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NME > Secretions of the Small Intestine, Liver, Gall Bladder and Pancreas > Flashcards

Secretions of the Small Intestine, Liver, Gall Bladder and Pancreas Flashcards

1
Q

The small intestine

A
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2
Q

GIP is

A

Gastric Inhibitory peptide/ glucose dependent insulinotrophic peptide

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3
Q

The small intestine governs

A

majority of chemical digestion,, absorption of nutrients, electrolytes and water

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4
Q

Primary Secretions of the small intestine are:

A
  • intestinal juice (mucous/HCO3-)
  • pancreatic juice (digestive enzymes)
  • bile (bile salts)
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5
Q

Key endocrine hormones in the small intestine:

A
  • secretin
  • cholecystokinin (CCK)
  • glucose dependent insulinotrophic
    peptide (GIP)
  • regulates bile and pancreatic
    secretion
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6
Q

Secretory cells of the small intestine

A
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7
Q

Secretory cells of the small intestine:

A
  • Villi: houses absorptive enterocytes
    and mucus secreting goblet cells
  • Intestinal Glands:
    • Enterocytes (isotonic fluid)
    • Enteroendocrine cells
      (hormones)
    • Paneth cells (lysozymes)
  • In the duodenum only:
    - brunner’s glands (only in
    duodenum) secrete alkaline
    mucus and HCO3-
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8
Q

Stem cell renewal of epithelial cells:

A

insert diagram
- rapid regeneration rate (3-6 days)
- rapid regeneration rate makes the
cells vulnerable to radiation and
chemotherapy

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9
Q

CCK (I cells) function

A

stimulate pancreatic and gallbladder secretion

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10
Q

Secretin (S cells) function

A

stimulate pancreatic and biliary bicarbonate secretion

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11
Q

GIP (K cells) function

A

may inhibit acid secretion/ stimulate insulin release

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12
Q

Exocrine pancreatic juice consists of

A

bicarbonate and digestive enzymes

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13
Q

Pancreas

A
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14
Q

Pancreas only has endocrine function.

True or False?

A

False
Endocrine and Exocrine

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15
Q

Pancreas is regulated by both hormonal and neural mechanisms via

A

subdivision of cranial nerve X (vagus)

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16
Q

Exocrine pancreas secretes

A

pancreatic juice containing bicarbonate rich secretion (pH8) and digestive enzymes essential for normal digestion and absorption

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17
Q

The pancreas consists of

A

glandular epithelial clusters

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18
Q

99% of pancreatic structure is

A

exocrine acinar clusters secreting pancreatic juice

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19
Q

Pancreatic Juice consists of

A
  • water
  • electrolytes
  • sodium bicarb
  • pro-enzymes
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20
Q

1% pancreatic structure consists of

A

endocrine pancreatic islets
(Islets of langerhans) of 4 types of secreting cells: alpha, beta, delta, F cells

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21
Q

Alpha cells in the Islets of Langerhans secrete

A

glucagon

22
Q

Beta cells in the Islets of Langerhans secrete

A

insulin

23
Q

Delta cells in the Islets of Langerhans secrete

A

somatostatin

24
Q

F cells in the Islets of Langerhans secrete

A

pancreatic polypeptide (PP cells)

25
Q

Exocrine Acinar clusters

A
26
Q

Regulation of exocrine pancreatic secretion

A

Acinar enzyme production:

  • Ach released via parasympathetic
    CNX (vagus) stimulation of CCK -
    trigger is chyme containing fat and
    protein products
  • produces lower volume of enzyme
    rich pancreatic juice

Ductal Bicarb and Water:

  • Secretin - trigger is H+ in highly
    acidic chyme
  • produces plentiful, HCO3- rich, low
    enzyme pancreatic juice
27
Q

Pancreatic Proteolytic Enzymes are secreted in —— form:

  • active
  • inactive
A

inactive

28
Q

Pancreatic Proteolytic enzymes are responsible for

A

the conversion of proteins to peptides

29
Q

Amylase hydrolyses

A

starch, glycogen and other carbs to form di/trisaccharides

30
Q

Lipases hydrolyse

A

fat into fatty acids and monoglycerides

31
Q

Nucleases digest

A

RNA and DNA to nucleic acids

32
Q

Trypsin inhibitor prevents

A

activation of trypsin to prevent pancreatic digestion

33
Q

Activation of Proteolytic Enzymes: how are they produced?

