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BRS 8 G: GASTROENTEROLOGY > 8.2 Pancreas > Flashcards

8.2 Pancreas Flashcards

1
Q

Foregut

A

oesophagus, stomach, pancreas, liver and bile ducts

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2
Q

Positioning of pancreas

A

Retroperitoneal

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3
Q

Parts of pancreas

A

Head neck and tail

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4
Q

Endocrine secretion in the oancreas

A

Into the bloodstream for effect on a distant target site (ductless gland)

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5
Q

Exocrine secretion in the oancreas

A

Secretion into a duct for a direct local effecr

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6
Q

What are the main endocrine secretions of the pancreas

A

Insulin

Glucagon

Somatostatin

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7
Q

Function of insulin as an endocrine secretion

A

Decrease blood glucose (promote transp into cells)

Promote protein synthesis and Lipogenesis

Promote storage of glucose as glycogen

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8
Q

Glucagon function as an endocrine secretion

A

Increase gluconeogenesis and glycogenolyeis to increase blood glucose

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9
Q

What is the majority of secretion in the pancreas endocrine or exocrine

A

Exocrine 98%

Pancreatic juice secreted into duodenum via main pancreatic duct/sohincter/ampulla

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10
Q

Endocrine secretion in pancreas concerned with

A

Islets of langerhans secrete insulin glucagon and somatostatin into blood for regulation of blood glucose metabolism and growth effects

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11
Q

Pancreatic cell differentiation

A

Formation of acini and islets from ducts in various stages of development

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12
Q

Acini

A

Ducts (clusters of secretory units)

Acinar cells secrete prod stems into ducts

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13
Q

Islets

A

Derived from the branching duct system

Lose contact with ducts to become islets

Differentiate into alpha and beta

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14
Q

Alpha islets

A

Secrete glucagon

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15
Q

Beta islets

A

Secrete insulin

Most prominent

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16
Q

Gamma cells

A

Secrete somatostatin

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17
Q

How is secretion from islets to blood stream ensured

A

Islets are highly vascular

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18
Q

Endocrine cells of pancreas are the

A

Islets

19
Q

Exocrine cells of the pancreas are the

A

Acini

20
Q

Exocrine pancreatic units

A

Secretory acinar cells (apical secretion granules)

Duct cells (small and pale)

21
Q

Two components of pancreatic juice [types)

A

Low vol, enzyme rich, viscous (acinar)

High vol, watery, bicarbonate rich (duct and centroacinar cells)

22
Q

What produces bicarbonate for pancreatic juice

A

Duct and centroacinar cells

23
Q

Functions of bicarbonate secretions

A

Neutralise acid chyme from stomach

Waahes low volume enzyme secretion out of pancreas to duodenum

24
Q

Duodenal ph and bicarbonate secretion

A

Below 5, bicarbonate is released linearly

Below 3 not much more secreted

25
Q

Why does hco3- secretion stop when ph is still acid

A

Bile also contains bicarbonate which helps to neutralise acid chyme

Brunneres glands secrete alkaline fluid

26
Q

Bicarbonate mechanism in pancreas duct cell

A

Co2 + H2O Catalysed by carbonic anhydrase to h+ and hco3-

Cl-/hco3- exchange at lumen

Na+/h+ exchange at basolateral membrane to blood

[exchange driven by gradients ]

Na+ back out by na+/k+ATPase

K+ returns to blood by k+channel

Cl- returns to lumen via cl- channel

27
Q

Gastric venous blood ph

A

Alkaline (hco3- to blood)

28
Q

Pancreatic venous blood ph is

A

Acidic (h+ into blood, hco3- to lumen)

29
Q

Which enzymes are secreted by acinar cells

A

Lipases, proteases, amylases synthesis and stored in zymogen grwnules as proemaymes

30
Q

How are pancreatic cells protected from the enzymes they secrete

A

Released as proemsymes (inactive)

Pancreas contains a trypsin inhibitor to prevent trypsin activation

Enzymes only activated in duodenum

31
Q

Blockage of mpd causes an overload protection leading to

A

Autodigestion or acute pancreatitis

32
Q

What converts trypsinogen to trypsin

A

Enterokinase

33
Q

What does trypsin do

A

Activates proteolytic and lipolytic enzymes

34
Q

How is lipase different to other enzymes

A

Secreted in an active form but requires a colipase and bile salts for effective action

35
Q

Orlistat

A

Anti obesity drug

36
Q

Orlistat route of action

A

Inhibits pancreatic lipases leading to Steatorrhea where fat isn’t digested

37
Q

Causes of Steatorrhea

A

Cystic fibrosis, chronic pancreatitis, Orlistat

38
Q

Gastric juice secretion control on pancreatic juice secretion

A

Mainly intestinal phase
Hormonally mediated
Both enzymes and hco3- flows into duodenum,

39
Q

Components of pancreatic juice

A

Enzymes and hco3-

40
Q

What controls enzyme secretion in acini

A

Vagus nerve (cholinergic )

Cholecystokinin (ca2+/PLC)

41
Q

What controls release of bicarbonate from ducts and centroacinar cells

A

Secretion cAMP

42
Q

What does acinar fluid resemble

A

Plasma

43
Q

What stimulates secretion of acinar fluid

A

Cck

44
Q

What stimulates secretion of H2O and hco3- from extraoobular duct lining cells

A

Secretin

BRS 8 G: GASTROENTEROLOGY (4 decks)

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