Exocrine and endocrine functions of the pancreas

Question 1

How does the pancreas lie in the abdomen?

Answer 1

Pancreatic head is towards the centre of the abdomen and the tail heads towards the left

Question 2

Blood supply to the pancreas

Answer 2

Coeliac and SMA arteries

Question 3

Venous drainage of the pancreas

Answer 3

Splenic and SMV veins -> portal vein

Question 4

Function of acing cells

Answer 4

Synthesise, store and secrete digestive enzymes - protease, lipase and amylase

Question 5

function of duct cell epithelium

Answer 5

Ion transport - neutralises pH, lots of mitochondria for transporting bicarbonate and water

Question 6

Function of centroacinar cells

Answer 6

Progenitor cells with ductal cell characteristics - secrete carbonic anhydrase

Question 7

Function of pancreatic stellate cells

Answer 7

regulate ECM production, roles in pancreatitis and pancreatic cancer

Question 8

Which two structures combine to form the ampulla of Vater ?

Answer 8

Pancreatic duct + bile duct

Question 9

What is the endocrine pancreas?

Answer 9

Acinar cells, duct cell epithelium, centroacinar cells, pancreatic stellate cells

Question 10

Exocrine pancreas

Answer 10

Cephalic, gastric and intestinal phase

Question 11

Cephalic phase:

Answer 11

Sensory input, regulated by vagus nerve

Question 12

Gastric phase

Answer 12

Stimulated by food entering stomach - gastric distension and raising pH
Regulated by vagus and gastrin

Question 13

Intestinal phase

Answer 13

Stimulated when food enters duodenum

Regulated by secretin and CCK

Question 14

What do D cells secrete

Answer 14

Somatostatin

Question 15

What do F cells secrete

Answer 15

Pancreatic polypeptide

Question 16

Somatostatin function

Answer 16

Inhibits bile secretion - pancreatic enzymes, cholecystokinin and VIP

Question 17

pancreatic polypeptide function

Answer 17

Satiety signals, slows gastric emptying, relaxes gall bladder and slows digestion

Question 18

Ghrelin functions

Answer 18

Increases food intake, promotes fat storage, reward processing

Question 19

Where is CCK made?

Answer 19

I cells, small intestine

Question 20

Where is secretin made?

Answer 20

S cells small intestine

Question 21

Where is VIP made?

Answer 21

small intestine and pancreas

Question 22

Where is somatostatin made?

Answer 22

D cells - pancreas and stomach

Question 23

Causes of pancreatitis

Answer 23

GETSMASHED - autoimmune, hypercalcaemia, alcohol, CF etc

Question 24

Sx pancreatitis

Answer 24

Abdo pain
nausea
Diarrhoea

Question 25

Dx pancreatitis

Answer 25

Blood tests and US/CT/MRI

Question 26

Tx pancreatitis

Answer 26

IV fluids
Medication
Surgery

Question 27

Pancreatic insufficiency

Answer 27

Can’t make sufficient enzyme quantities to digest food

Question 28

Causes of pancreatic insufficiency

Answer 28

Pancreatitis, CF, tumours, coeliac, IBD, bariatric surgery etc

Question 29

Where is PPP made

Answer 29

F cells

Question 30

Where is amylase made?

Answer 30

Acinar cells

Question 31

What does gastrin do?

Answer 31

Increased Hal secretion

Question 32

treating pancreatic insufficiency

Answer 32

PERT - substitute for missing enzymes