Pancreatitis Flashcards
What is the normal function of the Pancreas?
- Exocrine function enzyme release
- Endocrine function hormone release
What is the gland in the pancreas called?
Pancreatic Acinam
What do the glands in the pancreas do?
Excrete digestive enzymes via the pancreatic duct and into the Duodenum
What is the Islets of Langerhans and what do they contain?
- Tiny clusters of cells scattered throughout the pancreas.
- Alpha cells = produce glucagon
- Beta cells = produce insulin
What are the three different digestive enzymes?
Pancreatic proteases:
- Helps digest protein
- Break down protein
- Tryspin/trypsinogen and chymotryspin = help digest proteins
Pancreatic amylase:
- Helps digest sugars (carbohydrates)
- P-type amylase
- Heps break down carbohydrates
Pancreatic lipase:
- Helps digest fats
- Does not happen until the duodenum
- Lipase such as triglyceride
What is the role of the Pancreatic Duct?
- Transports pancreatic juices to dueodenum
Role of the Ductal cell (interlobar)?
- Branches from Pancreatic duct (lots of these)
- Visually like the trachea
- Branches from interlobar cell
- Visually like left and right bronchus
What are Acini Cells?
- Branch off interlobular cell
- Look like a mushroom
- Resemble capillaries
Where is the bile duct and what does it do?
- Liver and gall bladder - bile duct meets
- Move bile
What is Trypsin?
Active form or trypsinogen
Where is the Common Bile Duct?
- Liver and hall bladder bile ducts meet
- Moves bile
What is the Ampulla of Vater?
- Where Pancreatic duct and common bile duct meet
What is the Sphincter of ODDI?
- Bile and pancreatic juices push through here into the duodenum
What are Entero-endocrine cells?
- Live in duodenum
- Entero - GI
- Endocrine - hormone
2 main hormones:
- Secretin (stimulated by acid)
- Cholecystokinin (stimulated by food stuff)
What is Cholecystokinin?
- Goes to acini cells and stimulate the release of pancreatic juices (proteases, amalyse, lipase)
What is Enterokinase?
- This is also released
- Enterokinase activates the inactive protein/fats/carbs
When does trypsinogen become active?
- The ‘ogen’ means the molecule is inactive
- Trypsinogen in the pancreases (inactive) becomes active when it meets enterokinase cells in the duodenum and becomes Trypsin
- Trypsin can then break down the fat molecules
What are the two main causes of Acute Pancreatitis?
- Acinar cell degeneration
- Ductal obstructions
What is Acinar Cell Degeneration?
- Enzymes are released and activated within the pancreas itself leading to a breakdown of tissue (auto digestion)
What is Ductal Obstructions
- Blockage of pancreatic or bile duct, ampulla of vater or sphincter of ODDI
- Accumulation of pancreatic enzymes which can trigger activation
What is the culprit of acute pancreatitis?
Gall stones - ductual obstructions
Excess alcohol consumptions - acinar cell degeneration
Other causes are rare
What happens when there is excess alcohol consumption in the pancreas?
- Increase pancreatic juice secretion
- Increase viscosity of pancreatic juice
- Both can lead to stone and protein plug formation
- Also increases fatty acids in acinar cells leading to necrosis
- Onset 6-23 hours following heavy drinking
What is theory in relation to excess alcohol consumption and why is effects the pancreas?
Toxic agents, like alcohol, after pancreatic secretion rates and change metabolic reaction.
Reflux from the duodenum containing activated enzymes enters the pancreatic duct.
What happens during gall stones?
- A gallstone can pass through the bile duct and out into part of the gut just after the stomach (the duodenum) - usually does not cause a problem
- In some people, gallstone becomes stuck in the bile duct and pancreatic duct open into the duodenum.
- This can affect the chemicals int he pancreatic duct and trigger pancreatitis
