Pancreas

Question 1

What are the two general roles of the pancreas?

Answer 1

Exocrine and endocrine function

Question 2

What are the two protective roles that the pancreas has in it exocrine role?

Answer 2

Secrete bicarb and mucus

Question 3

What is the exocrine digestive role of the pancreas?

Answer 3

Enzyme secretion

Question 4

How do pancreatic secretions make it into the duodenum?

Answer 4

Pancreatic duct>common bile duct

Question 5

What are the cells that make up the glands of the pancreas?

Answer 5

Acinar cells, ductal cells, and goblet cells

Question 6

What is the function of acinar cells of the pancreas?

Answer 6

Protein synthesis

Secretion of enzymes/fluid

Question 7

What is the function of ductal cells?

Answer 7

bicarb secretion
Ion transport
Fluid transport

Question 8

What are the functions of the goblet cells of the pancreas?

Answer 8

Mucin secretion (hydrating, protecting, immunity)

Question 9

What is the function of Trypsinogen? Is this secreted in an inactive, or active form?

Answer 9

Protein digestion

Inactive

Question 10

What is the function of chymotrypsin? Is this secreted in an inactive, or active form?

Answer 10

Protein digestion

Inactive

Question 11

What is the function of proelastase? Is this secreted in an inactive, or active form?

Answer 11

Protein digestion

Inactive

Question 12

What is the function of proprotease E? Is this secreted in an inactive, or active form?

Answer 12

Protein digestion

Inactive

Question 13

What is the function of Procarboxypeptidase B? Is this secreted in an inactive, or active form?

Answer 13

Protein digestion

Inactive

Question 14

What is the function of Procarboxypeptidase B? Is this secreted in an inactive, or active form?

Answer 14

Protein digestion

Inactive

Question 15

What is the function of alpha amylase? Is this secreted in an inactive, or active form?

Answer 15

Carb digeston

active

Question 16

What is the function of carboxyl ester lipase? Is this secreted in an inactive, or active form?

Answer 16

Lipid digestion

Active

Question 17

What is the function of lipase? Is this secreted in an inactive, or active form?

Answer 17

Lipid digestion

Active

Question 18

What is the function of RNase? Is this secreted in an inactive, or active form?

Answer 18

Nucleotide digestion

Active

Question 19

What is the function of DNase? Is this secreted in an inactive, or active form?

Answer 19

Nucleotide digestion

Active

Question 20

What is the function of colipase? Is this secreted in an inactive, or active form?

Answer 20

Helps lipase with Lipid digestion

Active

Question 21

What is the function of Trypsin inhibitor? Is this secreted in an inactive, or active form?

Answer 21

Inhibits trypsin

Active

Question 22

What is the function of CCK and Ach in the pancreas?

Answer 22

Release of enzyme vesicles from the acinar cells of the pancreas

Activation of Cl channel

Question 23

What is the function of VIP and CCK?

Answer 23

VIP enhances the release of enzymes that CCK causes

Question 24

What happens when CCK increases to an extremely high level?

Answer 24

Negative feedback

Question 25

What is the effect of CCK on the gallbladder?

Answer 25

Contraction

Question 26

What is the effect of CCK on the pancreas?

Answer 26

Acinar secretion

Question 27

What is the effect of CCK on the stomach?

Answer 27

Reduced emptying

Question 28

What is the effect of CCK on the sphincter of oddi?

Answer 28

Relaxation

Question 29

What prevents the activation of pancreatic enzymes within vesicle/duct? (3)

Answer 29

1. Inactive form of enzymes 2. Vesicle contain a trypsin inhibitor 3. Low pH of vesicles

Question 30

How is trypsinogen activated?

Answer 30

Enteropeptidase in duodenal wall (from the crypts of Lieberkuhn)

Question 31

How is chymotrypsinogen activated?

Answer 31

Activated trypsin

Question 32

How is proelastase activated?

Answer 32

Activated trypsin

Question 33

How is procarboxypeptidase activated?

