Beruflich Dokumente
Kultur Dokumente
01.11.11
OUTLINE OF TOPICS
Topics
I. PANCREAS
a. Pancreatic Digestive Enzymes
b. Regulation of Pancreatic Secretion
c. Multiplicative Effect of Different
Stimuli
d. Phases of Pancreatic Secretion
e. Secretin Effect
II. HEPATOBILIARY TRACT
a. Physiologic Anatomy of Biliary
Secretion
b. Storage & Concentration of Bile in
Gallbladder
c. Gallbladder Contraction & Emptying
d. Synthesis of Bile Salts in the
Hepatocytes
e. Action of Bile Salts in Intestinal Tract
f. Enterohepatic Circulation of Bile
Salts
g. The Liver
h. Normal Hepatic Function
i. Metabolic Functions of the Liver
j. Jaundice
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PANCREAS
Lies parallel to and beneath the
stomach
Large compound gland with most of its
structure similar to that of the salivary
glands
PANCREATIC ACINUS
o Basic unit of the pancreas
PANCREATIC SECRETION
PANCREATIC ACINUS
Acinar Cells
Starches, Glycogen
(not cellulose)
Pancreatic amylase
PANCREATIC DUCTULES
Disaccharides
secrete
DUODENUM
through the Papilla of Vater,
surrounded by Sphincter of Oddi
Transcribed by Group : 4
destruction of near
Nuclease blood vessels (ex: acute
pancreatitis)
PANCREATIC DUCT
Pancreatic Digestive Enzymes
+
Sodium Bicarbonate + H2O
Carboxypolypeptidase
Amino Acids
Less important proteolytic enzymes
o Elastase
can promote
o
secrete
Trisaccharides
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PANCREAS
Inactive Proenzyme
Trypsinogen
INTESTINES
Active Enzyme
enterokinase
intestinal mucosa
AutoTrypsin
catalytically
Chymotrypsinogen
Chymotrypsin
SECRETIN
o Secreted by S cells of
duodenal and jejunal mucosa
o When highly acidic food enters
the small intestine
Procarboxypolypeptidase
Carboxypolypeptidase
TRYPSIN INHIBITOR
o Secreted simultaneously by the
acini
o Prevents premature activation
of trypsin
o Overwhelmed in acute
pancreatitis
Pancreatic Secretion
o Can rise to 145 meq/L (5x
greater than plasma levels)
CCK
Secretin
Absorbed in blood
PANCREAS
Pancreatic Secretions
In the pancreas:
Acetylcholine &
Secretin
CCK
Ductal epithelium
Acinar cells
NaHCO3
Digestive
Fluid
enzyme
Fluid
1 L/day secreted fluid volume
Phase
Cephalic
Secretion of isosmotic sodium bicarbonate solution
by the pancreatic ductules and ducts
Proteoses
Peptones
Transcribed by Group : 4
Gastric
Intestinal
Phenome
non
Acetylcholi
ne
released
from vagal
nerve
endings
Acetylcholi
ne
released
from vagal
nerve
endings
CCK
released
secretion
Result
Enzyme
secretion
(stored in
acini)
% Total
Secreti
on
20
Enzyme
secretion
(stored in
acini)
5-10
Enzyme
secretion
NaHCO3
Fluid
70
SECRETIN EFFECT
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Gall Bladder
Stimulated by Bile Salts
SECRETORY EPITHELIAL
CELLS LINING DUCTULES
AND DUCTS
(Na+, HCO3)
CO2
H2O
Blood
Interlobar Septa
End result:
o Neutralization of acid
o Peptic activity in duodenum
o Appropriate pH (2.0-8.0) for
action of pancreatic enzymes
Duodenum
Gall Bladder
Stimulated by Secretin
HEPATOBILIARY TRACT
Bilirubin
Cholesterol
Duodenum
Transcribed by Group : 4
Formation of Gallstones
Phenome
non
Slight
Result
Acetylcholi
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Contract
ion
Gastric
Intestin
al
smell,
taste of
food
stimulate
vagus
nerve
Stomach
distention
vagus
nerve
further
stimulated
Food (fat)
in
duodenum
Up to 18x
ne
secretion
Secreted in bile
Portal Blood
Intestines
Acetylcholi
ne
secretion
CCK
secretion
94% absorbed
in ileum
6% lost in feces
transport)
(diffusion/active
Bile
Formation of Micelles
Ferried to mucosa
Absorbed into the blood
***in absence of bile salts: 40% of lipids are
lost in feces
ENTEROHEPATIC CIRCULATION OF BILE
SALTS
Means of bile salt conservation
Bile salts in liver
Transcribed by Group : 4
THE LIVER
Function as:
o Blood reservoir
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E.) EXCRETION
B.) STORAGE
C.) SYNTHESIS
Transcribed by Group : 4
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D
B12
3-4 months
1 year
Reversibly combines
with iron (Ferritin)
Released in Circulation
Kidneys
Intestines
Group NYAKIS! 11
FLOM.ron.BLE.jay.JUD.baki.JING.chin.KAR.dalt
JAUNDICE
Yellowish tint to the body tissues (skin,
sclerae, deep tissue) caused by large
quantities of bilirubin in the
extracellular fluid greater than 3x the
normal level
Causes of jaundice:
o Prehepatic
RBC destruction
(hemolytic jaundice)
Unconjugated
bilirubin
o Hepatic
Normal bilirubin
production but cannot
pass from bile ducts to
intestine
Conjugated Bilirubin
Transcribed by Group : 4
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