Gastrointestinal Tract III (IV) Flashcards

1
Q

Accessory organs of the small intestine with a function in digestion

A

liver: production
gall bladder: storage of bile
pancreas: enzyme and bicarbonate secretion

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2
Q

The liver

A
  • largest gland in body
  • has thin capsule of dense connective tissue
  • weighs 1200g - 1600g
  • high metabolic activity
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3
Q

gross anatomy of the human liver

A
  • consists of four primary lobes: right, left, caudate, quadrate
  • falciform ligament: separated larger right and smaller left lobes, suspends liver from diaphragm and attached the liver ventral body wall
  • round ligament: remnant of foetal umbilical vein
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4
Q

Hepatic blood circulation

A
  • blood supply of the liver unusual because it has a dual blood supply
    liver receives:
  • arterial blood from the hepatic artery
  • from the hepatic portal vein (from small intestines) - all toxins are taken out at the liver before the blood goes back
  • branched of hepatic portal vein and hepatic artery empty together and mix in the liver sinusoids
    blood leaves liver:
  • through hepatic vein -> inferior vena cava
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5
Q

Hepatic arterial circulation

A
  • liver received approx. 30% arterial blood from the hepatic artery
  • highly oxygenated
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6
Q

Hepatic (liver tissue) portal system

A
  • liver receives 70% venous blood from organs of the gastrointestinal tract and spleen through the hepatic portal vein
  • contains nutrients absorbed from the GI tract
  • Oxygen poor
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7
Q

Blood supply of the liver - the liver as a filter

A
  • Liver functions as a filter to remove potentially harmful xenobiotics
  • Xenobiotics: chemical compounds that are foreign to a living organism = not normally naturally produced by or expected to be present within the organism
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8
Q

Microscopic anatomy of the liver

A
  • Liver lobules: hexagonal structural and functional units
  • Hepatocytes (liver cells) filter nutrient-rich blood, produce bile
  • central vein located in longitudinal axis
  • central vein for the blood vessels and nerves
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9
Q

Hepatocytes = liver cells

A
  • make up about 80% of the cells in the liver (others can be white blood cells)
  • filter and process nutrient-rich blood
  • increased rough and smooth ER, golgi, peroxisomes and mitochondria
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10
Q

Hepatocyte functions

A
  • produce 900mL bile/day
  • produces blood nutrients
  • store fat-soluble vitamins (fat storage)
  • perform detoxification
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11
Q

portal triad

A
  • not necessarily a triad at each corner of the hexagon, but it was what called when it was thought to have 3
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12
Q

5 parts in each corner of portal triad contain

A
  1. branch of hepatic artery, which supplies oxygen (from the heart)
  2. branch of hepatic portal vein, which brings nutrient-rich blood from intestine
  3. bile duct, which receives bile from bile canulicali
  4. lymphatic vessels
  5. a branch of the vagus nerve
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13
Q

Microscopic anatomy of the liver

A
  • liver sinusoids (liver blood vessels): leaky capillaries between hepatic plates
  • blood enters liver lobules through branched of hepatic portal vein and hepatic artery empty together and mix in the sinusoids
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14
Q

Stellate macrophages

A
  • hepatic macrophafes = kupffer cells
  • line walled of liver sinusoids
  • star-shaped, phagocytic
  • phagocytose invading agents
  • remove debris and old red blood cells
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15
Q

Bile

A
  • dark green/yellow fluid due to chemicals within and their composition
  • produced by the liver hepatocytes
  • collected in lobule canulicali (= bile capillaries)
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16
Q

Bile consists of

A
  1. water = 97%
  2. bile salts = 0.7%, fat emulsification and absorption
  3. bilirubin = 0.2%
  4. fats (cholestrol) = 0.5%
  5. electrolytes (the rest)
17
Q

Bile enterohepatic circulation

A
  • 95% of secreted bile salts are recycled
    1. reabsorbed into blood by ileum
    2. returned to liver via hepatic portal blood -> only 5% newly synthesised
    3. re-secreted in newly formed bile
  • after being produced, stored in gall bladder. Then once eating occurs, the bile is released and goes through pancreatic duct into the ileum
18
Q

Function of bile in digestion

A
  • fat is water repellent, but enzyme responsible for fat digestion (lipase) is water soluble
  • bile salts emulsify (mix of water and oils to the point where it looke like one) fats in the intestine
  • they surround fat droplets to from micelles, providing a greater surface area for pancreatic lipase to break down the fat
19
Q