Answer 33

Activated trypsin

Question 34

What is the protective function of secretin on the pancreas?

Answer 34

Secreted by duodenum, and induces pancreatic duct cells to secrete bicarb (via activation of bicarb/Cl transporter)

Question 35

What is the negative feedback mechanism that secretin plays a role in with the stomach to protect the duodenum? (3)

Answer 35

1. Increases somatostatin 2. Decrease gastrin 3. Decreases proton pump expression

Question 36

Pancreatic secretions during the interdigestive periods parallel what physiologic pattern?

Answer 36

The migrating motor complex

Question 37

What are the three regulators of the cyclical pattern of secretion of pancreatic enzymes?

Answer 37

1. Stimulation via parasymp 2. Stimulation CCK 3. Inhibition via alpha-adrenergic input (somatostatin and peptide YY)

Question 38

What is the primary regulator of pancreatic secretion during the fed state?

Answer 38

CCK

Question 39

What are the three phases of pancreatic secretion?

Answer 39

1. Cephalic 2. Gastric 3. Intestinal

Question 40

What is the stimulant for the cephalic phase of pancreatic secretion?

Answer 40

Sight smell, mastication Vagal pathways

Question 41

What is the stimulant for the gastric phase of pancreatic secretion?

Answer 41

Digestion, gastrin, peptides Vagal/gastrin

Question 42

What are the stimuli that increase acid secretion intestinal phase of pancreatic secretion? What hormone mediates the increase in acid secretion?

Answer 42

AAs, FAs, H+ CCK from AAs and FAs Secretin from H+

Question 43

What is the function of S cells?

Answer 43

Sense gastric acid and secrete Secretin (causes HCO3 to be produced from the pancreas

Question 44

What chemicals are the most potent stimulators of I cells? What does stimulation of I cells produce?

Answer 44

**Lipids** Causes CCK to be released

Question 45

What is the effect of Vagal stimulation (mediated by ACh) on ductal and acinar cells?

Answer 45

Increases HCO3 and Enzyme release

Question 46

What are the sequelae of chronic pancreatitis?

Answer 46

Malabsorption syndrome | CA

Question 47

Aberrant release of/blocked flow of pancreatic enzymes leads to what?

Answer 47

Autodigestion of the pancreas / leakage into the blood

Question 48

What are the two main regulators of pancreatic exocrine secretions?

Answer 48

Ach and CCK

Question 49

Lipids are the most potent stimulators of I cells to release CCK. What does this caused?

Answer 49

Delays gastric emptying | Increases bile and pancreatic secretion

Question 50

Which cells of the pancreas are highly efficient at protein synthesis?

Answer 50

Acinar cells

Question 51

Which cells of the pancreas primarily secrete fluid and HCO3?

Answer 51

Ductal cells

Question 52

Which cells of the pancreas specialize in the synthesis of mucin and secretion?

Answer 52

Goblet cells

Question 53

The primary stimulus for the secretion of pancreatic enzymes by acinar cells via what neurotransmitter, and what endocrine molecule?

Answer 53

ACh and CCK

Question 54

What endocrine or neurotransmitter would you want to give a patient to induce secretion of fluid from the pancreas? What transporter does this stimulate?

Answer 54

CCK or ACh Stimulates Cl/HCO3 transporter

Question 55

What hormone does the duodenum secrete to induce pancreatic duct cells to secrete more HCO3?

Answer 55

Secretin

Question 56

What are the four major protective effects of secretin? (hint, three decrease acid secretion from the stomach)

Answer 56

1. Induces pancreatic ductal cells to secrete HCO3 2. Induces D cells to release somatostatin 3. Decreases gastrin release from G cells 4. Decreases H+ ion channels of the parietal cells

Question 57

The amount of pancreatic enzyme secretion is dependent upon the meal type. In general (BLANK) induce the greatest increase in pancreatic secretions in the fed state.

Answer 57

Fats

Question 58

What is the intracellular ion that is associated with pancreatitis?

Answer 58

Ca