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brs > gastroenterology - pancreas and small bowel > Flashcards

gastroenterology - pancreas and small bowel Flashcards

1
Q

What are first 2 steps of pancreatic embryology?

A
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2
Q

What happens in 3rd step of pancreatic emrbryology?

A
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3
Q

What is the major pancreatic vessel? And what does it join up with?

A

major papilla

joins with distan commone bile duct to form papilla ampulla

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4
Q

Describe structure of pancrease?

A

head, neck, body, tail

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5
Q

Find the pancreas on this CT scan?

A
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6
Q

what type of imagery is this?

A
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7
Q

What is difference between endocrine and exocrine secretions?

A

endocrine - into blood stream, effect on distant target organ, ductless glands

exocrine - into duct have direct local effect?

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8
Q

Main endocrine secretions of pancreas?

A

insulin - anabolic

glucagon

somatostatin - endorcrine cyanide

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9
Q

Where is endocrine area of pancrease + how much of % of pancrease?

A

islets of langerhans

2

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10
Q

What is function of exocrine part of pancreas?

A

98%

secretess pancreatic juice into duodenum via sphincter of oddi/ampulla

digestive function

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11
Q

What are acinin?

A

ducts, grap like clusters of secretory units

acinar cells secrete pro enz into ducts

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12
Q

What are islets?

A

derived from brahncing duct

loose contact with ducts

differentiate into a and b cells secret into blood

more of them in tail than head

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13
Q

What is organisation of pancreatic microanatomy?

identify acinar and islets of langerhans

A
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14
Q

Label histologt of islet?

A
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15
Q

Label acini

A
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16
Q

What are 2 components of pancreatic juice

and which 2 cells produce each one?

A
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17
Q

How is bicarbaronate juice produces?

what is its function(2)?

A
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18
Q

What is relationship between dunodenal pH and bicarbonate secretions?

A
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19
Q

Why does HC03- secretions stop when pH is still acidic?

A
20
Q

What is mechanism of HC03 secretion (think C02)?

A
21
Q

What happens to HC03- produced in pancreatic duct cell?

A
22
Q

How is excess Na+ in panreactic cell dealt with?

A
23
Q

How are K+ and Cl- levels in pancreatic cell balanced out?

A
24
Q

How is what happens in pancreatic cell similar to gastric parietal cells?

A
25
Q

Where are enzymes for digestion stored and syntehied?

A

in zymogen granules in acinar cell

26
Q

What is a zymogen?

A

pro enzyme

27
Q

What preventes the enzymes from possbiel causing damage to pancreas (4)?

A
28
Q

How are some proteoylic and soem lytic enzymes converted into active forms?

A

duodenal mucosa secrete enterkinase

29
Q

What do lipases additionally need? (2)

A

some require colipase (precursor)

presence of bile salts for effective actions

30
Q

what can lack of pancreatic enzymes cause?

A

can cause malnutrition even if diertay input is ok

31
Q

side effects from orlistat ( inhibte lipases)?

A

increase faecal fat, steatohrea

32
Q

what are 3 phases of pancreatic juice secretion?

A

cephalic

gastric

intestinal

33
Q

What happens in cephalic?

A

reflex to sight good

causing enzyme rich compnent of acini only

low volume , mobilisation enz

34
Q

what happens in gastric phase?

A

stimulation of pancreatic secretion of food in stomach

same mechanism sa cephalic

35
Q

what happens in intestinal phase?

how is it mediated?

what is differnet about it?

A

hormnal mediated when gastric chyme enter duodenum

BOTH components of pancreatic huice are stimulated

HC03- AND enz flow in duodenum

36
Q

How in enz secretion of acini controlled?

A
37
Q

how is bicaronate secretion controlled in duct and centroacinar cells?

A

secretin (cAMP)

38
Q

how exactly does CCK control enzyme secretions in acini?

A

CCK is controlled by duodenal I cell

CCK release is stimulated by fatty acid and Amino acid

CCK is inhbited by trypsin

39
Q

What is important to consdier about acinar fluid?

A

It is isotonic - resembles plasma in its concs

secretions of acinar fluid and protients it contains is stimulated by CCK

40
Q
A
41
Q

What does the secretin cause?

A

secretions of H20 and HC03- from cells lining extralobular ducts

42
Q

Why is secretin stimulation secretions richer in HC03- than acinar secretions?

A

Due to Cl- and HC03 exhcnage

43
Q

how is HC03- controlled? (-ve feedback)

A
44
Q

What is important about CCK effect on HC30-?

A

no effect alone

NEEDS stimulattion on secretin

45
Q

What effect does vagus nerve have?

A

similar effect to CCK

46
Q

What effect does secretin have on enzyme secretions?

A

NO EFFECT

47
Q

What happens when you eat a meal?

starting with low pH stomach

to how pH is lowered

to enzyme release

A

brs (19 decks)

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