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GI - Week 2 > Pancreas / Hepatobiliary Physiology > Flashcards

Pancreas / Hepatobiliary Physiology Flashcards

1
Q

Are acini or ductal cells of the pancreas responsible for secretion of insulin, glucagon, mucin, and enzymes?

A

Acini
(and islet)

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2
Q

Are acini or ductal cells of the pancreas responsible for secretion of bicarbonate?

A

Ductal cells

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3
Q

Do acini and duct cells of the pancreas have exocrine or endocrine function?

A

Exocrine

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4
Q

Do islets of Langerhans of the pancreas have exocrine or endocrine function?

A

Endocrine

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5
Q

What effect do sympathetics have on pancreatic secretions?

A

Minimal

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6
Q

Do sympathetics or parasympathetics decrease blood flow to the pancreas?

A

Sympathetic

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7
Q

Do sympathetics or parasympathetics increase enzyme secretion?

A

parasympathetics

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8
Q

Do sympathetics or parasympathetics increase water bicarbonate secretion?

A

parasympathetic

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9
Q

Increase in pancreatic enzyme secretion is controlled by parasympathetic, specifically related to this compound

A

Acetylcholine

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10
Q

Increase in pancreatic water bicarbonate secretion is controlled by parasympathetic, specifically related to these compounds

A

Acetylcholine and VIP

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11
Q

Are pancreatic secretions isotonic or hypotonic to plasma?

A

ISOTONIC
at all rates of secretion (due to permeability of ductal cells to water)

*contrast to saliva, which is hypotonic

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12
Q

Are ductal cells of the pancreas permeable to water?

A

Yes

this is why pancreatic secretions are isotonic to plasma at all rates of secretion

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13
Q

Bicarbonate levels of the pancreas increase in response to acid present in this region

A

Duodenum

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14
Q

Do enzymes of the pancreas work best at higher or lower pH?

A

Higher

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15
Q

Does the presence of acids, carbs, and fats in the duodenum stimulate or inhibit pancreatic secretions?

A

Stimulate

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16
Q

Bicarbonate secretion in the pancreas is stimulated by this hormone

A

Secretin

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17
Q

In the process of secreting bicarbonate from the pancreas, this molecule enters the ductal cell and combines with water via carbonic anhydrase

A

Carbon dioxide

CO2 + H2O –> HCO3-

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18
Q

Secretin stimulates the ductal cells of the pancreas, causing an increase in this molecule

A

cAMP

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19
Q

This molecule stimulates the movement of chloride out of the pancreatic ductal cell, and into the lumen of the gland via the CFTR transporter

A

cAMP

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20
Q

cAMP stimulates the movement of this ion out of the pancreatic ductal cell, and into the lumen of the gland via the CFTR transporter

A

Chloride

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21
Q

Why does loss of CFTR in cystic fibrosis result in low bicarbonate transport?

A

Because there is no chloride to drive the release of bicarbonate

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22
Q

In cystic fibrosis, there is no chloride to drive the release of this compound

A

Bicarbonate

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23
Q

In cystic fibrosis, is there less or more water movement to the duct?

A

Less

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24
Q

Why is there “sticky” protein solution from the pancreas in cystic fibrosis?

A

Loss of CFTR = no chloride released in lumen = no bicarb transport

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25
Q

Why do enzymes need to be secreted in the proenzyme (inactivated) form in the pancreas?

A

Because activated enzymes will digest the pancreas

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26
Q

This pancreatic enzyme is secreted by intestinal mucosa, and cleaves trypsinogen to trypsin

A

Enteropeptidase (enterokinase)

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27
Q

Enteropeptidase (enterokinase) cleaves this compound

A

Trypsinogen –> trypsin

Trypsin then activates other proenzymes

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28
Q

This stops the premature activation of trypsin in pancreas/pancreatic duct

A

Trypsin inhibitor

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29
Q

This pancreatic carbohydrate enzyme hydrolyzes starches, glycogen, and other carbohydrates

A

Pancreatic amylase

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30
Q

What part of the GI tract secretes enteropeptidase?

A

Intestinal mucosa

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31
Q

This pancreatic lipolytic enzyme acts as a bridge to anchor lipase to the bile salts

A

Colipase (procolipase)

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32
Q

Cholecystokinin (CCK) is released in response to this

A

Amino acids and fats in the duodenum

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33
Q

Cholecystokinin (CCK) is released in response to amino acids and fats in this structure

A

Duodenum

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34
Q

Cholecystokinin (CCK) stimulates the contraction of this organ

A

Gallbladder

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35
Q

Cholecystokinin (CCK) acts via activation of these receptors

A

CCKA

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36
Q

What effect does Cholecystokinin (CCK) have on gastric motility?

