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104 Theme 1 > Lecture 6: Secretions of the Small Intestine and Accessory Organs > Flashcards

Lecture 6: Secretions of the Small Intestine and Accessory Organs Flashcards

1
Q

what are the secretions of the small intestine and what do they contain

A
  • intestinal juice (HCO3- and mucus)
  • pancreatic juice (digestive enzymes)
  • bile (bile salts)
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2
Q

what are the hormones secreted by the small intestine

A
  • secretin
  • cholecystokinin
  • glucose dependent insulinotrophic peptide (GIP)
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3
Q

what are the secretory cells in the villi

A
  • absorptive enterocytes

- goblet cells

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4
Q

what are the secretory cells in the intestinal glands

A
  • enterocytes secreting isotonic fluid
  • entero-endocrine cells
  • paneth cells
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5
Q

what are the secretory cells in the duodenum only

A

Brunner’s glands, which secrete mucus and HCO3-

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6
Q

how quick is epithelial cell turnover

A

3-6 days

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7
Q

CCK secretion and effect

A
  • I cells

- stimulate pancreatic and gallbladder secretion

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8
Q

secretin secretion and effect

A
  • S cells

- stimulate pancreatic and biliary bicarbonate secretion

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9
Q

GIP secretion and effect

A
  • K cells

- may inhibit acid secretion / stimulate insulin release

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10
Q

what clusters does the pancreas consist of

A
  • 99% exocrine acinar clusters

- 1% endocrine pancreatic islets (islets of langerhans)

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11
Q

what do the exocrine acinar clusters secrete

A

pancreatic juice containing:

  • water
  • electrolytes
  • sodium bicarbonate
  • proenzymes
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12
Q

what do the endocrine pancreatic islets secrete

A
  • glucagon
  • insulin
  • somatostatin
  • pancreatic polypeptide
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13
Q

what do the acinar cells secrete and what do the ducts secrete

A 
acinar:
- enzymes
- NaCl
- fluid
duct:
- NaHCO3
- fluid
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14
Q

what are the acinar secretions regulated by

A
  • acetylcholine

- cholecystokinin triggered by chyme containing fat and protein products

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15
Q

what are the ductal secretions regulated by

A

secretin triggered by H+ in highly acidic chyme

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16
Q

what enzyme activates proteolytic enzymes and where is it found

A
  • enterokinase enzyme

- in small intestinal brush border

17
Q

how is Cl- recycled out of the pancreatic cell

A
  • CTFR chloride channel
  • under secretin stimulation
  • via cAMP
18
Q

what is the composition of pancreatic juice with a low secretion rate

A

electrolyte content similar to that of plasma

19
Q

what is the composition of pancreatic juice with a high secretion rate

A
  • high in HCO3-

- low Cl-

20
Q

what happens in cystic fibrosis

A
  • dysfunctional CFTR channel
  • ducts become blocked with precipitated enzymes and mucus
  • pancreas undergoes fibrosis
  • impaired secretion of digestive enzymes
  • malabsorption
  • patients given oral pancreatic enzyme supplements during meals
21
Q

what happens in pancreatitis

A
  • pancreatic enzymes are activated within the pancreas
  • autodigestion
  • most common causes are gallstones and alcohol abuse
22
Q

which waste products does bile eliminate

A
  • bilirubin
  • cholesterol
  • drugs
23
Q

where is bile produced and stored

A
  • produced by hepatocytes

- stored in gallbladder

24
Q

what are the 3 overall causes of jaundice

A
  • prehepatic
  • hepatocellular / congenital
  • posthepatic
25
Q

what happens in pre-hepatic jaundice

A
  • excessive rbc breakdown
  • buildup of unconjugated bilirubin
  • eg due to haemolytic anaemia
26
Q

what happens in hepatocellular jaundice

A
  • altered hepatocyte function
  • eg Crigler-Najjar syndrome
  • absence of enzyme glucoronyl transferase, which normally conjugates bilirubin
  • results in increased unconjugated bilirubin
27
Q

what happens in post-hepatic jaundice

A
  • obstruction to normal bile drainage
  • eg due to gallstones
  • build up of conjugated bilirubin
28
Q

what is involved in regulation of bile secretion

A
  • cholecystokinin
  • secretin
  • minor role of acetylcholine
29
Q

when is cholecystokinin released and what effect does it have on bile secretion

A
  • released in response to fat content of duodenum
  • results in gall bladder contraction
  • sphincter of oddi relaxation
30
Q

when is secretin released and what effect does it have on bile secretion

A
  • released in response to acidic chyme

- results in liver duct secretion of bicarbonate rich watery secretions

31
Q

what effect does acetylcholine have on bile secretion

A
  • increased bile flow

- increased gallbladder contraction

32
Q

what are the common causes of gallstones

A
  • excessive water and bile salt reabsorption from bile
  • excessive cholesterol in bile (due to high fat diet)
  • inflammation of the epithelium

104 Theme 1 (13 decks)

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