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Physiology I Block 3 > GI Secretions - intestines & pancreas & biliary > Flashcards

GI Secretions - intestines & pancreas & biliary Flashcards

1
Q

in small and large intestine what cells secrete mucous

A

goblet cells

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2
Q

where is mucous the most thick and strong

A

stomach

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3
Q

what secretes bicarb

A

stomach
duodenum
colon

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4
Q

what is the gland in duodenum that secretes bicarb

A

Brunner’s glands

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5
Q

what activates Brunner’s glands

A

pH

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6
Q

duodenal bicarb secretion is stimulated by

A

prostaglandins

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7
Q

where does chloride secretion occur in small and large intestine

A

crypt glands

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8
Q

what does chloride secretion do

A

promotes water flux to gut

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9
Q

CFTR is dysfunctional in what disorder

A

cystic fibrosis

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10
Q

bacterial toxins can act on second messenger systems and what will that do

A

chloride channel will not work properly, solute concentration builds up water, can make toxigenic diarrhea

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11
Q

NKCC1 stands for

A

NA-K-2Cl transporter

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12
Q

in the small and large intestine what is the major apical chloride channel

A

CFTR

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13
Q

what does CFTR stand for

A

Cystic fibrosis transmembrane conductance regulator

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14
Q

what is the purpose of NACC1?

A

pulls more chloride into cell to make it no longer at equilibrium so that chloride can flow passively out of cell via the apical chloride channels

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15
Q

draw out a cell with intestinal chloride secretion and the chloride channels, as well as bacteria’s role

A

pg 9

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16
Q

pancreas has both ____ and ____ functions

A

exocrine and endocrine

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17
Q

exocrine pancreas secretions are essential for what

A

neutralize gastric acid and digest nutrients

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18
Q

describe the secretion of exocrine pancreas

A

very aqueous, lots of HCO3-, enzymatic component

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19
Q

what is the purpose of the enzymatic portion of exocrine pancreas secretion

A

digest carbohydrates, proteins, and lipids into absorbable molecules

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20
Q

what is an acinus

A

blind end of a branching duct system

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21
Q

exocrine pancreas has acinus, what kind of cells are in it

A

acinar cells

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22
Q

ducts of exocrine pancreas are lined with what cells

A

ductal epithelial cells

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23
Q

what does endocrine pancreas secrete

A

insulin & glucagon

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24
Q

centroacinar and ductal cells in exocrine pancreas secrete

A

aqueous HCO3-

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25
Q

enzymes from exocrine pancreas are secreted by what cells

A

acinar cells

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26
Q

describe how aqueous component of exocrine pancreas is made/secreted

A

secreted by centroacinar cells and modified by ductal cells

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27
Q

where are the enzymes stored in pancreas until a stimulus tells them to be released

A

in zymogen granules

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28
Q

what are the five major pancreatic proteases that are secreted as inactive precursors

A

trypsinogen, chymotrypsinogen, proelastase, procarboxypeptidase A, and procarboxypeptidase B

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29
Q

enterokinase is what kind of enzyme

A

brush border

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30
Q

what activates trypsinogen into active form trypsin

A

enterokinase

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31
Q

draw out the activation of trypsinogen and all the enzymes it makes active

A

pg 17

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32
Q

what do active proteases cleaved by trypsin hydrolyze

A

dietary proteins

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33
Q

active proteases hydrolyze dietary proteins into

A

amino acids, dipeptides, tripeptides, and oligopeptides

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34
Q

out of the amino acids, dipeptides, tripeptides, and oligopeptides that the protease hyrolyzes, what are absorbable?

A

amino acids, dipeptides, and tripeptides

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35
Q

what happens to oligopeptides since they are not absorbable

A

further hydrolyzed by brush border peptides

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36
Q

after the pancreatic proteases have digested the proteins, what do they do

A

digest themselves and each other

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37
Q

what is the tonicity of pancreatic juice

A

isotonic

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38
Q

what salts/ions are in pancreatic aqueous juice

A

Na+
Cl-
K+
HCO3-

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39
Q

where is the Cl- HCO3- exchanger of ductal cells

A

apical (lumen side)

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40
Q

where is the NA+ K+ ATPase exchanger of ductal cells

A

basolateral membrane

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41
Q

where is the Na+ H+ exchanger of ductal cells

A

basolateral membrane

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42
Q

draw out the exchangers in ductal cell

A

pg 18

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43
Q

what is the net result of ductal cell in pancreas

A

secretion of HCO3-

absorption of H+

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44
Q

pancreatic venous blood, describe it’s properites and why

A

it is acidic b/c it accepts the H+ that is absorbed by ductal cell

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45
Q

when flow rate changes, what ion concentrations remain the same in pancreas

A

Na+

K+

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46
Q

when flow rate changes, what ion concentratoins change in pancreas

A

HCO3-

Cl-

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47
Q

at highest pancreatic flow rates, describe concentration of HCO3-

A

it is at it’s highest

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48
Q

at highest pancreatic flow rate, describe concentration of Cl-

A

lowest

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49
Q

at low pancreatic flow rate, describe concentration of HCO3-

A

low

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50
Q

at low pancreatic flow rate, describe concentration of Cl-

A

high

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51
Q

what are the two functions of pancreatic secretion

A

to secrete the enzymes necessary for digestion of carbohydrates, proteins, and lipids and
(2) to neutralize H+ in the chyme delivered to the duodenum from the stomach.

