Physiology of Pancreatic Secretions : Gastrointestinal Physiology USMLE Step 1

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Physiology of Pancreatic Secretions : Gastrointestinal Physiology USMLE Step 1

The pancreas plays an important role in the digestion of food. It produces pancreatic juice, which contains enzymes that break down carbohydrates, proteins, and fats. The pancreatic juice also contains bicarbonate ions that help neutralize the acidic chyme (food mixed with stomach acid) as it enters the small intestine. The pancreas secretes its juice into the duodenum (the first part of the small intestine) through the pancreatic duct.

The production and secretion of pancreatic juice are regulated by both hormonal and neural mechanisms. The main hormones involved in the regulation of pancreatic secretion are secretin and cholecystokinin (CCK), which are released from cells in the duodenum in response to the presence of chyme. Secretin stimulates the secretion of bicarbonate ions from the pancreatic duct cells, while CCK stimulates the secretion of digestive enzymes from the acinar cells of the pancreas.

The neural regulation of pancreatic secretion is mediated by the vagus nerve and enteric nervous system. The vagus nerve stimulates the secretion of pancreatic juice in response to the sight, smell, and taste of food. The enteric nervous system responds to the presence of chyme in the duodenum and stimulates the release of both secretin and CCK.

The composition of pancreatic juice varies depending on the type of cells producing it. The acinar cells produce enzymes such as amylase, lipase, and proteases that break down carbohydrates, fats, and proteins respectively. The duct cells produce bicarbonate ions that neutralize the acidic chyme as it enters the small intestine. Other substances found in pancreatic juice include electrolytes, water, and mucus.

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