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D1 Spring - Physiology Exam 6 > 3/30: Accessory GI Organs > Flashcards

3/30: Accessory GI Organs Flashcards

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1
Q

Is the pancreas exocrine or endocrine?

A

More than 90% is exocrine

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2
Q

What do acinar cells synthesize and secrete?

A

Hydrolases for digestion

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3
Q

What do duct cells secrete?

A

Bicarbonate and water

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4
Q

What does the pancreas have luminal digestion of?

A

Carbohydrate, protein, fat

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5
Q

What does impaired digestion function of the pancreas cause?

A

Maldigestion and malabsorption

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6
Q

What does the pancreas neutralize?

A

Gastric H+: secretes HCO3- into duodenum up to 145 mEq/l

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7
Q

How are proteolytic enzymes synthesized, stored, and secreted as?

A

Inactive precursors

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8
Q

Where are proteolytic enzymes activated in/

A

Intestinal lumen
1. Enterokinase
2. Trypsin

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9
Q

What is trypsin inhibitor synthesized, stored, and secreted with/

A

Precursors

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10
Q

What is the function of acinar cells?

A

Digestive enzyme secretion

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11
Q

What are the two stimuli for acini cell enzyme secretion?

A
  1. CCK
  2. ACh/GRP (Vagovagal reflex)
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12
Q

What are CCKs function in the gallbladder?

A

Contraction

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13
Q

What do CCKs do in the pancreas?

A

Acinar secretion

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14
Q

What do CCKs do in the stomach?

A

Stimulates receptive relaxation
Reduce emptying
Reduce HCl secretion

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15
Q

What do CCK do in the sphincter of Oddi?

A

Relaxation

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16
Q

What cells secrete CCK?

A

I cells

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17
Q

What two substances stimulate I cells to secrete CCK?

A

Monitor peptide
CCK-RP

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18
Q

What does CCK-RP need to function?

A

Fatty acids
Amino acids

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19
Q

What are the two stimuli for ductal cell secretion of H2O and HCO3?

A
  1. Secretin (secretin receptor)
  2. ACh (M3 receptor)
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20
Q

What does secretin induce when bound?

A

cAMP
Phosphorylation of CFTR
Increase Cl conductance
Increase HCO3- secretion

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21
Q

What is HCO3 bicarbonate output used as an index of?

A

Secretin release

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22
Q

What pH is secretin released at?

A

pH <4.5

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23
Q

At what pH is secretin release maximal in segment of duodenum?

A

Below pH of 3

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24
Q

What does further release of secretin depend upon?

