Pancreas Flashcards

1
Q

Where is the pancreas found in the body and except which part?

A

Completely retroperitoneal apart from tail

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2
Q

What is the tail and what is it attached to?

A

Tail is attached to the spleen and is intraperitoneal

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3
Q

What does the exocrine pancreas secrete?

A

Digestive enzymes

HCO3-

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4
Q

What cells produce exocrine products of pancreas?

A

Acinar cells - digestive enzymes

Duct cells - bicarbonate

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5
Q

Where are these exocrine secretions secreted into ?

A

Secreted into ducts which converge into the pancreatic duct, which join the common bile duct just before entering duodenum at ampulla of vater

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6
Q

Reflux of bile down the pancreatic duct results in…

A

Acute inflammation due to its detergent Properties

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7
Q

What is HCO3- secreted by?

A

Epithelial cells lining the ducts known as duct cells

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8
Q

What does HCO3- do?

A

Protect the duodenal mucosa from gastric acid

Buffer material entering duodenum to a suitable pH for enzyme action

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9
Q

What stimulates the secretion of HCO3-?

A

The release of secretin in response to presence of of acid in the duodenum stimulates HCO3- from pancreas and liver & potentiates action of CCK

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10
Q

Where is secretin produced?

A

In the small intestine

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11
Q

How is HCO3- released from the pancreatic duct cells?

A

Into duct lumen via apical membrane HCO3-/Cl- exchanger
HCO3- out, Cl- in
Cl- leaves down conc gradient via CFTR channel

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12
Q

What are digestive enzymes secreted by?

A

Acinar cells (Gland cells) at the pancreatic end of the duct system

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13
Q

The enzymes secreted are either…

A

Active or precursors (secreted in inactive form (zymogens) similar to pepsinogen)

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14
Q

What stimulates the secretion of digestive enzymes?

What does this also potentiates?

A

Release of CCK (produced in small intestine) in response to presence of AA and FA in Small intestine stimulates dig enzymes and secretin (which stimulates bicarb from liver and pancreas)

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15
Q

What are the 2 active enzymes that are released and what do they break down?

A

Alpha amylase
Starch to maltose

Lipase
Triglycerides to monoglyceride and fatty acid

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16
Q

What precursors are released?

A

Zymogens

17
Q

Why is zymogen released as a precursor?

A

Protects pancreatic cells from autodigestion

18
Q

What is zymogen activated by and where from?

A

Activated by enterokinase, embedded in the brush border of intestinal epithelium

19
Q

What are some examples of proteases zymogens?

A

Trypsinogen to trypsin

Chymotrypsinogen to chymotrypsin

20
Q

What are the 4 endocrine cells?

A

Alpha
Beta
Delta
Pp cells

21
Q

What do the cells release?

A

A = glucagon
B= insulin and amylin
D=somatostatin
Pp= pancreatic polypeptide

22
Q

Where are all these cells found?

A

Islets of langerhans

23
Q

Somatostatin from D cells are a powerful inhibitor of…

A

Pancreatic exocrine secretions

24
Q

What happens in type 1 and 2 diabetes?

A

Type 1 = pancreas fails to produce enough insulin

Type 2 = cells don’t respond to insulin properly

25
Q

Cephalic phase

How are pancreatic exocrine secretions stimulated and secreted?

A

Initiated by seeing/eating food

Parasympathetic vagus nerve stimulate Acinar cells to produce digestive enzymes

26
Q

Gastric phase

How are pancreatic exocrine secretions stimulated and secreted?

A

Initiated by presence of food in stomach

Parasympathetic vagus nerve stimulate Acinar cells to produce digestive enzymes

27
Q

What Happens at the end of the cephalic/gastric phases?

A

Pancreatic ducts are filled with inactive digestive zymogens ready for release into the intestinal lumen with bicarbonate via sphincter of oddi

28
Q

What happens when AA and FA are present in the duodenum?

A

CCK is released and gall bladder contracts including enzyme secretion