Chapter 14- Pancreas Flashcards

1
Q

Is the pancreas covered with peritoneum?

A

The pancrease is retroperitoneal, but a small portion of the head is covered with peritoneum.

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2
Q

What are the 5 parts of the pancreas?

A

Uncinate process, head, neck, body, tail

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3
Q

What is the location of the pancreas?

A

it lies transverse between the c-loop of the duodenum and splenic helium.

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4
Q

What is the Duct of Wirsung? What does it join?

A

The main pancreatic duct. It joins the Common Bile Duct before entering the duodenum.

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5
Q

What is the Ampulla of Vater?

A

The place where the Pancreatic and Common Bile ducts enter the duodenum

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6
Q

What is the Duct of Santorini? Where is it?

A

The accessory pancreatic duct. It enters the duodenum from 2cm superior to the duct of Wirsung

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7
Q

What is the size of the pancreas?

A

12-18 cm

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8
Q

How long is the pancreas head A to P?

A

2-3 cm

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9
Q

How long is the pancreas neck A to P?

A

1.5-2.5 cm

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10
Q

How long is the pancreas body A to P?

A

2-3 cm

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11
Q

How long is the pancreas tail A to P?

A

1-2 cm

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12
Q

The primitive pancreas is formed from the Dorsal and Ventral buds. What does the Dorsal bud arise from?

A

The dorsal aspect of the duodenum

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13
Q

The primitive pancreas is formed from the Dorsal and Ventral buds. What does the Ventral bud arise from?

A

the primitive common bile duct

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14
Q

At 6 weeks, what happens to the ventral bud?

A

IT rotates 270 degrees to fuse with the dorsal bud. This creates the final pancreas.

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15
Q

After fusion, the ventral duct connects with the proximal dorsal duct to form what structure?

A

The Duct of Wirsung

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16
Q

What does the duct of Wirsung drain?

A

it drains most of the pancreas

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17
Q

The duct of Wirsung empties into the duodenum through which two structures?

A

Major Papilla and Common Bile Duct

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18
Q

How do the ampulla of vater, sphincter of Oddi, and major papilla work together?

A

The sphincter of Oddi controls the opening of the Papilla so the ampulla can enter the duodenum.

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19
Q

What is the Major Papilla?

A

The Major Papilla is the small opening where the end of the Ampulla enters the duodenum.

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20
Q

The duct of Santorini empties into the duodenum through what structure?

A

The minor papilla

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21
Q

Where is the duct of Santorini in relation to the Duct of Wirsung? Where is the minor papilla in relation to the major papilla?

A

superior and superior

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22
Q

Which is 90% of the pancreas’ function, endocrine or exocrine?

A

Exocrine is 90% of the function of the pancreas

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23
Q

What is the exocrine function of the pancreas?

A

Secreting pancreatic juices to contribute to digestion.

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24
Q

What is the endocrine function of the pancreas?

A

Secreting hormones that regulate carbohydrate metabolism

25
Q

What are Islets of Langerhans?

A

part of the endocrine function, they are groups of cells found throughout the pancreas.

26
Q

What do Alpha cells secrete and what does this hormone do?

A

Glucagon that turns stored glycogen into its usable form, glucose

27
Q

What do Beta cells secrete and what does this hormone do?

A

Insulin that lowers blood sugar

28
Q

What do Gamma cells secrete and what does this hormone do?

A

Pancreatic Peptide which regulates blood sugar

29
Q

What do Delta cells secrete and what does this hormone do?

A

Somatostatin which inhibits the release of glucagon and insulin from the pituitary gland.

30
Q

What do Epsilon cells secrete and what does this hormone do?

A

Ghrelin which regulates blood sugar

31
Q

60-70% of the endocrine cells are which type?

A

Beta

32
Q

Why do cells release glucose?

A

to meet the energy needs in the body

33
Q

What percent of the pancreas’ endocrine function is from alpha cells?

A

15-20%

34
Q

Delta cells make up what percent of the endocrine tissue?

A

5%

35
Q

Define hypofunction. What disease is the result of hypofunction?

A

Hypofunction is a low level of insulin production that results in diabetes.

36
Q

Define hyperfunction. What is the result of hyperfunction?

A

Hyperfunction is the production of too much insulin. This can result in low blood sugar or hypoglycemia

37
Q

What cells are responsible for the exocrine function of the pancreas? What do they do?

A

Acini cells that produce pancreatic juices.

38
Q

What are pancreatic juices composed of?

A

enzymes that aid digestion

39
Q

What enzyme digests carbohydrates?

A

Amylase

40
Q

What enzyme digests fats?

A

Lipase

41
Q

What 3 enzymes digest proteins?

A

Trypsin, Chymotrypsin, Carboxypepidase

42
Q

What enzyme digests Nucleic Acid?

A

Nucleases

43
Q

What enzyme is the largest and neutralizes hydrochloric acid in the stomach?

A

Sodium Bicarbonate

44
Q

What happens when chyme enters the duodenum?

A

hormones are released, the sphincter relaxes, and pancreatic juices enter the duodenum from the duct of Wirsung

45
Q

What are the vascular landmarks for the pancreas body and tail?

A

the Aorta, SMA, and Splenic vein are posterior.

46
Q

What are the 4 vascular landmarks for the pancreas head and where are they?

A

The SMV is to the left, IVC is posterior, and the Common Bile Duct and Gastroduodenal Artery are landmarks for the head.

47
Q

What are the vascular landmarks for the pancreas neck and where are they?

A

The SMV and Portal-Splenic Confluence are posterior.

48
Q

Even though the AP measurement is small, what is considered the largest part of the pancreas?

A

The body

49
Q

What small vessels supply the pancreas and what arteries do they come from?

A

The splenic artery, Superior pancreaticoduodenal from the GDA, and Inferior pancreaticoduodenal from SMA

50
Q

When looking at the transverse aorta at the level of the celiac axis, can we see the pancreas? Why?

A

no. the celiac axis branches into the splenic artery which is superior to the pancreas. In a transverse image, we cannot see superior or inferior.

51
Q

What 2 veins drain the pancreas?

A

Splenic vein and SMV

52
Q

What is the measurement of the pancreatic duct?

A

less than 2 mm

53
Q

What vessel does the GDA branch off of?

A

The Common Hepatic Artery

54
Q

What 2 patient positions would we use to scan the pancreas? Why might we need to do this?

A

Supine and Upright. The pancreas is posterior to the stomach so it can be hard to visualize.

55
Q

Hypertrophy in the head of the pancreas might lead to what obstruction?

A

Portal or Bile Duct

56
Q

Degeneration of the islets of Langerhans might lead to what disease?

A

Diabetes

57
Q

What is Pancreatitis?

A

serious inflammatory condition of the exocrine pancreas

58
Q

Where is cancer of the pancreas typically found? Is it common or fatal?

A

It is found in the body or tail. It is common and very fatal.