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Physiology III > Lecture 21: The Exocrine Pancreas > Flashcards

Lecture 21: The Exocrine Pancreas Flashcards

1
Q

What are two types of pancreatic glandular tissue

A
  1. Endocrine (ex: islets)
  2. Exocrine (digestive enzymes)
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2
Q

Pancreatic juice is rich in ___ enzymes and ___

A

Digestive, bicarbonate

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3
Q

Pancreatic fluids drain into __

A

Small intestine

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4
Q

Obstruction or inflammation of the pancreatic duct causes ___

A

Pancreatitis

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5
Q

What is the function of the pancreatic juice

A

Neutralize acid from stomach

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6
Q

Describe the pH changes from stomach to duodenum

A

Stomach: 1.5-2
Duodenum: 5-7 (due to pancreatic juices)

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7
Q

How does the ion transport in pancreatic duct cells differ from that of gastric cells

A

Gastric cells producing HCl into stomach and HCO3- into blood resulting in alkaline tide

Pancreatic duct cells secreting HCO3- into lumen and H+ into interstitium

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8
Q

What is the function of amylase

A

Break down glucose polymers

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9
Q

What is the function of lipases

A

Digest triglycerides, phospholipids, and cholesterols

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10
Q

What is the function of proteases

A

Break down proteins to AA, di, tri and oligopeptides

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11
Q

___ cells secrete enzymatic components

A

Acinar cells

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12
Q

What is ecbolic secretion

A

Refers to protein secretion by Acinar cells

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13
Q

___ and ___ cells secrete electrolytes, bicarbonate and water

A

Centroacinar and ductal cells

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14
Q

What is hydroelatic secretion

A

Alkaline and watery secretion from duct cells

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15
Q

__cells modify the pancreatic juice

A

Ductal cells

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16
Q

Ductal cells modify pancreatic juice by removing __ and adding __ to render it more alkaline

A

Remove Cl- and add bicarbonate

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17
Q

Pancreatic secretion of bicarbonate into small intestine is essential for ___

A

Neutralizing gastric acid emptied into small intestine

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18
Q

How is bicarbonate secreted in the pancreatic juice

A

Via Cl/HCO3- exchanger

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19
Q

T or F: water follows bicarbonate in the secretion of pancreatic juice

A

True

*unlike salivary glands that have tight junctions impermeable to water

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20
Q

Composition of pancreatic juice depends on what

A

Rate of secretion/flow rate

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21
Q

At low flow rates __is the main anion ion in pancreatic juice

A

Cl-

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22
Q

At high flow rates __ concentration in pancreatic juice increases

A

Bicarbonate

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23
Q

Elevated levels of ___ stimulate secretory rate

24
Q

___ and ___ stimulate Acinar cells to secrete pro enzymes

A

CCK and gastrin

25
Q

___ stimulates ductal cells to secrete water and bicarbonate

26
Q

___input stimulates both Acinar and ductal cells

27
Q

Describe the steps in stimulation of Acinar cells to production of pro enzymes

A
  1. Small peptides, FA act on I cells
  2. I cells release CCK
  3. CCK and ACH (PNS/vagal) stimulation increases intracellular Ca2+
  4. Phosphorylation of structural and regulatory proteins
28
Q

Describe the steps in stimulation of ductal cells to secrete bicarbonate

A
  1. H+ ions act on S cells
  2. S cells secrete secretin
  3. Secretin drives chloride out of cell and ACh (PNS/vagal) drives HCO3- out and Cl- in (Cl-/HCO3- exchanger)
29
Q

What are the two hormonal and one neural control to stimulate pancreatic secretion

A

Hormonal
1. CCK and gastrin stimulate Acinar cells
2. Secretin stimulates ductal cells

Neural
1. Vagal input stimulates Acinar and ductal cells

30
Q

What % of pancreatic secretion does the intestinal phase control

31
Q

In response to __ and __ in the duodenum CCK is released from __ cells. CCK enters circulation and stimulates ___

A

Fat and amino acids, I cells, Acinar cells

32
Q

In response to __ and __ in stomach gastrin in released from __ cells and stimulates ___

A

Peptides and AA, G cells, Acinar cells

33
Q

ACh, CCK, and gastrin stimulate __ secretion

34
Q

In response to low ___ in the duodenum secretin is released from __ cells. Secretin stimulates __ cell secretion

A

PH, S cells and ductal cells

35
Q

What is the enteropancreatic reflex

A

Peptides and AA stimulating gastrin to act on Acinar cells and fats and amino acids stimulating CCK to act on Acinar cells- form digestive enzymes

Low pH stimulating secretin to secrete bicarbonate to neutralize acidic pH

36
Q

Where are I cells found

A

Duodenum, jejunum and ileum

37
Q

What stimulates I cells

A

Fatty acids and amino acids

38
Q

What is the target for I cells

A

Acinar cells

39
Q

What does CCK do to gallbladder

40
Q

What does CCK do to pancreas

A

Acinar secretion

41
Q

What does CCK do to stomach

A

Reduced gastric emptying

42
Q

What does CCK do to sphincter on bile/pancreatic duct

43
Q

CCK acting on gallbladder, pancreas, stomach and sphincter of bile/pancreatic duct ensures matching of ___

A

Ingesta delivery to digestive/absorptive capacity

44
Q

Where do S cells exist

45
Q

What stimulates S cells

A

Low pH <4.5

46
Q

What is the target of S cells

A

Duct cells

47
Q

Increasing levels of secretin ___secretory flow rate

48
Q

Digestive enzymes are activated in the ___

49
Q

Proenzyme, trypsinogen is cleaved by __

A

Enterokinase

50
Q

Enterokinase cleaves trypinsogen to __ which then does what

A

Trypsin which then activates other pro enzymes

51
Q

Why is proenzyme activation so complex in duodenum

A

Protective mechanism against autodigestion

52
Q

What would be elevated on bloodwork that could indicate pancreatitis

A

Lipase levels

53
Q

What is pancreatitis

A

Inflammation of the pancreas with histological presence of edema, neutrophilic infiltrate and necrosis

54
Q

Describe the difference between normal function of pancreas and then what happens during pancreatitis

A

Normal: pancreatic enzymes activated once in duodenum

Pancreatitis: premature activation of enzymes in pancreatic duct resulting in autodigestion

55
Q

What are two potential causes of pancreatitis

A
  1. Obstruction keep from pancreatic enzymes exiting pancreatic duct and they will eventually activate and autodigest
  2. Spontaneous trypsin cleavage
56
Q

Pancreatitis causes __ and __ due to lack of enzymatic activity which can result in anorexia, lethargy, exercise intolerance/weakness, vomiting, diarrhea, abdominal pain, dehydration, fever, arrhythmia

A

Maldigestion and malabsorption

57
Q

What is the key factor in intiating pancreatic inflammation

A

Activation of trypsin within Acinar cells

Physiology III (34 decks)

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