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Physiology II > GI: Pancreas, Liver, Gallbladder > Flashcards

GI: Pancreas, Liver, Gallbladder Flashcards

1
Q

The pancreas has ___% exocrine function and ___% endocrine.

A

90% exocrine, 10% endocrine

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2
Q

The exocrine pancreas is organized similarly to…

A

salivary glands

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3
Q

Secretions from exocrine pancreas come from what cell types?

A

acinar and duct cells

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4
Q

What are 2 main functions of pancreatic juice?

A

neutralize acid, provide enzymes for digestion

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5
Q

Where does acid neutralization occur, and via what substance?

A

bicarb secretion to duodenum

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6
Q

What pH is optimal for most intestinal enzymes?

A

7

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7
Q

What are three major classes of enzymes in pancreatic juice?

A

amylase, lipase, protease

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8
Q

What cell type secretes the enzymatic component of pancreatic juice?

A

acinar cells

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9
Q

What cell types secrete the aqueous fraction of pancreatic juice? (electrolytes and bicarb)

A

ductal and centroacinar cells

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10
Q

What modification to pancreatic juice do ductal cells undertake?

A

remove Cl- and add bicarb

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11
Q

As flow rate of pancreatic juice secretion increases, _____ increases in conc. and _____ decreases in conc.

A

bicarb increases, chloride decreases

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12
Q

During the cephalic phase, aqueous secretion is what percent of max?

enzyme secretion is what percent of max?

A

aqueous 10-15% of max

enzyme 20% of max

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13
Q

What stimulates the secretion of pancreatic juices during the cephalic phase?

A

PNS ACh stimulation

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14
Q

What two factors modify enzyme secretion during the gastric phase?

A

gastric distension and gastrin

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15
Q

the _____ phase controls 80% of pancreatic secretion.

A

intestinal phase

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16
Q

What three substances stimulate duodenal I cells and S cells?

A

H+, fat, peptides

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17
Q

Duodenal I cells secrete…

A

CCK

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18
Q

Duodenal S cells secrete…

A

Secretin

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19
Q

Byproducts influence pancreatic activity by what mechanism?

A

hormonal mechanisms

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20
Q

CCK is released from I cells in response to what two components of duodenal chyme?

A

fatty acids and amino acids

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21
Q

CCK travels to the pancreas via…

A

circulatory system

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22
Q

CCK has what effect on which pancreatic cell types?

A

stimulates acinar cell enzyme secretion

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23
Q

Secretin is released from _____ cells in response to what?

A

released from S cells

response to duodenal H+

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24
Q

Secreten has what effect on ductal cells in the pancreas?

A

increase aqueous pancreatic juice (bicarb)

