Lecture 5: Gastric, Pancreatic, Bile Secretions Flashcards
What are the direct paths of vagal stimulation?
Vagus nerve -> Parietal cells -> ACh -> HCl
Vagus nerve -> GRP -> G Cells
What are the indirect paths of vagal stimulation
Rest of G cell path
Gastrin from G cells -> Systemic circulation -> HCl from parietal cells
Which pathway will atropine block?
Vagus nerve -> Parietal cells -> ACh -> HCl
Why will atrophne not block HCl secretion completely?
Only affecting 1 of 3 pathways
Name the phases of gastric HCl secretion
Cephalic, gastric, intestinal
Which phase accounts for 30% of total HCl?
Cephalic
Which phase accounts for 60% of total HCl?
Gastric
Which phase accounts for 10% of total HCl?
Intestinal
What are stimuli for the cephalic phase?
Smelling, tasting, chewing, swallowing, conditioned reflexes
What are the mechanisms to promote HCl secretion in the cephalic phase?
Direct stimulation of parietal cells by vagus nerve
Indirect stimulation via gastrin
What are the stimuli for the gastric phase?
Distention of stomach and presence of AA and peptides
What are the mechanisms to promote HCl secretion in gastric phase?
- Distention -> Vagal nerve stimulation -> Parietal cells
- Indirect via gastrin
- Distention of antrum -> Local reflexes -> Gastrin release
- AA + Peptides -> G cells -> Gastrin
What is the intestinal phase stimulated by?
Products of protein digestion
What is the intestinal phase stimulated by?
Products of protein digestion
When is HCl secretion inhibited (why is it no longer needed)
No longer needed for conversion of pepsinogen to pepsin
Decreased what of gastric contents inhibits HCl secretion?
pH
How does somatostatin directly inhibit HCl secretion?
Binds parietal cells and antagonizes histamine pathway by decreasing cAMP
How does somatostatin indirectly inhibit HCl secretion?
Inhibits both histamine and gastrin release
How do prostaglandins antagonize histamine in the inhibition of HCl secretion?
Reducing cAMP
What are the barriers to acid and pepsin damage to gastric mucosa?
Bicarbonate and mucus
What is peptic ulcer disease?
Ulcerative lesion of gastric or duodenal mucosa
Name the causes of peptic ulcer disease
Could be 1 or both:
Loss of mucus
Excessive H+ and pepsin secretion
Why do gastric ulcers form?
Because mucosal barrier is defective, so H+ and pepsin digest mucosa
Why do duodenal ulcers form?
Occur when H+ secretory rate higher than normal, overwhelm buffering capacity of pancreas
What is the SNS innervation of the exocrine pancreas?
Celiac and superior mesenteric plexuses
What is the PNS innervation of the exocrine pancreas?
Vagal nerve
What effect does PSNS stimulation have on exocrine pancreas?
Stimulates secretion
What effect does SNS stimulation have on exocrine pancreas?
Inhibits secretions
Name the two components of pancreatic secretions
Enzymatic component
Aqueous component
What is the enzymatic component of pancreatic secretions responsible for digesting?
Carbs, proteins, lipids
Where are the enzymes of pancreatic secretion synthesized?
Rough ER of acinar cells
Where are the enzymes of pancreatic secretion stored?
On zymogens
What form are amylase and lipases secreted by pancreas?
Active
What form are proteases secreted by pancreas?
Inactive (known as zymogens)
Pancreatic juice is ______
Isotonic
What does pancreatic juice contain
Na, Cl, K, HCO3
What cell produces initial aqueous component of pancreas secretion?
Centroacinar and ductal cells
What cell modifies the secretion of pancreatic juice?
Ductal cells
For pancreatic secretions, where does HCO3 go, and where does H+ go?
HCO3 goes to lumen
H+ goes to blood
What transports are on the luminal membrane?
HCO3/Cl exchanger
What transports are on the basolateral membrane?
Na/K ATPase
Na/K Exchanger
How do Na+ and K+ concentrations in pancreatic juice compare to plasma?
Similar
The concentrations of Cl and HCO3 of pancreatic juice…
Vary with flow rate
T/F: The concentrations of Na+ and K+ in plasma vary with flow rate
False
At high flow rates HCO3 concentration
Increases
At low flow rates HCO3 concentration
Decreases
At high flow rates Cl concentration
Decreases
At low flow rates Cl concentration
Increases
At high flow rates, what does pancreatic juice mostly contain?
Na, HCO3, water
At low flow rates, what does pancreatic juice mostly contain?
Na, Cl, water
What is aqueous portion of pancreatic secretion stimulated by?
H+ in duodenum (will need bicarb)
What is the enzymatic portion of pancreatic secretions stimulated by?
Products of digestion
Gastric phase accounts for what % of secretions?
80%
Acinar cells contain receptors for what
CCK and ACh (muscarinic)
H+ stimulates which cells to release what?
S cells to release secretin
AA and peptides stimulate secretion of what?
CCK
What potentiates action of CCK?
ACh
Describe the pathway for aqueous secretion in pancreatic juice
H+ > S cells > Secretin > cAMP on ductal cells (Ach and CCK potentiate) > Secretion
Describe the pathway for enzymatic secretion in pancreatic juice
Small peptides + fatty acids > I cells > CCK > IP3, Ca2+ (Ach potentiates) > Enzymes
Ductal cells have receptors for what
CCK, ACh, Secretin
Stimulation of ductal cell receptors stimulates
Bicarb for aqueous portion of pancreatic juice
Mixture of bile salts, bile pigments, cholesterol, phospholipids, ions, water
Bile
Emulsify lipids to prepare for digestion, then solubilizes products into micelles for absorption
Bile salts
What is contained in the biliary system?
Liver, gallbladder, bile duct, duodenum, ileum, portal circulation
What synthesize components of liver bile?
Hepatocytes
What does CCK do in biliary system?
Stimulates contraction of gallbladder
Relaxes sphincter of Oddi
What happens to bile salts after lipid absorption?
Recirculated to liver via reabsorption in ileum
What is the composition of bile?
Bile salts, bile pigments, cholesterol, phospholipids, ions, water
What is 50% of the composition of bile?
Bile salts
What is 40% of the composition of bile?
Phospholipids
What does liver conjugate to form bile salts?
Bile acids and AA (glycine and taurine)
What are the two primary bile acids made by hepatocytes?
Colic acid and chenodeoxycholic acid
What is the responsibility of bile acids?
Emulsify lipids so digestion can occur
T/F: Bile acids are amphipathic
True
Bile salts bind to form
Micelles
What does the core of a micelle contain?
Products of digestion
What two things equal a micelle?
Finely emulsified fat + bile salts
What is the product of hemoglobin degradation?
Bilirubin
What are the functions of the gallbladder?
Stores, concentrates, ejects bile
Filling of gallbladder
Concentration of bile
Ejection of bile
Is bile produced continuously or periodically?
Continuously
Bile ejection occurs how long after meal ingested
30 minutes
CCK contacts and relaxes what for bile ejection
Contracts gallbladder
Relaxes sphincter of Oddi
Bile is ejected in
Spurts
Enterohepatic circulation
How most bile salts return to the liver
What are bile salts transported from ileum lumen to portal blood by?
Na+/bile salt co-transporters