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Gastrointestinal > The Exocrine Pancreas > Flashcards

The Exocrine Pancreas Flashcards

1
Q

What nerves supply the pancreas?

A

Coeliac plexus from sympathetic chain of splanchnic nerves T5-T9

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2
Q

What does secretin act on?

A

Duct cells

To do with bicarbonate/water

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3
Q

What does cck act on?

A

Acinar cells

To do with enzymes

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4
Q

What lymph node is close to celiac plexus?

A

Celiac lymph node

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5
Q

What lymph node sits by the superior mesenteric artery?

A

Superior mesenteric lymph node

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6
Q

Which lymph node points out towards the spleen?

A

Splenic lymph node

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7
Q

Which pancreatic lymph nodes are next to the duodenum?

A

Anterior and posterior pancreaticoduodenal lymph nodes

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8
Q

Which pancreatic lymph node is next to the stomach/pyloris?

A

Pyloric lymph node

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9
Q

Which pancreatic lymph node goes out by the hepatic artery?

A

Hepatic lymph node

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10
Q

Where are the lymph nodes on the body of the pancreas?

A

Superior body and inferior body

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11
Q

Which artery runs over the top of the pancreas towards the spleen?

A

Splenic artery

Splenic vein goes back behind the pancreas

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12
Q

Which artery goes off the aorta in the direction of the liver?

A

Hepatic artery

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13
Q

Where does the tail on the pancreas head towards?

A

The spleen

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14
Q

What is the hooklike structure at the head of the pancreas next to the duodenum?

A

Uncinate process

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15
Q

How do enzymes get out of the pancreas?

A

Main pancreatic duct

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16
Q

Where do pancreatic enzymes flow?

A

From main pancreatic duct, into duodenum via the pancreaticoduodenal ampulla

17
Q

What duct do only some people have?

A

Auxiliary duct

18
Q

What cells are the exocrine pancreas and endocrine pancreas?

A

Expo-acinar units and ducts

Endocrine- islets of langerhans

19
Q

Where does the pancreas form from?

A

Ventral and dorsal buds from bud cells

20
Q

What cells make all cells of the pancreas?

A

Bud cells

21
Q

What do PP cells secrete?

A

Pancreatic polypeptide

22
Q

What causes increase in PP secretion?

A

Intestinal phase

Amino acids in blood stream

23
Q

What are pancreatic stem cells called?

A 
Centroacinar cells
(Edge of acinar cells, can turn into a duct cell and repair damage)
24
Q

What do acinar cells produce?

A

Zymogens (active enzyme+part of protein on end making it inactivated) - of lipase, amylase and protease - cleavage causes active enzyme

25
Q

What proteases are produced by acinar cells?

A

Elastase, chymotrypsin and trypsin

26
Q

Which enzyme produced by acinar cells is linked to pancreatitis and disease?

A

Trypsin

27
Q

What regulates the release of enzymes from acinar cells?

A

CCK

28
Q

What is trypsin released by acinar cells as?

A

Trypsinogen which is activated by enterokinase in the duodenum to trypsin. Start digesting protein, get amino acids which stimulates pancreatic polypeptide which gives further stimulation of digestion

29
Q

What binds to receptor to allow the secretion of bicarbonate and water from duct cells?

A

Secretin

30
Q

Why do duct cells need to release water?

A

To wash enzymes down into duodenum

31
Q

What protein regulates pancreatic ductal cells?

A

CFTR

32
Q

What occurs when secretin binds to receptor on ductal cells?

A

cAMP activated, activates pKa which activates CFTR channel, CFTR channel pumps Cl- ions out of the pancreatic ductal cell so water follows
HCO3- is swapped for Cl- and HCO3- moves out of ductal cells

33
Q

What is Acute pancreatitis associated with?

A

Necrosis

34
Q

What is apoptosis?

A

Non inflammatory programmed cell death

35
Q

What goes wrong in pancreatitis?

A

Trypsin is activated within the acinar cell causing cell damage, causing cytokine release causing pancreatitis and necrosis

36
Q

What activates trypsinogen release within acinar cells?

A

Pulse of Ca2+ release within the cell

37
Q

What does I GET SMASHEDD stand for?

A 
Idiopathic - hereditary
Gallstones
Ethanol 
Trauma
Steroids
Mumps
Autoimmune
Scorpion stings
Hyper -calcaemia, lipidaemia, thermos
ERCP
Drugs
38
Q

Causes of pancreatitis

A

Increase in activity of CCK
Increase in level and amount of trypsinogen
Decrease in amount of SPINK1 or trypsinogen inhibitors
Causes acinar damage

39
Q

How do gallstones cause pancreatitis?

A

Gallstone obstructs pancreatic duct
Build up of pressure within pancreatic duct
Trypsinogen activated in acinar cells

Gastrointestinal (11 decks)

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