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GI - Week 2 > Pancreas / Hepatobiliary Physiology > Flashcards

Pancreas / Hepatobiliary Physiology Flashcards

(112 cards)

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1
Q

Are acini or ductal cells of the pancreas responsible for secretion of insulin, glucagon, mucin, and enzymes?

A

Acini
(and islet)

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2
Q

Are acini or ductal cells of the pancreas responsible for secretion of bicarbonate?

A

Ductal cells

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3
Q

Do acini and duct cells of the pancreas have exocrine or endocrine function?

A

Exocrine

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4
Q

Do islets of Langerhans of the pancreas have exocrine or endocrine function?

A

Endocrine

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5
Q

What effect do sympathetics have on pancreatic secretions?

A

Minimal

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6
Q

Do sympathetics or parasympathetics decrease blood flow to the pancreas?

A

Sympathetic

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7
Q

Do sympathetics or parasympathetics increase enzyme secretion?

A

parasympathetics

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8
Q

Do sympathetics or parasympathetics increase water bicarbonate secretion?

A

parasympathetic

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9
Q

Increase in pancreatic enzyme secretion is controlled by parasympathetic, specifically related to this compound

A

Acetylcholine

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10
Q

Increase in pancreatic water bicarbonate secretion is controlled by parasympathetic, specifically related to these compounds

A

Acetylcholine and VIP

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11
Q

Are pancreatic secretions isotonic or hypotonic to plasma?

A

ISOTONIC
at all rates of secretion (due to permeability of ductal cells to water)

*contrast to saliva, which is hypotonic

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12
Q

Are ductal cells of the pancreas permeable to water?

A

Yes

this is why pancreatic secretions are isotonic to plasma at all rates of secretion

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13
Q

Bicarbonate levels of the pancreas increase in response to acid present in this region

A

Duodenum

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14
Q

Do enzymes of the pancreas work best at higher or lower pH?

A

Higher

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15
Q

Does the presence of acids, carbs, and fats in the duodenum stimulate or inhibit pancreatic secretions?

A

Stimulate

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16
Q

Bicarbonate secretion in the pancreas is stimulated by this hormone

A

Secretin

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17
Q

In the process of secreting bicarbonate from the pancreas, this molecule enters the ductal cell and combines with water via carbonic anhydrase

A

Carbon dioxide

CO2 + H2O –> HCO3-

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18
Q

Secretin stimulates the ductal cells of the pancreas, causing an increase in this molecule

A

cAMP

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19
Q

This molecule stimulates the movement of chloride out of the pancreatic ductal cell, and into the lumen of the gland via the CFTR transporter

A

cAMP

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20
Q

cAMP stimulates the movement of this ion out of the pancreatic ductal cell, and into the lumen of the gland via the CFTR transporter

A

Chloride

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21
Q

Why does loss of CFTR in cystic fibrosis result in low bicarbonate transport?

A

Because there is no chloride to drive the release of bicarbonate

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22
Q

In cystic fibrosis, there is no chloride to drive the release of this compound

A

Bicarbonate

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23
Q

In cystic fibrosis, is there less or more water movement to the duct?

A

Less

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24
Q

Why is there “sticky” protein solution from the pancreas in cystic fibrosis?

