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Bile Secretion Reviewer, Study notes of Physiology

Reviewer for bile secretion taken from Guyton

Typology: Study notes

2019/2020

Uploaded on 08/19/2020

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Bile Secretion
- Secreted by liver
- (600-1000 mL/day)
I. Functions of bile:
1) Fat digestion and absorption due to bile acids
Bile acid functions:
a) emulsification of large fat particles into tiny
minute particles
increase in surface area allows for easier
attack by lipase enzymes secreted in pancreatic
juice
b) aid in absorption of digested fat end products
thru the intestinal mucosal membrane
2) Serves as a means for excretion of several important waste
products from the blood
II. Physiologic Anatomy of Biliary Secretion
Fig. Control of secretion
2 Stages of Bile Secretion by the Liver:
1) Initial portion
- secreted by hepatocytes into minute bile canaliculi
(between the hepatic cells)
- contains large amounts of bile acids, cholesterol, other
organic constituents
2) Bile
i) Flows in the canaliculi towards the interlobular septa
ii) In the interlobular septa, the canaliculi empty into terminal
bile ducts progressively larger ducts hepatic duct
common bile duct
In the bile ducts
- a second portion of secretion is added to the initial
bile
- Second portion/secretion watery solution of sodium
and bicarbonate ions (secreted by epithelial cells
lining the ductules and ducts)
o Sometimes increases total quantity of bile by
as much as 100%
o Stimulated especially by secretin
o Release of additional HCO3- to supplement
HCO3- in pancreatic secretion
o Bicarbonate neutralizes acid that empties
into duodenum from stomach
iii) After the ducts, bile either:
iii.a) empties into duodenum directly; or
iii.b) diverted thru cystic duct gallbladder (storage
for minutes to several hours)
Fig. Bile acid stimulation/inhibition
Storing and Concentrating Bile in the Gallbladder
Bile continually secreted by the liver cells
Normally stored in gallbladder until needed by
duodenum
Gallbladder maximum volume capacity = 30-
60 mL
As much as 12 hours of bile secretion (~450
mL) can be stored. How?
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Bile Secretion

  • Secreted by liver
  • (600-1000 mL/day) I. Functions of bile:
  1. Fat digestion and absorption – due to bile acids Bile acid functions: a) emulsification of large fat particles into tiny minute particles
  • increase in surface area allows for easier attack by lipase enzymes secreted in pancreatic juice b) aid in absorption of digested fat end products thru the intestinal mucosal membrane 2 ) Serves as a means for excretion of several important waste products from the blood II. Physiologic Anatomy of Biliary Secretion Fig. Control of secretion 2 Stages of Bile Secretion by the Liver:
  1. Initial portion
  • secreted by hepatocytes into minute bile canaliculi (between the hepatic cells)
  • contains large amounts of bile acids, cholesterol, other organic constituents
  1. Bile i) Flows in the canaliculi towards the interlobular septa ii) In the interlobular septa, the canaliculi empty into terminal bile ducts → progressively larger ducts → hepatic duct → common bile duct In the bile ducts
  • a second portion of secretion is added to the initial bile
  • Second portion/secretion – watery solution of sodium and bicarbonate ions (secreted by epithelial cells lining the ductules and ducts) o Sometimes increases total quantity of bile by as much as 100% o Stimulated especially by secretin o Release of additional HCO 3 -^ to supplement HCO 3 -^ in pancreatic secretion o Bicarbonate neutralizes acid that empties into duodenum from stomach iii) After the ducts, bile either: iii.a) empties into duodenum directly; or iii.b) diverted thru cystic duct → gallbladder (storage for minutes to several hours) Fig. Bile acid stimulation/inhibition Storing and Concentrating Bile in the Gallbladder Bile – continually secreted by the liver cellsNormally stored in gallbladder until needed by duodenum
  • Gallbladder maximum volume capacity = 30- 60 mL
  • As much as 12 hours of bile secretion (~ mL) can be stored. How?
  • Water and electrolytes (Na+, Cl-) are continuously being absorbed by gallbladder mucosaConcentrates bile constituents in the gallbladderConcentrated 5-fold (normally) up to max 20-fold o Gallbladder absorption – active transport of sodium thru gallbladder epithelium causes secondary absorption of sodium & chloride ions, water, diffusible constituents III. Composition of Bile Subs- tance Liver Bile Gallbladd er bile Reabsorbe d by gallbladde r mucosa? Secrete d/ excrete d in large amount s Water 97. g/dL

