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GI > Lecture 8 - Pancreas and liver > Flashcards

Lecture 8 - Pancreas and liver Flashcards

1
Q

Chyme

A

Low pH
Hypertonic
Partially digested food

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2
Q

Brunner’s glands

A

Secrete alkaline mucous, protecting the cells lining the duodenum from acidic chyme

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3
Q

Hypertonicity of chyme

A

Stomach is impermeable to water therefore chyme is hypertonic in stomach

Controlled release of chyme to prevent rapid water movement from the ECF and circulation to the chyme in the duodenum which would decrease blood pressure

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4
Q

Pancreatic secretions

A

Pancreatic enzymes aqueous bicarbonate solution

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5
Q

Liver secretions

A

Bicarbonate

Bile

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6
Q

Stimuli for pancreatic secretions

A

Acetylcholine (vagus PS)
CCK
Secretin

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7
Q

Secretin

A

Stimulated by acidity in the duodenum and jejunum

Stimulates pacreatic ductal epithelium to secrete aqueous bicarbonate solution

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8
Q

Cholecystokinin

A

Stimulated by proteins and fatty acids entering the small intestines

Stimulates pancreatic acinar to release enzymes

Causes gall bladder to contract and sphincter of Oddi to relax

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9
Q

Pancreatic exocrine function

A

90% exocrine - digestive enzymes

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10
Q

Pancreatic structure

A

Head located in the ‘C’ shape of the duodenum where the common bile duct and pancreatic duct enter the duodenum at the sphincter of Oddi

Contains:
Acinar - release enzymes
- Ducts - release aq bicarbonate solution which neutralises acidic chyme

Endocrine function:
- Islets of Langerhan - insulin and glucagon released into blood stream

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11
Q

Pancreatic enzymes

A

Amylase
Lipase
Proteases (inactive)

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12
Q

Proteases

A

Trypsin
Chymotrypsin
Elastase
Carboxypeptidase

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13
Q

Zymogen granules

A

Inactive proteases are stored in zymogen granules preventing the digestion of the pancreas

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14
Q

Pancreatitis

A

In pancreatitis due to blockage, pH decreases which activates proteases and causes pancreatic digestion

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15
Q

Ampulla of Vater

A

Where the common bile duct and pacreatic duct come together to enter the duodenum at the sphincter of Oddi

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16
Q

Bile

A

Made in the liver
Stored and concentrated in the gall bladder
Released in the duodenum (250 - 1000 ml/day)

17
Q

What is bile made of?

A

Secreted by heaptocytes:

  • Bile salts from bile acids
  • Bile pigments

Alkaline solution - secreted by cells lining the bile ducts stimulated by secretin

18
Q

Role of bile

A

Emulsifyes fats, increasing SA so they are readily digested by lipases

19
Q

Liver components

A 
Hepatocytes (80%)
Lots of RER and SER
Stacks of golgi apparatus 
Contains lots of glycogen 
Kupffer cells - macrophages in the liver
20
Q

Portal vein

A

All blood from gut drains into the liver via the PORTAL VIEN

21
Q

Sections of the liver

A

Left
Right
Caudate - near IVC
Quadrate - near gallbladder

22
Q

Connective tissue connecting the liver to the abdominal wall

A

Falciform ligament

23
Q

Liver lobule

A

Hexagonal
Central vein in middle
6 portal triads

24
Q

Portal triad

A

Bile duct
Portal vein
Hepatic artery

25
Q

Hepatic artery

A

Provides oxygenated blood to hepatocytes

Blood flow opposite to bile flow

26
Q

Caniculi

A

Hepatocytes produce substances in bile and excreted into the caniculi to the bile duct

27
Q

Functional area of liver lobule

A

Acinus

28
Q

Acinus

A

Blood enters from the periphery of the lobule to the centre

29
Q

Zone 1

A

Closest to periphery

More prone to toxicity as first exposure

30
Q

Zone

A

Closest to the centre

More prone to ischaemia as furthest from the hepatic artery

31
Q

Bile salts

A

Conjugated bile acids

More soluble at duodenal pH than bile acids

32
Q

Bile acids

A

Cholic acid

Synthesised and conjugated to amino acids in liver to form bile salts

33
Q

What do bile salts do?

A

Amphipathic - Emulsification of dietary lipids into smaller units to increase surface area

Create micelles to transport hydrophobic molecules (lipid digestion products) towards enterocytes of duodenum where the bile salt disperses.

34
Q

Lipid products of digestion

A

Cholesterol
Free fatty acids
Monoglycerides

35
Q

Bile salts at the enterocyte

A

Lipids diffuse into the enterocyte but bile salts do not

Bile salts remain in gut and are reabsorbed by the terminal ileum therefore returned to liver via the portal vein .

Liver recycles the bile salts

36
Q

Chylomicrons

A

Lipids are re-estified in the enterocyte into triglycerides in ER

Packed with apoproteins and carried via chylomicrons (lipoprotein) where it is exocytosed from the cell.

Carried in the lymph system via lacteals to the thoracic duct

[chylomicrons too large to enter capillary]

37
Q

Steatorrhoea

A

Undigested fat in the faeces

  • pale
  • floating
  • foul smell

Due to: inadequate secretion of bile salts/bile acids/pancreatic lipase

GI (18 decks)

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