A

Loss of CFTR = no chloride released in lumen = no bicarb transport

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25
Why do enzymes need to be secreted in the proenzyme (inactivated) form in the pancreas?
Because activated enzymes will digest the pancreas
26
This pancreatic enzyme is secreted by intestinal mucosa, and cleaves trypsinogen to trypsin
Enteropeptidase (enterokinase)
27
Enteropeptidase (enterokinase) cleaves this compound
Trypsinogen --> trypsin Trypsin then activates other proenzymes
28
This stops the premature activation of trypsin in pancreas/pancreatic duct
Trypsin inhibitor
29
This pancreatic carbohydrate enzyme hydrolyzes starches, glycogen, and other carbohydrates
Pancreatic amylase
30
What part of the GI tract secretes enteropeptidase?
Intestinal mucosa
31
This pancreatic lipolytic enzyme acts as a bridge to anchor lipase to the bile salts
Colipase (procolipase)
32
Cholecystokinin (CCK) is released in response to this
Amino acids and fats in the duodenum
33
Cholecystokinin (CCK) is released in response to amino acids and fats in this structure
Duodenum
34
Cholecystokinin (CCK) stimulates the contraction of this organ
Gallbladder
35
Cholecystokinin (CCK) acts via activation of these receptors
CCKA
36
What effect does Cholecystokinin (CCK) have on gastric motility?
Decreases
37
Secretin is released in response to this
Acid in duodenum
38
Secretin is release in response to acid in this structure
Duodenum
39
Secretin stimulates secretion of this from pancreatic/liver duct cells
Bicarbonate
40
This hormone stimulates secretion of HCO3- ion from pancreatic/liver duct cells
Secretin
41
Secretin stimulates secretion of HCO3- ion from these cells
Duct cells (of the pancreas/liver)
42
Vagovagal reflexes are initiated by entry of this into the duodenum
Chyme
43
Does activation of the vagovagal reflex increase or decrease enzyme and bicarbonate secretions?
Increases
44
This hormone is the major stimulus for bicarbonate secretion Is due to the presence of acid in the duodenum No major role in enzyme secretion
Secretin
45
Does secretin have a major role in enzyme secretion of the pancreas?
No
46
Does VIP have a major role in enzyme secretion of the pancreas?
No
47
Does CCK have a major role in enzyme secretion of the pancreas?
YES CCK and possibly gastrin can stimulate enzyme secretion from the acinus
48
The presence of food (fats and proteins) in the duodenum can cause the release of this, which will stimulate a vagal reflex (acetylcholine) to produce more enzyme release from the acinus
Cholecystokinin (CCK)
49
CCKA and M3 receptors have a major role in this function of the pancreas
Enzyme secretion
50
These two receptors have a major role in pancreatic enzyme secretion
CCKA and M3
51
What is the main stimulus for pancreatic secretion?
Presence of food in the duodenum (intestinal phase of secretion)
52
This phase of pancreatic secretion is responsible for the majority of secretions
Intestinal chyme enters small intestine --> acid stimulates S cells --> secretion --> increase bicarb secretion / fluid from ductal cells
53
Does the gastric phase of pancreatic secretions involve duct cell stimulation?
NO
54
Does the intestinal phase of pancreatic secretions involve duct cell stimulation?
YES chyme enters small intestine --> acid stimulates S cells --> secretion --> increase bicarb secretion / fluid from ductal cells
55
Pancreatitis is inflammation usually associated with this
Chronic alcohol abuse
56
Why is pancreatitis usually associated with chronic alcohol abuse?
Alcohol changes the ratio of trypsinogen/trypsin inhibitor
57
What leads to steatorrhea in pancreatitis?
Loss of pancreatic lipase
58
Blockage of papilla of Vater (gallstones) cause pancreatic enzymes to accumulate in the duct, overcome the effect of this compound and digest the pancreas
Trypsin inhibitor
59
Steatorrhea is due to a loss of this pancreatic enzyme
Lipase
60
Can lingual lipase break down all lipids in the absence of pancreatic lipase?
No (limited exposure and optimal pH is 4.5-5.5)
61
Xenical (orlistat), olestra, and simvastatin are drugs that can adversely cause this condition
Steatorrhea
62
Most common cause of pancreatic insufficiency in children
Cystic fibrosis
63
Blood flow to the liver is from these two sources
Portal vein Hepatic artery
64
"Secondary" blood flow through the liver (via the portal vein) allows these cells to remove bacteria and particulates Prevents direct access of harmful agents into the body
Reticuloendothelial cells
65
What is the series vascular arrangement of splanchnic blood flow?
Aorta --> superior mesenteric artery --> intestinal arterioles --> venules --> portal vein
66
What is the parallel vascular arrangement of splanchnic blood flow?
Celiac artery in parallel to the superior and inferior mesenteric arteries
67
