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pancreas physiology Flashcards

1
Q

what is anabolism

A

build up or synthesis of larger organic macromolecules

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2
Q

do anabolic reactions require energy

A

yes

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3
Q

what is the storage form of glucose

A

glycogen

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4
Q

what is catabolism

A

breakdown of large molecules

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5
Q

what is glycogenesis

A

glucose to glycogen

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6
Q

what effect does glycogenesis have on glucose

A

decrease

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7
Q

what is glycogenolysis

A

glycogen to glucose

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8
Q

what effect does glycogenolysis have on glucose

A

increase

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9
Q

what is gluconeogenesis

A

amino acids to glucose

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10
Q

what effect does gluconeogensis have on glucose

A

increase

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11
Q

where is excess glucose stored

A

in the liver and muscle

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12
Q

what is excess glucose stored as

A

glycogen

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13
Q

what is additional glucose transformed into

A

fatty acids and glycerol

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14
Q

what is glycerol used to synthesise

A

triglycerides

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15
Q

what is triglyceride made up of

A

glycerol with three fatty acids attached

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16
Q

where is triglyceride mostly

A

in adipose tissue

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17
Q

what are excess amino acids converted to

A

glucose and fatty acids (stored as triglyceride)

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18
Q

what can glycerol be converted to

A

glucose by the liver

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19
Q

what plays an important role in maintaining normal blood glucose

A

liver

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20
Q

what is primary energy storage site

A

adipose tissue

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21
Q

what does adipose tissue regulate

A

fatty acid levels

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22
Q

what is muscle the primary site of

A

amino acids storage

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23
Q

where is glycerol from

A

triglycerides hydrolysis

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24
Q

during prolonged starvation what does the brain use instead of glucose

A

ketones

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25
Q

what are the dominant hormonal regulators that shift the metabolic pathway

A

insulin and glucagon

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26
Q

what 2 types of tissue is the pancreas made up of

A

endocrine and exocrine

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27
Q

what does the exocrine portion secrete

A

watery, alkaline solution and digestive enzymes

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28
Q

what are the endocrine cells called

A

islet of Langerhans

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29
Q

what is the most abundant endocrine cell

A

beta cells

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30
Q

what do beta cells. produce

A

insulin

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31
Q

what do the alpha cells produce

A

hormone glucagon

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32
Q

what do delta cells produce

A

somatostatin

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33
Q

what is the least abundant endocrine cell

A

F cells

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34
Q

what do F cells secrete

A

pancreatic polypeptide

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35
Q

what does pancreatic polypeptide play a role in

A

reducing appetite and food intake

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36
Q

where are the beta cells mostly

A

in the centre

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37
Q

what does somatostatin do

A

inhibit the digestive system

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38
Q

what secretes somatostatin

A

D cells

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39
Q

when is somatostatin released

A

in response to an increase in blood glucose and blood amino acids

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40
Q

what kind of system does somatostatin regulate via

A

paracrine

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41
Q

where else is somatostatin produced

A

in hypothalamus

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42
Q

what does somatostatin released from hypothalamus do

A

inhibits secretion of growth hormone and TSH

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43
Q

what is the overall outcome of insulin

A

to lower blood glucose levels and promote their storage

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44
Q

what effect does insulin have on glycogen synthase

A

increases its activity

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45
Q

what effect does insulin have on glucose transport

A

facilitates glucose transport into most cells

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46
Q

what effect does insulin have on glucose storage

A

stimulates glycogenesis (production of glycogen from glucose in both skeletal muscle and liver)

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47
Q

how does insulin affect glycogenolysis

A

inhibits it favouring storage

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48
Q

how does insulin affect blood glucose

A

decrease it by promoting cells uptake of glucose from the blood for use and storage

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49
Q

what is the only hormone capable of lowering blood glucose

A

insulin

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50
Q

how is glucose uptaken by cells

A

by glucose transporters (GLUT)

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51
Q

what happens to glucose once it is transported into a cell

A

immediately phosphorylated into glucose-6-phosphate

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52
Q

what does GLUT 1 do

A

transport glucose across the blood brain barrier

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53
Q

what does GLUT 2 do

A

transfers glucose into kidney and intestinal cells by means of the sodium and glucose co transporter

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54
Q

what does GLUT 3 do

A

main Transporter of glucose into neurons

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55
Q

what glucose transporter is responsible for majority of glucose uptake

A

GLUT 4

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56
Q

what is the only transporter that responds to insulin

A

GLUT 4

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57
Q

what happens when insulin binds toto a receptor that acts as a tyrosine kinase enzyme

