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The Hamburger Journey

Arellano - Cando
Digestion/Pancreatic secretions
Guyton & Hall (Chap 65, p.825)

Intro to pancreas (what? where?)

Digestion/Pancreatic secretions
Pancreatic Juice
- Made of pancreatic digestive enzymes, sodium bicarbonate, water
- Passes through the pancreatic duct, which combines with the hepatic duct to form
the hepatopancreatic ampulla / papilla of Vater through which it enters the small

Pancreatic Digestive Enzymes

- Secreted by pancreatic acini (in their activated form)
- Activated by enzymes of the small intestine when they reach the small intestine

Trypsin Inhibitor
- Formed in the glandular cells of the pancreas in order to prevent the activation of
trypsin and other digestive enzymes
- Pancreatic digestive enzymes must not be activated until they reach the small
intestine since their premature activation would digest the pancreas, and potentially
lead to acute pancreatitis
Digestion/Pancreatic secretions
Pancreatic Digestive Activated by Breaks Down

Trypsinogen (Trypsin**) Enterokinase, [activated] Proteins → smaller peptides


Chymotrypsinogen Trypsin Proteins → smaller peptides


Pro-carboxypolypeptidase Trypsin Proteins →

(Carboxypolypeptidase) peptides/individual amino

Pancreatic lipase Neutral fat → FA +


Cholesterol esterase Cholesterol esters

Phospholipase Phospholipid → FA +

Pancreatic amylase Carbohydrates (starch,

glycogen) except cellulose →

* most important secretions

**most abundant enzyme
Digestion/Pancreatic secretions
Bicarbonate Ions and Water
- From epithelial cells of ducts and
ductules from the pancreatic acini
- Bicarbonate cc can rise up to 145
mEq/L ( 5x that of bicarbonate found
in the plasma), and therefore
neutralize the HCl emptied into the
duodenum from the stomach

For mode of secretion, see: notes;

simplify / cut into chunks + add more
3 Basic Stimuli Causing Pancreatic Secretion:
1. Acetylcholine (Ach)
2. Cholecystokinin (CCK)
3. Secretin

Ach and CCK - acinar cells of pancreas

Secretin - water (from NaHCO3)

Lack of water - temporary storage of enzymes in the acini & ducts until there is

Pancreatic secretion results from COMBINED effects of the basic stimuli

Pancreatic Secretion Phases:
1. Cephalic
-Ach release
- 20% of postmeal secretions

2. Gastric
-nervous stimulation of enzyme secretion
- 5-10% of postmeal secretions

3. Intestinal
-Intestinal - large amounts of pancreatic secretion due to secretin

Cephalic and Gastric - little amounts of enzyme flow due to lack of fluid
-stimulates secretion of large amounts of bicarbonate ions
Bicarbonate → appropriate pH for pancreatic digestive enzymes (pH 7-8)
-released when pH is < 4.5-5
-pancreatic juice secretion (NaHCO3)
-Net result: HCl + NaHCO3 → NaCl + H2CO3
H2CO3 becomes CO2 and H2O
CO2 absorbed into the blood and expired through the lungs
NaCl in duodenum is neutralized
Cholecystokinin (CCK)
- Stimulated by the presence of proteases, peptones, and long-chain fatty acids
in the upper small intestine
- Secreted by the I cells in the mucosa of duodenum and upper jejunum
- Result: increased secretion of pancreatic digestive enzymes by acinar cells
Differences between pancreatic stimulatory effects of secretin and CCK
-neutralization of acidic contents from the stomach
-blocking of peptic digestive activity of gastric juices

Purpose: protection of small intestine mucosa from duodenal ulcers