A

inactive precursors called zymogens

34
Q

Activation of Proteolytic Enzymes: how is active trypsin formed?

A

small intestinal brush border enterokinase cleaves hexapeptide to form active trypsin from trypsinogen

35
Q

Activation of proteolytic enzymes: active trypsin purpose:

A

trypsin cleaves and activates other proteolytic enzymes

36
Q

What prevents autodigestion?

A
  • trypsin inhibitor
  • process of pancreatic enzymes
    destroying its own tissues, resulting
    in inflammatory response
37
Q

Duct Secretion of Sodium Bicarbonate

A
38
Q

Duct secretion of sodium bicarbonate:

A
  • secretin stimulates a high volume
    of HCO3- rich pancreatic juice
  • HCO3- secretion out of cell into the
    duct lumen is via CL-/HCO3-
    exchange at the apical cell
    membrane
  • Cl- is recycled out of the cell via the
    cystic fibrosis transmembrane
    conductance regulator CFTR Cl-
    channel under secretin stimulation
    via cAMP
  • Na+ is secreted transcellularly into
    the duct lumen following HCO3-
    secretion down electrochemical
    gradient, water follows by osmosis
39
Q

Regulation of Pancreatic Juice Secretion:

A
  • Ach: vago-vagal gastro-pancreatic
    reflex, gastrin, secretin,
    CKK/pancreozymin
40
Q

Cystic Fibrosis and the Pancreas

A
  • lack a functional Cl- channel in the
    luminal membrane, which results in
    defective ductal fluid secretion
    (CFTRE Cl-)
  • the ducts become blocked with
    precipitated ezymes and mucus
    and the pancreas undergoes
    fibrosis
  • blocked ducts impair secretion of
    needed pancreatic enzymes for
    digestion of nutrients, resulting in
    malabsorption
41
Q

Treatment of cystic fibrosis pancreas effects

A
  • treatment of malabsorption
    includes oral pancreatic enzyme
    supplements taken with each meal
42
Q

Pancreatitis:
- is
- common cause

A
  • inflammatory disease where
    pancreatic enzymes are activated
    within the pancreas and
    surrounding tissues, resulting in
    autodigestion
  • the most common causes:
    gallstones, alcohol misuse, which
    obstruct the pancreatic duct
43
Q

The role of bile in digestion

A
  • bile salts emulsify fats for digestion
    by pancreatic lipase, solubilise fat
    digestion products into
    aggregations for absorption across
    the mucosa
  • elimination of waste products
  • bile pigment bilirubin from haem in
    RBC degradation (breakdown
    product stercobilin gives faecal
    brown)
  • cholesterol
  • drugs
44
Q

Synthesis and Secretion of Bile in the Liver

A
  • bile is constantly synthesised by
    hepatocytes lining sinusoidal blood
    vessels in the liver acinus
  • hepatocytes are the key functional
    cell of the liver forming 80% of the
    liver mass
  • it drains into the blind ended
    canaliculi and into the L/R hepatic
    bile ducts of the liver
45
Q

Bile is stored in the gall bladder

A
46
Q

Bile Secretion Regulation

A
  • CCK released in response to fat
    content of duodenum leads to:
    • gall bladder contraction
    • sphincter of hepatopancreatic
      ampulla
    • sphincter of oddi relaxation
  • secretin release in respons to acidic
    chyme
  • liver ductal secretion of HCO3-.
    H2O
  • minor role for vagal stimulation:
    bile flow, gall bladder contraction
47
Q

Enterohepatic circulation of bile salts

A
  • bile salts are continuously recycled through active reabsorption within the ileum
  • 94% bile salts return via the portal vein to drive bile synthesis in the liver
  • many hydrophobic drugs are
    deactivated by the liver and
    excreted into bile; enterohepatic
    recycling frequently occurs, slowing
    the rate of drug elimination
48
Q

Enterohepatic circulation of bile salts

A
49
Q

Gall Bladder Disease:

A

Occurs in several forms, ranging from asymptomatic cholelithiasis [gallstones] to biliary colic [blockage of the cystic duct]. These disorder can affect different areas of the biliary tract

50
Q

Gallstones common causes:

A
  • Excessive water and bile salt
    reabsorption from bile
    [supersaturation ofbile]
  • Excessive cholesterol in bile
    causing precipitation [high fat diet].
  • Inflammation of epithelium [low
    grade chronic infection].
51
Q

Gall Bladder Disease

A

NME (52 decks)

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