A

it induces these vesicles to move too the plasma membrane and fuse with it, thus inserting GLUT 4 molecules into the plasma membrane

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58
Q

what happens to the glucose transporters when insulin secretion decreases

A

the glucose transporters are retrieved from the membrane by endocytosis and returned to the intercellular pool

59
Q

what tissues do not depend on insulin for their glucose uptake

A

the brain, working muscle and liver

60
Q

how does the brain constantly get its glucose supply

A

via GLUT 1 and GLUT 3 molecules

61
Q

what GLUT transporter supplies the muscle

A

GLUT 4

62
Q

does the liver use GLUT 4

A

no

63
Q

how does insulin lower blood fatty acids

A
  1. enhances the entry of fatty acids from the blood into adipose tissue cells 2. increase the transport of glucose into adipose tissue cells via GLUT 4 3. promotes chemical reactions that use fatty acids and glucose for triglyceride synthesis 4. inhibits lipolysis (fat breakdown) reducing the release of fatty acids from adipose tissue into the blood
64
Q

how does insulin lower blood amino acid levels

A
  1. promotes active transport of amino acid from the blood into muscle and other tissue (this provides building blocks for protein synthesis) 2. increases the rate of amino acid into protein by stimulating protein synthesising 3. inhibits protein degradation
65
Q

what does an increase in blood glucose stimulate beta cells to do

A

synthesise and release insulin

66
Q

what does the increased insulin do

A

reduce blood glucose to normal and promote use and storage of glucose

67
Q

what does a fall in blood glucose do to insulin

A

inhibits insulin secretion

68
Q

how does glucose enter beta cells

A

through GLUT 2

69
Q

what happens to glucose once it enters the beta cell

A

glucose is immediately phosphorylated to glucose-6-phosphate

70
Q

what happens to the glucose 6 phosphate

A

it is oxidised by the beta cell to yield ATP

71
Q

what 2 channels does the beta cell have

A
  • ATP K+ channel - voltage gated Ca2+ channel
72
Q

is ATP K+ channel open or closed when ATP is bound

A

remains open unless ATP binds to it

73
Q

what happens to the K+ channel when ATP is generated form glucose-6-phosphate

A

K+ channel closes

74
Q

what happens now the K+ channel is closed

A

the cell depolarises

75
Q

now the cell depolarises what happens to the Ca2+ channel

A

the Ca2+ channel now opens allowing Ca2+ entry

76
Q

what happens now Ca2+ enters a cell

A

triggers exocytosis of secretory vesicles that contain insulin resulting in insulin secretion

77
Q

how do amino acids affect insulin

A

they increase insulin secretion

78
Q

what 2 GI hormones are released in response to food

A
  • glucose dependent insulinotropic peptide (GIP) - glucagon-like-peptide (GLP)
79
Q

what do GIP and GLP do

A

stimulate insulin secretion

80
Q

what are incretins

A

hormones that notify the pancreatic beta cell of a rise in blood nutrients

81
Q

what do incretins do

A

increase insulin secretion by increasing cAMP which enhances Ca2+ induced release of insulin

82
Q

how does the parasympathetic affect insulin secretion

A

through acetylcholine acting through IP3/Ca2+ pathway (feedforward pathway)

83
Q

how does sympathetic stimulate affect insulin secretion

A

inhibit insulin secretion by decreasing cAMP

84
Q

DIABETES MELLITUS

A

DIABETS MELLITUS

85
Q

what is diabetes term

A

inadequate insulin action

86
Q

what happens in diabetes

A

blood glucose is elevated = hyperglycaemia

87
Q

what is the urine like in mellitus

A

sweet

88
Q

why is the urine sweet in diabetes mellitus

A

from excess blood glucose that spills into the urine

89
Q

what is the urine like in patients with diabetes insipidus

A

not sweet

90
Q

what are the 2 types of diabetes mellitus

A

type 1 (lack of insulin secretion) type 2 (normal or even increased insulin secretion but reduced sensitivity of insulin targets)

