12 Pancreas test Flashcards
- The majority of the pancreas lies within which abdominal cavity?
a. Perineum
b. Intraperitoneum
c. Retroperitoneum
d. Pericardium
ANS: C
The pancreas is located in the retroperitoneal cavity
- The pancreas is found behind the ___________ omental sac.
a. Greater
b. Inferior
c. Superior
d. Lesser
ANS: D
The pancreas lies behind (posterior to) the lesser omental sac
Which one of the following statements is false?
a. The head of the pancreas is anterior to the inferior vena cava (IVC).
b. The head of the pancreas is superior to the caudate lobe.
c. The uncinate process is posterior to the superior mesenteric vessels.
d. The gastroduodenal artery is the anterolateral border of the head.
ANS: B
The head of the pancreas lies inferior to the caudate lobe of the liver and the main portal vein.
The head of the pancreas lies:
a. Anterior to the liver
b. Posterior to the aorta
c. Medial to the duodenum
d. Lateral to the inferior vena cava
ANS: C
The head of the pancreas lies medial to the duodenum (in the C-loop of the duodenum).
- The head of the pancreas is inferior to the _____________ of the liver:
a. Right lobe
b. Caudate lobe
c. Right lateral fissure
d. Left lateral fissure
ANS: B
The head of the pancreas is inferior to the caudate lobe of the liver and the main portal vein.
- The ___________ passes through a groove posterior to the pancreatic head.
a. Common bile duct
b. Gastroduodenal artery
c. Hepatic duct
d. Superior mesenteric vein
ANS: A
The common bile duct passes through the first part of the duodenum and courses through the groove posterior to the pancreatic head
- Which one of the following structures is located in the anterolateral border of the pancreas?
a. Common bile duct
b. Gastroduodenal artery
c. Hepatic duct
d. Superior mesenteric vein
ANS: B
The gastroduodenal artery is located along the anterolateral border of the pancreas as it travels a short distance along the anterior aspect of the pancreatic head just to the right of the neck before it divides into the superior pancreaticoduodenal artery branches.
The tail of the pancreas is located:
a. Posterior to the left kidney, near the splenic hilum
b. Anterior to the left kidney, near the splenic hilum
c. Posterior to the right kidney, near the liver hilum
d. Anterior to the right kidney, near the liver hilum
ANS: B
The tail of the pancreas lies anterior to the left kidney and posterior to the left colic flexure and transverse colon.
The primary pancreatic duct is the duct of ______________.
a. Santorini
b. Ampulla
c. Vater
d. Wirsung
D
The duct of Wirsung is a primary duct of the pancreas. It extends the entire length of the gland.
An older man with a history of alcoholism is recently diagnosed with acute pancreatitis. His hematocrit and hypotension levels are decreased. Your differential diagnosis includes:
a. Hemorrhagic pancreatitis
b. Cholecystitis
c. Pseudocyst
d. Chronic pancreatitis
A
Hemorrhagic pancreatitis may demonstrate symptoms that include a decrease in hematocrit and serum calcium levels, severe (intense) abdominal pain radiating to the back, and hypotension. Nearly one half of these patients have sudden necrotizing destruction of the pancreas after an alcohol binge or an excessively large meal
Which one of the following veins courses in a sagittal plane and passes posterior to the neck of the pancreas?
a. Splenic
b. Superior mesenteric
c. Inferior mesenteric
d. Main portal
B
The superior mesenteric vein passes anterior to the third part of the duodenum and posterior to the neck of the pancreas
A patient with painless jaundice, weight loss, and a decrease in appetite should be evaluated for:
a. Cholecystitis
b. Adenocarcinoma of the pancreas
c. Pancreatitis
d. Pancreatic pseudocyst
B
Clinical findings of adenocarcinoma of the pancreas include weight loss, decreased appetite, nausea and vomiting, stool changes, pain radiating to the back, painless jaundice, and metastases.
The duct of Santorini is a(n):
a. Small accessory duct to the gallbladder
b. Accessory duct to the cystic duct
c. Accessory duct to the pancreas
d. Small opening in the duodenum
C
The duct of Santorini is a secondary duct that drains the upper most anterior pancreatic head.
The normal dimension of the pancreatic head is usually less than ___________.
a. 3 mm
b. 2 cm
c. 2.4 cm
d. 1 cm
B
The head of the pancreas is the thickest part of the gland, measuring 2 to 3 cm
The normal size of the pancreatic duct is less than _____ mm.
a. 1
b. 3
c. 5
d. 6
B
The duct should measure less than 2 mm with tapering as it reaches the tail.
