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Y2 - GI > Pancreas And Liver > Flashcards

Pancreas And Liver Flashcards

1
Q

What is the substance that leaves the stomach into the duodenum?

A

Chyme

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2
Q

What are some key properties of chyme?

A

Hypertonic
Acidic
Is partially digested food

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3
Q

Why does chyme need to be modified before it can be effectively processed by the small intestine?

A

Its hypertonic

Its acidic

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4
Q

What is meant by the chyme is hypertonic?

A

It has a higher solute concentration than the plasma

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5
Q

What makes the chyme hypertonic compared to the plasma?

A

The breakdown of food particles increases the number of solutes increasing the number of osmotically active paraticles

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6
Q

How does the body modify chyme to counteract its hypertonicity in the duodenum?

A

Water gets moved into the chyme from the surrounding circulation to dilute the chyme

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7
Q

How does the body deal with the acidic nature of chyme in the duodenum?

A

Pancreas releases Bicarbonate ions into the duodenum to increase the pH

Liver also makes bicarb from bile

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8
Q

Where is the pancreas located?

A

Head is nestled in C shape of duodenum

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9
Q

How does the body help deal with chyme being partially digested?

A

Produces pancreatic enzymes (exocrine)

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10
Q

What is the basic structure of the pancreas where the enzymes are made?

A

Acinus makes enzymes
Centroacinar cells makes aqueous component
Duct modifies aqueous secretion

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11
Q

What stimulates pancreatic secretions?

A

Parasympathetic
Sympathetics inhibit

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12
Q

What enzymes does the pancreas make?

A

Active:
Amylase + lipase
Inactive:
Trypsinogen
Chymotrypsinogen
Proelastase
Procarboxypeptidase A
Procarboxypeptidase B

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13
Q

What form are protease enzymes like trypsin produced in and way?

A

Inactive to prevent self digestion

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14
Q

What is the process of producing a pancreatic secretion?

A

Acinus producing enzyme:
-formed on RER
-moved to Golgi
-concentrated n zymogen granules if inactive
-then released with appropriate stimulus like CCK needs parasympathetic stimulus

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15
Q

What is a zymogen granule?

A

A membrane bound granule contains an inactive precursor enzyme called zymogen

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16
Q

What does pancreatic enzymes in the blood signify?

A

Pancreatic damage

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17
Q

What enzyme stimulates the pancreas to secrete bicarbonate ions?

A

Secretin

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18
Q

What cells produce secretin and when do they produce secretin?

A

S cells when the duodenal pH is low

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19
Q

What enzyme stimulates the pancreas to release digestive enzymes?

A

Cholecystokinin

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20
Q

What cell stimulates the release of cholecystokinin?

A

I cells in duodenum

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21
Q

What are the general functions of the liver?

A

Energy metabolism
Detoxification (everything absorbed by the gut drains to the liver)
Plasma protein production

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22
Q

What alkaline/bicarbonate rich secretion is produced but the liver?

A

Bile acids

It excretes bile pigments

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23
Q

What are the main functional cells of the liver?

A

Hepatocytes

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24
Q

What vessels are located in the portal triads of the liver?

A

Bile duct
Hepatic artery
Portal vein

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25
Q

What is the blood vessel in the middle of each liver lobule?

A

Central vein

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26
Q

What 2 blood vessels join together running through the sinusoids to the central vein of the liver lobules?

A

Hepatic artery and portal vein

27
Q

What cells form bile in the liver?

A

Hepatocytes into the bile canaliculi

28
Q

How are the hepatocytes adapted to being highly metabolically active?

A

Lots of smooth and rough ER
Stacks of Golgi

Lots of glycogen

29
Q

What vessel takes most of the blood to the liver where does it get this from?

A

Portal vein

Drains all the blood from the GI system so it can be detoxified

30
Q

What blood vessels do the central veins of the liver lobules become?

A

Merge to hepatic veins which drain to the inferior vena cava

31
Q

What is the functional unit of the liver called?

A

Acinus

32
Q

What is a liver acinus?

A

Adjoining liver lobules, area between the 2 central veins and the 2 portal triads between them

33
Q

What are the zones/how are the zones arranged in a liver acinus?

