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Systems 1 > Physiology of pancreas, liver, gallbladder > Flashcards

Physiology of pancreas, liver, gallbladder Flashcards

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1
Q

Pancreatic fluid has what components?

A

An aqueous component and an enzymatic component

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2
Q

Secretory acini are surrounded by what?

A

A basal lamina, which is supported by reticular fibers and a rich capillary network

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3
Q

Acinus cells are polarized and have what type of granules?

A

Zymogen

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4
Q

Amylase and lipases are secreted in what form?

A

Active form

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5
Q

Proteases are secreted in what form?

A

Inactive form

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6
Q

What hormone is involved in the release of pancreatic enzymes and bicarbonate?

A

CCK

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7
Q

Acinar cells release

A

enzymes

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8
Q

Centroacinar cells secrete

A

Water and bicarb

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9
Q

Pancreatic exocrine glands are innervated by what?

A

Parasympathetic (excitatory) and sympathetic (inhibitory) nerves

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10
Q

What is pancreatic juice modified by?

A

Ductal cells (fluid is isotonic)

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11
Q

Pancreatic juices contain what?

A

Na+, Cl-, K+ and HCO3-

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12
Q

What is the difference between pancreatic glands and salivary glands?

A

Pancreatic do not contain myoepithelial cells

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13
Q

Centroacinar and ductal cells contain HCO3-/Cl- exchanger in

A

apical membrane

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14
Q

CFTR channel is also located on what?

A

Apical membrane

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15
Q

What does the basolateral membrane of the pancreas contain?

A

Na+/K+ ATPase, Na+/H+ exchanger, and other transporters/channels

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16
Q

What is the net result of pancreatic secretion?

A

Secretion of HCO3- and absorption of H+. Pancreatic venous blood becomes acidified

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17
Q

In low pancreatic flow, pancreatic juice contains

A

Na+, K+ and Cl-

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18
Q

High pancreatic flow, pancreatic juice contains

A

Na+, K+ and HCO3-

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19
Q

Pancreatic secretions dows what 2 things?

A
  • Secrete enzymes necessary for digestion in duodenum
  • Neutralizes H+ ions in the chyme delivered by the stomach
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20
Q

What stimulates I cells?

A

Small peptides, AA, FA

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21
Q

What do I cells cause release of?

A

CCK

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22
Q

What does CCK do?

A

Increase intracellular Ca which causes exocytosis of enzymes, such as pancreatic lipase

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23
Q

What do H+ ions stimulate?

A

S cells

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24
Q

What do S cells release?

A

Secretin

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25
What does secretin do?
Increases cAMP levels in ductal cells and this will cause the secretion of both Na+ and HCO3-
26
How does Ach potentiate the effects of CCK?
By binding to M3 receptors
27
GRP can increase
enzyme exocytosis
28
VIP and secretin can modify the activity of the
predominant pathway (this is minor)
29
If enzymes become activated while in the acinar cells, what can occur?
Pancreatitis
30
Presence of fat in the distal SI will inhibit what?
Pancreatic secretion
31
What is the optimal pH range of acinar cell enzymes?
6.8-7.2
32
High carb diet will result in release of increased
alpha-amylase
33
Defective CFTR channels, such as in CF patients, will make the fluid
viscous and block pancreatic ducts
34
Treatment of Defective CFTR channel
pancreatic enzyme replacement therapy. Fat soluble vitamins are also given
35
Majority of liver's blood supply comes from what artery?
Celiac
36
Many GI organs will have metabolic products going to the liver through what vein?
Portal
37
Livers makes what?
Albumin, coagulation factors and it regulates nutrient delivery to other tissues Also cholesterol, lipoproteins, phospholipids and bile acids
38
Liver converts ammonia to
urea
39
Common bile duct and pancreatic duct form the
ampulla of Vater (hepatopancreatic duct)
40
During digestion, the sphincter of ODdi is inhibited by what?
CCK
41
When sphincter of Oddi is inhibited, bile will now flow into
the duodenal lumen
42
During interdigestive periods, most of the bile acid will be stored where?
Gallbladder
43
How does the gallbladder concentrate bile acids?
By absorbing water and electrolytes
44
CCK induces gallbladder contractions via
a hormonal system
45
Fatty foods are the stimulus for what release?
CCK
46
NO and VIP will induce
SM relaxation to allow bile acid to flow into the duodenum
47
CCK can also stimualte vagal afferents to control the amount of
parasympathetic output
48
CCK stimulates contraction of the _________ and relazation of the _________
gallbladder; sphincter of Oddi
49
Secretin will stimulate secretion of
ions and water
50
When lipid abdorption is complete, bile salts are
recirculated to the liver via enterohepatic circulation
51
Describe dependent pathway of bile acid secretion
- Re-secretion of recycled bile salts by liver hepatocytes - Secretion fo de-novo bile acids - Bile salts osmotically draw water and electrolytes into biliary canaliculus, thus increasing flow
52
Describe independent pathway of bile acid secretion
- Secretion of water, electrolytes and HCO3- by secretin - Helps to neutralize intestinal acid
53
Water and many electrolytes, except for _______ are reabsorbed by gallbladder mucosa
calcium
54
What 2 primary bile acids come from cholesterol?
Cholic or chenodeoxycholic acid
55
Intestinal bacteria will produce what secondary bile acids?
Deoxycholic and lithocholic acid
56
Liver will conjugate the bile acids with either ______ or _____ to form bile salts
Glycine or taurine
57
Conjugation of bile acids changed their pKas and causes them to be more
water soluble
58
Once conjugated, bile salts are _________ ehich helps in the emulsification of lipids
ampipathic
59
Bile salts will also form _______ with the products of lipid digestion
micelles
60
Micelles diffuse to the cell membrane where the
small lipids will be absorbed
61
A lack of bile will reduce absorption of fat. unabsorbed fat will cause
steatorrhea
62
Bile salts are largely recovered by the
ileum
63
Patients with ileal resection will have a disruption in
recycling of bile salts, resulting in extensive fecal loss of bile salts
64
What is the rate-limiting enzyme in the biosynthetic pathway?
Cholesterol 7alpha-hydroxylase
65
Recirculation of bile salts to the liver will also stimulate
biliary secretion
66
What are the 2 major pigments found in bile?
Biliverdin and bilirubin
67
Cells of the RES degrade hemoglobin to form
biliverdin and then it is converted to bilirubin
68
Bilirubin is carried in the blood bound to what?
Albumin
69
Liver will extract bilirubin from blood and conjugate it to what?
Glucuronide
70
Bilirubin glucuronide is converted back into
urobilinogen by intestinal bacteria
71
Some urobilinogen will be sent back to the liver, or excreted in urine or oxidized to
urobilin and stercobilin
72
Urobilin and stercobilin are compounds that give
feces its dark color
73
Kernicterus can occur in infants and excessive bilirubin can cause
irreversible CNS damage and may prove fatal
74
What is cholelithiasis?
Formation of gallstones in the gallbladder and ducts
75
Cholesterol is released in the
bile and it is insoluble in water
76
What are causes of gallstones?
- Too much absorption of water from bile - Too much absorption of bile acids from bile - Too much secreteion of cholesterol in bile - Inflammation of gallbladder epi
77
If gallstone blocks the pancreatic duct, this can cause
acute pancreatitis

Systems 1 (35 decks)

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