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Abdomen > Chapter 12 - Pancreas > Flashcards

Chapter 12 - Pancreas Flashcards

1
Q

Branch of splenic artery that supplies the tail of the pancreas

A

caudal pancreatic artery

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2
Q

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

A

tail of the pancreas

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3
Q

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

A

portal-splenic confluence

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4
Q

Help supply blood to the pancreas along with the splenic artery

A

pancreaticoduodenal arteries

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5
Q

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

A

body of the pancreas

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6
Q

Forms the lateral border of the head of the pancreas

A

C-loop of duodenum

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7
Q

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

A

neck of the pancreas

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8
Q

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

A

superior mesenteric vein

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9
Q

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

A

common hepatic artery

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10
Q

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

A

duct of Wirsung

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11
Q

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

A

head of the pancreas

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12
Q

Serves as the posterior border to the body of the pancreas

A

superior mesenteric artery

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13
Q

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

A

duct of Santorini

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14
Q

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

A

dorsal pancreatic artery

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15
Q

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

A

uncinate process

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16
Q

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

A

endocrine

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17
Q

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

A

islets of Langerhans

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18
Q

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

A

glucagons

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19
Q

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

A

exocrine

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20
Q

Pancreatic enzyme that is elevated during pancreatitis

A

serum amylase

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21
Q

Cells that perform exocrine function

A

acini cells

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22
Q

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

A

insulin

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23
Q

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

A

lipase

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24
Q

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

A

amylase

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25
Q

Congenital condition in which elevated fat levels cause pancreatitis

A

hyperlipidemia

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26
Q

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

A

obstructive jaundice

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27
Q

Malignant neoplasm that arises from the lymphoid tissues

A

lymphoma

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28
Q

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

A

ileus

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29
Q

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

A

pseudocyst

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30
Q

Inflammation of the pancreas; may be acute or chronic

A

pancreatitis

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31
Q

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

A

pancreatic pseudocyst

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32
Q

Abnormal increase in white blood cells caused by infection

A

leukocytosis

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33
Q

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

A

Courvoisier’s gallbladder

34
Q

Elevated levels of calcium in the blood

A

hypercalcemia

35
Q

Fluid accumulation caused by a rupture of a pancreatic pseudocyst into the abdomen; free-floating pancreatic enzymes are very dangerous to surrounding structures

A

pancreatic ascites

36
Q

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

A

cystic fibrosis

37
Q

The pancreas is located in the _______________ cavity posterior to the stomach, duodenum, and proximal jejunum of the small bowel.

A

retroperitoneal

38
Q

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

A

isoechoic, hyperechoic

39
Q

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

A

aorta, IVC

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

SMV

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 _______________ duct crosses the anterior aspect of the portal vein to the right of the proper hepatic artery.

A

common bile

47
Q

The portal vein is _______________ to the inferior vena cava.

A

anterior

48
Q

The pancreas is both a digestive (_______________) and a hormonal (_______________) gland.

A

exocrine, endocrine

49
Q

Failure of the pancreas to furnish sufficient insulin leads to _______________.

A

diabetes mellitus

50
Q

Exocrine function is performed by _______________ of the pancreas

A

acini cells

51
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

52
Q

The endocrine function is located in the _______________ in the pancreas.

A

islets of Lagerhans

53
Q

The beta cells are most prevalent and produce _______________, a hormone that causes glycogen formation from glucose in the liver.

A

insulin

54
Q

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

A

glucagons

55
Q

Delta cells are the smallest composition of endocrine tissue and produce _______________.

A

somatostatin

56
Q

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

A

amylase, lipase

57
Q

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

A

lipase

58
Q

_______________ controls the blood sugar level in the body.

A

glucose

59
Q

Explain how fat influences the echogenicity of the pancreas on ultrasound.

A

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. The internal echoes of the pancreas consist of closely spaced elements of the same intensity with uniform distribution throughout the gland. Fat is strongly echogenic.

60
Q

Name the structures that should be identified as landmarks to locate the pancreas.

A

SMA and SMV; portal and splenic veins; aorta and IVC; common bile duct; gastroduodenal artery; left renal vein; duodenal bulb; posterior wall of the stomach; pancreatic duct

61
Q

Describe the water technique used to image the pancreas with ultrasound.

A

The patient should drink 32-300 mL of fluid through a straw in the erect or the eight lateral decubitus position. The fluid fills the duodenal cap to outline the lateral margin of the head of the pancreas. The upright position allows air to move from the gastric antrum to the fundus of the stomach and causes the upper viscera to move downward for a better sonic window.

62
Q

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

A

IVC

63
Q

When the pancreas becomes damaged and malfunctions as a result of increased secretion and blockage of ducts, _______________ occurs.

A

pancreatitis

64
Q

An acute attack of pancreatitis is commonly related to _______________ and _______________.

A

alcoholism, biliary tract disease

65
Q

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

A

epigastrium, back

66
Q

When swelling does occur, the gland is hypoechoic to anechoic and is less echogenic than the liver because of the increased prominence of _______________ and _______________.

A

lobulations, congested vessels

67
Q

The pancreatic duct may be obstructed in acute pancreatitis as a result of _______________, _______________, _______________, _______________, and _______________.

A

inflammation, spasm, edema, papilla swelling, and pseudocyst

68
Q

Fluid collections around the pancreatic _______________, along the _______________ spaces, withing the _______________ pouch, and around the _______________ may be present in a patient with acute pancreatitis.

A

bed, pararental, Morison’s, duodenum

69
Q

Patients with acute pancreatitis may develop complications, such as _______________, _______________, _______________, _______________, and _______________.

A

pseudocyst, phlegmon, abscess, hemorrhage, duodenal obstruction

70
Q

Necrosis of the blood vesseels results in the development of hemorrhagic areas referred to as _______________ sign.

A

Grey Turner’s

71
Q

An inflammatory process that spreads along fascial pathways, causing localized areas of diffuse inflammatory edema of soft tissue, is known as _______________.

A

phlegmon

72
Q

The _______________ become obstructed with a buildup of protein plugs with resultant calcifications along the duct in ______________ pancreatitis.

A

pancreatic ducts, chronic

73
Q

Describe how a pseudocyst develops.

A

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

74
Q

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

A

lesser sac

75
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

76
Q

The most common primary neoplasm of the pancreas is _______________.

A

adenocarcinoma

77
Q

List the clinical findings in a patient with carcinoma of the pancreas.

A

weight loss, painless jaundice, nausea, vomiting, and changes in stools

78
Q

The most frequent parapancreatic neoplasm is _______________.

A

lymphoma

79
Q

A 45-year-old male presents with midepigastric pain, elevated amylase and lipase levels, and tenderness. Identify the sonographic findings.

A

Sonographic findings consist of an enlarged, edamatous pancreas–pancreatitis

80
Q

A patient with known acute pancreatitis presents with continued pain. Describe the sonographic findings.

A

Findings consist of pancreatitis with hemorrhage. The gland is enlarged and echogenic secondary to freshly clotted blood.

81
Q

A 56-year-old male with a 1-week history of jaundice and pain has reported a 3-month history of nausea, vomiting, weight loss, and diarrhea. Given this information, what are the sonographic findings?

A

Findings consist of adenocarcinoma of the pancreas with a dilated common bile duct. The gallbladder is dilated.

Abdomen (4 decks)

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