2C-"We ate Pancreas!" Flashcards
What does pancreas endocrine function refer to?
Insulin and Glucagon
What does pancreas exocrine function refer to?
Pancreatic Juice
What are the 2 GENERAL contents of pancreatic juice? What is the pH?
1.HCO3 2.Digestive Enzymes(9)…pH of 7.6 to 8.2-Alkaline to balance stomach acid
What are the three anatomical divisions of the pancreas? Which division is closest to the Duodenum?
Tail, Body, and Head (next to Duodenum)
What are the two main cell groups of the pancreas? What % composition?
1.Islets of Langerhans (endocrine)-5% 2.Ascinar cells (exocrine cells)-95%
How does pancreatic juice travel from the pancreas to the duodenum?
The main pancreatic duct
Review: How much Pancreatic Juice is produced per day?
1.5 L
What 2 juices, along with pancreatic juice, are neutral or alkaline to bring the Duodenum pH to 6.0-7.0?
Bile and Intestinal Juice
What is the INFAMOUS region where the Bile Duct Sphincter, the Pancreatic Duct Sphincter, and the Sphincter of Oddi all join together?
the Papilla of Vater (NOT darth Vader)
BOOM: WHAT ARE THE 9, yes NINE, Enzymes of the Pancreatic Juice??!!
1.Pancreatic Amylase 2.Pancreatic Lipase 3.CoLipase 4.Trypsinogen 5.Chymotrypsinogen 6.Procarboxypeptidase (A/B) 7.Pro-Elast-ase 8.RiboNuclease 9.DeOxyRiboNuclease
What are the proteases of the pancreatic juice secreted as?
Inactive “pro-enzymes”
What converts Trypsinogen to Trypsin? Where does this happen?
EnteroKinase(EnteroPeptidase)..At the entrance of the Duodenum
What are the three proteases that Trypsin converts from inactive to active forms?
1.Chymotrypsinogen—>Chymotrypsin 2.ProCarboxyPeptidase—->CarboxyPeptidase 3.Pro-elastase—>Elastase
_________ deficiency can occur as a congenital abnormality, which leads to protein malnutrition.
Enterokinase
What does Pancreatic tissue keep up its sleeve to keep its enzymes from digesting itself?
Trypsin Inhibitors!
What are the two hormones controlling pancreatic juice secretion? What are their products like?
1.Secretin-Pancreatic Juice that’s RICH in HCO3- and LOW in enzymes. 2.CCK-Pancratic Juice that’s Rich in enzymes and Low in HCO3-
What CN stimulates secretion of pancreatic juice? How does this juice compare to to Secretin/CCK? What triggers this CN response?
VAGUS X! A juice rich in enzymes, but not as much as CCK. The SIGHT or SMELL of food can trigger this!
___________ is a severe, life-threatening disorder associated with the escape of activated pancreatic enzymes into the pancreas and surrounding tissues.
Acute pancreatitis
Measurement of the plasma _________ or __________ is therefore of value in diagnosing problems associated with inflammation and necrosis of pancreatic acinar cells.
pancreatic amylase or pancreatic lipase
In pancreatitis, these enzymes cause _______, or “_______” of the pancreas and produce fatty deposits in the abdominal cavity with hemorrhage from the necrotic vessels.
fat necrosis or “auto digestion”
What are the two main causes for Pancreatitis?
1.Gallstones in the common bile duct 2.EtOH
What are the two pancreas results of Alcohol?
1.EtOH is a POTENT pancreatic secretion stimulator 2.Contraction of the Sphincter of Oddi
LISTS! What 6 things is Acute Pancreatitis also associated with?
1.HyperLipidEmia 2.HyperParathyroidism 3.Viral Infections 4.Abdominal/Surgical Trauma 5.Drugs-STEROIDS 6.Thiazide Diuretics
What is the most common initial symptom of Pancreatitis?
SEVERE Epigastric and Abdominal Pain radiates to the Back that is bad in a SUPINE position!
What condition is associated with abdominal distention accompanied by hypoactive (soft) bowel sounds?
Pancreatitis
Mild _______ may appear after the first 24 hours because of biliary obstruction in pancreatitis.
jaundice
An important disturbance related to acute pancreatitis is the loss of a large _________ into the abdominal cavity.
volume of fluid
Tachycardia, hypotension, cool and clammy skin, and fever often are evident in _________.
Acute Pancreatitis
Signs of hypocalcemia may develop in acute pancreatitis, probably as a result of the precipitation of serum calcium in the areas of ________.
fat necrosis
The commonly used term “pancreatic cancer” usually refers to a _____________ of the pancreas (including its subtypes).
ductal adenocarcinoma
More than 95% of malignant neoplasms of the pancreas arise from the ________ elements and are referred to as “____________”.
exocrine…“exocrine pancreatic cancers”
What are the three most common presenting symptoms in patients with exocrine pancreatic cancer?
1.Pain 2.Jaundace 3.Weight
The initial presentation of pancreatic cancer varies according to tumor location. Approximately 60-70% exocrine pancreatic cancers are localized to the ______ of the pancreas, while 20-25% are in the ________ and the remainder involve the whole organ. Compared to tumors in the body and tail of the gland, pancreatic head tumors more often present with _______, ________, and ________.
head…..body/tail…. jaundice, steatorrhea (Fat in stool) (not being digested), and weight loss (no food digested)
___________ is the only potentially curative treatment for exocrine pancreatic cancer, but because of the late presentation of the disease, only ______% of patients are candidates for _________.
Surgical resection..15-20% ..pancreatectomy
The prognosis of pancreatic cancer is poor. The five-year survival following pancreatico- duodenectomy is only about ______% for node-negative and _____% for node- positive tumors.
25-30%…10% (node positive means trouble)
What are the 5 major risk factors for pancreatic cancer?
1.Cigarette Smoking 2.High Body Mass 3.Lack of Physical Activity 4.History of Chronic Pancreatitis 5.Genetic
What is the most common LETHAL genetic disease among “whites”?
Cystic Fibrosis
Cystic Fibrosis results from a defect in ________ that is caused by a mutation in the _______________(____) gene.
Cl- channels……cystic fibrosis transmembrane conductance regulator (CFTR)
Characteristics of Cystic Fibrosis include malfunction of ______ glands, resulting in increased ______ of mucus and increased chloride concentration in _____ and _____.
exocrine….viscosity….sweat and tears
What is the most important diagnostic procedure for Cystic Fibrosis?
The sweat test!
What are the three clinical manifestations of Cystic Fibrosis?
1.Chronic Pulmonary Disease 2.Pancreatic Insufficiency 3.Meconium Ileus (thick stool blocking the ilium in a baby)
