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Phys Phinal (Annie & Lauren) 💩🚽 > Pancreas, Liver, And Gallbladder 💚 > Flashcards

Pancreas, Liver, And Gallbladder 💚 Flashcards

1
Q

Pancreatic juice is rich in _____ and _____

A

Digestive enzymes

Bicarbonate

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2
Q

Is pancreas more of an exocrine or endocrine organ?

A

Exocrine 90%

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3
Q

What cells in the pancreas release exocrine secretions?

A

Acinar cells

Duct cells

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4
Q

Exocrine pancreas is organized like what organ?

A

Salivary gland

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5
Q

What are the functions of pancreatic juice?

A

Neutralize acids from the stomach

Provide enzymes for digestion of food

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6
Q

How does pancreatic juice neutralize acids from he stomach?

A

Bicarb

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7
Q

Most intestinal enzymes have optima pH near ____

A

7

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8
Q

What enzymes are in pancreatic juice?

A

Amylases- break down starch

Lipases- digest TGs, PLs and cholesterols

Proteases- break down proteins to AA’s and smaller peptides

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9
Q

What do acinar cells do?

A

Secrete enzymatic component

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10
Q

What do ductal cells do?

A

Modify the juice by removing Cl- and adding HCO3- the creation of this HCO3- helps offset the alkaline tide created by the parietal cells in the stomach, because it also yields an H+ that gets put into the blood

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11
Q

Where does the aqueous portion of pancreatic juice come from?

A

Centroacinar cells

Ductal cells

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12
Q

As the pancreatic juice gets secreted faster and faster, how does the composition of it change?

A

The juice gets MORE HCO3- and LESS Cl-

Na+ and K+ are unchanged

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13
Q

What are the 3 phases of pancreatic stimulation?

A

Cephalic

Gastric

Intestinal **most important

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14
Q

How much can the cephalic and gastric phase increase pancreatic secretion?

A

Only 10-15%

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15
Q

What is the MOST important phase of pancreatic stimulation

A

Intestinal phase- controls 80%

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16
Q

Does the intestinal phase affect the pancreas via Hormonal or Nervous mechanisms?

A

Hormonal!**

CCK and Secretin

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17
Q

What causes the duodenum to release CCK?

A

fatty acids and amino acids in duodenal chyme

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18
Q

Where does CCK come from?

A

I cells (of the duodenum)

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19
Q

Where does Secretin come from?

A

S cells (of duodenum)

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20
Q

What causes the release of Secretin?

A

H+ in the duodenum

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21
Q

What is “nature’s antacid?’

A

Secretin

(In response to H+, it causes ductal cells in pancreas to increase the aqueous component of pancreatic juice, which contains bicarb)

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22
Q

How does CCK get to the pancreas?

A

Via circulatory system

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23
Q

What does CCK do?n

A

Stimulates the acinar cells to increase enzyme secretion

Little effect on aqueous secretion

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24
Q

How much does secretin stimulate enzyme secretion?

A

Not much

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25
Q

What are the functions of the liver?

A

Regulate blood glucose (stores glycogen) 🍭

Regulates vascular volume (albumin, reservoir for blood)

Detoxification and conjugation

Cholesterol metabolism (making bile)

Synthesis of plasma proteins

Digestion and absorption of fats*

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26
Q

What does bile help you do?

A

Fat emulsification and digestion

Transport and elimination of cholesterol

Fat absorption

(Breaks up big fat droplets into smaller ones)

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27
Q

What are the 2 blood sources for the liver?

A

Hepatic portal system- nutrient rich but oxygen poor

Hepatic artery- oxygenated blood

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28
Q

The _____ is the fundamental unit of the liver

A

Lobule

29
Q

What is in the very middle of a lobule?

A

Central vein

30
Q

What is in the portal space?

A

Hepatic portal vein

Hepatic artery

Bile duct

31
Q

What cells secrete bile into the bile canaliculi?

A

Hepatocytes

32
Q

What is in the sinusoids within lobules?

A

Blood from the portal vein

33
Q

Are all of the cells in the sinusoidal endothelium continuous with each other?

A

No, they have large fenstrations that allow proteins through

34
Q

Is the pathway of blood within the liver lobules high or low resistance

A

Low resistance

GI > portal vein > sinusoids > central vein > vena cava

35
Q

What happens to the blood as it moves from the portal vein toward the central vein?

A

Hepatocytes reabsorb bile and transfer it to bile canaliculi

36
Q

Do the bile canaliculi come into contact with the sinusoids?

