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Practice Topics Exam 5 > GI Physiology 4 > Flashcards

GI Physiology 4 Flashcards

1
Q

Pancreatic secretions have what roles

A

Protective roles - HCO3 and mucus

Digestive roles - Enzymes

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2
Q

Cells of the pancreas include

A

Acinar cells
Duct cells
Goblet cells

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3
Q

Cells of the pancreas - Acinar cells

A

Protein synthesizing cell
Secretion of digestive enzymes
Secrete fluid

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4
Q

Cells of the pancreas - Duct cells

A

HCO3 secretion (important protective role)
Ion transport
Fluid transport

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5
Q

Cells of the pancreas - Goblet cells

A

Mucin secretion

- lubricates, hydrates, protects, and gives immune function

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6
Q

Pancreatic digestive enzymes - Inactive includes (one important one)

A

Trypsinogen

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7
Q

Pancreatic digestive enzymes - Active includes (4 important ones)

A

Alpha amylase
Lipase
Colipase
Trypsin inhibitor

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8
Q

Pancreatic digestive enzymes - Trypsinogen Function

A

INACTIVE
Functions in protein digestion
We do not want to initiate protein digestion in the pancreas (we want to wait until duodenum)

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9
Q

Pancreatic digestive enzymes - Alpha amylase Function

A

ACTIVE

Carb digestion

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10
Q

Pancreatic digestive enzymes - Lipase Function

A

ACTIVE

Lipid digestion

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11
Q

Pancreatic digestive enzymes - Colipase Function

A

ACTIVE

Lipid digestion

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12
Q

Pancreatic digestive enzymes - Trypsin Inhibitor

A

Inhibits trypsin

If we do not inhibit trypsin and protein digestion starts in pancreas, damage will occur

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13
Q

Stimulation of enzyme and fluid secretion - Key stimuli for secretion of fluid and enzymes

A

CCK and Ach
They promote Ca influx and promote docking of enzymes containing vesicles at the apical membrane
As you inc conc of CCK, you get inc in release of the enzymes

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14
Q

Multiple roles of CCK in the pancreas to include

A

CCK acts on the pancreas with reduces gastric emptying and stimulates acinar cells

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15
Q

Protection against and activation of digestive enzymes

A

Secretions of the pancreas can be very destructive so many of the digestive enzymes are inactive
Vesicles contain trypsin inhibitor
Low pH of vesicle prevents enzyme activation

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16
Q

How do we protect pancreas from its own secretions?

A

By making the proteases in the inactive form and keep the pH low in the vesicles
Trypsin inhibitor is there too just in case

17
Q

Activation of enzymes in the____

A

DUODENUM
The on switch is located in the duodenum
When the enzymes empty into the duodenum, Entero Peptidase converts trypsinogen to trypsin and once you have a few molecules of trypsin they can go on to activate the other proteases

18
Q

Duodenal Protection - Pancreas also functions to protect the

A

duodenum from the acid being emptied from the stomach to the duodenum

19
Q

Duodenal protection - how does the pancreas protect it?

A

Acid come in, the duodenum senses it and releases secretin which stimulates the pancreatic ducts to release HCO3 which is important in protection

20
Q

When you hear secretin think

A

GI PROTECTION

21
Q

Duodenal protection - Negative regulation of acid secretion by secretin

A

Inc release of somatostatin
Dec gastrin secretion
Dec proton pump expression

22
Q

Phase of pancreatic secretion - interdigestive - Pancreatic secretions during the interdigestive period parallel the _______
Therefore _____
Secretion is highest during ____

A

migrating motor complexes
Therefore, pancreatic secretions parallel motility
Secretion is highest during intestinal contractility

23
Q

Phase of pancreatic secretion - interdigestive - Regulators of the cyclical pattern include

A

Stimulation by the PNS and CCK

Inhibition by alpha adrenergic input, somatostatin, and peptide YY (at the distal end of SI)

24
Q

Phase of pancreatic secretion - interdigestive - During the “fed” state, there is a __ fold (inc/dec) in pancreatic secretions

A

5-20 fold INCREASE

25
Q

Phase of pancreatic secretion - interdigestive - The spike in secretion during the “fed” state is primarily regulated by

A

CCK

However multiple signals inc pancreatic secretions

26
Q

Phase of pancreatic secretion - interdigestive - during “fed” state, pancreatic secretions inc. What brings them back to basal levels

A

Peptide YY and somatostatin play important roles in returning the pancreatic secretion levels back to basal

27
Q

Phases of pancreatic secretion

A

Cephalic
Gastric
Intestinal

28
Q

Phases of pancreatic secretion - Cephalic

Stimulant?
Regulation pathway?
% max enzyme secretion

A

Stimulant = sight, smell, taste, mastication

Regulation pathway = Vagal pathways

% Max enzyme secretion = 25%

29
Q

Phases of pancreatic secretion - Gastric

Stimulant?
Regulation pathway?
% max enzyme secretion

A

Stimulant = Distention, gastrin, peptides/peptones

Regulation pathway = Vagal/Gastrin

% Max enzyme secretion = 10-20%

30
Q

Phases of pancreatic secretion - Intestinal

Stimulant?
Regulation pathway?
% max enzyme secretion

A

Stimulant = Amino acids, fatty acids, H+

Regulation pathway = CCK, Secretin, Enteropancreatic reflexes

% Max enzyme secretion = 50-80%

31
Q

Phases of pancreatic secretion - greatest amount in what phase

A

Intestinal

Stimulated by nutrients (mainly fatty acids) which lead to release of CCK

32
Q

Key regulators of pancreatic secretions - what are the primary nutrient regulators

A

Lipids or fatty acids are the primary nutrient regulators of pancreatic secretion

Lipids in the duodenum induce the release of CCK from I cells

33
Q

Key regulators of pancreatic secretions - Others (besides nutrients)

A

Vagal stimulation

Gastric acid

34
Q

Key regulators of pancreatic secretions - Others - Vagal stimulation - how?

A

Promotes the release of both pancreatic enzymes from acinar cells and HCO3 from duct cells

35
Q

Key regulators of pancreatic secretions - Others - Gastric acid - How?

A

Promotes the release of secretin from duodenal S cells

Secretin will stimulate the duct cell to secrete HCO3

36
Q

Pancreatitis - define

A

Inflammation of the pancreas

37
Q

Pancreatitis - Common causes

A

Alcohol, gallstones, hypertriglyceridemia, blunt abdominal trauma, antimetabolites, estrogen, tetracylcine, HIV meds, or postoperatively

38
Q

Pancreatitis - Description

A

Generally 3 phases
1 Initial - intrapancreatic digestive enzyme activation and acinar cell damage
2 Intrapancreatic inflammation
3 Proteolytic enzyme and cytokines effect distant organs

39
Q

Pancreatitis - Consequences

A

Can range from mild, acute pancreatic complications to chronic and irreversible pancreatic damage

Practice Topics Exam 5 (13 decks)

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