2 buds, a dorsal and a ventral from the endodermal lining of the duodenum
Which endodermal pancreatic bud is located closer to the gall bladder and bile duct
Ventral pancreatic bud
Once the pancreas is fully developed, where do the dorsal and ventral buds end up in relation to each other
The ventral bud ends up caudal to the dorsal bud
When does the pancreas begin budding
Around day 30
Uncinate process of the pancreas
Derived from the ventral bud inferior to the head of the pancreas
What is the main pancreatic duct derived from
Entire Ventral pancreatic duct and the distal dorsal duct
Accessory pancreatic duct
Persistent dorsal pancreatic duct, this is not found in everyone
Annular pancreas
The ventral pancreas fails to shift to the left of the duodenum and ends up choking it, giving a partial or complete obstruction
Exocrine pancreas does what
It is a Tubuloacinar serous gland that secretes about 1.2 liters of a bicarbonate rich fluid of digestive enzymes
What are the four regions of the pancreas
Uncinate process
Head (lies in a C shaped curve of the Duodenum)
Body
Tail (closest to the spleen)
What is the location called where the pancreatic duct empties into the duodenum
Hepatopancreatic ampulla (of Vater)
This is the same entrance of the bile duct
What is the primary cell type of the pancreas
Acinar cells
Acini are made up of what cells and arrangement
Acinar cells pyramid in shape with its peak towards the lumen with a round nucleus on the basal end
How does an acinar cell stain
Basophilic on the basal end and acidophilic on the apical end (due to the excess of secretory granules containing enzymes)
Cholecystokinin and acetylcholine receptors are found where on the Acinar cell and come from what nerve fibers
On the basal end
Acetylcholine comes from postganglionic parasympathetic nerve fibers
Cholecystokinin from enteroendocrine cells
The duct system of the exocrine pancreas starts how
It begins at the apical end of the acinar cells by cells called centroacinar cells
What kind of cells are centroacinar cells
Squamous to low cuboidal
Centroacinar cells and intercalated ducts both have what receptors
Receptors on their basal membrane for secretin and acetylcholine
Intralobular ducts are a continuation of
Centroacinar cells and intercalated ducts joining together delivering their contents into the main pancreatic duct
What are the enzymes that the Acinar cells synthesize
Amylase
Lipase
Ribonuclease
Dnase
Trypsinogen
Chymotrypsinogen
Elastase
Procarboxypeptidase
"Louisiana PD REACT"
What do the Acinar cells produce that protects them from accidental intracellular damage
Trypsin inhibitor
Cholecystokinin and Acetylcholine have what effect on Acinar cells
They stimulate the synthesis and release of the pancreatic enzymes
Cholecystokinin is made by
Enteroendocrine cell of the Duodenum
Secretin and Acetylcholine affect Centroacinar cells and intercalated ducts how
They trigger them to synthesize and release a serous bicarbonate (rich alkaline fluid)
What is the purpose of the serous bicarbonate made by the centroacinar cells and intercalated ducts
It is a rich alkaline fluid which nuetralizes and buffers the acidic chyme that enters the Duodenum from the stomach
Secretin is made by
Enteroendocrine cells of the small intestines
Islets of Langerhans are most numerous where
In the tail of the pancreas
Islets of Langerhans is made up of what cells
Alpha cells (15-20%)
Beta cells (60-70%)
Delta cells (5-10%)
Surrounded by reticular fibers
How do the Islets of Langerhans in humans and rats compare
Rats have more glucagon in the dorsal portion and more insulin in the ventral region. Humans however have more Insulin in the dorsal region
Rats also have the characteristic insulin core
Alpha cells in the Islet of Langerhan secrete ---------, in response to what
Glucagon in response to low blood glucose
Glucagon acts mainly on
Hepatocytes
Delta cells in the Islet of Langerhans secrete
Somatostatins
"D stat"
Somatostatin is released by the pancreas in response to
Increased levels of blood glucose amino acids or chylomicrons after a meal
How do Delta cells compare in size to Alpha and Beta
They are larger
"D cup as compared to an A cup"
What is the difference in Paracrine and Endocrine effects of Delta cells in the pancreas
Paracrine effects are inhibition of nearby alpha and beta cells
Endocrine effects are on smooth muscles reducing the motility of the GI tract and gall bladder
Glycogenolysis
Conversion of glucogen to glucose
D1 (second delta cell type) cells secrete what
Vasoactive intestinal peptide (VIP) inducing glycogenolysis and hyperglycemia as well as regulates smooth muscle and motility in the gut
Pancreatic Polypeptide (PP)
A hormone that inhibits pancreatic enzymes and HCO3 secretions in the pancreas, stimulates enzyme release from the gastric chief cells, and depresses HCl release from parietal cells
A tumor of the Islets of Langerhans can cause
Excessive secretion of the Gastrin hormone which ironically has not been significantly demonstrated in normal islets
Insuloacinar portal system
Afferent arterioles forming a network of capillaries lined by fenestrated endothelial cells around the Islets of Langerhans
Acinar vascular system
A system independent of the insuloacinar portal system supplying the pancreatic acini