Does the parallel or series vascular arrangement of splanchnic blood flow have a pressure drop at each area?
Series
68
Does the parallel or series vascular arrangement of splanchnic blood flow have no loss in driving pressure for each segment?
Parallel
69
The parallel vascular arrangement of splanchnic blood flow involves the celiac artery in parallel to these
Superior and inferior mesenteric arteries
70
RBCs are broken down by this system, and hemoglobin is then released and broken down to bilirubin
Reticuloendothelial system (RES: liver, bone marrow, spleen, lymph nodes, lungs, blood, connective tissue)
71
Once bilirubin is formed, is it released from the reticuloendothelial system bound to this
Albumin
72
In the liver hepatocyte, bilirubin is bound to this to make it water soluble (less toxic)
Glucuronic acid
73
In this type of cell, bilirubin is bound to glucuronic acid to make it water soluble (less toxic)
Liver hepatocyte
74
Bilirubin can be oxidized to form this, which is the brown color of feces
Stercobilin
75
Some bilirubin glucuronide is converted to this compound, by bacteria in the gut
Urobilinogen
76
Urobilinogen can either be excreted in the feces or transported back to the liver (via active transport in the ileum), then to kidney where it is hydrolyzed to this, which is the color of urine
Urobilin
77
This product of bilirubin is the color of urine
Urobilin
78
Primary and secondary bile acids (salts) form from this
Cholesterol
79
Primary bile acids (salts) are formed in this organ
Liver
80
Secondary bile acids (salts) are formed in this organ
Gut (by the actions of bacteria in the gut)
81
Micelles are surrounded by these compounds, and help in the absorption of fats
Bile salts
82
Cholesterol is synthesized in this organ and absorbed from diet
Liver
83
What are the three main functions of bile?
Emulsify fats Excretion (of bilirubin) Bicarbonate (secretin)
84
Distal ileum only functions in the absorption of these two compounds
Bile salts Vitamin B12
85
This part of the body functions in the absorption of bile salts and vitamin B12
Distal ileum
86
Are bile salts typically reabsorbed?
95% of bile salts are reabsorbed (via Enterohepatic circulation)
87
Fiber lowers the levels of this compound because it binds to bile acids/salts
Cholesterol
88
This compound lowers serum cholesterol because it binds to bile acids/salts
Fiber
89
A diet high in this prevents/relieves constipation and other gut issues/conditions because it has an osmotic effect, and results in less time for feces in colon
Fiber
90
Bile is stored highly concentrated in this organ
Gallbladder
91
When there is fat in the duodenum, CCK is released and causes this to contract, releasing concentrated form of bile
Gallbladder
92
Is Na/H or Cl/HCO3 exchange greater?
Na/H exchange is greater - so have a net secretion of H+ (this neutralizes HCO3 and acidifies bile)
93
Acidification increases the solubility of these in bile, resulting in less chance of gallstones
Calcium salts
94
Jaundice is yellowing of the skin/sclera due to excess production/loss of metabolism of this
Bilirubin / biliverdin
95
Hemolytic jaundice is due to excessive breakdown of this
RBCs
96
Physiologic hyperbilirubinemia (neonatal jaundice) occurs often due to these two reasons
Excessive bilirubin production Immature hepatocyte function
97
This is brain damage due to high levels of bilirubin
Kernicterus
98
Kernicterus is brain damage due to high levels of this
Bilirubin
99
Treatment for this condition is multifaceted, and includes exposure to sunlight/UV light to aid in the breakdown of bilirubin to lumirubin
Physiologic hyperbilirubinemia (neonatal jaundice)
100
This ethnic population has a high incidence of gallstone formation
Native American
101
This type of gene promotes the formation of calculi (stone)
Lithogenic genes
102
Gallstones can form from this organ's hypersecretion of cholesterol
Liver
103
Gallstones can form from this organ's failure to empty and inflammation
Gallbladder
104
Gallstones can form from this organ's increased cholesterol absorption
Intestinal
105
Are gallstones more prevalent in males or females?
Females (2-3x higher) Is linked to use of contraceptive, and progesterone and estrogen
106
Progesterone and estrogen impair emptying from this organ
Gallbladder
107
Progesterone and estrogen can cause hypersecretion of this into bile
Cholesterol
108
This color of gallstones indicates too much cholesterol
Light
109
This color of gallstones indicates too much bilirubin
Black
110
Is light or black colored gallstones seen with cirrhosis of liver and hereditary blood disorders?
Black
111
Light colored gallstones indicate too much of this compound
Cholesterol
112
Black colored gallstones indicate too much of this compound
Bilirubin

GI - Week 2 (12 decks)

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