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PHYS Exam 6 > GI 4- Accessory GI Organs- Pancreas, Liver and Gall Bladder > Flashcards

GI 4- Accessory GI Organs- Pancreas, Liver and Gall Bladder Flashcards

1
Q

What do the acinar cells of the pancreas do?

A

synthesize and secrete hydrolases for digestion

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2
Q

What do the duct cells of the pancreas do?

A

secrete bicarbonate and water

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3
Q

How does the pancreas make the small intestine neutral pH?

A

Neutralizes gastric H+ by secreting HCO3-

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4
Q

Why Doesn’t the Pancreas Digest Itself?

A
  • Proteolytic enzymes synthesized, stored and secreted as inactive precursors.
  • Activated in intestinal lumen
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5
Q

What are the proteolytic enzymes of the pancreas?

A

enterokinase
trypsin

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6
Q

What are the two stimuli for acini cells in the pancreas?

A

CCK
ACh/GRP (vasovagal reflux

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7
Q

What does CCK stimulate?

A
  • gallbladder contraction
  • sphincter of oddi relaxation
  • acinar secretion
  • reduced stomach emptying
  • reduced HCl secretion
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8
Q

What two substances cause the secreting of CCK through the I cell?

A

CCK-RP
monitor peptide

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9
Q

What is the main funtion of trypsin?

A
  • breakdown proteins
  • if most proteins are broken down then it activates CCK-RP and monitor peptide (causes increased CCK)
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10
Q

What causes an increase in CCK-RP which in turn increases CCK?

A

fatty acids and peptides in the intestinal lumen

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11
Q

What are the two stimuli for the ductal cells in the pancreas?

A

secretin
ACh

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12
Q

What do secretin and ACh stimulate the ductal cells to do?

A

release bicarbonate and neutralize the pH of the small intestine

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13
Q

What is the function of secretin?

A

➢ cAMP
➢ Phosphorylation of CFTR
➢ increased Cl- conductance
➢ increased HCO3- secretion

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14
Q

Secretin released when pH < ___

A

4.5

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15
Q

What is secreted more in the presence of HCl: secretin or CCK?

A

secretin (ductal cells)

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16
Q

What is secreted more in the presence of soap/fats: secretin or CCK?

A

about equal

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17
Q

What is secreted more in the presence of peptone: secretin or CCK?

A

CCK (acinar cells)

18
Q

What mediates the cephalic and gastric phases of pancreatic secretion?

A

Both phases mediated by vagovagal reflex - low volume, high enzyme secretion (Ach/GRP)

19
Q

What happens during the intestinal phase of pancreatic secretion?

A
  • acid causes the release of secretin which causes increased HCO3- and H2O
  • fats/proteins indirectly cause in increase in CCK through CCK-RP and monitor peptides which then releases enzymes
20
Q

If the pancreatic secretion rate is low what happens to bicarb and Cl?

A

− bicarbonate concentration is low
− chloride concentration is high

21
Q

If the pancreatic secretion rate is high what happens to bicarb and Cl?

A

− bicarbonate concentration is high
− chloride concentration is low

22
Q

Pancreatic juice is hypertonic, hypotonic, or isotonic?

A

isotonic

23
Q

What does cystic fibrosis do to pancreatic function?

A

➢ Abnormal sweat composition.
➢ Decreased pulmonary and pancreatic secretion.
➢ Mendelian autosomal recessive
➢ Defective CFTR:
– Sweat Cl- reabsorption
– Pancreatic duct cell function
– Pulmonary mucus clearance

24
Q

What is pancreatitis?

A

– Acute and chronic
– Trypsin activation causes pain, inflammation
– Chronic disease destroys acini
– Consequences reflect decreased digestive enzyme production

25
Q

What can happen without pancreatic enzymes?

A

− 60% fat not absorbed (steatorrhea)
− 30-40% protein and carbs not absorbed

26
Q

What is the function of the liver?

A

➢Cleansing and storage of blood
➢Metabolism of nutrients
➢Synthesis of proteins
➢Metabolism of hormones
➢Storage of energy, vitamins, iron
➢Excretion of lipid-soluble waste products
➢Marked capacity for cellular regeneration
➢Secretion of bile

27
Q

Cirrhosis increases resistance and produces ____________

A

portal hypertension

28
Q

Increased vascular resistance in the liver can cause _______

A

ascites

29
Q

What is the role of bile salts (acids)?

A
  • Bile salts (acids) and lecithin required for emulsification and absorption (micelles) of dietary fat.
  • Excretion of lipophilic metabolites (bilirubin), excess cholesterol, other waste products, drugs, and toxins
30
Q

What secretes bile salts,cholesterol,
lecithin, bilirubin, many other lipophilic substances?

A

hepatocytes

31
Q

Duct epithelial cells modify primary secretion from pancreas and add…

A

HCO3-

32
Q

Where can bile be transported after being secreted from the liver?

A
  1. Small intestine for fat digestion
  2. Gall Bladder for storage
33
Q

Electrolytes and water reabsorbed or secreted from bile while in Gall Bladder?

A

reabsorbed

34
Q

If someone has a cholecystectomy can they still digest fat?

A

YES
➢ No problems with fat digestion
➢ Bile flow directly into duodenum

35
Q

What hormone stimulates liver ductal secretion via the blood stream?

A

secretin

36
Q

What causes weak contraction of the gallbladder?

A

vagal stimulation

37
Q

What causes gallbladder contraction and relaxation of the sphincter of oddi?

A

CCK

38
Q

What is the enterohepatic circulation of bile salts?

A

➢Substance secreted into bile by hepatocytes.
➢ Delivered to lumen of ileum, then reabsorbed.
➢ Transported to hepatocytes via sinusoids
➢ 94% of bile salts recirculated
➢ Bile salts circulate 17x before lost in feces.

39
Q

What transporter allows for active absorption of bile salts?

A

Apical sodium-dependent bile salt transporter (ASBT)

40
Q

What are bile acid reabsorption inhibitors (BARI)?

A

➢ Drugs that inhibit Bile Recycling
➢ Used to lower LDL levels in blood

41
Q

What are the different types of bile acid reabsorption inhibitors (BARI)?

A
  • bile acid sequestrants (bined to bile salts in lumen and block transport)
  • ASBT inhibitors (new drug that reduces cholesterol levels in ECF)
42
Q

What is low Apical sodium-dependent bile salt transporter (ASBT) activity associated with?

A

➢Crohn’s disease
➢Congenital 1° bile acid malabsorption
➢Idiopathic chronic diarrhea
➢Irritable Bowel Syndrome

PHYS Exam 6 (4 decks)

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