Exocrine and endocrine functions of the pancreas Flashcards
How does the pancreas lie in the abdomen?
Pancreatic head is towards the centre of the abdomen and the tail heads towards the left
Blood supply to the pancreas
Coeliac and SMA arteries
Venous drainage of the pancreas
Splenic and SMV veins -> portal vein
Function of acing cells
Synthesise, store and secrete digestive enzymes - protease, lipase and amylase
function of duct cell epithelium
Ion transport - neutralises pH, lots of mitochondria for transporting bicarbonate and water
Function of centroacinar cells
Progenitor cells with ductal cell characteristics - secrete carbonic anhydrase
Function of pancreatic stellate cells
regulate ECM production, roles in pancreatitis and pancreatic cancer
Which two structures combine to form the ampulla of Vater ?
Pancreatic duct + bile duct
What is the endocrine pancreas?
Acinar cells, duct cell epithelium, centroacinar cells, pancreatic stellate cells
Exocrine pancreas
Cephalic, gastric and intestinal phase
Cephalic phase:
Sensory input, regulated by vagus nerve
Gastric phase
Stimulated by food entering stomach - gastric distension and raising pH
Regulated by vagus and gastrin
Intestinal phase
Stimulated when food enters duodenum
Regulated by secretin and CCK
What do D cells secrete
Somatostatin
What do F cells secrete
Pancreatic polypeptide
Somatostatin function
Inhibits bile secretion - pancreatic enzymes, cholecystokinin and VIP
pancreatic polypeptide function
Satiety signals, slows gastric emptying, relaxes gall bladder and slows digestion
Ghrelin functions
Increases food intake, promotes fat storage, reward processing
Where is CCK made?
I cells, small intestine
Where is secretin made?
S cells small intestine
Where is VIP made?
small intestine and pancreas
Where is somatostatin made?
D cells - pancreas and stomach
Causes of pancreatitis
GETSMASHED - autoimmune, hypercalcaemia, alcohol, CF etc
Sx pancreatitis
Abdo pain
nausea
Diarrhoea
Dx pancreatitis
Blood tests and US/CT/MRI
Tx pancreatitis
IV fluids
Medication
Surgery
Pancreatic insufficiency
Can’t make sufficient enzyme quantities to digest food
Causes of pancreatic insufficiency
Pancreatitis, CF, tumours, coeliac, IBD, bariatric surgery etc
Where is PPP made
F cells
Where is amylase made?
Acinar cells
What does gastrin do?
Increased Hal secretion
treating pancreatic insufficiency
PERT - substitute for missing enzymes