A

NO!! NO !!! NO! NO! ON!OONONONO he said this 3746 times!!

NOOOOO direct passage from blood bile!!

MUST be moved through the hepatocyte

37
Q

What are Kupffer cells?

A

Phagocytic cells inside the liver lobules

Not sure this is important

38
Q

Bile canaliculi are separated from sinusoids by _______

A

Tight junctions

39
Q

Materials entering bile canaliculi must ____________

A

Pass through the hepatocyte

******

40
Q

What are the components of bile?

A

Bile salts (50%)

Phospholipids (40%)

Cholesterol (4%)

Bile pigments (2%)

41
Q

What cells make bile acids and bile salts?

A

Hepatocytes

42
Q

What determines how much new bile acid is synthesized?

A

The amount of bile salts returned to liver via enterohepatic circulation

43
Q

How much bile salt is in the body ? Does it ever change?

A

2-4g. TIGHTLY regulated

44
Q

What are the 3 forms of bile?

A

Primary (hepatic origin)

Secondary (bacterial origin)

Conjugated (can be primary or secondary)

45
Q

How does primary bile salt get turned into secondary bile salt?

A

Bacteria change it

46
Q

What is the purpose of conjugating bile salts?

A

Makes it more soluble in the duodenum

47
Q

What groups are added onto bile salts to conjugate them?

A

Glycine or Taurine

48
Q

Why does conjugating bile salts make them more soluble in the duodenum?

A

It lowers the pK from 7 to <4. Allows them to remain hydrophobic bile salts at duodenal pH (3-5)

49
Q

Do phosophilpids in bile get recirculated?

A

No

50
Q

Are phospholipids water soluble?

A

No, but they are amphipathic

51
Q

What purpose do phospholipids serve in bile salts?

A

Increase ability of bile salts to solubilize cholesterol

52
Q

What is the most important bile pigment?

A

Bilirubin

53
Q

Where does bilirubin come from?

A

Porphyrins from senescent RBCs

54
Q

What form is bilirubin in when it’s in the bile: conjugated or uinconjugated?

A

Conjugated ONLY

55
Q

What group gets added onto bilirubin to conjugate it?

A

Glucuronic acid

Tags it for removal by the kidney= reason peepee is yellow

56
Q

What gives bile its yellow color?

A

Bilirubin glucuronide

Aka conjugated bilirubin

57
Q

What is this:

visually detectable buildup of bile pigments (bilirubin) in the blood

A

Jaundice

58
Q

What are the 3 types of jaundice?

A

Prehepatic (hemolytic)

Hepatic (liver disease)

Posthepatic (obstructive)

59
Q

What causes prehepatic jaundice?

A

Excessive breakdown or RBCs which creates too much bilirubin for the liver to excrete

Ex: pernicious anemia, infants

60
Q

What causes hepatic jaundice?

A

Liver is diseased and unable to deal with the normal load of bilirubin

Ex: cirrhosis, Gilbert’s syndrome (deficiency of conjugating enzyme)

61
Q

What causes posthepatic jaundice?

A

Obstruction of the bile duct

Ex: gallstone, pancreatic cancer

62
Q

What are the 2 ways bile salts aid fat digestion?

A
  1. Emulsifying large fat droplets (detergent action)

2. Forming small lipid aggregations called micelles

63
Q

Why do we need to emulsify fats?

A

Increases surface area of fat droplets that is available for attack by pancreatic lipase

64
Q

After emulsification, what keeps all the small fat droplets from just reconvening?

A

They repel each other due to negative charges of bile salts?

65
Q

What are micelles?

A

Aggregations of amphipathic bile components that form spontaneously in aqueous environments

Hydrophilic portions face outward and hydrophobic portions face the interior (cholesterol, phospholipids, FFA’s, etc)

66
Q

What are the functions of micelles?

A

Act as lipid “shuttles” to deliver to enterocyte

Increase lipid solubility in chyme

67
Q

What is happening in the gallbladder in the inter digestive period (aka not processing a meal)

A

Bile flows to gallbladder and concentrated

Sphincter of Oddi Contracts** to prevent bile flow into duodenum

68
Q

What is happening to the gallbladder during the digestive period?

A

Gallbladder contracts (CCK)

Sphincter of Oddi relaxes (CCK)

=Continuous bile duct secretion for as long as CCK is present in the bloodstream

69
Q

What is the primary regulator of release of bile from the gallbladder?

A

CCK**

Phys Phinal (Annie & Lauren) 💩🚽 (4 decks)

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