Ch 12 Pancreas

Question 1

body of the pancreas

Answer 1

Lies in the midepigastrium anterior to the superior mesenteric artery and vein, aorta, and inferior vena cava

Question 2

caudal pancreatic artery

Answer 2

Branch of splenic artery that supplies the tail of the pancreas

Question 3

C-loop of the duodenum

Answer 3

Forms the lateral border of the head of the pancreas

Question 4

Common hepatic artery

Answer 4

Forms the right superior border of the body and head of the pancreas and gives rise to the gastroduodenal artery

Question 5

dorsal pancreatic artery

Answer 5

Branch of the splenic artery that supplies the body of the pancreas

Question 6

duct of Santorini

Answer 6

Small accessory duct of the pancreas found in the head of the gland

Question 7

duct of Wirsung

Answer 7

Largest duct of the pancreas that drains the tail, body, and head of the Gland; it joins the common bile duct to enter the duodenum through the ampulla of Vater

Question 8

head of the pancreas

Answer 8

Lies in the C- Loop of the duodenum; the gastroduodenal artery is the anterolateral border, and the common bile duct is the posterolateral border

Question 9

neck of the pancreas

Answer 9

Small area of the pancreas between the head and the body; anterior to the superior mesenteric vein

Question 10

pancreaticoduodenal artery

Answer 10

Help supply blood to the pancreas along with the splenic artery

Question 11

portal-splenic confluence

Answer 11

Junction of the splenic and main portal vein; posterior border of the pancreas

Question 12

superior mesenteric artery

Answer 12

Serves as the posterior border to the body of the pancreas

Question 13

superior mesenteric vein

Answer 13

Lies posterior to the neck or body of the pancreas and anterior to the uncinate process of the gland

Question 14

Tail of the pancreas

Answer 14

Tapered end of the pancreas that lies in the left hypochondrium near the hilus of the spleen and upper pole of the left kidney

Question 15

uncinate

Answer 15

Small, curved tip of the pancreatic head that lies posterior to the superior mesenteric vein

Question 16

acini cell

Answer 16

Cells that perform exocrine function

Question 17

amlylase

Answer 17

Enzyme secreted by the pancreas to aid in the digestion of carbohydrates

Question 18

endocrine

Answer 18

The kind of pancreatic function that involves the production of the hormone insulin

Question 19

exocrine

Answer 19

The kind of pancreatic function that involves the production and digestion of pancreatic juice

Question 20

glucagons

Answer 20

Stimulates the liver to convert the glycogen to glucose; produced by alpha cells

Question 21

insulin

Answer 21

Hormone that cause glycogen formation from glucose in the liver and that allows circulating glucose to enter tissue cells

Question 22

islets of Langerhans

Answer 22

Portion of the pancreas that has an endocrine function and produces insulin, glucagon, and somatostatin

Question 23

lipase

Answer 23

Pancreatic enzyme that break down fats; enzyme is elevated in pancreatitis and remains increased longer than amylase

Question 24

serum amylase

Answer 24

Pancreatic enzyme that is elevated during pancreatitis

Question 25

Courvoisier's gallbladder

Answer 25

Enlargement of the gallbladder caused by a slow, progressive obstruction of the distal common bile duct from an external mass such as adenocarcinoma of the pancreatic head

Question 26

cystic fibrosis

Answer 26

Hereditary disease that causes excessive production of thick mucus by the endocrine glands

Question 27

hypercalcemia

Answer 27

Elevated levels of calcium in the blood

Question 28

hyperlipidemia

Answer 28

Congenital condition in which elevated fat levels cause pancreatitis

Question 29

ileus

Answer 29

Dilated loops of bowel without peristalsis; associated with various abdominal problems, including pancreatitis, sickle cell crisis, and bowel obstruction

Question 30

leukocytosis

Answer 30

Abnormal increase in white blood cells caused by infections

Question 31

lymphoma

Answer 31

Malignant neoplasm that arises from the lymphoid tissues

Question 32

obstructive jaundice

Answer 32

Excessive bilirubin in the bloodstream caused by an obstruction of bile from the liver; characterized by a yellow discoloration of the sclera of the eye, skin, and mucous membranes

Question 33

pancreatic ascites

Answer 33

Fluid accumulation caused by a rupture of a pancreatic enzymes are very dangerous to surrounding structures

Question 34

pancreatic pseudocyst

Answer 34

"Sterile abscess" collection of pancreatic enzymes that accumulate in the available space in the abdomen, usually in or near the pancreas

Question 35

pancreatitis

Answer 35

Inflammation of the pancreas; may be acute or chronic

Question 36

pseudocyst

Answer 36

Space or cavity that contains fluid but has no true endothelial lining membrane

Question 37

The pancreas is located in the ____ cavity posterior to the stomach, duodenum and proximal jejunum.

Answer 37

retroperitoneal

Question 38

The pancreatic gland appears sonographically _____ to slightly more _____ than the hepatic parenchyma

Answer 38

isoechoic, heyerechoic

Question 39

The major posterior vascular landmarks of the pancreas are the ____ and ____.

Answer 39

aorta, inferior vena cava

Question 40

The head of the pancreas lies | ____ to the inferior vena cava

Answer 40

anterior

Question 41

The _____ crosses anterior to the uncinate process of the head of the gland and posterior to the neck and body

Answer 41

Superior mesenteric vein

Question 42

The tortuous ____ is the superior border of the pancreas

Answer 42

splenic artery

Question 43

The tail of the pancreas is more difficult to image because it lies anterior to the left kidney and posterior to the left _____ and ____.

