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GI physiology > Bile,Gall Bladder And Gallstones > Flashcards

Bile,Gall Bladder And Gallstones Flashcards

1
Q

What is function of gallbladder?

A

Storage and concentration of bile

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2
Q

What does pancreatic juice consist of?

A

Bile salts, bile pigments and dissolved substances in alkaline electrolytes

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3
Q

Describe the flow of bile?

A

Hepatocytes-> bile canaliculi(merge to form ductules)-> terminal bile ducts-> common bile ducts

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4
Q

What are 2 different cell types that secrete bile?

A

Hepatocytes and epithelial cells of bile ducts

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5
Q

What does hepatocytes secrete?

A

Cholesterol, lecithin, bile acids, bile pigments (bilirubin,biliverdin, urobilin)

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6
Q

What does epithelial cells of bile ducts secrete?

A

Bicarbonate rich salt solution

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7
Q

What influences the secretion of bicarbonate rich salt solution?

A

Secretin

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8
Q

When is Sphincter of Oddi contracted?

A

During periods of fasting

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9
Q

When is Sphincter of Oddi relaxed?

A

During and after meals

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10
Q

What substances are secreted across bile canalicular membrane?

A 
Bile acids 
Phosphatidylcholine 
Conjugated bilirubin
Cholesterol 
Xenobiotics
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11
Q

Describe the composition of hepatic bile?

A

97% water

Cholesterol, lecithin, bile acids, bile pigments etc

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12
Q

Describe the composition of gallbladder bile?

A

89% water

HCO3-, Cl-, Ca2+, Mg2+, Na+, cholesterol, bilirubin, bile salts etc

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13
Q

What are bile acids made from?

A

Made from cholesterol

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14
Q

What is bile acids secreted into and conjugated to?

A

Secreted into bile and conjugated to glycine or taurine

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15
Q

What are 4 major bile acids found in humans?

A

Cholic acid=50%
Chenodeoxycholic acid=30%
Deoxycholic acid=15%
Lithocholic acid=5%

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16
Q

What are primary bile acids? Where are they formed?

A

Chenodeoxycholic acid
Cholic acid
Formed in the liver

17
Q

What are secondary bile salts? Where are they formed?

A

Lithocholic acid
Deoxycholic acid
Formed in the colon

18
Q

What converts the primary bile acids to secondary bile acids?

A

Anaerobic intestinal bacteria
Chenodeoxycholic acid -> lithocholic acid
Cholic acid-> deoxycholic acid

19
Q

What are main functions of bile/bile acids?

A

Elimination of cholesterol to bile acids
Reduce the precipitation of cholesterol in gallbladder; bile acids and phospholipids help solubilise cholesterol in bile
Facilitate absorption of fat soluble vitamins (ADEK)
Regulate their own transport and metabolism via enterohepatic circulation
Facilitate digestion of TGs

20
Q

What does CCK trigger in gallbladder?

A

Triggers contractions

21
Q

What does CCK cause in Sphincter of Oddi?

A

CCK causes relaxation

22
Q

What secretin in liver stimulate?

A

Stimulates duct cells

23
Q

What controls contraction of gallbladder and release of bile into duodenum?

A

Control of gallbladder motility
Presence of fatty meal stimulates secretion of CCK
Relaxation/opening of Sphincter of Oddi

24
Q

What is enterohepatic circulation?

A

Recycling process of bile acids

Recycling pathway from intestine to liver and back to intestine

25
Q

Where is bile acids, lecithin (phospholipids synthesised)?

A

Synthesised in liver

26
Q

What does interruption of enterohepatic circulation cause?

A

Excess synthesis of bile salts by liver

Kidneys will excrete the synthesised bile salts

27
Q

What are bile salts?

A

Bile compounded with a cation e.g. Na+, cholesterol and phospholipids

28
Q

What causes increased cholesterol?

A

Liver secretes excess

Reabsorption of salt and water

29
Q

What are 2 types of gallstones?

A 
Cholesterol stones (85%): obesity; decrease bile acids vs decrease phospholipids 
Calcium bilirubinate stones: due to increase conjugated bilirubin (haemolytic anaemia)
30
Q

What are factors involved in gallstone formation?

A

Bile stasis
Deceased amount of bile acids due to malabsorption
Chronic infection
Super saturation of bile with cholesterol

31
Q

Diagnoses of gallstones

A

Ultrasonography
Cholescintigraphy
Endoscope retrograde cholangiopancreotography

32
Q

What are the clinical features of gallstones?

A

Gallstone in cystic bile duct
Gallstone blocking common bile duct
Gallstone blocking duodenal papilla

GI physiology (9 decks)

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