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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
Q

What effect does the liver have on regulating blood glucose?

A

acts as glycogen storage depot

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26
Q

What effect does the liver have on vascular volume?

A

blood reservoir and albumin synthesis

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27
Q

Where do the following take place?

Detox & Conjugation

Cholesterol metabolism

plasma protein synth

digestion and absorption of fat

A

The Liver

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28
Q

Bile is produced in the _____, stored in the ____ and secreted into the _____

A

product of liver

stored in gallbladder

secreted to small intestine

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29
Q

What are three effects of bile?

A

fat emulsification/digestion

transport and elimination of cholesterol

fat absorption

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30
Q

2 sources of blood flow to the liver…

A

hepatic portal system and hepatic artery

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31
Q

The _______ drains the intestines to carry metabolic products of food to the liver for processing…

A

the portal system

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32
Q

The _____ supplies the liver with oxygenated blood.

A

hepatic artery

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33
Q

what are the fundamental units of the liver?

A

lobules

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34
Q

Lobules contain what two important features?

A

central vein, portal space

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35
Q

what 3 structures are contained in a lobular portal space?

A

hepatic portal vein, hepatic artery, bile duct

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36
Q

What is the low resistance pathway in the liver?

A

GI to portal vein to sinusoids to central vein to vena cava

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37
Q

The sinusoidal endothelium is permeable to proteins due to…

A

large fenestrations

38
Q

Which liver cells are phagocytic?

A

kupffer cells

39
Q

Are bile canaliculi part of sinusoids?

A

no

40
Q

Bile canaliculi are separated from sinusoids by…

A

tight junctions

41
Q

Materials entering canaliculi must pass through what structure?

A

hepatocyte

42
Q

What are the four components of bile and in what percent?

A

bile salts 50%
phospholipids 40%
cholesterol 4%
bile pigments 2%

43
Q

are bile salts and acids amphipathic?

A

yes

44
Q

Bile acids and salts are synthesized by ______ from what precursor?

A

synth in hepatocytes from cholesterol

45
Q

Synth. of new bile acids depends on what factor?

A

amount of bile salts returned to liver via enterohepatic circ.

46
Q

The body pool of bile salts is tightly regulated at…

A

2-4 g

47
Q

What are the three basic steps of bile salt production?

A

primary to secondary to conjugated

48
Q

Primary bile salts begin in the liver as…

A

cholic and chenodeoxycholic acids

49
Q

Cholic and chenodeoxycholic acids become secondary bile salts via…

A

bacterial beta dehydroxylase

50
Q

What are the two secondary bile salts?

A

deoxycholic and lithocholic acid

51
Q

conjugation of secondary bile salts lowers pK from…

A

7 to < 4

52
Q

What two substances conjugate bile salts?

A

glycine or taurine

53
Q

What is the pH of bile satls?

A

3-5

54
Q

Conjugated bile salts are more soluble at what pH?

A

physiologic pH

55
Q

What constituent of bile has the following characteristics?

no recirculation

amphipathic, not water soluble

soluble in bile salts

20-40% of bile

A

phospholipids

56
Q

What is the function of phospholipids in bile salts?

A

increase ability to solubilize cholesterol

57
Q

What constituent of bile has the following characteristics?

Dietary and hepatocyte origin

much is excreted, but can be reabsorbed

may be recirculated

A

cholesterol

58
Q

What is the most important bile pigment?

A

bilirubin

59
Q

bilirubins makeup what percent of bile?

A

2%

60
Q

What are bile pigments derived from?

A

porphyrins from senescent RBCs

61
Q

What carries bile pigments in the blood?

A

albumin

62
Q

The liver removes bilirubin from the blood and conjugates it to…

A

glucuronic acid

63
Q

What gives bile its yellow color?

A

bilirubin glucuronide

64
Q

What bile pigment gives urine its yellow color?

A

urobilin

65
Q

what gives feces its brown color?

A

stercobilin

66
Q

Which type of jaundice?

-excessive RBC breakdown

A

prehepatic/hemolytic

67
Q

Which type of jaundice?

-diseased liver

A

hepatic

68
Q

What type of jaundice?

-blockage of bile duct

A

Post-hepatic/obstructive

69
Q

What causes prehepatic/hemolytic jaundice…

A

pernicious anemia, infancy

70
Q

what causes hepatic jaundice?

A

cirrhosis, gilbert’s

71
Q

What causes post-hepatic/obstructive jaundice?

A

gallstones, pancreatic CA

72
Q

Bile acids aid fat digestion in what two ways?

A

emulsification/detergent action

micelle formation

73
Q

What is the purpose of emulsification of lipids by bile?

A

increased surface area available for pancreatic lipase

74
Q

These are small (50 A) amphipathic aggregations

A

micelles

75
Q

Micelles are amphipathic… the hydrophilic portion faces the _______ and the hydrophobic faces…

A

hydrophilic - aqueous environment

hydrophobic: interior

76
Q

What are two functions of micelles

A

act as lipid shuttles

increase lipid solubility in chyme

77
Q

Bile flows from the liver to the gallbladder for what to occur?

A

concentration

78
Q

What contracts to prevent bile flow into the duodenum in the interdigestive period?

A

sphincter of oddi

79
Q

During the digestive phase, the _______ contracts and the _______ relaxes

A

gallbladder contracts

sphincter of oddi relaxes

80
Q

What stimulates bile secretion and for how long?

A

CCK as long as it is present

81
Q

what occurs with 98% efficiency to minimize loss of bile salts in feces?

A

reuptake/resecretion

82
Q

How many cycles do bile salts go through per day?

A

6-10

83
Q

Bile salts are absorbed via ______ in the ileum

A

Na+ co-transport

84
Q

Synthesis of new bile salts is _______ related to salt reabsorption

A

inversely related

85
Q

what is responsible for the inverse relationship between bile salt reabsorption and sythesis?

A

cholesterol 7-alpha-hydroxylase inhibition in presence of bile salts

86
Q

Ileal resection has what effect on reuptake?

A

greatly reduced

87
Q

85% of gallstones are what type?

A

cholesterol

88
Q

What are three factors that favor gallstone formation?

A

bile stasis, cholesterol supersaturation, nucleating factors

89
Q

E. Coli may initiate or perpetuate gallstones by producing…

A

beta-glucuronidase

90
Q

What does e. coli beta-glucuronidase do to bile pigments?

A

deconjugates them to favor stone formation

91
Q

What two tests are available for gallstone dx?

A

US and CT with iodine anion dyes

Physiology II (28 decks)

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