The Exocrine Pancreas Flashcards
What nerves supply the pancreas?
Coeliac plexus from sympathetic chain of splanchnic nerves T5-T9
What does secretin act on?
Duct cells
To do with bicarbonate/water
What does cck act on?
Acinar cells
To do with enzymes
What lymph node is close to celiac plexus?
Celiac lymph node
What lymph node sits by the superior mesenteric artery?
Superior mesenteric lymph node
Which lymph node points out towards the spleen?
Splenic lymph node
Which pancreatic lymph nodes are next to the duodenum?
Anterior and posterior pancreaticoduodenal lymph nodes
Which pancreatic lymph node is next to the stomach/pyloris?
Pyloric lymph node
Which pancreatic lymph node goes out by the hepatic artery?
Hepatic lymph node
Where are the lymph nodes on the body of the pancreas?
Superior body and inferior body
Which artery runs over the top of the pancreas towards the spleen?
Splenic artery
Splenic vein goes back behind the pancreas
Which artery goes off the aorta in the direction of the liver?
Hepatic artery
Where does the tail on the pancreas head towards?
The spleen
What is the hooklike structure at the head of the pancreas next to the duodenum?
Uncinate process
How do enzymes get out of the pancreas?
Main pancreatic duct
Where do pancreatic enzymes flow?
From main pancreatic duct, into duodenum via the pancreaticoduodenal ampulla
What duct do only some people have?
Auxiliary duct
What cells are the exocrine pancreas and endocrine pancreas?
Expo-acinar units and ducts
Endocrine- islets of langerhans
Where does the pancreas form from?
Ventral and dorsal buds from bud cells
What cells make all cells of the pancreas?
Bud cells
What do PP cells secrete?
Pancreatic polypeptide
What causes increase in PP secretion?
Intestinal phase
Amino acids in blood stream
What are pancreatic stem cells called?
Centroacinar cells (Edge of acinar cells, can turn into a duct cell and repair damage)
What do acinar cells produce?
Zymogens (active enzyme+part of protein on end making it inactivated) - of lipase, amylase and protease - cleavage causes active enzyme
What proteases are produced by acinar cells?
Elastase, chymotrypsin and trypsin
Which enzyme produced by acinar cells is linked to pancreatitis and disease?
Trypsin
What regulates the release of enzymes from acinar cells?
CCK
What is trypsin released by acinar cells as?
Trypsinogen which is activated by enterokinase in the duodenum to trypsin. Start digesting protein, get amino acids which stimulates pancreatic polypeptide which gives further stimulation of digestion
What binds to receptor to allow the secretion of bicarbonate and water from duct cells?
Secretin
Why do duct cells need to release water?
To wash enzymes down into duodenum
What protein regulates pancreatic ductal cells?
CFTR
What occurs when secretin binds to receptor on ductal cells?
cAMP activated, activates pKa which activates CFTR channel, CFTR channel pumps Cl- ions out of the pancreatic ductal cell so water follows
HCO3- is swapped for Cl- and HCO3- moves out of ductal cells
What is Acute pancreatitis associated with?
Necrosis
What is apoptosis?
Non inflammatory programmed cell death
What goes wrong in pancreatitis?
Trypsin is activated within the acinar cell causing cell damage, causing cytokine release causing pancreatitis and necrosis
What activates trypsinogen release within acinar cells?
Pulse of Ca2+ release within the cell
What does I GET SMASHEDD stand for?
Idiopathic - hereditary Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion stings Hyper -calcaemia, lipidaemia, thermos ERCP Drugs
Causes of pancreatitis
Increase in activity of CCK
Increase in level and amount of trypsinogen
Decrease in amount of SPINK1 or trypsinogen inhibitors
Causes acinar damage
How do gallstones cause pancreatitis?
Gallstone obstructs pancreatic duct
Build up of pressure within pancreatic duct
Trypsinogen activated in acinar cells
