Lecture 42 - The Pancreas

Question 1

fat is assimilated into ____ for delivery to ____

Answer 1

micelle; small intestine

Question 2

what are the functions of the pancreas

Answer 2

1. endocrine
2. exocrine
3. secretion of water, Na+, HCO3-, and Cl-

Question 3

what hormones are produced by the pancreas

Answer 3

1 insulin
2. glucagon
3. somatostatin
4. pancreatic polypeptide

Question 4

what are the exocrine products of the pancreas

Answer 4

digestive enzymes

Question 5

what is the anatomy of the pancreas

Answer 5

lobulated, thin, elongated organ

Question 6

how are pancreatic enzymes delivered to the GI tract

Answer 6

through duct system ( [accessory] pancreatic duct) and opening into major/minor papilla

Question 7

T/F: the pacreatic duct is most important in cats whereas the accessory duct is most important in dogs

Answer 7

TRUE

Question 8

describe the pancreatic duct in cats and what their specific anatomy predisposes them to

Answer 8

duct fuses with common bile duct before entering the duodenum which predisposes them to inflammatory disease of the intestine, pancreas, and biliary tree (triaditis)

Question 9

what is the consequence of pancreatitis in the:

duodenum

Answer 9

intestinal inflammation, melena, V+

Question 10

what is the consequence of pancreatitis in the:

greater curvature

Answer 10

V+, gastric ulcers, hematemesis

Question 11

what is the consequence of pancreatitis in the:

transverse colon

Answer 11

large bowel D+, hematochezia

Question 12

what is the consequence of pancreatitis in the:

peritoneum

Answer 12

abdominal pain, effusion

Question 13

what is the consequence of pancreatitis in the:

liver/common bile duct

Answer 13

hepatocellular damage, stasis of bile

Question 14

what is the histology of the pancreas

Answer 14

1. Islet of Langerhans (polygonal cells)
2. Acini

Question 15

what produces insulin? what is the action?

Answer 15

beta cells
lower blood glucose

Question 16

what produces glucagon? what is the action?

Answer 16

alpha cells
increase blood glucose

Question 17

what produces somatostatin? what is the action?

Answer 17

D cells
inhibit secretions

Question 18

what produces pancreatic polypeptide? what is the action?

Answer 18

F cells
reduce secretions and appetite

Question 19

acinar cells do what

Answer 19

produce enzymes
stimulated by CCK and acetylcholine

Question 20

what activates all digestive enzymes

Answer 20

trypsin

Question 21

T/F: digestive enzymes are synthesized and secreted as inactive precursors

Answer 21

TRUE

Question 22

T/F: the pancreas makes enzymes that only diagnose protein and fats

Answer 22

FALSE - all diet components

Question 23

in exocrine pancreatic insufficiency, the trypson-like immunoreactivity test is ____

Answer 23

decreased

Question 24

pancreatitis can be indicated by ____ lipase

Answer 24

increased

Question 25

what converts trypsinogen to trypsin

Answer 25

enteropeptidase

Question 26

pancreatic enzymes are digested ____, while brush border enzymes are digested ____

Answer 26

intraluminally; at surface

Question 27

summarize nutrient breakdown

Answer 27

1. lumen enzymes 2. brush border enzymes 3. nutrient transporters 4. intracellular!!!

Question 28

what are the 4 reasons the pancreas does not digest itself

Answer 28

1. enzymes are synthesized as inactive zymogens 2. zymogens are packaged in granules 3. in granules there is a trypsin inhibitor 4. activating enyme found in GI tract

Question 29

the control of pancreatic secretion is both ____ and _____ mediated

Answer 29

neurally, hormonally

Question 30

the cephalic, gastric, and intestinal phase stimulates the

Answer 30

vagus nerve

Question 31

what phase of digestion secretes CCK and secretin

Answer 31

intestinal phase

Question 32

gastric motility is inhibited by what hormone

Answer 32

secretin

Question 33

____ entering the proximal duodenum reults in the release of CCK

Answer 33

lipids

Question 34

gallbladder contraction is mediated by

Answer 34

CCK

Question 35

secretion of bicarbonate-rich fluid by the pancreatic duct does what

Answer 35

1. neutralizes gastric pH 2. provides optimal pH for pancreatic and brush border enzyme function 3. increase solubility of bile and fatty acids

Question 36

why does vomiting cause metabolic alkalosis

Answer 36

patient vomits acidic content so H+ ions. do not trigger bicard production

Question 37

what is required for B12 absorption

Answer 37

intrinsic factor

Question 38

summarize B12 absorption

Answer 38

1. B12 binds to intrinsic factor 2. intrinsic-B12 complexes are recognized by receptors on apical membrane of ileum epithelium 3. transport to blood strea

Question 39

T/F: Intrinsic factor in the dog is made in the stomach and pancreas

Answer 39

TRUE

Question 40

what are the 3 causes of B12 deficiency

Answer 40

1. exocrine pancreatic insufficiency (cats -failure to make intrinsic factor) 2. small intestinal bacterial overgrowth (bacteria consume B12) 3. malabsorptive disease of the ileum (failure to absorb B12)