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DR AYOADE O. A
PANCREAS
Pan (all); kreas (flesh). Exocrine and endocrine organ. Retroperitoneal. Termed Most unforgiving organ. Tremendous reserve capacity. 75 - 100gm in weight. 15 - 20cm in length.
Sphincter of Oddi
ERCP
1.5 2.5L/day of alkaline juice ( pH 8.0- 8.3) Over 20 digestive enzymes Amylase carbohydrate Protease protein Lipase fat 3 phase secretion Cephalic, Gastric, Intestinal
Over 1 million islet of langerhan cells. 4 major cell types - Glucagon - Insulin - Somatostatin - pancreatic polypeptide
BILIRUBIN METABOLISM
Jaundice or icterus
Yellowish discolouration of the skin, mucous membranes, sclera. Excess plasma bilirubin Normal range < 1 mg / dl
Clinically obvious
> 3 mg / dl Not a disease but a Sign.
BILIRUBIN METABOLISM
Heme
Heme oxygenase
Biliverdin
Biliverdin reductase
Bilirubin + albumin
UDP glucuronyl transferase
BMG, BDG
glucuronidases
Urobilinogen
Bacteria enzymes
Stercobilinogen Feaces
Unconjugated bilirubin (aka indirect) is fat soluble and toxic. Bilirubin is excreted in Bile. Main constituent of Bile is water , bile acids, bile pigments, cholesterol, phospholipids & all inorganic ions found in plasma.
INTESTINE - converted to Secondary bile acids - deoxycholate , lithocholate & are absorbed in terminal ileum.
Main function are:
Reduction of surface tension (surfactants) Emulsification of Fat for easy digestion and absorption in the small intestine. (Detergents) Absorption of Fats and fat soluble vitamins ( A D E K ) Maintain cholesterol homeostasis.
Pancreas
Sorrounded by the Great vessel and vital organs. Avascular plane behind its neck Coeliac plexus block.
Bilirubin
80 % from breakdown of RBC In its unconjugated form is toxic
Bile acids
Obstruction to its flow - malabsorption of fats & vitamins A, D, E, K.