Answer 43

colic flexure, transverse colon

Question 44

The _____ receives tributaries from lobules at right angles and enters the medial second part of the duodenum with the common bile duct at the ampulla of Vater

Answer 44

Duct of Wirsung

Question 45

The blood supply for the pancreas is from the ____ artery and the ____ arteries

Answer 45

Splenic, pancreaticoduodenal

Question 46

The _____ artery is seen along the anterolateral border of the pancreas as it travels a short arteries

Answer 46

gastroduodenal

Question 47

The ____ duct crosses the anterior aspect of the portal vein to the right of the proper hepatic artery

Answer 47

common bile

Question 48

The portal vein is ____ to the inferior vena cava

Answer 48

anterior

Question 49

The pancreas is both a digestive ____ and a hormonal ____ gland

Answer 49

exocrine, endocrine

Question 50

Failure of the pancreas to furnish sufficient insulin leads to ____

Answer 50

diabetes mellitus

Question 51

Exocrine function is performed by _____ of the pancreas

Answer 51

acini cell

Question 52

The ____ is a muscle surrounding the ampulla of Vater that relaxes to allow pancreatic juice and bile to empty into the duodenum

Answer 52

sphincter of Oddi

Question 53

The endocrine function is located in the ____ in the | pancreas.

Answer 53

islets of Langerhans

Question 54

The beta cells are most prevalent and produce ____, a hormone that cause glycogen formation from glucose in the liver

Answer 54

insulin

Question 55

Alpha cells produce ____, a hormone that causes the cells to release glucose to meet the energy needs of the body.

Answer 55

glucagons

Question 56

Delta cells are the smallest composition of the endocrine tissue and produce ____

Answer 56

somatostatin

Question 57

There are specific enzymes of the pancreas that may become altered in pancreatic disease namely, ____ and ___.

Answer 57

amylase, lipase

Question 58

Both amylase and lipase rise at the same rate, but the elevation in _____ concentration persists for a longer period in pancreatitis

Answer 58

lipase

Question 59

____ controls the blood sugar level in the body

Answer 59

Glucose

Question 60

Explain how fat influences the echogenicity of the pancreas on ultrasound

Answer 60

Fat is strongly echogenic, the internal echoes of the pancreas consist of closely spaced elements of the same intensity with uniform distribution throughout the gland. Parenchymal texture of the pancreas depends on the amount of fat between the lobules and to a less extent on the interlobular fibrous tissue

Question 61

Name the structures that could be identified as landmarks to locate the pancreas

Answer 61

superior mesenteric artery and vein, portal and splenic vein, aorta and inferior vena cava, common bile duct, gastroduodenal artery, left renal vein

Question 62

Describe the water technique used to image the pancreas with ultrasound

Answer 62

Patient should drink 32 to 3000 ml through a straw in a erect position. Fluid fills the duodenal cap to outline the lateral margin of the head of the pancreas. Upright position allow air to move from the gastric antrum to the fundus of the stomach and cause the upper viscera to move downward for a better sonic window.

Question 63

When the pancreas is enlarged, the anterior border of the ____ may depict a slight indentation

Answer 63

inferior vena cava

Question 64

When the pancreas becomes damaged and malfunctions as a result of secretion and blockage of ducts ____ occurs

Answer 64

Pancreatitis

Question 65

An acute attack of pancreatitis is commonly related to ____ and ____

Answer 65

alcoholism, biliary tract disease

Question 66

The patient with pancreatitis typically presents with moderate to severe tenderness in the ____ radiating to the ____.

Answer 66

epigastrium, back

Question 67

When swelling does occur the gland is hypoechoic and is less echogenic than the liver because of the increased prominence of ____ and ____

Answer 67

lobulations, congested vessels

Question 68

The pancreatic duct may be obstructed in acute pancreatitis as a result ___, ____, ____, ____, and ___.

Answer 68

inflammation, spasm, edema, swelling of the papilla and pseudocyst

Question 69

Fluid collections around the pancreatic ____, along the ___ spaces, with in the ____ pouch, and around the ____ may be present in a patient with acute pancreatits

Answer 69

Bed, pararenal, Morison's, duodenum

Question 70

Patients with acute pancreatitis may develop complications, such as

Answer 70

pseudocyst, phlegmon, abscess, hemorrhage, and duodenal obstruction

Question 71

Necrosis of the blood vessels results in the development of hemorrhagic areas referred to as ___ signs

Answer 71

Grey's Turner's

Question 72

An inflammatory process that spreads along fascial pathway, causing localized areas of diffuse inflammatory edema of soft tissue, is known as ___

Answer 72

phlegmon

Question 73

The ____ becomes obstructed with build up of protein plugs with resultant calcification along the duct in ____ pancreatitis

Answer 73

pancreatic ducts, chronic

Question 74

Describe how a pseudocyst develops

Answer 74

Pancreatic enzymes that escape the ductal system cause enzymatic digestion of surrounding tissue and pseudocyst development. The walls of the pseudocyst form in various potential spaces in which escaped the pancreatic enzymes are found. The pseudocyst usually presents few symptoms until it becomes large enough to cause pressure on surrounding organs

Question 75

The most common location of a pseudocyst is in the ____, anterior to the pancreas and posterior to the stomach

Answer 75

lesser sac

Question 76

A pseudocyst develops when pancreatic _____ escape from the gland and break down tissue to form a sterile abscess somewhere in the abdomen

Answer 76

enzymes

Question 77

The most common primary neoplasm of the pancreas is ____

Answer 77

adenocarcinoma

Question 78

List clinical findings in a patient with carcinoma of the pancreas

Answer 78

weight loss, painless jaundice, nausea, vomiting, and change is stool

Question 79

The most frequent parapancreatic neoplasm is ____>

Answer 79

lymphoma