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Exocrine Pancreas Flashcards

1
Q

Endocrine secretion

A

Insulin
Glucagon

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2
Q

Exocrine secretion

A

Bicarbonate
Enzymes

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3
Q

Pancreatic Islets

A

Alpha cells
Beta cells
To bloodstream

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4
Q

What do alpha cells secrete

A

Glucagon

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5
Q

What do beta cells secrete

A

Insulin

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6
Q

Acini cells

A

Secrete enzymes to pancreatic duct
Centrocinar cells
Ductable cells
CFTR channel

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7
Q

What do centrocinar cells produce

A

HCO3-

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8
Q

Function of ductable cells

A

HCO3- and Cl- exchange

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9
Q

Zymogen of trypsin

A

Trypsinogen

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10
Q

Zymogen of chymotrypsin

A

Chymotrypsinogen

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11
Q

Proteases released from the pancreas

A

Trypsin and chymotrypsin (in inactive form)

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12
Q

Where are proteases activated

A

Small intestine

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13
Q

What activates trypsinogen and chymotrypsinogen

A

Enterokinase

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14
Q

Where is enterokinase found

A

On epithelial cell walls

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15
Q

Function of proteases

A

Digests proteins and peptides (not to amino acids)

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16
Q

What activates trypsinogen

A

Enterokinase
Trypsin - positive feedback loop

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17
Q

Function of pancreatic lipase

A

Triglyceride digestion by hydrolysis to produce monoglycerides and free fatty acid chains

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18
Q

Steatorrhea

A

Fatty stools
Pancreatic insufficiency of pancreatic lipase

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19
Q

Function of amylase

A

Hydrolyses starch to maltose and dextrins

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20
Q

Pancreatic enzymes

A

Trypsin
Chymotrypsin
Pancreatic lipase
Amylase
Gelatinase
Elastase
Ribonuclease
Deoxyribonuclease

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21
Q

Primary pancreatic enzyme secretion

A

NaHCO3

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22
Q

Secondary pancreatic enzyme secretion

A

HCO3- is exchanged for Cl-

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23
Q

Fluid composition of enzyme secretions

A

Dependent of flow rate
The faster it flows the less exchange of HCO3- and Cl- so it is richer in HCO3- and lower in Cl-
Na+ and K+ levels do not change

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24
Q

Functions of pancreatic bicarbonate secretion

A

Protects duodenal mucosa by neutralising acid
Buffers duodenal contents
Optimises pH for enzyme digestion

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25
Resting phase- bicarbonate secretion
Low flow Predominantly Na+ and Cl-
26
High flow bicarbonate secretion
Mainly Na+ and HCO3-
27
Average flow of bicarbonate secretion per day
1 L
28
Which nerve stimulates release of pancreatic enzymes
Vagus
29
HCO3- rich component of pancreatic secretions
Mainly stimulated by production of acid in the stomach Neutralising effect Stimulated by secretin and CCK
30
Which phase of gastric motility is most dominant in pancreatic enzyme secretion
Intestinal phase
31
Enzymatic component of pancreatic secretion
Secreted from Acinar cells in response to an increased intracellular Ca2+ concentration Produced by ACh from vagal stimulation CCK secreted from small intestine can stimulate enzyme release
32
Cholecystokinin stimulus
HCl Proteins and fats in duodenum
33
Production of cholecystokinin
I cells of duodenum and Jejunum
34
Action of cholecystokinin
Pancreatic enzyme and HCO3- secretion Gallbladder contraction- causing bile secretion Inhibition of gastric acid secretion Delays gastric emptying (aid digestion0
35
Secretin stimulus
Low duodenal pH
36
Secretin production
Upper small intestine
37
Action of secretin
Pancreatic water and HCO3- secretion - carries the enzymes Alllows enzymes to work in small intestine as it raises the pH
38
Gastrin stimulus
Gastric distension and irritation
39
Gastrin production
G cells in stomach
40
Action of gastrin
HCl secretion (parietal cells) Enzyme release (Acinar cells)
41
Which cells secrete pancreatic enzymes
Acinar cells
42
What causes Acinar cells to secrete pancreatic enzymes
Increased intracellular Ca2+ concentration
43
What increases Ca2+ concentration in Acinar cells
ACh from vagal stimulation
44
Orlistat
Pancreatic lipase inhibitor
45
Enzyme secretion- Cephalic phase
Cephalic stage- vagal innervation Low level stimulus in anticipation of a meal
46
Enzyme secretion - intestinal stage
Secretin Cholecystokinin Gastrin
47
Symptoms of pancreatic exocrine symptoms
Maldigestion Diarrhoea Steatorrhoea Weight loss
48
Pancreatic exocrine insufficiency prevalence
11000 adults/year in uk develop PEI
49
Pancreatic exocrine insufficiency consequences
Malnutrition Osteoporosis Increased cardiovascular morbidity Symptoms burden
50
Pancreatic exocrine insufficiency - parenchymal diseases
Chronic pancreatitis Acute pancreatitis Cystic fibrosis Pancreatic cancer Autoimmune pancreatitis
51
Pancreatic exocrine insufficiency - extra-pancreatic diseases
Coeliac disease IBD Diabetes Zollinger-Ellison Ampullary obstruction
52
Pancreatic exocrine insufficiency
Reduction in pancreatic enzyme activity in the intestinal lumen below the threshold required to maintain normal digestion
53
Pancreatic exocrine insufficiency - post surgical states
Gastric resection Whipple’s Short bowel syndrome Post bariatric surgery
54
Assessment of pancreatic function
History, risk factors Imaging Faecal elastase Markers of malnutrition
55
Treatment of Pancreatic exocrine insufficiency
Pancreatic enzyme replacement therapy Stop smoking Bone health assessment Treat the underlying cause
56
Pancreatic exocrine insufficiency mechanisms
Loss of parenchyma cells Obstruction of secretion
57
Type 3c diabetes
develops when your pancreas experiences damage, such as from chronic pancreatitis or cystic fibrosis. People with Type 3c diabetes often also have a lack of pancreatic enzymes that are important for digestion. Type 3c diabetes is manageable with oral diabetes medications and/or insulin.
58
Which receptors activate pancreatic enzyme and bicarbonate secretion
M1 and M3 muscarinic receptors
59
Which 2 enzymes are secreted from the pancreas in their active form
Amylase Lipase
60
Pepsin is an important digestive enzyme. Which of the following statements concerning pepsin is true?
It hydrolyses bonds between aromatic amino acids

GI (12 decks)

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