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25
What effect does the liver have on regulating blood glucose?
acts as glycogen storage depot
26
What effect does the liver have on vascular volume?
blood reservoir and albumin synthesis
27
Where do the following take place? Detox & Conjugation Cholesterol metabolism plasma protein synth digestion and absorption of fat
The Liver
28
Bile is produced in the _____, stored in the ____ and secreted into the _____
product of liver stored in gallbladder secreted to small intestine
29
What are three effects of bile?
fat emulsification/digestion transport and elimination of cholesterol fat absorption
30
2 sources of blood flow to the liver...
hepatic portal system and hepatic artery
31
The _______ drains the intestines to carry metabolic products of food to the liver for processing...
the portal system
32
The _____ supplies the liver with oxygenated blood.
hepatic artery
33
what are the fundamental units of the liver?
lobules
34
Lobules contain what two important features?
central vein, portal space
35
what 3 structures are contained in a lobular portal space?
hepatic portal vein, hepatic artery, bile duct
36
What is the low resistance pathway in the liver?
GI to portal vein to sinusoids to central vein to vena cava
37
The sinusoidal endothelium is permeable to proteins due to...
large fenestrations
38
Which liver cells are phagocytic?
kupffer cells
39
Are bile canaliculi part of sinusoids?
no
40
Bile canaliculi are separated from sinusoids by...
tight junctions
41
Materials entering canaliculi must pass through what structure?
hepatocyte
42
What are the four components of bile and in what percent?
bile salts 50% phospholipids 40% cholesterol 4% bile pigments 2%
43
are bile salts and acids amphipathic?
yes
44
Bile acids and salts are synthesized by ______ from what precursor?
synth in hepatocytes from cholesterol
45
Synth. of new bile acids depends on what factor?
amount of bile salts returned to liver via enterohepatic circ.
46
The body pool of bile salts is tightly regulated at...
2-4 g
47
What are the three basic steps of bile salt production?
primary to secondary to conjugated
48
Primary bile salts begin in the liver as...
cholic and chenodeoxycholic acids
49
Cholic and chenodeoxycholic acids become secondary bile salts via...
bacterial beta dehydroxylase
50
What are the two secondary bile salts?
deoxycholic and lithocholic acid
51
conjugation of secondary bile salts lowers pK from...
7 to < 4
52
What two substances conjugate bile salts?
glycine or taurine
53
What is the pH of bile satls?
3-5
54
Conjugated bile salts are more soluble at what pH?
physiologic pH
55
What constituent of bile has the following characteristics? no recirculation amphipathic, not water soluble soluble in bile salts 20-40% of bile
phospholipids
56
What is the function of phospholipids in bile salts?
increase ability to solubilize cholesterol
57
What constituent of bile has the following characteristics? Dietary and hepatocyte origin much is excreted, but can be reabsorbed may be recirculated
cholesterol
58
What is the most important bile pigment?
bilirubin
59
bilirubins makeup what percent of bile?
2%
60
What are bile pigments derived from?
porphyrins from senescent RBCs
61
What carries bile pigments in the blood?
albumin
62
The liver removes bilirubin from the blood and conjugates it to...
glucuronic acid
63
What gives bile its yellow color?
bilirubin glucuronide
64
What bile pigment gives urine its yellow color?
urobilin
65
what gives feces its brown color?
stercobilin
66
Which type of jaundice? -excessive RBC breakdown
prehepatic/hemolytic
67
Which type of jaundice? | -diseased liver
hepatic
68
What type of jaundice? | -blockage of bile duct
Post-hepatic/obstructive
69
What causes prehepatic/hemolytic jaundice...
pernicious anemia, infancy
70
what causes hepatic jaundice?
cirrhosis, gilbert's
71
What causes post-hepatic/obstructive jaundice?
gallstones, pancreatic CA
72
Bile acids aid fat digestion in what two ways?
emulsification/detergent action micelle formation
73
What is the purpose of emulsification of lipids by bile?
increased surface area available for pancreatic lipase
74
These are small (50 A) amphipathic aggregations
micelles
75
Micelles are amphipathic... the hydrophilic portion faces the _______ and the hydrophobic faces...
hydrophilic - aqueous environment hydrophobic: interior
76
What are two functions of micelles
act as lipid shuttles increase lipid solubility in chyme
77
Bile flows from the liver to the gallbladder for what to occur?
concentration
78
What contracts to prevent bile flow into the duodenum in the interdigestive period?
sphincter of oddi
79
During the digestive phase, the _______ contracts and the _______ relaxes
gallbladder contracts sphincter of oddi relaxes
80
What stimulates bile secretion and for how long?
CCK as long as it is present
81
what occurs with 98% efficiency to minimize loss of bile salts in feces?
reuptake/resecretion
82
How many cycles do bile salts go through per day?
6-10
83
Bile salts are absorbed via ______ in the ileum
Na+ co-transport
84
Synthesis of new bile salts is _______ related to salt reabsorption
inversely related
85
what is responsible for the inverse relationship between bile salt reabsorption and sythesis?
cholesterol 7-alpha-hydroxylase inhibition in presence of bile salts
86
Ileal resection has what effect on reuptake?
greatly reduced
87
85% of gallstones are what type?
cholesterol
88
What are three factors that favor gallstone formation?
bile stasis, cholesterol supersaturation, nucleating factors
89
E. Coli may initiate or perpetuate gallstones by producing...
beta-glucuronidase
90
What does e. coli beta-glucuronidase do to bile pigments?
deconjugates them to favor stone formation
91
What two tests are available for gallstone dx?
US and CT with iodine anion dyes

Physiology II (28 decks)

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