in propulsion digesting material.

28

The function of the hepatic portal circulation is to ________.

-distribute hormones throughout the body
-carry toxins to the kidney for disposal through the urinary tract
-return glucose to the general circulation when blood sugar is low
-collect absorbed nutrients for metabolic processing in the liver

collect absorbed nutrients for metabolic processing in the liver

29

The sheets of peritoneal membrane that hold the digestive tract in place are called ________.

mucosal lining
serosal lining
mesenteries
lamina propria

mesenteries

30

Which of the following does NOT describe a basic regulator of digestive control?

-Digestive effectors are smooth muscle and glands.
-pH, stretch, and osmolarity are some of the inputs that can initiate digestive responses.
-Short reflexes act locally in the GI tract.
-conscious neural control

-conscious neural control

31

In the enteric nervous system, a long reflexive pathway has an advantage over a short reflexive pathway in the fact that ________.

-long reflexive pathways last much longer than short reflexive pathways
-long reflexive pathways are quicker to respond than short reflexive pathways
-long reflexive pathways can be stimulated by things outside of the GI tract
-long reflexive pathways can respond throughout the entire length of the GI tract while short reflexive pathways can only respond in the proximal end

long reflexive pathways can be stimulated by things outside of the GI tract

32

Nervous control of gastric secretion is provided by ________.

the rubrospinal tracts
somatic neurons in the spinal cord
the reticulospinal and vestibulospinal tracts
the vagus nerve and enteric plexus

the vagus nerve and entire plexus

33

From the esophagus to the anal canal, the walls of every organ of the alimentary canal are made up of the same four basic layers. Arrange them in order from the lumen.

-submucosa, serosa, muscularis externa, and mucosa
-mucosa, submucosa, muscularis externa, and serosa
-serosa, mucosa, submucosa, and muscularis externa
-muscularis externa, serosa, mucosa, and submucosa

mucosa, submucosa, muscularis externa, and serosa

34

The capillaries that nourish the epithelium and absorb digested nutrients lie in the ________.

serosa
submucosa
adventitia
lamina propria

lamina propria

35

Which of these is not part of the splanchnic circulation?

superior mesenteric artery
celiac artery
hepatic portal vein
inferior vena cava

inferior vena cava

36

Which layer of the digestive tract controls digestive propulsion?

serosa
muscularis externa
mucosa
submucosa

muscularis externa

37

The peritoneum is the most extensive serous membrane in the body.

true OR false

true

38

How are wisdom teeth (third molars) classified?

as permanent teeth
as incisors
as primary teeth
as milk teeth

permanent teeth

39

How many total permanent teeth should an adult have, assuming none have been lost or removed?

8
16
20
32

32

40

Which of the following is NOT a function of saliva?

-Saliva moistens food and helps compact it into a bolus.
-Saliva contains enzymes that begin the chemical breakdown of proteins.
-Saliva cleanses the mouth.
-Saliva dissolves food chemicals so that they can be tasted.

Saliva contains enzymes that begin the chemical breakdown of proteins.

41

Which of the following inhibits salivation?

ingestion of spicy foods
the sight or smell of food
being stressed or frightened
relaxing after a meal

being stressed OR frightened

42

Where do the ducts of the submandibular salivary glands empty into the oral cavity?

the vestibule near the upper molars
along the upper surface of the tongue
the floor of the mouth under the tongue
the base of the lingual frenulum

the base of the lingual frenulum

43

What muscle forms the labia of the mouth and controls most lip movement, including puckering?

zygomaticus
levator labii superioris
orbicularis oris
buccinator

orbicularis oris

44

The palatine tonsils are located between which two structures?

the palatopharyngeal arch and the palatoglossal arch
the tongue and the floor of the oral cavity
the palatopharyngeal arch and the throat
the soft palate and the hard palate

the palatopharyngeal arch and the palatoglossal arch

45

The uvula is an extension of the __________.

oral vestibule
palatopharyngeal arch
lingual frenulum
soft palate

soft palate

46

The dental formula for an adult is 2-1-2-3. What does the 1 stand for?

incisor tooth
molar tooth
canine tooth
premolar tooth

canine tooth

47

Which of the following is true concerning the number and type of permanent teeth?

