Basic GI Physio - Class 1 HN 510 2012

E insulin glucagon endocrine anatomical regions head

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Unformatted text preview: Pancreas Pancreas • The pancreas has two main functions – Exocrine - produces digestive enzymes – Endocrine – hormones (i.e., insulin, glucagon) Endocrine • Anatomical regions – Head – Neck – Uncinate – Body – Tail Pancreas Pancreas • The pancreas has two main functions – Exocrine - produces digestive enzymes – Endocrine – hormones (i.e., insulin, glucagon) Endocrine • Anatomical regions – Head – Neck – Uncinate – Body – Tail Normal pancreatic cell Exocytosis Lysosomes Zymogen granules Golgy complex Condensing vacuoles N RER DrMel® Exocrine Pancreas Exocrine • Mechanisms to prevent autodigestion Mechanisms autodigestion – Catalytically inactive zymogens – Segregation of zymogens and lysosomal Segregation lysosomal enzymes into different compartments – Specific trypsin inhibitor Pancreatitis Pancreatitis Exocytosis Abnormal vacuoles Zymogen granules Lysosomes N RER DrMel® Pancreatitis • Site of initiation of enzyme activation is intracellular. • Fusion of lysosomes and zymogen granules. • Abnormal routing of lysosomes and zymogen vacuoles. • Failure of normal intercellular transport and exocytosis. • Imbalance of active trypsin and protease inhibitors Pancreatic enzymes Pancreatic Pancreas Pancreas clinical flash • Accessory or Ectopic pancreas • Pancreatic tissue outside the normal pancreas • found in the stomach, duodenum and ileum • found in autopsies up to 15% • do not usually cause any symptoms • pancreatic malignancy in an ectopic pancreas is extremely rare Ectopic Pancreas Ectopic Pancreatitis Pancreatitis clinical flash • Multiple etiological factors • Hereditary pancreatitis in human beings – 2 mutations of cationic trypsin gene • 80 % acute pancreatitis in people – alcohol or gallstones Liver – main functions Liver – main functions Bile composition Bile Bile acids Bile • up to 95% of bile acids are reabsorbed • Bile acids can circulate > 50 times before they are eliminated • Deoxycholic and lithocholic are produced in the colon • lithocolic is the most insoluble bile acid • bile acid pool circulates • twice per meal • 6 -8 times/day Liver T Enterohepatic circulation - bile acids - Conjugated bile acid Portal system T T 95% are conjugate d B.A. Deconjugating Unconjugated B.A. enzymes (5%) D T T T D Intestinal lumen T Duodenum Jejunum T Receptor for C-BA Ileum DrMel®...
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