91
Q

how does hyperglycaemia occur in diabetes mellitus

A

arises form reduced glucose uptake by cells

92
Q

INCREASE IN BLOOD GLUCOSE

A

INCREASE IN BLOOD GLUCOSE

93
Q

what is glucosuria

A

glucose in the urine

94
Q

what does glucose in the urine cause

A

osmotic effect that draws water with it producing an osmotic diuresis

95
Q

what is polyuria

A

frequent urination

96
Q

what does excess fluid loss from the body lead to

A

dehydration

97
Q

what can circulatory failure lead to

A

death because of low cerebral blood flow or secondary renal failure

98
Q

what cells are especially sensitive to shrinking

A

brain cells

99
Q

what is polydipsia

A

excessive thirst

100
Q

why does polydipsia occur

A

to counteract dehydration

101
Q

what happens in intracellular glucose deficiency

A

appetite is stimulated leading to polyphagia

102
Q

what is polyphagia

A

excessive food intake

103
Q

is there weight gain because of the polyphagia

A

no weight loss still occurs from the effects of insulin. deficiency on fat and protein metabolism

104
Q

CONSEQUENCES OF FAT METABOLISM

A

CONSEQUENCES OF FAT METABOLISM

105
Q

what is increased blood fatty acids used by cells as

A

an alternative energy source

106
Q

what does increased liver use of fatty acids result in

A

excessive ketone bodies into the blood causing ketosis

107
Q

what are ketone bodies

A

result of incomplete breakdown of fat during hepatic energy production

108
Q

what does ketosis lead to

A

metabolic acidosis

109
Q

what effect does acidosis have on the brain

A

depresses the brain and can lead to diabetic coma and death

110
Q

what is a compensatory mechanism for metabolic acidosis

A

increase ventilation too blow off extra acid forming CO2

111
Q

what symptoms is caused by blowing off ketones

A

fruity breath odour combination of fruit and nail varnish remover

112
Q

CONSEQUENCES OF PROTEIN METABOLISM

A

CONSEQUENCES OF PROTEIN METABOLISM

113
Q

how does a lack of insulin affect protein metabolism

A

results in protein catabolism

114
Q

what does breakdown of muscle protein lead to

A

wasting and weakness of skeletal muscle

115
Q

what does reduced amino acid uptake lead to

A

excess amino acids in the blood this causes an increase in gluconeogenesis and further aggravates hyperglycaemia

116
Q

LONG TERM COMPLICATION

A

LONG TERM COMPLICATION

117
Q

what is the most common cause of premature death in diabetes

A

cardiovascular lesions

118
Q

what is the leading cause fo kidney failure and blindness

A

diabetes

119
Q

why may patients limbs need amputated

A

due to impaired delivery of blood to the extremities

120
Q

what is the best treatment for diabetes mellitus

A

continuously keep blood glucose levels within normal limits

121
Q

INSULIN EXCESS

A

INSULIN EXCESS

122
Q

what is the characteristic of excess insulin

A

hypoglycaemia

123
Q

how can excess insulin occur

A
  • when a diabetic patient injects too much insulin - blood insulin level rises too high in a non diabetic patient
124
Q

what are the symptoms of hypoglycaemia

A
  • tremor - fatigue - sleepiness - inability to concentrate
125
Q

how to counteract hypoglycaemia

A

diabetic person should eat or drink something sugary

126
Q

what happens if there is chronic insulin deficiency in a diabetic

A

diabetic ketoacidosis

127
Q

ketoacidosis symptoms

A
  • deep laboured breathing - fruity breath (from exhaled ketones)
128
Q

GLUCAGON

A

GLUCAGON

129
Q

what secretes glucagon

A

alpha cells

130
Q

where is main site of glucagon action

A

liver

131
Q

what does glucagon increase

A

cAMP

132
Q

what does glucagon decrease

A

glycogen synthesis

133
Q

what does glucagon promote

A

glycogenolysis and stimulates gluconeogenesis

134
Q

effects of glucagon on fat

A
  • promotes fat breakdown - inhibits triglyceride synthesis
135
Q

what is glucagon the opposite of

A

insulin

136
Q

what is the mainstay of glucagon actions

A

promotes catabolism of nutrient stores between meals to keep up the blood nutrient levels, especially blood glucose

137
Q

what does glucagon work simultaneously with

A

insulin

138
Q

EPINEPHRINE AND CORTISOL

A

EPINEPHRINE AND CORTISOL

139
Q

what are the 2 stress hormones

A

epinephrine and cortisol

140
Q

what do stress hormones do to blood glucose levels

A

increase it t

141
Q

how does growth hormone affect glucose

A

increase glucose uptake by muscles

142
Q

look at diagram

A
143
Q

look at diagram

A

endocrine (6 decks)

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