(42) Pancreas

Question 1

(Macroscopic Appearance of Pancreas)

1-3. What three parts should we know?

Answer 1

1. left lobe
2. pancreatic angle
3. right lobe

Question 2

(Microscopic Anatomy of Pancreas)

1-2. What two main cells does he want us to know?

Answer 2

1. Acinar Cells
2. Ductal Cells

Question 3

1-2. What are two major functions of acinar cells?

Answer 3

1. release zymogen granules (contain zymogens = inactivated enzymes) into ductal system

enzymatic digestion of food - protease, lipase, amylase

2. secrete anti-bacterial proteins (keep intestinal bacteria in check)

Question 4

1-2. What are the two major functions of ductal cells?

Answer 4

1. secrete fluid (chloride, sodium, bicarbonate (neutralizes acid from intestine))
2. secrete intrinsic factor

(this is the sole site of release in cats - dogs also release intrinsic factor from stomach - human just from stomach)

Question 5

(Mammalian Portal Venous Systems: Hepatic, Hypophyseal, Islet-Acinar)

1. What hormones regulate acinar function?
2. What effect does insulin have on acinar cells?
3. What are Diabete Mellitus patients at risk for?

Answer 5

1. islet hormones
2. stimulates acinar cell growth
3. Exocrine pancreatic insufficiency

Question 6

(Duct Cells: HCO3-/Fluid Secretion)

(After eating this is what happens)

• note increase in HCO3 to pretect from stomach acid

Question 7

(Duct Cells: Intrinsic Factor Secretion)

1. Gastric and pancreatic inctrinsic factor mediate what in the dog?
2. Feline intrinsic factor (IF) is pancreatic in origin and mediates what?

Answer 7

1. absorption of B12
2. ileal cobalamin absorption

Question 8

(Acinar Cells: Enzyme Secretion)

Recognize that acinar cells produce trypsinogen which is converted to trypsin by enterokinase in small intestine

Then note that trypsin activates a bunch more zymogens to active enzyme form

therefore - if acinar cells get messed up - won’t get good digestion because responsible for activation of digestive enzymes

Question 9

(Physiologic Regulation of Pancreatic Secretion)

(Cephalic Phase of Pancreatic Secretion)

1. What binds to receptors on pancreatic acinar cells? stimulating what?
2. Protons emptying from stomach to intestine activate what that release what? binds to what to do what?
3. there is also what kind of regulation?

Answer 9

1. gastrin; production of zymogen
2. secretin cells that release secretin; duct cells to release HCO3
3. paracrine regulation via mast cells

Question 10

(Gastric/Intestinal Phases - Pancreatic Secretion)

1. Delivery of protein and fats into small intestine that activate what cell to release what? What does it bind to to do what?

he just seemed to skip ove GRP, SP, and VIP

Answer 10

1. CCK cells to release CCK; acinar cells to stimulate zymogen secretion

Question 11

(Receptors/Signal Transduction - Pacreatic Secretion)

1. Fluid one? Autonomic nervous system innervation of pancreas secretes something that has the same effect - what is it called?
2. What type of innervations are on the other side?

Answer 11

1. Secretin; VIP (vasoactive intestinal polypeptide secretory…)
2. neural innervation (ACH) and CCK (he also mentioned GRP and SP but don’t learn them)

He glossed over everything that I didn’t mention - but it might be a good idea to learn what each of these cause the release of (shown in picture)

(THINK OF RIGHT SIDE AS ACINAR CELL)

Question 12

(Species Differences is Intrinsic Factor secretion)

1. dog
2. human
3. cat

Answer 12

1. both
2. gastric
3. pancreatic

Question 13

(Acinar Cells: Self Protection from Auto Digestion)

name them - 8 ways

Every very good looking zero says ED

Answer 13

1. ER Zymogen Synthesis (inactive from)
2. Vectorial Transport –> golgi
3. glycosylation (zymogen pathway) and phophorylation (lysozome pathway)
4. lysosomal sequesteration
5. zymogen granules
6. SPINK! –> PTSI
7. Endocytosis/Export

8, Distal Activation

Question 14

(Pathogenesis of Exocrine Pancreatic Injury)

1. A is normal
2. What is abnormal in B?
3. What is abnormal in C?

Answer 14

1.

2. lysosome and zymogen get loaded into one common vacuole (co-localization) - then fuck shit up in cell
3. pretty much the same thing I guess - remember colocationzation

Question 15

(Chemical Pathology - Pancreatic Necrosis)

1. What damage does trypsin cause?
2. What 3 things does elastase do?
3. What do Lipase and Phospholipase A do?

Answer 15

1. broad range of proteolytic activity
2. blood vessel elastin digestion, vascular damage, and hemorrhage
3. fat necrosis, membrane dissolution

Question 16

(The Three Phases of Acute Pancreatitis)

1. There are 5 initiating events - what are they? I TIDI

moves to…

2. Acinar Events - there are four of them - what are they?

moves to

3. severity determinants… What are they? there are 5
4. What do acinar events and severity determinants lead to?

Answer 16

1. Ischemia, Toxins, inflammation, drugs, infection
2. Blocked secretion, co-localization, enzyme activation, cell injury
3. Inflammatory Cytokines, Reactive O2 species, Altered redox state, ischemia, apoptosis
4. acute pancreatitis

Question 17

He then skipped some slides at the end