A

1 = furthest from central vein closest to triads
3 = closest to central vein

34
Q

What zone would be affected most by toxins flowing into the liver?

What zone would be most affected by ischaemic damage?

A

Toxins in = zone 1 since its closest to the portal triads where the toxins would flow into the lobule

Ischaemic damage = zone 3 since its furthest away from the inflow fo oxygenated blood which is from the hepatic artery in the triads (portal vein blood not completely deoxygenated tho)

35
Q

What part of the duodenum does bile produced in the liver drain to after being stored in the gall bladder?

A

D2

36
Q

What forms the common bile duct which drains into the duodenum (D2)?

A

Bile canaliculi join to form bile ducts which join to form the common bile duct

37
Q

What are the 2 components of bile?

A

Bile acids and bile pigments (bile acid dependant)

Alkaline solution (bicarbonate and cholesterol) which is bile acid independant

38
Q

What hormone stimulates the production of the alkaline (bicarbonate) component of bile?

A

Secretin

39
Q

What cells produce the alkaline component of bile?

A

Duct cells

40
Q

What are bile salts?

A

Bile acids that have been conjugated with an amino acid

41
Q

What are the 2 main bile acids?

A

Cholic acid
Chenodeoxycholic acid

42
Q

What is the point of bile salts when we have bile acids?

A

Bile salts are normally soluble at duodenal pHs whereas bile acids aren’t always

Bile salts = amphipathic structure

43
Q

What is the significance of bile being amphipathic?

A

Can at the water/oil interface o can emulsify fats since it has a hydrophilic water soluble end and a hydrophobic lipid soluble end

44
Q

What is the function of bile salts emulsifying fats?

A

Increases surface area for enzyme digestion

45
Q

What is the structured called which forms when bile salts emulsify fats and transport them?

A

Micelles

46
Q

What is a Micelle?

A

When a bile acid forms a sphere transporting hydrophobic lipid molecules through an aqueous medium

47
Q

Where do micelles transport the breakdown products of fat to?

A

Brush border of enterocyte s

48
Q

What happens when the Micelle reaches the brush border of enterocyte?

A

Lipids diffuse into cell down conc gradient

Re esterification of lipids to:
-triglycerides
-cholesterol
-phospholipids

49
Q

What happens to the resterified lipids in the enterocytes?

A

Get packed with apoproteins forming Chylomicrons

50
Q

What happens to the Chylomicrons once they’ve been exocytosed from the enterocyte?

A

Enter lymphcapillaries travelling to lymphatic system

Renter vascular system reaching the blood stream via the thoracic duct which drains to left subclavian or left internal jugular vein

51
Q

What happens to bile salts in the body after they’ve done their function?

A

Remain in gut lumen
Most reabsorbed in terminal ileum so get returned to liver via portal vein so get reused

52
Q

How can a high fibre diet reduce cholesterol levels?

A

Cholesterol is a component of bile salts

High fibre diet removes bile salts from body reducing cholesterol

53
Q

What organ stores bile?

A

Gall bladder

54
Q

How does the gall bladder maximise the amount of bile it can store?

A

Concentrates the bile removing water and ions

Can then be reconcentraed when it needs to released into duodenum

55
Q

How do gallstones form?

A

When the bile in gallbladder is concentrated too much

56
Q

What hormone stimulates the gall bladder to contract to squeeze out bile and relax the sphincter of Oddi?

A

Cholecystokinin

57
Q

What is Steatorrhoea?

A

When fat appears in the faeces

58
Q

What is Steatorrhoea?

A

When fat appears in the faeces

59
Q

What causes steatorrhoea?

A

When bile acids/salts or pancreatic lipases are not secreted in adequate amounts leadinign to malabsorption of lipids

60
Q

How does steatorrhoea present?

A

Fat in faeces:
-pale
-floating
-foul smelling

61
Q

What is bilirubin?

A

Breakdown product of Haemoglobin

62
Q

How is bilirubin excreted from the body?

A

Conjugated in liver (makes water soluble)
Secreted into bile
Excreted in faces making it brown

63
Q

what happens if bilirubin accumulates in blood if it cant be excreted?

A

Jaundice

Y2 - GI (35 decks)

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