A

Decreases

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37
Q

Secretin is released in response to this

A

Acid in duodenum

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38
Q

Secretin is release in response to acid in this structure

A

Duodenum

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39
Q

Secretin stimulates secretion of this from pancreatic/liver duct cells

A

Bicarbonate

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40
Q

This hormone stimulates secretion of HCO3- ion from pancreatic/liver duct cells

A

Secretin

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41
Q

Secretin stimulates secretion of HCO3- ion from these cells

A

Duct cells
(of the pancreas/liver)

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42
Q

Vagovagal reflexes are initiated by entry of this into the duodenum

A

Chyme

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43
Q

Does activation of the vagovagal reflex increase or decrease enzyme and bicarbonate secretions?

A

Increases

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44
Q

This hormone is the major stimulus for bicarbonate secretion
Is due to the presence of acid in the duodenum
No major role in enzyme secretion

A

Secretin

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45
Q

Does secretin have a major role in enzyme secretion of the pancreas?

46
Q

Does VIP have a major role in enzyme secretion of the pancreas?

47
Q

Does CCK have a major role in enzyme secretion of the pancreas?

A

YES

CCK and possibly gastrin can stimulate enzyme secretion from the acinus

48
Q

The presence of food (fats and proteins) in the duodenum can cause the release of this, which will stimulate a vagal reflex (acetylcholine) to produce more enzyme release from the acinus

A

Cholecystokinin (CCK)

49
Q

CCKA and M3 receptors have a major role in this function of the pancreas

A

Enzyme secretion

50
Q

These two receptors have a major role in pancreatic enzyme secretion

A

CCKA and M3

51
Q

What is the main stimulus for pancreatic secretion?

A

Presence of food in the duodenum
(intestinal phase of secretion)

52
Q

This phase of pancreatic secretion is responsible for the majority of secretions

A

Intestinal

chyme enters small intestine –> acid stimulates S cells –> secretion –> increase bicarb secretion / fluid from ductal cells

53
Q

Does the gastric phase of pancreatic secretions involve duct cell stimulation?

54
Q

Does the intestinal phase of pancreatic secretions involve duct cell stimulation?

A

YES

chyme enters small intestine –> acid stimulates S cells –> secretion –> increase bicarb secretion / fluid from ductal cells

55
Q

Pancreatitis is inflammation usually associated with this

A

Chronic alcohol abuse

56
Q

Why is pancreatitis usually associated with chronic alcohol abuse?

A

Alcohol changes the ratio of trypsinogen/trypsin inhibitor

57
Q

What leads to steatorrhea in pancreatitis?

A

Loss of pancreatic lipase

58
Q

Blockage of papilla of Vater (gallstones) cause pancreatic enzymes to accumulate in the duct, overcome the effect of this compound and digest the pancreas

A

Trypsin inhibitor

59
Q

Steatorrhea is due to a loss of this pancreatic enzyme

60
Q

Can lingual lipase break down all lipids in the absence of pancreatic lipase?

A

No
(limited exposure and optimal pH is 4.5-5.5)

61
Q

Xenical (orlistat), olestra, and simvastatin are drugs that can adversely cause this condition

A

Steatorrhea

62
Q

Most common cause of pancreatic insufficiency in children

A

Cystic fibrosis

63
Q

Blood flow to the liver is from these two sources

A

Portal vein
Hepatic artery

64
Q

“Secondary” blood flow through the liver (via the portal vein) allows these cells to remove bacteria and particulates
Prevents direct access of harmful agents into the body

A

Reticuloendothelial cells

65
Q

What is the series vascular arrangement of splanchnic blood flow?

A

Aorta –> superior mesenteric artery –> intestinal arterioles –> venules –> portal vein

66
Q

What is the parallel vascular arrangement of splanchnic blood flow?

A

Celiac artery in parallel to the superior and inferior mesenteric arteries

67
Q

Does the parallel or series vascular arrangement of splanchnic blood flow have a pressure drop at each area?

68
Q

Does the parallel or series vascular arrangement of splanchnic blood flow have no loss in driving pressure for each segment?

