12. Pancreas Physiology

Question 1

Tell me about the biliary tree (common bile duct, cystic duct, pancreatic duct, hepatic duct)

Answer 1

Cystic duct + hepatic duct = common bile duct

Common bile duct and pancreatic duct merge at the Sphincter of Oddi (exit at ampulla of vater)

Question 2

Functional unit of exocrine pancreas

Functional unit of endocrine pancreas

Answer 2

Exocrine FU = acini

Endocrine FU = Islets of Langerhaans

Question 3

Name the hormones secreted by the endocrine pancreas

Answer 3

insulin, glucagon, somatostatin

Question 4

Name the enzymes secreted by the exocrine pancreas and their functions

Answer 4

Trypsinogen & chymotrypsinogen = protein digestion, do not yield amino acids
Carboxypeptidase = individual amino acids

Question 5

Difference between pancreatic lipase and amylase

Answer 5

Lipase = fat digestion; amylase = carbohydrate digestion

Pancreatic lipase is more specific for pancreas than amylase

Question 6

How are the zymogens produced by pancreas activated?

Answer 6

enteropeptidase in the gut

Question 7

What does trypsin inhibitor do?

Answer 7

inhibit pancreatic enzyme activation to prevent autodigestion of pancreas

Question 8

CA pathway for bicarb secretion

Answer 8

CO2 moves into cell and combines with H20 to form H2CO3.
H2CO3 disassociates to form H+ and HCO3-
HCO3- goes into lumen of duct

Question 9

Effect of ACh, CCK, and secretin on pancreas

Answer 9

ACh, CCK –> secrete digestive enzymes

Secretin –> bicarb release

Question 10

Alpha, beta, and delta secrete which hormones?

Answer 10

alpha = glucagon
beta = insulin 
delta = somatostatin

Question 11

Function of somatostatin

Answer 11

Inhibits glucagon and insulin

Question 12

Function of amylin

Answer 12

Inhibits insulin secretion

Question 13

Function of pancreatic polypeptide

Answer 13

Unknown

Question 14

What enzyme breaks down insulin, where is it found

Answer 14

insulinase; kidney, liver, muscle

Question 15

Actions of insulin

Answer 15

Acts on liver, adipose, muscle
Decreases blood glucose (inc uptake glucome, promote glycogen, decrease GNG)
Dec blood fatty acid and ketoacid (stimulates fat deposition and inhibits lipolysis)
Dec blood amino acid concentration (anabolic)
Decreases blood K+ concentration

Question 16

Lack of insulincan cause increased use of fats leading to __________

Answer 16

ketosis and aciosis

Question 17

Insulin’s relationship to GH

Answer 17

Insulin enhances GH function

Question 18

Which GI hormones act to stimulate insulin secretion

Answer 18

Gastric inhibitory peptide (GIP), secretin, CCK, gastrin

Question 19

Do sulfonylurea medications inhibit or stimulate insulin release?

Answer 19

sulfonylurea meds increase insulin release (close the K+ channel responsible for increasing intracellular Ca2+ concentration –> insulin release)

Question 20

Tissues that do not require insulin for glucose transport

Answer 20

BRICK 
Beta cells of pancreas
RBC
Intestines
CNS
Kidney