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Gastrointestinal - Physiology > Pancreas/Gall Bladder Physiology > Flashcards

Pancreas/Gall Bladder Physiology Flashcards

1
Q

What cells in the pancreas secrete digestive enzymes?

A

Acinar cells

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2
Q

What cells in the pancreas secrete bicarbonate?

A

Centroacinar and duct cells

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3
Q

What proteases are secreted by the pancreas?

A

Trypsinogen
Chymotrypsinogen
Proelastase
Procarboxypeptidase A and B

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4
Q

What amylolytic enzymes are secreted by the pancreas?

A

Amylase (pancreatic amylase)

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5
Q

What lipase are secreted by the pancreas?

A

lipase
Nonspecific esterase
Prophospholipase A2

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6
Q

What nucleases are secreted by the pancreas?

A

Deoxyribonuclease

Ribonuclease

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7
Q

What is the role of colipase?

A

Works with lipase to activate it.

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8
Q

What are the granules called that hold enzymes in the pancreas?

A

Zymogen granules

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9
Q

What two ions are exchanged as a part of the duct function?

A

Bicarbonate pushed out for chloride being brought in

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10
Q

What transporter is important for Cl homeostasis in the centroacinar cells?

A

CFTR

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11
Q

During the cephalic/gastric phase, what stimulates acinar cells?

A

ACh, GRP from vagal centers

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12
Q

In the intestinal phase, what changes in enzyme output is seen?

A

30% enzyme output increased to 70%

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13
Q

What cells secrete CCK? What activates them?

A

I cells activated by CCK-RP and monitor peptide

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14
Q

What cells secrete secretin? What activates them?

A

S cells activated by H+

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15
Q

What is the intracellular pathway by which acinar cells increase content discharge?

A

Ca mostly

Then cAMP

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16
Q

What activates CCK-RP release?

A

Amino acids and fatty acids in lumen

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17
Q

What are four things that CCK does?

A

Gall bladder contraction
Pancreas acinar secretion
Stomach reduced emptying
Sphincter of Oddi relaxation

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18
Q

What activates trypsinogen?

A

Enteropeptidase

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19
Q

What enzyme is mutated in hereditary pancreatitis? What is its role?

A

PRSS1 gene

Trypsinogen gene mutation that prevents trypsin elimination

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20
Q

What are some effects of pancreatitis?

A

Abdominal pain from pancreatic autodigestion
Increased serum lipase and amylase
Steatorrhea and fat-soluble vitamin insufficiency
Malignancy, diabetes, infx

21
Q

Why does oral glucose lead to higher insulin levels than IV glucose?

A

GLP1 is released from L cells in the intestine and GIP from K cells

22
Q

What happens to satiety when someone lacks sleep?

A

Leptin levels lower, decreasing satiety and inducing hyperphagia and overeating

23
Q

What four hormones stimulate insulin secretion of beta cells in the islets of langerhans? Which are negative regulators?

A

GLP-1, gastrin, cholecystokinin, and acetylcholine

Negative regulators: somatostatin, norepinephrine

24
Q

What molecules are satiety signals at the hypothalamus?

A

GLP1, CCK, Insulin, Leptin

25
Q

What molecule stimulates appetite and decreases energy expenditure?

A

Ghrelin

26
Q

What produces ghrelin?

A

Fundus of stomach

27
Q

What are the major functions of the liver?

A

Processing all ingested nutrients, detoxification
Metabolism of carbs, fats, proteins
Buffers glucose
Synth of factors important for circulatory system
Bile formation for uptake and excretion of lipophilic molecules

28
Q

What cells synthesize bile?

A

Hepatocytes

29
Q

What is the hepatic triad?

A

Portal vein, hepatic artery, bile duct

30
Q

What is a Kupffer cell?

A

Macrophage of the liver

31
Q

Where are chylomicron remnants sieved into?

A

Space of Disse

32
Q

What is the role of stellate cells?

A

Produce collagen

Store lipids like Vitamin A

33
Q

What synthetic cells are hyperactive in cirrhosis?

What does that cause?

A

Stellate cells

Irreversible deposition of excess collagen

34
Q

What causes stellate cells to be hyperactive in cirrhosis?

A

Oxidative stress causes Kupffer cells to release cytokines inducing collagen production

35
Q

What is hepatic encephalopathy?

A

When toxins enter blood stream because of too much shunting

36
Q

What facilitates excretion of hydrophobic molecules?

A

Bile salts

37
Q

Describe the pathway of bile salts

A 
Secreted into bile duct
Concentrated in gall bladder
Passes to duodenum
Reabsorbed from ileum into portal vein
Goes back to liver
38
Q

How much of the bile salts are lost in feces?

A

5%

39
Q

What enzyme is critical for cholesterol conversion into bile acid?

A

7-a-hydroxylase

40
Q

What must be added to a bile acid to become a bile salt?

A

Glycine or taurine

41
Q

What bacterial product of bile salts must be sulfated and excreted?

A

Lithocholic acid

42
Q

After leaving the canaliculi, where does bile go? What lines these ducts?

A

Canals of Hering

Lined with cholangiocytes

43
Q

What is taken out and added in the canals of Hering

A

Glucose and amino acids removed

IgA and mucus added

44
Q

What causes bile to be concentrated in the gall bladder?

A

Na and Cl pumped out of bile, water follows osmotic gradient

45
Q

What transporter is responsible for conjugated bile salt uptake from the GI lumen? Where is it found?

A

Apical sodium-dependent bile salt transporter

Foundin Ileum

46
Q

What transporter is responsible for taking up conjugated bile salts from the sinusoids?

A

Na dependent taurocholate transporter

47
Q

What are causes of cholestasis (impaired bile secretion)?

A

Primary Biliary Cirrhosis (destruction of cholangiocytes)
Primary Sclerosing Cholangitis (inflammation of bile ducts)
Pregnancy (progesterone reduces GB smooth muscle tone)

48
Q

What are some effects of cholestasis?

A

Metabolic dysfunction (bile accumulation in liver)
Itching (bile in plasma)
Hypercholesterolemia
Deficiency of ADEK

Gastrointestinal - Physiology (5 decks)

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