69
Q

The parallel vascular arrangement of splanchnic blood flow involves the celiac artery in parallel to these

A

Superior and inferior mesenteric arteries

70
Q

RBCs are broken down by this system, and hemoglobin is then released and broken down to bilirubin

A

Reticuloendothelial system
(RES: liver, bone marrow, spleen, lymph nodes, lungs, blood, connective tissue)

71
Q

Once bilirubin is formed, is it released from the reticuloendothelial system bound to this

72
Q

In the liver hepatocyte, bilirubin is bound to this to make it water soluble (less toxic)

A

Glucuronic acid

73
Q

In this type of cell, bilirubin is bound to glucuronic acid to make it water soluble (less toxic)

A

Liver hepatocyte

74
Q

Bilirubin can be oxidized to form this, which is the brown color of feces

A

Stercobilin

75
Q

Some bilirubin glucuronide is converted to this compound, by bacteria in the gut

A

Urobilinogen

76
Q

Urobilinogen can either be excreted in the feces or transported back to the liver (via active transport in the ileum), then to kidney where it is hydrolyzed to this, which is the color of urine

77
Q

This product of bilirubin is the color of urine

78
Q

Primary and secondary bile acids (salts) form from this

A

Cholesterol

79
Q

Primary bile acids (salts) are formed in this organ

80
Q

Secondary bile acids (salts) are formed in this organ

A

Gut
(by the actions of bacteria in the gut)

81
Q

Micelles are surrounded by these compounds, and help in the absorption of fats

A

Bile salts

82
Q

Cholesterol is synthesized in this organ and absorbed from diet

83
Q

What are the three main functions of bile?

A

Emulsify fats
Excretion (of bilirubin)
Bicarbonate (secretin)

84
Q

Distal ileum only functions in the absorption of these two compounds

A

Bile salts
Vitamin B12

85
Q

This part of the body functions in the absorption of bile salts and vitamin B12

A

Distal ileum

86
Q

Are bile salts typically reabsorbed?

A

95% of bile salts are reabsorbed (via Enterohepatic circulation)

87
Q

Fiber lowers the levels of this compound because it binds to bile acids/salts

A

Cholesterol

88
Q

This compound lowers serum cholesterol because it binds to bile acids/salts

89
Q

A diet high in this prevents/relieves constipation and other gut issues/conditions because it has an osmotic effect, and results in less time for feces in colon

90
Q

Bile is stored highly concentrated in this organ

A

Gallbladder

91
Q

When there is fat in the duodenum, CCK is released and causes this to contract, releasing concentrated form of bile

A

Gallbladder

92
Q

Is Na/H or Cl/HCO3 exchange greater?

A

Na/H exchange is greater - so have a net secretion of H+
(this neutralizes HCO3 and acidifies bile)

93
Q

Acidification increases the solubility of these in bile, resulting in less chance of gallstones

A

Calcium salts

94
Q

Jaundice is yellowing of the skin/sclera due to excess production/loss of metabolism of this

A

Bilirubin / biliverdin

95
Q

Hemolytic jaundice is due to excessive breakdown of this

96
Q

Physiologic hyperbilirubinemia (neonatal jaundice) occurs often due to these two reasons

A

Excessive bilirubin production
Immature hepatocyte function

97
Q

This is brain damage due to high levels of bilirubin

A

Kernicterus

98
Q

Kernicterus is brain damage due to high levels of this

99
Q

Treatment for this condition is multifaceted, and includes exposure to sunlight/UV light to aid in the breakdown of bilirubin to lumirubin

A

Physiologic hyperbilirubinemia (neonatal jaundice)

100
Q

This ethnic population has a high incidence of gallstone formation

A

Native American

101
Q

This type of gene promotes the formation of calculi (stone)

A

Lithogenic genes

102
Q

Gallstones can form from this organ’s hypersecretion of cholesterol

103
Q

Gallstones can form from this organ’s failure to empty and inflammation

A

Gallbladder

104
Q

Gallstones can form from this organ’s increased cholesterol absorption

A

Intestinal

105
Q

Are gallstones more prevalent in males or females?

A

Females (2-3x higher)

Is linked to use of contraceptive, and progesterone and estrogen

106
Q

Progesterone and estrogen impair emptying from this organ

A

Gallbladder

107
Q

Progesterone and estrogen can cause hypersecretion of this into bile

A

Cholesterol

108
Q

This color of gallstones indicates too much cholesterol

109
Q

This color of gallstones indicates too much bilirubin

110
Q

Is light or black colored gallstones seen with cirrhosis of liver and hereditary blood disorders?

111
Q

Light colored gallstones indicate too much of this compound

A

Cholesterol

112
Q

Black colored gallstones indicate too much of this compound

GI - Week 2 (12 decks)

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