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Concept
Pancreatic juice
Summary
Pancreatic juice is a liquid secreted by the pancreas, which contains a number of digestive enzymes, including trypsinogen, chymotrypsinogen, elastase, carboxypeptidase, pancreatic lipase, nucleases and amylase. The pancreas is located in the visceral region, and is a major part of the digestive system required for proper digestion and subsequent assimilation of macronutrient substances required for living.
Pancreatic juice is alkaline in nature due to the high concentration of bicarbonate ions. Bicarbonate is useful in neutralizing the acidic gastric acid, allowing for effective enzymic changes.
Pancreatic juice secretion is principally regulated by the hormones secretin and cholecystokinin, which are produced by the walls of the duodenum, and by the action of autonomic innervation.
The release of these hormones into the blood is stimulated by the entry of the acidic chyme into the duodenum. Their coordinated action results in the secretion of a large volume of pancreatic juice, which is alkaline and enzyme-rich, into the duodenum. The pancreas also receives autonomic innervation. The blood flow into pancreas is regulated by sympathetic nerve fibers, while parasympathetic neurons stimulate the activity of acinar and centroacinar cells.
Pancreatic secretion is an aqueous solution of bicarbonate originating from the duct cells and enzymes originating from the acinar cells. The bicarbonate assists in neutralising the low pH of the chyme coming from the stomach, while the enzymes assist in the breakdown of the proteins, lipids and carbohydrates for further processing and absorption in the intestines. Secretin-stimulated pancreatic juice can be collected during endoscopy and provides an important source for diagnostic biomarkers, allowing detection of pancreatic pathology, especially cancer not yet visible on medical imaging..
Pancreatic juice is secreted into the duodenum through duodenal papillae. Some individuals have also an accessory duct, named accessory pancreatic duct, which may be functional (that is, it also empties the contents of the exocrine pancreas into the duodenum) or non-functional.
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Human digestive system
The human digestive system consists of the gastrointestinal tract plus the accessory organs of digestion (the tongue, salivary glands, pancreas, liver, and gallbladder). Digestion involves the breakdown of food into smaller and smaller components, until they can be absorbed and assimilated into the body. The process of digestion has three stages: the cephalic phase, the gastric phase, and the intestinal phase. The first stage, the cephalic phase of digestion, begins with secretions from gastric glands in response to the sight and smell of food.
Cholecystokinin
Cholecystokinin (CCK or CCK-PZ; from Greek chole, "bile"; cysto, "sac"; kinin, "move"; hence, move the bile-sac (gallbladder)) is a peptide hormone of the gastrointestinal system responsible for stimulating the digestion of fat and protein. Cholecystokinin, formerly called pancreozymin, is synthesized and secreted by enteroendocrine cells in the duodenum, the first segment of the small intestine. Its presence causes the release of digestive enzymes and bile from the pancreas and gallbladder, respectively, and also acts as a hunger suppressant.
Pancreatic duct
The pancreatic duct, or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct), is a duct joining the pancreas to the common bile duct. This supplies it with pancreatic juice from the exocrine pancreas, which aids in digestion. The pancreatic duct joins the common bile duct just prior to the ampulla of Vater, after which both ducts perforate the medial side of the second portion of the duodenum at the major duodenal papilla. There are many anatomical variants reported, but these are quite rare.