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Digestion and Renal Sciences > Secretion in the pancreas and intestines > Flashcards

Secretion in the pancreas and intestines Flashcards

1
Q

Describe some of the functions of the pancreas

A

Produces enzymes for digestion of nutrients
Achieving optimum pH in small intestine
Regulates fed and fasted states

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2
Q

What is the pancreas divided into?

A

Lobules

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3
Q

Describe the network of ducts in the pancreas

A

Lobules drain into intralobular ducts, into interlobular ducts and into a main duct

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4
Q

What does the pancreatic duct merge with?

A

The bile duct

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5
Q

Where do the pancreatic products enter the duodenum?

A

Duodenal papilla

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6
Q

What controls secretion into the duodenum?

A

The sphincter of Oddi

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7
Q

What is the functional secretory unit of the pancreas?

A 
An acinus
(and a small intercalated duct)
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8
Q

What makes up an acinus?

A

A cluster of acinar cells

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9
Q

What do acinar cells secrete?

A

Zymogens
Digestive enzymes
Isotonic plasma-like fluid

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10
Q

How are acinar cells specialised for their role?

A

Large number of RER and secretory vesicles

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11
Q

What is a centroacinar cell?

A

The cells at the junction of the duct cells and acinar cells

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12
Q

What do goblet cells do?

A

Produce mucus

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13
Q

What is the purpose of mucus?

A

Lubrication
Hydration
Mechanical protection
Immunological role

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14
Q

How are acinar cells stimulated?

A

Through CCK and muscarinic acetylcholine receptors

Located on the basolateral cell membrane

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15
Q

What pathway leads to secretion from an acinar cell?

A

Phospholipase C (PLC/PKC)/Ca2+ signal-transduction pathway

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16
Q

What is the second method of activating an acinar cell?

A

VIP and secretin activate adenylyl cyclase, leading to the production of cAMP and the activation of PKA

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17
Q

What is the primary function of the pancreatic duct cell?

A

Secrete HCO3- that alkalinises and hydrates the enzymes secreted by the acinar cells

18
Q

What stimulates pancreatic duct cells?

A

Secretin (mainly)

Ach (a little)

19
Q

By what method is HCO3- secreted?

A

A HCO3-/Cl- exchanger

20
Q

Which anion channel allows Cl- to diffuse into the lumen?

A

The cystic fibrosis transmembrane conductance regulator (CFTR)

21
Q

What produces secretin?

A

S cells

22
Q

What is secretin produced in response to?

A

Duodenal acidification

23
Q

What problems may someone with cystic fibrosis encounter in the pancreas?

A

Faulty CFTR channels
Decreased secretion of HCO3- and water by the pancreas
Ductal obstruction and pancreatic tissue destruction

24
Q

What role does CCK play in pancreatic secretion?

A

CCK stimulates acinar cells to increase protein secretion

It is produced by duodenal I cells in response to fatty food

25
Q

What inhibits pancreatic secretion?

A

Somatostatin

26
Q

How does somatostatin inhibit pancreatic secretion?

A

Inhibits the release of CCK and secretin

27
Q

Name the phases of pancreatic secretion

A

Cephalic phase
Gastric phase
Intestinal phase

28
Q

Describe the cephalic phase of pancreatic secretion

A

Accounts for 25%

Mediated by Ach

29
Q

Describe the gastric phase of pancreatic secretion

A

Accounts for 10-20%
Gastrin mediated (gastrin is a weak CCK agonist)
Neural pathways via gastric distension

30
Q

Describe the intestinal phase of pancreatic secretion

A

Accounts for 50-80%
Chyme enters the duodenum
Gastric acid triggers secretin to be produced
Lipids stimulate CCK production

31
Q

How does the pancreas prevent autodigestion?

A

Zymogens only become activated after coming in contact with the small bowel enzyme enterokinase
Secretory granule membrane is impermeable to proteins
Enzyme inhibitors are also present in the secretory granules
pH and ionic conditions limit activity

32
Q

What may cause acute pancreatitis?

A 
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hypercalcaemia
ERCP
Drugs
33
Q

What symptoms are characteristic of acute pancreatitis?

A

Abdominal pain (epigastrium and radiates to the back)
Serum amylase and/or lipase >3 times the upper limit of normal
CT scan

34
Q

How many stages of acute pancreatitis are there?

A

3

35
Q

Describe phase 1 of acute pancreatitis

A

Premature activation of trypsin within pancreatic acinar cells

36
Q

Describe phase 2 of acute pancreatitis

A

Intra-pancreatic inflammation

37
Q

Describe phase 3 of acute pancreatitis

A

Extra-pancreatic inflammation
Systemic sepsis
Multiple organ failure

38
Q

How is acute pancreatitis treated?

A

Resting the pancreas with IV fluids
Pain relief
Therapeutic Endoscopic Retrograde Cholangiopancreatography

39
Q

What is chronic pancreatitis?

A

Chronic pancreatitis is inflammation of the pancreas that does not heal or improve

40
Q

What is the most common cause of chronic pancreatitis?

A

Chronic alcohol abuse

Digestion and Renal Sciences (27 decks)

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