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52
Q

aqueous secretion is stimulated by

A

arrival of H+ in duodenum

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53
Q

enzymatic secretion is stimulated by

A

products of digestion - small peptides, AA, fatty acids

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54
Q

what is the function of the enzymatic secretion

A

secretes enzymes necessary for digestion for carbohydrates, proteins and lipids

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55
Q

what is the function of the aqueous secretion

A

containing HCO3- neutralizes H+ in chyme delivered to duodenum

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56
Q

what does secretin do to pancreatic fluid

A

causes secretion

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57
Q

what does CCK do to pancreatic fluid

A

causes secretion of enzymes

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58
Q

what are the three phases of pancreatic secretion

A

cephalic
gastric
intestinal

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59
Q

what is stimulus for cephalic phase of pancreatic secretion

A

thought of food, smell, taste, chewing, swallowing

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60
Q

what is mediator for cephalic phase of pancreatic secretion

A

ACh and gastrin release via vagus stimulation

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61
Q

what is the pancreatic response to cephalic phase

A

secretion, but especially enzymatic component

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62
Q

what is the stimulus of gastric phase of pancreatic secretion

A

protein in food

gastric distension

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63
Q

what are the mediators of the gastric phase of pancreatic secretion

A

gastrin

ACh

64
Q

what is the pancreatic response to gastric phase

A

increased secretion, but especially enzymatic component

65
Q

intestinal phase accounts for what percentage of pancreatic secretion

66
Q

what is stimulus of intestinal phase of pancreatic secretion

A

digestion products & H+

67
Q

what kind of receptors do pancreatic acinar cells have

A

muscarinic receptors

68
Q

muscarinic receptors of pancreatic acinar cells allow what to bind

69
Q

what is the most important stimulant for enzymatic secretion during intestinal phase

70
Q

what cells secrete CCK

71
Q

pancreatic ductal cells have receptors for what

A

CCK, ACh, and secretin.

72
Q

what cell secretes secretin

73
Q

what is the major stimulant of aqueous HCO3- pancreatic secretion

74
Q

what is nature’s antacid

75
Q

what nerve mediates the gastric phase of pancreatic secretion

A

vagal nerve - vagovagal reflex

76
Q

draw out the cephalic and gastric phase

77
Q

draw out the intestinal phase secretion

78
Q

what are the main functions of the liver

A

Processing of absorbed substances

Synthesis and secretion of bile acids

Bilirubin production and excretion

Participation in metabolism of key nutrients (carbohydrates, proteins, and lipids)

Detoxification and excretion of waste products

79
Q

the common bile duct terminates at the

A

sphincter of oddi

80
Q

where does the sphincter of oddi open

A

duodenal opening

81
Q

what is bile needed for

A

digestion and absorption of lipid in SI

82
Q

what is bile made of

A

bile salts, cholesterol, phospholipids, bile pigments, ions, and water

83
Q

bile is produced and secreted by the

84
Q

bile is stored in the

A

gall bladder

85
Q

where is bile ejected to

A

lumen of small intestine

86
Q

bile salts emulsify lipids into packets called

87
Q

what are the components of the biliary system

A

liver, gallbladder and bile duct, duodenum, ileum, and portal circulation

88
Q

the gall bladder stores bile and does what else to it

A

concentrates it

89
Q

what does CCK do to biliary system

A

stimulates contraction of gall bladder & relaxation of sphincter of oddi

90
Q

when lipid absorption is complete what happens to bile salts

A

recircultaed to liver via enterohepatic circulation

91
Q

what is the purpose of bile being recirulated to liver

A

liver doesn’t have to produce a ton of new bile

92
Q

draw out the flow of bile

93
Q

what happens regarding bile in people who have had ileal resection

A

recirculation of bile salts to liver is interrupted and large amounts of bile salts are excreted in feces

94
Q

what is ultiamate result of people who have had ileal resection

A

impaired absorption of dietary lipids and steatorrhea (fat in stool).

95
Q

can liver keep producing enough bile in pts who have had ileal resection

96
Q

what cell secretes bile

A

hepatocytes

97
Q

hepatocytes synthesize what two primary bile acids

A

cholic acid and chenodeoxycholic acid.

98
Q

when primary bile acids are secreted into lumen of intestine, what happens to them

A

a portion of them are dehydroxylated by bacteria to produce secondary bile acids

99
Q

what are the two secondary bile acids

A

deoxycholic acid and lithocholic acid.

