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Chapter 9 Vascular > Ch 12 Pancreas > Flashcards

Ch 12 Pancreas Flashcards

1
Q

body of the pancreas

A

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

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2
Q

caudal pancreatic artery

A

Branch of splenic artery that supplies the tail of the pancreas

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3
Q

C-loop of the duodenum

A

Forms the lateral border of the head of the pancreas

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4
Q

Common hepatic artery

A

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

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5
Q

dorsal pancreatic artery

A

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

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6
Q

duct of Santorini

A

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

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7
Q

duct of Wirsung

A

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

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8
Q

head of the pancreas

A

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

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9
Q

neck of the pancreas

A

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

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10
Q

pancreaticoduodenal artery

A

Help supply blood to the pancreas along with the splenic artery

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11
Q

portal-splenic confluence

A

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

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12
Q

superior mesenteric artery

A

Serves as the posterior border to the body of the pancreas

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13
Q

superior mesenteric vein

A

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

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14
Q

Tail of the pancreas

A

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

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15
Q

uncinate

A

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

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16
Q

acini cell

A

Cells that perform exocrine function

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17
Q

amlylase

A

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

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18
Q

endocrine

A

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

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19
Q

exocrine

A

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

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20
Q

glucagons

A

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

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21
Q

insulin

A

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

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22
Q

islets of Langerhans

A

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

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23
Q

lipase

A

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

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24
Q

serum amylase

A

Pancreatic enzyme that is elevated during pancreatitis

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25
Q

Courvoisier’s gallbladder

A

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

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26
Q

cystic fibrosis

A

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

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27
Q

hypercalcemia

A

Elevated levels of calcium in the blood

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28
Q

hyperlipidemia

A

Congenital condition in which elevated fat levels cause pancreatitis

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29
Q

ileus

A

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

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30
Q

leukocytosis

A

Abnormal increase in white blood cells caused by infections

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31
Q

lymphoma

A

Malignant neoplasm that arises from the lymphoid tissues

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32
Q

obstructive jaundice

A

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

33
Q

pancreatic ascites

A

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

34
Q

pancreatic pseudocyst

A

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

35
Q

pancreatitis

A

Inflammation of the pancreas; may be acute or chronic

36
Q

pseudocyst

A

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

37
Q

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

A

retroperitoneal

38
Q

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

A

isoechoic, heyerechoic

39
Q

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

A

aorta, inferior vena cava

40
Q

The head of the pancreas lies

____ to the inferior vena cava

A

anterior

41
Q

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

A

Superior mesenteric vein

42
Q

The tortuous ____ is the superior border of the pancreas

A

splenic artery

43
Q

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

A

colic flexure, transverse colon

44
Q

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

A

Duct of Wirsung

45
Q

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

A

Splenic, pancreaticoduodenal

46
Q

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

A

gastroduodenal

47
Q

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

A

common bile

48
Q

The portal vein is ____ to the inferior vena cava

A

anterior

49
Q

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

A

exocrine, endocrine

50
Q

Failure of the pancreas to furnish sufficient insulin leads to ____

A

diabetes mellitus

51
Q

Exocrine function is performed by _____ of the pancreas

A

acini cell

52
Q

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

A

sphincter of Oddi

53
Q

The endocrine function is located in the ____ in the

pancreas.

A

islets of Langerhans

54
Q

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

A

insulin

55
Q

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

A

glucagons

56
Q

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

A

somatostatin

57
Q

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

A

amylase, lipase

58
Q

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

A

lipase

59
Q

____ controls the blood sugar level in the body

A

Glucose

60
Q

Explain how fat influences the echogenicity of the pancreas on ultrasound

A

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

61
Q

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

A

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

62
Q

Describe the water technique used to image the pancreas with ultrasound

A

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.

63
Q

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

A

inferior vena cava

64
Q

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

A

Pancreatitis

65
Q

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

A

alcoholism, biliary tract disease

66
Q

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

A

epigastrium, back

67
Q

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

A

lobulations, congested vessels

68
Q

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

A

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

69
Q

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

A

Bed, pararenal, Morison’s, duodenum

70
Q

Patients with acute pancreatitis may develop complications, such as

A

pseudocyst, phlegmon, abscess, hemorrhage, and duodenal obstruction

71
Q

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

A

Grey’s Turner’s

72
Q

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

A

phlegmon

73
Q

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

A

pancreatic ducts, chronic

74
Q

Describe how a pseudocyst develops

A

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

75
Q

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

A

lesser sac

76
Q

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

A

enzymes

77
Q

The most common primary neoplasm of the pancreas is ____

A

adenocarcinoma

78
Q

List clinical findings in a patient with carcinoma of the pancreas

A

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

79
Q

The most frequent parapancreatic neoplasm is ____>

A

lymphoma

Chapter 9 Vascular (16 decks)

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