pancreatic and intestinal secretions Flashcards

1
Q

what two functions do the pancreas have and what do they secrete

A

endocrine - glucagon and insulin into the blood

exocrine - lipases, proteases and amylase into ducts that lead directly to the duodenum

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2
Q

what secretes pancreatic juice

A

acini

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3
Q

what is the ionic composition of primary pancreatic juice

A

high in bicarbonate and Na
low in cl
low in K

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4
Q

how does pancreatic juice get modified

A

hco3 is exchanged for cl normally so less hco3 in duodenum

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5
Q

what happens to the ionic composition during fast flow rates

A

less time for modification and higher in HCO3 which is good for neutralisation of stomach acid

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6
Q

what happens to the level of Na and K in pancreatic secretions

A

stay the same

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7
Q

what is the ductal pathway for pancreatic juice

A

acini to pancreatic duct to ampulla to sphincter of oddi to duodenum

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8
Q

what are the three reflex causing increase in pancreatic secretion

A

gastric: food in the stomach causing distension triggers the vaso vagal pathway which increase ACh and more primary secretion
cephalic: sight or smell also triggers vaso-vagal pathway
intestinal (most dominant 80%): high ph and presence of fats stimulates s cells to secrete secretin which increases pancreatic secretion. presence of aa and fats stimulates release of cck to increase secretions.

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9
Q

what are the two main roles of the small intestine

A

absorption and digestion

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10
Q

what enzymes does the pancreas release

A

trypsinogen, chymotrypsinogen and procarboxy-peptidase

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11
Q

what regulates activation of enzymes released from the pancreas

A

enterokinase released from duodenal cells

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12
Q

how does activation of enzymes in the duodenum work

A

enterokinase activates trypsinogen to trypsin which in in turn changes chymotrysinogen and procarboxy-petidase to chymotrypsin and carboxy-peptidase

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13
Q

what are the two main secretions from the duodenum

A

nahco3

nacl

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14
Q

what is the role of NaHCO3 in the duodenum and where does it come from

A

bruner cells in the duodenum mainly and its function are to neutralise acidity and favour conditions for digestive enzymes
act as a lubricant for chyme

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15
Q

what are the theories of NaCl release in the duodenum

A

maintain osmotic balance of fluids

flushing of pathogens: paneth cells at the bottom of crypts release a defensins and lysosomes

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16
Q

what is the role of vili

A

increase surface area and also have micro villi increase sa by 600x

17
Q

what stimulates the release of nacl from the small intestine

A

release of VIP and adrenergics

18
Q

what effect does VIP and adrenergics have on nacl secretion

A

increases cAMP and more nacl release

19
Q

describe the process of cl into the lumen from the ecf

A

2 cl moves into the cell with 1 na and 1 k
3 na out and 2 k in
k leaves basolateral membrane across open channel
cl freely moves into the lumen

20
Q

describe the process of na into the lumen

A

paracellular

21
Q

what does the cholera toxin do

A

chronically stimulates cAMP via stimulates of g protein in small intestine
this causes continuous influx of cl into the lumen and water via osmosis follows producing dehydration and diarrhoea

22
Q

how do you relieve symptoms of cholera

A

treat with ORS containing lots of salt and sugar therefore water moves back from lumen into ecf

23
Q

what ion transport occurs in the colon

A

na and cl are reabsorbed

k and hco3 are secreted

24
Q

what is colonic ion transport fuelled by

A

aldosterone causes uptake of Na

25
what is crohns disease, what are the causes and treatment
inflammatory disease of large intestine abdominal pain, diarrhoea - greater risk to bowel cancer can be autoimmune or due to pathogens no cure but treatment include methotrexate, thiopurine or corticosteroids
26
what is chronic pancreatitis, symptoms causes and treatments
inflammation of the pancreases causing reduced enzyme secretions can be autoimmune, tumour or pathogen induced surgery or replacement of pancreatic enzyme