100
Q

what is the bile salt pool

A

includes bile salts in the liver, bile ducts, gallbladder, and intestine

101
Q

what amino acids are used to make bile salts

A

glycine or taurine

102
Q

how does liver make bile salt

A

conjugates the bile acids with the amino acids glycine or taurine

103
Q

what is the function of creating the bile salts

A

1.emulsify

2 solubulize dietary lipids (they are very water soluble) -

104
Q

what is the critical property of bile salts

A

amphipathic

105
Q

what doe amphipathic mean

A

have hydrophilic and hydrophobic part

106
Q

surface of micelle is lined with

A

bile salts

107
Q

phospholipid property

A

amphipathic

108
Q

what is function of phoshpolipid being secreted in bile

A

helps bile salts form micelle

109
Q

what is the major bile pigment

110
Q

cells of what system degrade hemoglobin to make bilirubin

A

reticuloendothelial

111
Q

how is bilirubin carried in blood

A

bound to albumin

112
Q

liver extracts bilirubin in blood and does what with it

A

conjugates it with glucuronic acid

113
Q

when liver conjugates bilirubin with glucuronic acid what does it form

A

bilirubin glucuronide

114
Q

what accounts for biles yellow color

A

bilirubin glucuronide

115
Q

what is steatorrhea

A

fat in stool

116
Q

bile is made up of 50%

A

bile salts

117
Q

draw out cholsterol into primary and then secondary bile acids

118
Q

draw out bilirubin metabolism

119
Q

in the intestine, bilirubin glucorunide is turned into

A

back to bilirubin

120
Q

what does secretin do to bile ducts

A

stimulates ion and water secretion

121
Q

what are the three functions of the gall bladder

A

store bile
concentrates bile
ejects bile

122
Q

compare hepatic bile vs. gallbladder bile
include percentage of solids
bile salts
pH

123
Q

what is the major stimulus for ejection of bile

124
Q

what is the effect of CCK on gall bladder

A

relaxation of sphicnter of oddi

contraction of gall baldder

125
Q

how is bile ejected from gall bladder

A

spurts, not a steady stream

126
Q

how does duodenum contracts effect bile ejection from gall bladder

A

when duodenum is contracted pressure is too high and gall bladder cannot eject
when duodenum is relaxed, bile is ejected

127
Q

what are the two types of gall stones

A

cholesterol stones

pigment stones

128
Q

how do cholesterol stones form

A

obeses pts: too much cholesterol.
other pts; phospholipids and bile salts too low
too much cholesterol → crystals

129
Q

pigments stones are made from

A

precipitates (solids) of unconjugated:

biliribuin with calcium

130
Q

what is cholestasis

A

decreased bile flow

131
Q

if stones get stuck in bile duct what happens

A

decreased bile flow and jaundice

132
Q

what are the causes of gall stones

A

too much absorption of water from bile
too much absorption of bile acids from bile
too much cholesterol
inflammation of epithelium

133
Q

enterokinase is released from

A

intestinal epithelial cells

134
Q

pancreatic juice is an isotonic solution containing

A 
Na+
Cl-
K+
HCO3-
enzymes
135
Q

chloride bicarb exchanger is stimulated when

A

when you have a meal

136
Q

chloride bicarb exchanger does what

A

brings chloride in, secretes bicarb into lumen of ductal area

137
Q

why is sodium potassium pump on basolateral side

A

sodium comes through secondary active transport mechanisms and then sodium builds up its electrical chemical gradient and has to be pumped to basolateral side (?)

138
Q

the only major transporter in apical membrane of epithelial cell that modifies pancreatic juice

A

chloride bicarb exchanger

139
Q

why doesn’t sodium and potassium change their concentrations if eat or fast

A

they don’t have exchangers to make a difference in their levels

140
Q

what hormone stimulates bicarb secretion

141
Q

gastric phase for pancreatic secretion is not

A

a major phase

142
Q

what are the main phases for pancreatic secretion

A

cephalic & intestinal

143
Q

what cells release secretin

144
Q

where are S cells

A

intestines

145
Q

what cells release CCK

146
Q

where are I cells

147
Q

cck acts on acinar cells to release

148
Q

cck acts on vagus nerve and stimulates

A

vagovago reflex - which will go to acinar cells

149
Q

gastrin release is mostly in

150
Q

hydrogen stimulates what cells in intestinal phase

151
Q

if there’s a problem in duodenum there will be problem with secretion in

A

CCK

secretin

152
Q

where is pepsinogen released?

A

chief cells in stomach

153
Q

how are acinar cells simtulated, what pathway

154
Q

bile acids are _____ soluble

155
Q

every time there is contraction what happens to pressure in duodenum

A

it goes up, which is greater than gall bladder so stops it from leaving gall bladder

Physiology I Block 3 (14 decks)

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