-The number of permanent teeth is always equal to the number of primary teeth.
-There are 32 permanent teeth, and the wisdom teeth are the last to emerge.
-There are 27 permanent teeth, and the first molars are usually the last to emerge.
-The number of upper permanent teeth is not equal to the number of lower permanent teeth.

There are 32 permanent teeth, and the wisdom teeth are the last to emerge.

48

Select the statement that is true concerning primary teeth.

-There are 20 primary teeth, and by 24 months of age most children have all 20.
-There are 24 primary teeth, and no new primary teeth appear after 13 months.
-There are 32 primary teeth, and by 36 months of age, most children have all 32.
-There are 27 primary teeth, and the molars are permanent.

There are 20 primary teeth, and by 24 months of age most children have all 20.

49

What part of the tooth bears the force and resists the friction of chewing?

crown
pulp
enamel
cementum

enamel

50

The deciduous dentition consists of __________ teeth.

10
16
20
32

20

51

Dentin anchors the tooth in place.

true OR false

False

52

The digestive function of the liver is to produce bile.

true OR false

true

53

Which layer of the stomach contains the gastric pits that secrete mucous, acid, and digestive enzymes?

submucosa
muscularis externa
serosa
mucosa

mucosa

54

Which area of the stomach adjoins the small intestine?

pylorus
fundus
body
cardia

pylorus

55

Chief cells secrete inactive pepsinogen in order to prevent acid erosion inside of the chief cells.

true OR false

false

56

In the __________ phase of gastric secretion, chyme is moved into the duodenum.

reflux
cephalic
intestinal
gastric phase

intestinal

57

In a patient suffering from a gastric ulcer caused by Helicobacter pylori, the cells most likely to have been damaged first are the ______.

enteroendocrine cells
parietal cells
chief cells
mucous cells

mucous cells

58

Some antacid drugs block histamine receptors, resulting in reduction of the production and excretion of stomach acid. These drugs have the biggest effect on which of the following?

mucous neck cells
chief cells
parietal cells
surface epithelial cells

parietal cells

59

Generally the hormones secretin and cholecystokinin which are released by duodenal enteroendocrine cells will ________.

increase the release of digestive enzymes and bile
increase the force of stomach contractions
increases stomach emptying
decrease the activities of the accessory digestive organs

increase the release of digestive enzymes and bile

60

The bolus is liquefied in the ________ and it is now called chyme.

esophagus
mouth
small intestine
stomach

stomach

61

Pepsinogen, an inactive digestive enzyme, is secreted by the ________.

goblet cells of the small intestine
Brunner's glands
chief cells of the stomach
parietal cells of the duodenum

chief cells of the stomach

62

Which of the following produce intrinsic factor?

enteroendocrine cells
zymogenic cells
mucous neck cells
parietal cells

parietal cells

63

Hormones or paracrines that inhibit gastric secretion include ________.

gastrin
secretin
histamine
ACh

secretin

64

What role of the stomach is essential to life?

production of VIP
production of hydrochloric acid
production of intrinsic factor
production of chyme

production of intrinsic factor

65

Some of the microbes that often invade other organs of the body are rarely found in the stomach. The reason for this is the presence of HCl.

true OR false

True

66

The major stimulus for production of intestinal fluid is distention or irritation of the intestinal mucosa by hypertonic or acidic chyme.

true OR false

True

67

Fats significantly delay the emptying of the stomach through hormonal and neuronal signals.

true OR false

True

68

Which of the following constitute a portal triad?

the hepatic artery and two hepatic veins
three lobules sharing a common central vein
a bile duct along with a portal venule and arteriole
the porta hepatis

a bile duct along with a portal venule and arteriole

69

What is a major function of pancreatic juice?

emulsifying fats by breaking them into smaller pieces
acidifying the contents of the small intestine
acidifying the contents of the stomach
neutralizing chyme entering the small intestine from the stomach

neutralizing chyme entering the small intestine from the stomach

70

Which chemical activates the transformation of trypsinogen to trypsin?

enteropeptidase
carboxypeptidase
amylase
chymotrypsin

enteropeptidase

71

Which vessel delivers nutrient-rich blood to the liver from the digestive tract?

hepatic portal vein
central vein
hepatic vein
inferior vena cava

hepatic portal vein

72

Bile is produced by the __________ under hormonal influence of __________.

pancreas; secretin
gallbladder; CCK
small intestine; CCK
liver; secretin

liver; secretin

73

Select the best explanation for why protease enzymes are secreted in inactive forms.

