PANCREAS Flashcards

1
Q

Exocrine function of pancreas

A
  • Duct cells - Secrete HCO3- to neutralize acid in chyme
  • Excorine acinar cells - secrete digestive enzymes that break down macromolecules for absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Endocrine function of pancreas

A

Islet of langerhans:secrete insulin, glucagon and several other hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the pathway of digestive enzymes/exocrine products

A

Digestive enzymes are stored inside zymogen granules within the pancreatic acinar cell

  • Secrete them by exocytosis into the lumen of the acinus
  • -> flow into intercalated ducts > intralobular ducts > interlobular ducts
  • -> ducts coalesce into the main pancreatic duct
  • -> drains directly into the duodenum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the lumen of the acinus communicates directly with __lobular ducts

A

Intralobular ducts

Epithelial cells of the intralobular ducts project ‘back’ into the lumen of the acinus as centro-acinar cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

All interlobular ducts coalesce into

A

two pancreatic ducts - Santorini & Wirsung - which drain directly into the duodenum or join w the common bile duct first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do ACh and CCK promote pancreatic enzyme secretion?

A

ACh binding to M3 receptors

CCK & gastrin bind to CCK-B receptors

  • Elevates IP3 and DAG
  • -> increased [Ca2+]cytosol
  • -> stimulation of protein kinase C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Secretion of NaCl and water from pancreatic acinar cells

A
  • Basolateral NCCK transporter takes Na down its gradient and Cl & K against their gradient into the cell.
    • Na,K-ATPase maintains the Na+ gradient
  • Cl- can now enter the lumen via the apical CFTR Cl- channel
  • Lumen is now more negative, attracting Na+ to enter the lumen by traveling across leaky tigh tjunctions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CCK & vagus stimulation ____ enzyme and NaCl secretion from the acinar cells

A

increase enzyme & NaCl secretion

The CFTR Cl- channel is activated by cAMP & Ca2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the route of bicarbonate secretion

A
  1. Secretin increases cAMP in duct cells
  2. Opens CFTR Cl- channels so Cl- empties into the duct lumen
  3. Drives the HCO3/Cl antiporter to send HCO3- into lumen
    1. Sources of HCO3- in the cell:
      1. Basolateral NBC-1 symporter takes in Na+ & HCO3-
      2. Carbonic anhydrase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acinar cells & duct cells produce independent secretions.

What does the acinar cell produce?

A
  • Digestive enzymes
  • Cofactors:
    • Trypsin inhibitor protein
    • Co-lipase
  • Lactoferrin & IgA (antibacterials)
  • Pancreatitis-associated proteins (incresaes in early pancreatic injury)
  • Lithostathine - forms protein aggregates; can prevent stone formation
  • Glycoprotein-2 (may regulate endocytosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acinar cells and duct cells produce indpenedent secretions.

What do ductal cells secrete?

A

HCO3- & water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When a meal enters the small intestine, the volume of pancreatic secretions increases rapidly.

What impact does this have on the composition of the pancreatic juice?

A

Increased flow rate of pancreatic juice will make the juice more alkaline and dilute.

  • Increase HCO3-
  • Lower Cl-
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name the digestive enzymes of pancreatic juice

A
  • Trypsin & chymotrypsin (proteases)
    • Packaged in secretory vesicles as proenzymes trypsinogen & chymotrypsinogen
  • Pancreatic lipase hydrolyzes triglycerides
  • Amylase hydrolyzes starch into maltose
  • Ribonuclease, deoxyribonuclease, gelatinase, elastase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Orlistat (Xenical)

A

Pancreatic lipase inhibitor

–> reduces absorption of dietary fat –> weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Activation of trypsinogen & chymotrypsinogen

A

After release into the lumen of the small intestine,

  • Trypsinogen is activated by enterokinase on the brush border –> trypsin
  • Trypsin activates chymotrypsinogen & more trypsinogens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Protein digestion

A
  • Chymotrypsin & trypsin digest proteins into smaller and smaller peptides, but not into aa
  • Peptidases on the surface of the small inestine epithelial cells break down peptides into aa
    • Carboxypeptidases (pancreatic protease) can also do this, but not as much
17
Q

Triglyceride breakdown & absorption requires

A
  • Pancreatic lipase
  • Bile salts from the liver
19
Q

What are the primary mechanisms that prevent pancreatic tissue from auto-digestion?

A
  • The enzymes are produced as inactive zymogens that aren’t activated until they’re in the SI
  • The enzymes are stored in vesicles until exocytosis
  • Pancreas produces a trypsin inhibitor to prevent accidental activation of trypsin in the pancresa
20
Q

What causes pancreatic exocrine secretion?

A
  • Acid in the small inestine stimulates secretin secretion –> HCO3- secretion
    • Potentiated by dual stimulation from CKK & Ach
    • Neutralized acid –> pancreatic secretion slows
  • Proteins, starch, and triglycerides in the stomach & small inestine stimulate CKK secretion
21
Q

Cholecystokinin

A
  • Synthesized & secreted by enteric endocrine cells in the dudoenum
    • Stimulated by proteins & fats in the small inestine
  • Binds receptors on pancreatic acinar cells to secrete a lot of digestive enzymes
22
Q

Secretin

A
  • Produced by enteric endocrine cells in the duodenum
  • Secreted in response to acid in the duodenum
  • Stimulates duct cells to secrete H3O- and water
    • –> Flushes the enzymes from acinar cell sout of the pancreas, through the pancreatic duct, and into the duodenum
23
Q

Gastrin

A
  • Secreted by the stomach
  • Produed in response to gastric disenteion & irritation
  • Stimulates acid secretion from parietal cells
  • Stimualtes pancreatic acinar cells to secrete digestive enzymes
24
Q

Cephalic phase of pancreatic secretion

A
  1. Sight, smell, and taste of food stimulates the vagus
  2. Ach stimulates acinar & ductal ells
  3. 25-50% of pancreatic secretions
25
Gastric phase of pancreatic secretions
1. **Food in stomach** stimulates vagus 2. Vagus stimulates **Ach** & **Gastrin,** both of which stimulates pancreatic acinar cells 3. ~10% of pancreatic secretions
26
Intestinal phase
* **Digestive products in the duodenum** stimulates the vagus * **Ach and CCK --\>** pancreatic acinar cells release **enzymes\*** & HCO3- * **Acid in the duodenum** stimulates secretin * **Secretin** --\> ductal cells release **HCO3- & water** * Potentiated by Ach and CCK * 50-100% of pancreatic secretions
27
Causes of pancreatitis Tests for pancreatitis
* Causes * Usually \***gallstones\* or alcohol** * Infections, some medicines * Blood tests for * Serum **amylase** (high) * Serum **lipase** (high) * **Cholesterol (very low)** * **Bilirubin** (high) * **​**CBC for **WBCs** (high) * Liver fxn tests for **ALT & alkaline phosphatase**
28
What is pancreatitis?
Digestive enzymes from an inflamed pancreas accidentally get activated before they reach the small intestine. May be acute or chronic ## Footnote Inflammation may be from gallstones, alcohol abuse, infection, medications, trauma, tumors, etc
29
Cause of cystic fibrosis
* **Recessive autosomal CFTR gene mutation** * **--\> Messed up CFTR channel** * --\> **decreased HCO3- & water secretion** by pancreatic duct cells leaves them vulnerable to the pancreatic proteases * --\> **inflammation** & tissue destruction
30
Symptoms of CF patients
* Recurrent pulmonary infection * Chronic pancreatitis * Abnormal sweat * Malaborption * steatorrhea * Malnutrition * Thick, viscous pulmonary secretions