Pancreas

Front 1

What are the functions of the pancreas? (3)

Back 1

- To lubricate and protect the GI mucosa

- To secrete digestive and hormonal enzymes

- To neutralize chyme

Front 2

What substances do the exocrine acinar cells of the pancreas secrete? (2)

Back 2

- Enzymes

- Ultrafiltrate

Front 3

What do the duct cells of the pancreas secrete?

Back 3

Bicarbonate

Front 4

Name 4 endocrine cell types in the islets of Langerhans and what each secretes?

Back 4

Alpha cells: glucagon

Beta cells: insulin

Delta cells: somatostatin

G-cells: gastrin

Front 5

What disease is caused by a gastrin-secreting tumor of the pancreas?

Back 5

Zollinger-Ellison Syndrome

Front 6

Besides those named above, what additional endocrine proteins are produced in the pancreas? (2)

Back 6

- Pancreatic polypeptide

- VIP

Front 7

What are the names of the two pancreatic ducts?

Back 7

Ducts of Santorini and Wirsung

Front 8

What is the major source of stimulation of pancreatic enzyme secretion?

Back 8

- CCK from the gut (some Vagal PNS stim too)

Front 9

How are enzymes released by pancreatic cells?

Back 9

Exocytosis

Front 10

What happens to pancreatic enzymes after they have served their function?

Back 10

Some are transported by intestinal mucosa and recirculated but most are digested as well

Front 11

Why does a sudden change in fat content of diet lead to diarrhea?

Back 11

enzymes are regulated at the genetic level and cannot accommodate sudden changes in diet

Front 12

Why would a pancreatic duct occlusion lead to pancreatic necrosis?

Back 12

Pressure in ducts can occlude capillaries and lead to ischemia

Front 13

What are all pancreatic proteases secreted as?

Back 13

Zymogens

Front 14

Where is trypsinogen activated and what enzyme activates it?

Back 14

In the lumen of the intestines by enteropeptidase

Front 15

What is the significance of trypsin?

Back 15

It is autocatalytic and activates all the other enzymes

Front 16

What prevents autocatalyzed trypsin from eating the pancreas?

Back 16

Trypsin inhibitor

Front 17

Besides trypsinogen, what other proteases are released the pancreas? (3)

Back 17

- Chymotrypsinogen

- Procarboxypeptidase A & B

Front 18

What is the significance of procarboxypeptidases A&B?

Back 18

When activated, these enzymes can cleave single amino acids at polypeptide terminal ends; the rest cleave polypeptides

Front 19

What is the action of amylase?

Back 19

Breaks starches down to disaccharides

Front 20

What enzyme breaks down DNA and RNA?

Back 20

Nuclease

Front 21

What enzyme helps lipase by changing the shape of micelles to allow contact with fats?

Back 21

Colipase

Front 22

How much function of the pancreas must be lost before nutrition is affected?

Back 22

90%

Front 23

What nutrient is affected first by pancreatic deficits?

Back 23

Digestion of fats

(Bc not a lot of enzymatic redundancy)

Front 24

What cells secrete sodium and bicarbonate into pancreatic secretions? (2)

Back 24

Duct cells and centroacinar (myoepithelial) cells

Front 25

What enzyme produces bicarbonate?

Back 25

Carbonic anhydrase

Front 26

Where does hydrogen ion go when bicarbonate is produced and secreted to the pancreatic duct?

Back 26

Into portal blood (lowers pH) and mixes with basic stomach blood to neutralize it

Front 27

How are the electrolytic secretions of duct cells controlled?

Back 27

Secretin w/ weak stimulation from CCK and ACh

Front 28

What cells release secretin in the intestines?

What stimulates this release?

Back 28

S-cells

acid

Front 29

In what state does Cl- outweigh bicarbonate in the pancreatic secretion?

Back 29

Fasted state

Front 30

What does cAMP stimulate in pancreatic duct cells?

What are the down stream effects of this?

Back 30

cAMP activates Cl- channel that pushes chlorine into the duct, where it can interact with a Cl-/HCO3- antiporter to help excrete bicarbonate.

Front 31

How does the cephalic phase influence the pancreas?

Back 31

Vagal stimulation increases synthesis of pancreatic enzymes

Front 32

How does the gastric phase influence the pancreas?

Back 32

Gastrin released by the stomach and neuronal stimulation by ACh begins some release of pancreatic enzymes into the duct

Front 33

What is the primary mechanism by which the intestinal phase stimulates synthesis and release of pancreatic enzymes? (2)

Give their effects.

Back 33

Secretin stimulates bicarbonate release from duct cells

CCK stimulates enzyme release from acinar cells

Front 34

Which hormone is nature's antacid?

Back 34

Secretin

Front 35

What reflex promotes pancreatic secretion?

Back 35

Enteropancreatic reflex

Front 36

What cells produce CCK in the intestines?

Back 36

I-cells

Front 37

What stimulates release of secretin? (2)

CCK? (2)

Back 37

Secretin - acidic chyme and amino acids

CCK - amino acids, fatty acids, CCK-RP

Front 38

What is the second messenger for Secretin?

CCK?

Back 38

Secretin - cAMP

CCK - IP3/Ca++

Front 39

What is the function of Monitor Peptide?

What cells release it?

Back 39

Stimulates enzyme synthesis and CCK release by I-cells

acinar cells

Front 40

What 2 hormones stimulate CCK release from I-Cells?

What enzyme inhibits release of CCK from I-cells?

Back 40

CCK-RP (releasing peptide) and Monitor peptide

Trypsin

Front 41

What effect does CCK have on the sphincter of Oddi?

Back 41

Relaxation

Front 42

What function is lost first in pancreatitis?

Back 42

Exocrine function

Front 43

What secondary disease can occur if endocrine function is also lost in pancreatitis?

Back 43

Diabetes

Front 44

If acid is not neutralized in the duodenum, what results?

Back 44

duodenal ulcers

Front 45

What must occur for a gastric ulcer to present?

Back 45

Pancreatic enzymes moving retrograde into lumen of the stomach

Front 46

What is a sign of a loss of pancreatic lipase?

Back 46

Steatorrhea