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secretions.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1">
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<title>Ginger_Jungle, DMD (tbd)</title>
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</head>
<nav class="navbar navbar-default navbar-static-top" style="background-color:rgba(255,255,255,.7);">
<div class="container-fluid">
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<a class="navbar-brand" href="index.html">Preston's Site</a>
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<li><a href="index.html">Home</a></li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-haspopup="true" aria-expanded="false">Gastrointestinal Unit<span class="caret"></span></a>
<ul class="dropdown-menu">
<li><a href="anatomy.html">Overview and Anatomy</a></li>
<li class="active"><a href="secretions.html">GI secretions</a></li>
<li><a href="swallow.html">Swallowing</a></li>
<li><a href="disorders.html">GI Disorders</a></li>
<li><a href="hormones.html">Hormones</a></li>
<li><a href="gidisorders1.html">GI Disorders I</a></li>
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<a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-haspopup="true" aria-expanded="false">Pharmacology<span class="caret"></span></a>
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<li><a href="gipharm1.html">GI Pharmacology I</a></li>
<li><a href="gipharm2.html">Disorders of GI Function</a></li>
<li><a href="endocrinepharm1.html">Endocrine Pharmacology I</a></li>
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<li><a href="ksecretion.html">K+ excretion</a></li>
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<h1>Gastrointestinal Secretions</h1>
</div>
<div class="container text-left custom-background-transparentwhite">
<div style="font-size:16px">
<ol>
<li>Water, mucous, K+ secreted everywhere</li>
<li>Duct cells in stomach, goblet cells in intestine secrete mucous</li>
<li>Saliva contains HCO3- and amylase</li>
<li>Gastric - HCl, pepsinogen, gastric lipase, intrinsic factor, water, mucous</li>
<li>Pancreatic - HCO3-, water, amylase, lipase, proteases, nucleases -
and inactive Zymogens (must be converted into active form)</li>
<li>7 L of fluid a day is secreted by GI tract, either through <b>Duct delivery systems</b>
or through <b>Direct secretion</b> in the lumen of the alimentary canal (full GI traxt)</li>
<li>Ducts include: salivary ducts, pancreatic ducts, biliary ducts</li>
<li>GI input = GI output</li>
<li>Brunner's gland in duodenum secretes with high basicity due to
large concentration of bicarbonate (pH = 8-9)</li>
<li>Saliva is an <b>exocrine</b> secretion - 1.5 L of secretion a day</li>
<li>PSNS controls salivary secretion</li>
<li>Basic secretory unit of saliva is acinar cells - always hypotonic to plasma</li>
<li>Major glands - parotid (serous), submandibular (serous and mucus), sublingual (mucus)</li>
<li>Sensory reflexes, pressure, nausea stimulate secretion</li>
<li>Fatigue, fear, sleep, depression inhibit secretions</li>
<li>Saliva is composed of 99.5% water, along with</li>
<ul><li>electrolytes (bicarbonate, sodium, potassium, chloride)</li>
<li>mucins</li>
<li>WBCs</li>
<li>IgA, lysozyme (Paneth cells), lactoferrin, lactoperoxidase</li>
<li>Amylase (hydrolysis of starch), lipase (hydrolysis of fats),
kallikrein (serine protease)</li>
</ul>
<li>Minor salivary glands secrete mainly mucous</li>
<li>Problems with dentures mainly involve minor salivary glands</li>
<li>Parotid is 30% of total output and has most of the enzymes and IgA,
submandibular is 60% of output</li>
<li>Saliva lubricates, digests, transports, and defends</li>
<li>Saliva facilitates taste and neutralizes gastric acid</li>
<li>Secretion is mainly dependent on calcium ion signaling</li>
<li>Duct cells absorb NaCl, potassium and HCO3- are secreted</li>
<li>Gastric secretions</li>
<ul>
<li>HCl</li>
<li>Intrinsic factor - binds B12</li>
<li>Pepsinogen</li>
<li>Mucous</li>
<li>During meals, more H+ secretion, during rest, more NaCl</li>
<li>Gastric juice can kill bacteria and parasites</li>
</ul>
<li>Parietal cells (oxynytic cells) -
release HCl, intrinsic factor to active pepsin and kill bacteria</li>
<li>Mucuous cells (duct cells) release mucuous and bicarbonate</li>
<li>Enterochromaffin cells release histamine to stimulate gastric acid secretion (parietal cells)</li>
<li>Chief (peptic) cells release pepsin and gastric lipase</li>
<li>D cells release somatostatin to inhibit gastric acid secretion</li>
<li>G cells release gastrin to stimulate gastric acid secretion</li>
<li>Acetylcholine, gastrin, histamine stimulate parietal cells</li>
<li>In Zollinger-Ellison syndrome (gastrinoma), gastric acid output is greatly increased</li>
<li>Mucuous and bicarbonate protect the surface of the stomach from autodigestion</li>
</ol>
</div>
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