-The cells producing inactive enzymes are themselves protected from the enzymes until they are safely within the lumen of the GI tract.
-The enzymes would digest each other if they were not properly regulated.
-The immunoglobulins protecting the digestive tract would be digested without proper regulation of protein digesting enzymes.
-Inactive enzymes will simply be expelled with the feces if no protein is present in the digesting food, this will help to conserve energy.

The cells producing inactive enzymes are themselves protected from the enzymes until they are safely within the lumen of the GI tract.

74

Hepatocytes do not ________.

process nutrients
store fat-soluble vitamins
produce digestive enzymes
detoxify toxic chemicals

produce digestive enzymes

75

Digestion and absorption of which of the following would be affected the most if the liver were severely damaged?

proteins
carbohydrates
lipids
starches

lipids

76

Which of the following is NOT a secretion of the pancreas?

bile
bicarbonate
insulin
nutrient enzymes

bile

77

The ducts that deliver bile and pancreatic juice from the liver and pancreas, respectively, unite to form the ________.

pancreatic acini
bile canaliculus
portal vein
hepatopancreatic ampulla

hepatopancreatic ampulla

78

Choose the incorrect statement regarding bile.

Bile functions to emulsify fats.
Bile functions to carry bilirubin formed from breakdown of worn-out RBCs.
Bile is both an excretory product and a digestive secretion.
Bile contains enzymes for digestion.

bile contains enzymes for digestion

79

A doctor consulting a patient that recently has had their gall bladder removed would likely advise ________.

eating foods that are low in fat
a low to no carb diet
fewer, but larger meals
increasing unsaturated fats while eliminating trans fats in their diets

eat foods low in fat

80

What structural modification of the small intestine slows the movement of chyme through the lumen?

circular folds
villi
intestinal crypts
microvilli

circular folds

81

Which cells in the small intestine's mucosa secrete mucus?

Paneth cells
enterocytes
goblet cells
enteroendocrine cells

goblet cells

82

Which of these best describes a lacteal?

-a lymphatic vessel designed to help introduce fats to the blood
-a deep pocket in the intestinal wall where endocrine and antimicrobial cells are located
-a projection of the small intestine wall designed to increase surface area
-special capillaries in the villi designed for absorbing food effectively

a lymphatic vessel designed to help introduce fats to the blood

83

The __________ is the first segment of the small intestine.

jejunum
colon
ileum
duodenum

duodenum

84

Most absorption of nutrients occurs in the __________.

duodenum
jejunum
stomach
large intestine

jejunum

85

A patient has esophageal cancer and must have a feeding tube inserted. The nurse tells the patient that the tube will be inserted surgically into the duodenum. The patient's wife asks why the tube will not be inserted into the stomach. What should the nurse say?

-Insertion of a tube into the stomach will likely cause gastric ulcers.
-Contraction of the muscles in the stomach wall will interfere with the delivery of the food through the tube.
-There is less risk for vomiting, which could cause complications. Digestion is also completed in the small intestines, so there is no need for the stomach with a liquid food diet.
-The stomach's acid will digest the tube, leading to possible infections through the degraded tube.

There is less risk for vomiting, which could cause complications. Digestion is also completed in the small intestines, so there is no need for the stomach with a liquid food diet.

86

Cirrhosis can cause ______.

hepatitis
a bleeding disorder
primary hypertension
None of the listed responses is correct.

a bleeding disorder

87

___________ Increases output of enzymatic-rich pancreatic juice.

Cholecystokinin

88

____________ Increases output of pancreatic juice rich in bicarbonate ions.

Secretin

89

___________ Increases HCl secretion and stimulates contraction of intestinal muscle.

Gastrin

90

___________________ Stimulates insulin release and mildly inhibits HCl production.

Gastric Inhibitory Peptide

91

Which of the following is the best explanation of the benefit in the digestive system having the largest collection of lymphoid tissue (MALT) at the distal end of the small intestine?