The gallbladder definition

A
  • a thin-walled muscular sac
  • attached to visceral layer of the liver = on ventral liver surface
  • received and stored bile from the liver via the hepatic and then cystic duct
  • muscular contractions released bile via cystic duct, which flows into the bile duct
20
Q

the gallbladder

A
  • lined by a simple columnar epithelium
  • functions to store and concentrate bile by absorbing water and ions
  • can store 50-100mL in humans
  • contains many honeycomb folds that allow it to expand as it fills
21
Q

Functions of a healthy liver: metabolism

A

carbohydrates, amino acids and fats

22
Q

Functions of a healthy liver: energy homeostasis via

A

glycogenesis, glycogenolysis, gluconeogenesis, ketogenesis, repackaging excess FA

23
Q

Functions of a healthy liver: synthesis and secretion of

A

albumin, plasma proteins, clotting factors, transport proteins, insulin-like growth factoe-1, cholestrol, bile salts, glutathione

24
Q

Functions of a healthy liver: storage of

A

glycogen, vitamin A, vitamin B12, iron, copper

25
Functions of a healthy liver: purification transformation and clearance of:
toxins, drugs, hormones, ammonia -> urea, bilirubin
26
the pancreas
- no distinct capsule, but covered by a thin layer of loos connective tissue - location: mostly retroperitoneal, deep to greater curvature of stomach - head is encircled by duodenum - tail touches spleen
27
Exocrine functions of pancreas (basic)
produces pancreatic juice
28
Endocrine functions of pancreas (basic)
- secretion of insulin and glucagon by pancreatic islet and cells = islets of Langerhans - clumps of secretory cells supports by reticulin fibres, and containing fenestrated capillaries - delicate capsule arounf each islet - paler than the surrounding exocrine cells due to less rough endoplasmatic reticulum - isles do not have an acinar organisation - endocrine pancreas is made up of clusters of cells called islets of langerhans
29
the endocrine pancreas - islets of Langerhans
- islets cells: 3 secretory cell types: - 20% alpha - secrete glucagon - 75% beta - secrete insulin (insulin stimulates the synthesis of glycogen, protein and fatty acids)(facilitates the uptake of glucose into cells and activated glucokinase in liver) - 5% delta - secrete somatostatin (locally acting hormone which inhibits other endocrine cells)
30
The exocrine pancreas
- closely packed serous acini= clusters of secretory cells - produce zymogen granules containing proenzymes - secrete an enzyme rich alkaline fluid into the duodenum via the pancreatic duct - the alkaline pH is due to the presence of bicarbonate ions, and helps to neutralise the acid chyme from the stomach, as it enters the duodenum - the enzymes digest proteins, carbohydrates, lipids and nucleic acids - > ducts: secrete to duodenum via main pancreatic duct - > smaller duct cells produce water and bicarbonate
31
Secretions of the exocrine pancreas
- secretions of the acini empty into ducts lined with a simple low cuboidal epithelium, which becomes stratifies cuiboidal in the larfer ducts
32
what is secreted of the exocrine pancreas
1. proteases: digests proteins, secreted in inactive form to prevent self-digestion 2. lipases: digests fats 3. amylase: digest carbohydrates 4. bicarbonate: neutralises chyme
33
Structure of the enzyme - producing tissue of the pancreas
DIAGRAM
34
Pancreatic juice composition and role in digestion
- 1200-1500mL produced daily containing: watery, alkaline solution (pH 8), electrolytes, primarily HCO3- 1. neutralises gastric acid and acidic chyme in duodenum 2. enzymes to break down protein (protease), fat (lipase), starch (amylase) and nucleic acids (nucleases 3. suppresses gastric acid secretion
35
Enzyme-producing tissue of the pancreas - histology
DIAGRAM
36
Activation of pancreastic proteases in SI
DIAGRAM
37
Bile and pancreatic secretions into the small intestine
- bile duct and pancreatic duct unite in wall of duodenum - fust together in the bulblike structure called heaptopancreatic ampulla - ampulla opens into duodenum via volcano-shaped majoy duodenal papilla - hepatopancreatic sphincter controls entry of bil and pancreatic juice into duodenum
38
Control of secretion
- bile and pancreatic juice secretions are both stimulated by neural and hormone controls