A

Area of small intestine affected

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25
When is pH rarely <3.5 or 4?
During a meal
26
Compare the rate of pancreatic secretion of CCK and secretin
HCl- - increases levels of Water and HCO3 because HCl stimulates secretin which stimulates ductal cells to secrete water and NaHCO3 Soap- - fatty acids Acids secrete secretin Fats secrete CCK Peptone- - increases levels of enzymes because peptides stimulate CCK which stimulates acinar cells to secrete enzymes
27
What are cephalic and gastric phases mediated by?
Vagovagal reflex
28
What kind of secretion is vagovagal secretion?
Low volume, high enzyme (Ach/GRP)
29
What does acid in the intestine stimulate?
Secretin -> HCO3-/H2O
30
What do fats/proteins stimulate in the intestine?
CCK -> Enzymes (indirectly via CCK-RP and monitor peptide)
31
What is secretion rate proportional to?
[secretin], [Ach], [CCK]
32
What is bicarb and chloride concentration at low secretion rates?
Bicarbonate concentration is low Chloride concentration is high
33
What is bicarb and chloride concentration at high secretion rates?
Bicarbonate concentration is high Chloride concentration is low
34
What concentrations are always the same as the plasma?
Sodium and potassium concentrations
35
What tonicity is pancreatic juice?
Isotonic
36
What abnormal composition is caused by cystic fibrosis?
Abnormal swear composition Decreased pulmonary and pancreatic secretion
37
What is the inheritance trait of cystic fibrosis?
Mendelian autosomal recessive occurrence
38
What does a defective CFTR cause?
Sweat Cl- reabsorption Pancreatic duct cell function Pulmonary mucus clearance
39
What are disorders of exocrine pancreatic function?
Cystic fibrosis Pancreatitis Duct obstruction
40
What are types of pancreatitis?
Acute and chronic
41
What causes pain and inflammation in pancreatitis?
Trypsin activation
42
What does chronic pacreatitis destroy?
Acini
43
What do consequences of pancreatitis reflect?
Decreased digestive enzyme production
44
What are types of duct obstruction?
Gallstones Tumors
45
What happens if there are no pancreatic enzymes?
60% fat not absorbed (steatorrhea) 30-40% protein and carbs not absorbed
46
What is the functional unit of the liver?
Liver lobule
47
What are hepatic functions?
- cleansing and storage of blood - metabolism of nutrients - synthesis of proteins (coagulation factors, plasma proteins, angiotensinogen) - metabolism of hormones, chemicals - storage of energy, vitamins, iron - excretion of lipid-soluble waste products - marked capacity for cell regenerations
48
Describe the resistance of vessels to blood flow in liver
Very low
49
What does cirrhosis do?
Increases resistance, produces portal hypertension
50
What can increased vascular resistance cause?
Ascites
51
What are bile salts (acids) and lecithin required for?
Digestion (emulsification) and absorption (micelles) of dietary fat
52
What is the role of bile with excretion?
Excretion of lipophilic metabolites (bilirubin), excess cholesterol, other waste products, drugs, and toxins
53
What do hepatocytes secrete?
Bile salts, cholesterol, lecithin, bilirubin, many other lipophilic substances
54
What do duct epithelial cells modify?
Primary secretion, add HCO3
55
Where is bile stored and concentrated?
Gallbladder
56
What reabsorbs some components of bile?
Enterohepatic circulation
57
What synthesizes and secretes bile?
Liver hepatocytes
58
What are organic compounds that hepatocytes secrete?
Bile salts (produced from cholesterol) Cholsterol Organic substances
59
What do bile duct cells secrete?
Water, Na and HCO3
60
Describe the transport of bile
1. Small intestine for fat digestion 2. Gall bladder for storage
61
What happens to someone whos had a cholecystoectomy?
- no problems with fat digestion - bile flow directly into duodenum
62
What does secretin stimulate in the gallbladder?
Liver ductal secretion
63
What does vagal stimulation cause?
Weak contraction of gallbladder
64
What does cholecystokinin via blood stream cause?
1. Gallbladder contraction 2. Relaxation of sphincter of Oddi
65
How are substances secreted into bile by?
Hepatocytes
66
Where are substances that are secreted into bile delivered to?
Lumen of ileum, then reabsorbed
67
Where and how are bile salts transported?
To hepatocytes via sinusoids
68
What transporter helps with active absorption of bile salts?
Apical sodium-dependent bile salt transporter (ASBT)
69
What are BARI (bile acid reabsorption inhibitors)?
Drugs that inhibit bile recylcing
70
What is BARI used for?
To lower LDL levels in blood
71
How is LDL taken up from blood?
Via hepatocytes as source of cholesterol for bile salts
72
What are the two types of drugs that inhibit bile recycling?
1. BIle acid sequestrants 2. ASBT inhibitors
73
What do bile acid dequestrants bind to?
Bile salts in intestinal lumen and block transport
74
What are benefits of bile acid sequestrants?
- drugs work in intestinal lumen (do not need to be absorbed) - reduce harmful side effects
75
What do ASBT inhibitors do?
Promising new drugs to reduce cholesterol levels in ECF
76
What is low ASBT activity awssociated with?
- Crohn's dsease - congenital primary bile acid malabsorption - idiopathic chronic diarrhea - Irritable bowel syndrome
77
What are disorders of biliary secretion?
- hepatocyte dysfunction impairs bilirubin, bile salt secretion: drugs (acetaminophen), viral hepatitis, toxins fibrosis, cirrhosis - duct obstruction Gallstones, tumors - intestinal mucosal defects impair bile salt reabsorption

D1 Spring - Physiology Exam 6 (6 decks)

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