Biliary and Pancreatic Anatomy

1
Biliary and Pancreatic Anatomy
Liver
Gallbladder
Common bile duct
Pancreas
Pancreatic duct
Duodenum
2
Pancreatic Anatomy
Insulin and glucagon
Blood
Islet cell secreting hormones
Cells secreting pancretic juice
Duodenum
Pancreas
Pancretic duct
Common bile duct
3
Pancreatic Secretions
Cell Type Component Function

• Acinar Enzymes
  Digestion
• Ductal HCO3 and Water Protection
  Digestion

4
PANCREATIC ACINAR CELL
ATP
Secretin
Adenyl cyclase
cAMP
?
Enzymes
?
Ca2
Ach
Ca2 stores
IP3
CCK
Primary Stimulus
The Hormones also Modulate Enzyme Expression
5
Pancreatic Duct Cell
6
Regulators of Pancreatic Secretion
Cell Type PrimaryActivator Potentiator

• Acinar CCK / Ach Secretin
• Ductal Secretin CCK / Ach

(Ca2 )
(cAMP )
Cephalic and Gastric Neural Ach Intestinal
Hormonal
7
Liver
Hepatic Ducts
Left
Right
Pancreatic Duct
Common Bile Duct
Cystic Duct
Ampulla of Vater
Gallbladder
Sphincter of Oddi
Duodenal Lumen
8

• Excretory Component - Bilirubin, Drug
  Metabolites.
• Secretory Component
• Bile Produced and Filtered by Hepatocytes
• Primary Bile Acids Cholic
  Acid, Chenodeoxycholic Acid
• Secondary Bile Acids - Formed by Bacteria
  in the Intestine
• Deoxycholic Acid, Lithocholic Acid

9
Bile Acids
Secondary bile acids
Primary bile acids
20
80
Fraction of Total
Deoxycholic acid
Cholic acid
Cholesterol
Cholesterol 7-hydroxylase
Amphipathic Carboxylic Acids
Lithocholic acid
Chenodeoxycholic acid
Liver
Intestine
10
Bile Acids are Amphipathic
Have both Hydrophilic and Hydrophobic domains
Formation of Micelles
Co-Lipase
C
11
Hepatic cell plate
Bile canaliculus
Central vein
Kupffer cell
Venous sinusoid
Terminal bile duct
Portal venule
12
To Systemic Circulation
Rates ml/min
Aorta
LIVER
HEPATIC
Celiac (700)
(200)
STOMACH
SPLEEN
Superior Mesenteric (700)
(1800) mls/min
Portal Vein
PANCREAS
SMALL INTESTINE
Inferior Mesenteric (400)
COLON
13
EnterohepaticCirculation
14
SECRETIONS of the INTESTINES
Information pertaining to the next 3 slides is
found in the Lecture Notes for the last Lecture
15
Cell Loss
Blood vessels Lymph vessels Nerves Smooth
muscle Connective tissue lymphocytes Plasma
cells Eosinophiles
Absorp- tive cells
Villous epithelium
Goblet cells
Crypt lumen
Undifferentiated
Crypt epithelium
Goblet
Mitoses
Endocrine cells
Endocrine cells
Muscularis mucosa
16
Secretions of the Small Intestine (2000 ml/day)

• Crypts of Lieberkuhn Small and Large Intestine
• Contain Primarily Epithelial Cells, Mucus Goblet
  Cells, and Endocrine Cells.
• Water Secretion - VIP Activates Water Secretion
  by Elevating cAMP and Cl- conductance.
• Cell Growth and Differentiation Cell Turnover at
  the Tip of a Villus is High (3-6 day Cycle).

17
Key Players cAMP Activated Cl- Channel Na / K
/ Cl- Co-transport Na-K ATPase
VIP neurotransmitter Histamine also can
activate