-The digestive systems first and foremost job is to digest and absorb nutrients so it puts off immunity for last.
-The alkaline secretion of the small intestine aid in the growth of bacteria and must be controlled.
-The body will actively excrete pathogens out the body, into the digestive system to be removed from the body in feces.
-The huge numbers of bacteria living in the large intestine must be prevented from entering the lumen of the small intestine and being absorbed with food's nutrients into the blood stream.

The huge numbers of bacteria living in the large intestine must be prevented from entering the lumen of the small intestine and being absorbed with food's nutrients into the blood stream.

92

The absorptive effectiveness of the small intestine is enhanced by increasing the surface area of the mucosal lining. Which of the following accomplish this task?

the vast array of digestive enzymes
the rugae and haustra
villi, and microvilli
Brunner's glands and Peyer Patches

villi, and microvilli

93

The function of the goblet cells is to ________.

-produce mucus that protects parts of the digestive organs from the effects of powerful enzymes needed for food digestion
-absorb nutrients from digested food and store them for future use
-provide protection against invading bacteria and other disease-causing organisms that enter the digestive tract in food
-secrete buffers in order to keep the pH of the digestive tract close to neutral

produce mucus that protects parts of the digestive organs from the effects of powerful enzymes needed for food digestion

94

Paneth cells ________.

secrete hormones
secrete digestive enzymes
secrete bicarbonate ions
secrete enzymes that kill bacteria

secrete enzymes that kill bacteria

95

The major role of absorption in the ileum is to reclaim bile salts to be recycled back to the liver.

true OR false

true

96

The circular folds of the small intestine enhance absorption by causing the chyme to spiral, rather than to move in a straight line, as it passes through the small intestine.

true OR false

true

97

Peyer's patches are found in the submucosa of the distal end of the small intestine.

true OR false

True

98

Which other organ can affect small-intestine motility?

mouth
large intestine
pancreas
stomach

stomach

99

Which of the following propels food residue over large areas of the colon three to four times a day?

Valsalva's maneuver
haustral contractions
defecation reflex
mass movement

mass movement

100

As wastes navigate the large intestine, which features do they pass through, in order?

the cecum, left colic, and right colic flexures
the sigmoid, right colic, and left colic flexures
the right colic, left colic, and sigmoid flexures
the sigmoid, left colic, and right colic flexures

the right colic, left colic, and sigmoid flexures

101

Which of the following is the primary physiological function of the large intestine?

primary digestion of food
nutrient absorption
mechanical breakdown of food
water absorption and feces elimination

water absorption and feces elimination

102

Which of the following is NOT a function of the large intestine?

absorption of electrolytes
absorption of water
absorption of vitamins
production of intrinsic factor

producing intrinsic factor

103

__________ can result if food passes too slowly through the large intestine.

Constipation
Colitis
Diarrhea
Irritable bowel syndrome

Constipation

104

An obstruction by a gallstone is least likely to occur in the ______.

common hepatic duct
bile duct
cystic duct
lumen of the hepatopancreatic sphincter

common hepatic duct

105

The formation of diverticula involves, most significantly, the ______.

atrophy of the muscularis externa
atrophy of the mucosa
weakening of the colon's submucosa
thickening of the serosa

weakening the colons submucosa

106

A ruptured appendix is life threatening because ________.