A serum _____ level of twice normal usually indicates acute pancreatitis.
a. lipase
b. amylase
c. alkaline phosphatase
d. aspartate aminotransferase (AST)
D
A serum level of twice normal usually indicates acute pancreatitis. Lipase levels also increase with acute pancreatitis
The microscopic collection of cells within the tissues of the pancreas is called?
a. Glucagon cells
b. Islets of Langerhans
c. Insulin
d. Amylase cells
B
Islets of Langerhans are specialized cells that produce insulin (alpha cells), glycogen (beta cells), and somatostatin (smallest delta cells).
The splenic vein courses along the ____________________ of the pancreas.
a. Anterior border
b. Along the superior border
c. Posteromedial border
d. Inferior posterior border
C
The splenic vein courses across the posteromedial surface of the pancreas to join the main portal vein.
If the celiac axis is well visualized, the sonographer should move the transducer in the __________ direction to image the pancreas?
a. Superior
b. Anterior
c. Inferior
d. Posterior
C
The celiac axis serves as the superior border of the pancreas; therefore the sonographer should move inferiorly to image the pancreas.
The splenic artery is considered to be along the _________________ border of the pancreas.
a. Superior
b. Lateral
c. Anterior
d. Inferior posterior
A
The splenic artery follows a tortuous course along the superior border of the pancreas.
The main pancreatic duct joins the __________ before entering the second part of the duodenum.
a. Common bile duct
b. Duct of Santolina
c. Cystic duct
d. Accessory duct
A
The duct of Wirsung enters the medial aspect of the second part of the duodenum with the common bile duct at the ampulla of Vater.
Clinical signs and symptoms in acute pancreatitis include all of the following except:
a. Severe abdominal pain radiating to the back
b. Severe abdominal pain radiating to the right shoulder
c. Elevated amylase
d. Nausea and vomiting
B
Clinical signs and symptoms of acute pancreatitis include sudden onset of moderate-to-severe abdominal pain radiating to the back, nausea and vomiting, history of gallstones or alcoholism, mild fever, increase in pancreatic enzymes (amylase and lipase), leukocytes, and abdominal bloating
A most common cause of acute pancreatitis in the United States is:
a. Colitis
b. Alcohol intake
c. Biliary tract disease
d. Pancreatic malignancy
C
The most common cause of acute pancreatitis is gallstone(s). Alcohol abuse is the second most common cause
The pancreas is reflective in its sonographic appearance because of the multiple:
a. Islets of Langerhans
b. Cooper ligaments
c. Small glands or acini
d. Fat between the lobules
D
The parenchymal texture of the pancreas depends on the amount of fat between the lobules and, to a lesser extent, on the interlobular fibrous tissue.
What vessel runs posterior to the lower neck of the pancreas and anterior to the uncinate process?
a. Splenic vein
b. Superior mesenteric vein
c. Gastroduodenal artery
d. Hepatic artery
B
The superior mesenteric vein crosses anterior to the uncinate process and posterior to the neck and body of the pancreas
The persistence of the dorsal and ventral pancreas with the head encircling the duodenum is called:
a. Hypoplasia
b. Cystic fibrosis
c. Agenesis
d. Annular pancreas
D
Annular pancreas is a rare anomaly in which the head of the pancreas surrounds the second part of the duodenum. This condition is more common in men and may be associated with a complete or partial atresia of the duodenum
A condition that causes increased secretion of abnormal mucus by the exocrine glands is:
a. Cystic fibrosis
b. Fibrocystic disease of the pancreas
c. Diabetes
d. Cystic mucosal disease
A
Cystic fibrosis is a hereditary disease that causes excessive production of thick mucus by the endocrine glands
Gallstones are present in 40% to 60% of patients with:
a. Chronic pancreatitis
b. Annular pancreas
c. Cystic fibrosis
d. Acute pancreatitis
D
Gallstones are present in 40% to 60% of patients with acute pancreatitis. Of the patients with gallstones, 5% have acute pancreatitis.
A common course of enzyme destruction via the pancreas is the accumulation in the:
a. Greater omentum
b. Lesser omentum
c. Lesser sac
C
The common course is for fluid to break through the pancreatic connective tissue layer and the thin posterior layer of the peritoneum and enter the lesser sac.
In cases of acute pancreatitis, the parenchyma of the pancreas generally appears:
a. Homogeneous
b. Echogenic
c. Calcified
d. Hypoechoic
D
Early stages of acute pancreatitis may appear sonographically normal. When swelling of the pancreas occurs, the pancreas is hypoechoic to anechoic and is less echogenic because of the increased prominence of lobulation and congested vessels.