92 g/dL ✔

Bile salts

- Most abundant, ~50% total solutes

g/dL

6 g/dL ✖ Largely

secreted , small excretion Bilirubin 0. g/dL

0.3 g/dL ✖ ✔

Cholester ol

g/dL

g/dL

Fatty acids

g/dL

g/dL Lecithin 0. g/dL

0.3 g/dL ✔

Na+^ 145 mEq/ L

130 mEq/L ✔ ✔

K+^ 5

mEq/ L

12 mEq/L ✔

Ca++^ 5 mEq/ L

23 mEq/L ✖ ✔

Cl-^ 100 mEq/ L

25 mEq/L ✔ ✔

HCO 3 -^ 28

mEq/ L

10 mEq/L ✔

IV. Emptying of Bile

  • Cholecystokinin (CCK) – hormone that stimulates gallbladder emptying
  • Begins when food starts to be digested in the upper GIT o Especially when fatty foods reach the duodenum (~ minutes after meal) o Initial poor emptying, normalizes with presence of significant quantities of fat (in about 1 hour) Mechanism:
  • Rhythmical contractions of gallbladder wall and simultaneous relaxation of the sphincter of Oddi o Sphincter of Oddi – guards exit of common bile duct into the duodenum ▪ Stimulated by:
  • CCK – most potent stimulus for gallbladder contractions o ↑ secretion of digestive enzymes by acinar cells of pancreas o Stimulated by presence of fatty foods in duodenum
  • Acetylcholine-secreting nerve fibers – less strongly stimulates gallbladder o Stimulus from both vagi and intestinal enteric NS o Also promote motility and secretion in other GIT parts V. Function of Bile Salts in Fat Digestion and Absorption
  • Liver – synthesize ~ 6 grams of bile salts/day
  • Precursor of bile salts – cholesterol
  • Cholesterol – synthesized or from diet o First converted to cholic acid or chenodeoxycholic acid (~equal quantities) o Acids + glycine (or taurine) = glyco- (or tauro-) conjugated bile acids o Acid salts (acid + Na+) = sodium salt; secreted in bile Important actions in the intestinal tract:
  1. Emulsifying/Detergent function – detergent action by:
  • decreases surface tension of particles
  • allows agitation in the intestinal tract
  • breaks fat globules into minute sizes
  1. Absorption of lipids – more important than emulsification
  • absorption the following lipids in the intestinal tract:
  1. FA
  2. Monoglycerides
  3. Cholesterol
  4. Other lipids
  • forms micelles with lipids
  • micelles = bile salts + lipids
  • semi soluble in chyme bec. of electrochemical charges of bile salts
  • “ferries” lipids to intestinal mucosa where they are absorbed in the blood
  • without bile salts, up to 40% of ingested fats are lost in the feces & causes metabolic deficit
  • Continually undergo mitosis (new cells migrate upward out of crypts towards tips of villi) o Aged villus – shed into intestinal secretions (life cycle ~5 days) o Allow rapid repair of excoriations that occur in mucosa Fig. Crypt of Lieberkühn Regulation of Secretion
  • Most important regulator of small intestine secretion – local enteric nervous reflexes o Main stimuli: tactile or irritative stimuli from chyme in the intestines Secretion of Mucus by the Large Intestine Large intestine ▪ Mucosa contain numerous crypts of Lieberkühn ▪ No villi ▪ Epithelial cells secrete almost no digestive enzymes ▪ Contain mucous cells that secrete only mucus ▪ Increased peristaltic motility of the colon by parasympathetic stimulation Mucus ▪ Composition: moderate amounts of HCO 3 -^ secreted by few non-mucus-secreting epithelial cells ▪ Function: Provides protection against excoriation, gastric acid, and from bacterial activity that takes place inside feces and holds fecal matter together ▪ Rate of secretion: regulated mainly by tactile stimulation of epithelial cells lining the large intestine and local nervous reflexes to the mucous cells in the crypts of Lieberkühn
  • Increased secretion by parasympathetic stimulation carried by pelvic nerves from spinal cord (distal ½ to 2/3 of large intestine) Extreme parasympathetic stimulation
  • during emotional disturbances – causes bowel movement of ropy mucus (contains little or no fecal matter) every 30 minutes o Diarrhea ▪ Caused by excess H 2 O, electrolyte secretion in response to irritation
  • for diluting irritating factors and rapid movement of feces towards anus ▪ Occurs when bacterial infection is rampant during enteritis ▪ Also secretes normal viscid alkaline mucus