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Alim 1 > bile, gall bladdder, gallstones > Flashcards

bile, gall bladdder, gallstones Flashcards

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1
Q

primary function of gallbladder

A

concentration and storage of bile

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2
Q

how does the gallbladder concentrate bile

A

active na+ transport from gallbladder is followed actively by water

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3
Q

how does bile in the GB become acidic

A

Na+ exchanged for protons

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4
Q

how does {Na+] increase in bile stroage

A

more Cl- and HCO3- are lost

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5
Q

what makes up pancreatic juice

A

bile salts, pigments, dissolved substances in alkaline electrolytes

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6
Q

which substances are secreted across the bile canalicular membrane

A 
bile acids
phosphatidylcholine (PC)
conjugated bilirubin
cholesterol
xenobiotics
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7
Q

how do water, glucose, GSH, AA, urea etc enter the bile

A

diffusion

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8
Q

what is the correct ratio of bile acids:phosphatidylcholine:cholesterol in canalicular bile

A

10:3:1

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9
Q

what happens if the normal acid ratio for acid:PC:cholesterol is altered

A

formation of cholesterol gallstones

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10
Q

where is the bile modified

A

larger ductules and ducts

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11
Q

how is bile composition modified

A

water may be added by specific junctions w/in the ductules

- ductules scavenge glu, AA, - GSH is hydrolysed

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12
Q

why do ductules secrete IgA

A

mucosal protection

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13
Q

why do ductules secrete HCO3-

A

response to secretin in the postprandial period

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14
Q

what are bile salts made of

A

bile + cation e.g. Na+

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15
Q

what are the four main human bile acids

A

cholic acid
chenodeoxycholic acid
deoxycholic acid
lithocholic acid

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16
Q

what happens to bile acids when they reach the intestine

A

deconjugated by bacteria, then excreted or reabsorbed

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17
Q

how are bile acids removed by the intestine

A

by portal circulation into the liver

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18
Q

what do anaerobic bacteria in the colon do to 1* bile acids

A

modify them to 2* bile acids e.g cholic > deoxycholic acid

chenodeoxycholic acid > lithocholic acid

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19
Q

what are bile acids made from

A

cholesterol

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20
Q

what happens to bile acids before they’re secreted into bile

A

conjugated to glycine or tauring

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21
Q

what does conjugation do

A

increase the ability of bile acids to be secreted, decreases their cytotoxicity

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22
Q

metabolic functions of bile acids

A

reduce precipitation of cholesterol in the gall bladder
allow fat digestion via emulsification
allow fat soluble vitamins to be absorbed
regulate lipid and glucose metabolism

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23
Q

what makes up hepatic bile

Study These Flashcards
A

97% water
cholesterol
lecithin
bile acids, pigments

24
Q

what makes up gallbladder bile

Study These Flashcards
A 
89% water 
bicarb
Cl-
Ca2+
mg, na, cholesterol, bilirubin
25
which 2 types of cells secrete bile
hepatocytes, epithelial cells of bile ducts
26
what does secretin do
influences secretion of bicarb-rich salt solutions and water
27
when is bile secretion greatest
during and after eating
28
what does the sphincter of Oddi do during fasting periods
contracts - no communication between duodenum and pancreas
29
when does the sphincter of Oddi relax
during and after meals
30
how is contraction of the gallbladder controlled
impulses via vagus nerve - gastric phase (stomach distension) and cephalic phase
31
what is the intestinal phase
- period of most gallbladder emptying - CCK and secretin
32
what does motilin modulate
gallbladder motility and volume
33
what stimulates secretion of cholecystokinin (CCK)
presence of fatty meal
34
what is stimulated by a rise in plasma CCK
gallbladder contraction | relaxation of sphincter of Oddi
35
what is caused by gallbladder contraction
increased bile flow into Common bile duct
36
what does increased flow into CBD and relaxation of sphincter of Oddi cause
increased flow of bile into duodenum
37
where are bile salts and lecithin synthesized
liver
38
where do HCO3- and other ions act
duodenum - synthesise acids
39
how are bile salts related to GI function
really fucking important
40
what reabsorbs bile salts
Na+/bile salt coupled transporters
41
how do bile salts get recycled
returned to liver and secreted back into the bile
42
what is the recycling pathway from intestine to liver to intestine called
enterohepatic circulation
43
how often can the contents of the body's bile acid pool get recylced
up to twice per meal
44
what ultimately happens to the cholesterol in bile
excreted in the faeces
45
what can interruption of the enterohepatic circulation cause
excess synthesis of bile salts by liver | excretion by the kidneys of bile salts, plus some cholesterol
46
fancy name for gallstones
cholelithiasis
47
gender ratio of incidence of gallstones
2:1 (F:M)
48
what happens to concentration of phospholipids and bile salts in bile if the cholesterol content is increased
the phospholipid and bile salt concentration is increased
49
how does cholesterol form gallstones
crystallization, precipitation of bile pigments
50
what are the 2 types of gallstones
calcium bilirubinate | cholesterol
51
factors in formation of gallstones
bile stasis - sequesteration in gallbladder decreased amount of bile acids due to malabsorption chronic infection supersaturation of bile with cholesterol
52
why is bile yellow
bilirubin
53
where do larger gallstones lodge
opening of the gallbladder
54
what happens if gallstones lodge at the point where the bile duct joins the duodenum
stoppage of bile and pancreatic secretions
55
what is jaundice
increased accumulation of bilirubin in the blood caused by pressure build up causing decreased bile secretion
56
how are gallstones diagnosed
ultrasound/CT in upper right quadrant of gallbaldder
57
clinical features of gallstones
if neck of cystic duct is impaired, there will be biliary pain common bile duct - bile flow obstruction - cholestatic jaundice which can cause infection

Alim 1 (11 decks)

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