-loss of the appendix's function will cause an immune deficiency in the digestive system
-it is likely to cause massive infection of the abdominopelvic cavity
-the large intestine will no longer be able to receive digested material from the small intestine
-it is likely to cause severe internal bleeding

-it is likely to cause massive infection of the abdominopelvic cavity

107

Which of the following is an essential role played by large intestine bacteria?

synthesize vitamins C and D
absorb bilirubin
produce gas
fermentation of indigestible carbohydrates

fermentation of indigestible carbohydrates

108

Which of the following is not characteristic of the large intestine? It ________.

does not contain villi
exhibits external muscular bands called teniae colic
is longer than the small intestine
has pocket-like sacs called haustra

is longer than the small intestine

109

Carbohydrates are digested into __________.

glycerol
amino acids
nucleotides
monosaccharides

monosaccharides

110

One of the direct consequences of lactose intolerance is ______.

increased intestinal absorption of this disaccharide
increased osmotic pressure of the large intestine contents
decreased motility of the small and large intestines
increased blood glucose levels

increased osmotic pressure of the large intestine contents

111

Which of the following are NOT correctly matched?

protease: lipid digestion
lipase: fat digestion
nuclease: DNA and RNA digestion
amylase: carbohydrate digestion

protease: lipid digestion

112

Fat absorption through the plasma membrane of epithelial cells ________.

-occurs by simple diffusion because lipids are able to penetrate the hydrophobic fatty acid tails within the plasma membrane
-requires enzymes attached to the brush border to further breakdown the fats
-requires vesicular, active transport of the relatively large fatty acids and monoglyceride
-Is accomplished by cotransporters that use the concentration gradient of Na+ outside of the cells

occurs by simple diffusion because lipids are able to penetrate the hydrophobic fatty acid tails within the plasma membrane

113

You have just eaten a meal high in complex carbohydrates. Which of the following enzymes will help to digest the meal?

cholecystokinin
gastrin
trypsin
amylase

amylase

114

How are fats absorbed into the lymph?

in the form of fatty acids and glycerol
in the form of chylomicrons
in the form of micelles
in the form of glycerol

in the form of chylomicrons

115

Which of the following enzymes would be most active in the presence of a high concentrations of protein fragments?

lipase
dextrinase
trypsin
amylase

trypsin

116

Select the correct statement about electrolyte absorption.

-If vitamin B is not present, calcium is not absorbed.
-Iron and calcium are absorbed mostly by the duodenum.
-Potassium moves across the epithelium by active transport.
-Chloride ion absorption is coupled to glucose and amino acid transport.

iron and calcium are absorbed mostly by the duodenum

117

During which phase in the control of the digestive system would bicarbonate and bile be stimulated?

gastric phase
intestinal phase
cephalic phase

intestinal phase

118

Norepinephrine is the neurotransmitter released by which fibers?
interneurons of the enteric nervous system
both sympathetic and parasympathetic preganglionic fibers
parasympathetic postganglionic fibers
sympathetic postganglionic fibers

sympathetic postganglionic fibers

119

Enteric interneurons that are inhibitory to smooth muscle use which of the following neurotransmitters?

norepinephrine
substance P
VIP (vasoactive intestinal peptide)
ACh (acetylcholine)

VIP (vasoactive intestinal peptide)

120

Which of the following intestinal hormones stimulates the release of bile from the gall bladder?

CCK (cholecystokinin)
GIP (gastric inhibitory peptide)
gastrin
motilin

CCK cholecytokinin

121

Which of the following GI hormones promotes a pancreatic juice rich in bicarbonate ions?

secretin
motilin
GIP (gastric inhibitory peptide)
gastrin

secretin

122

Salivation is controlled almost entirely by the nervous system. Which of the following stimuli would inhibit salivation?
a lemon
the thought of food
fear
nausea

fear

123

HCl secretions convert pepsinogen to the active hormone pepsin. What cells in the gastric pits produce pepsinogen?
G cells
chief
paracrine (also known as enteroendocrine cells)
parietal

chief

124

In response to a steak dinner, certain secretions are needed to aid digestion. What cells in the pancreas would provide these secretions?
duct cells
islet of Langerhans cells
acinar cells

acinar cells

125

An increase in HCl (hydrochloric acid) arriving in the duodenum would stimulate which hormone that would help to counteract the effects of HCl?
CCK (cholecystokinin)
secretin
GIP (gastric inhibitory peptide)
gastrin

secretin

126

The secretion in the large intestine consists of which of the following?
bile
intrinsic factor
digestive enzymes such as CCK and secretin
bicarbonate- and potassium-rich mucus

bicarbonate- and potassium-rich mucus