Chapter 14- Pancreas Flashcards
Is the pancreas covered with peritoneum?
The pancrease is retroperitoneal, but a small portion of the head is covered with peritoneum.
What are the 5 parts of the pancreas?
Uncinate process, head, neck, body, tail
What is the location of the pancreas?
it lies transverse between the c-loop of the duodenum and splenic helium.
What is the Duct of Wirsung? What does it join?
The main pancreatic duct. It joins the Common Bile Duct before entering the duodenum.
What is the Ampulla of Vater?
The place where the Pancreatic and Common Bile ducts enter the duodenum
What is the Duct of Santorini? Where is it?
The accessory pancreatic duct. It enters the duodenum from 2cm superior to the duct of Wirsung
What is the size of the pancreas?
12-18 cm
How long is the pancreas head A to P?
2-3 cm
How long is the pancreas neck A to P?
1.5-2.5 cm
How long is the pancreas body A to P?
2-3 cm
How long is the pancreas tail A to P?
1-2 cm
The primitive pancreas is formed from the Dorsal and Ventral buds. What does the Dorsal bud arise from?
The dorsal aspect of the duodenum
The primitive pancreas is formed from the Dorsal and Ventral buds. What does the Ventral bud arise from?
the primitive common bile duct
At 6 weeks, what happens to the ventral bud?
IT rotates 270 degrees to fuse with the dorsal bud. This creates the final pancreas.
After fusion, the ventral duct connects with the proximal dorsal duct to form what structure?
The Duct of Wirsung
What does the duct of Wirsung drain?
it drains most of the pancreas
The duct of Wirsung empties into the duodenum through which two structures?
Major Papilla and Common Bile Duct
How do the ampulla of vater, sphincter of Oddi, and major papilla work together?
The sphincter of Oddi controls the opening of the Papilla so the ampulla can enter the duodenum.
What is the Major Papilla?
The Major Papilla is the small opening where the end of the Ampulla enters the duodenum.
The duct of Santorini empties into the duodenum through what structure?
The minor papilla
Where is the duct of Santorini in relation to the Duct of Wirsung? Where is the minor papilla in relation to the major papilla?
superior and superior
Which is 90% of the pancreas’ function, endocrine or exocrine?
Exocrine is 90% of the function of the pancreas
What is the exocrine function of the pancreas?
Secreting pancreatic juices to contribute to digestion.
What is the endocrine function of the pancreas?
Secreting hormones that regulate carbohydrate metabolism
What are Islets of Langerhans?
part of the endocrine function, they are groups of cells found throughout the pancreas.
What do Alpha cells secrete and what does this hormone do?
Glucagon that turns stored glycogen into its usable form, glucose
What do Beta cells secrete and what does this hormone do?
Insulin that lowers blood sugar
What do Gamma cells secrete and what does this hormone do?
Pancreatic Peptide which regulates blood sugar
What do Delta cells secrete and what does this hormone do?
Somatostatin which inhibits the release of glucagon and insulin from the pituitary gland.
What do Epsilon cells secrete and what does this hormone do?
Ghrelin which regulates blood sugar
60-70% of the endocrine cells are which type?
Beta
Why do cells release glucose?
to meet the energy needs in the body
What percent of the pancreas’ endocrine function is from alpha cells?
15-20%
Delta cells make up what percent of the endocrine tissue?
5%
Define hypofunction. What disease is the result of hypofunction?
Hypofunction is a low level of insulin production that results in diabetes.
Define hyperfunction. What is the result of hyperfunction?
Hyperfunction is the production of too much insulin. This can result in low blood sugar or hypoglycemia
What cells are responsible for the exocrine function of the pancreas? What do they do?
Acini cells that produce pancreatic juices.
What are pancreatic juices composed of?
enzymes that aid digestion
What enzyme digests carbohydrates?
Amylase
What enzyme digests fats?
Lipase
What 3 enzymes digest proteins?
Trypsin, Chymotrypsin, Carboxypepidase
What enzyme digests Nucleic Acid?
Nucleases
What enzyme is the largest and neutralizes hydrochloric acid in the stomach?
Sodium Bicarbonate
What happens when chyme enters the duodenum?
hormones are released, the sphincter relaxes, and pancreatic juices enter the duodenum from the duct of Wirsung
What are the vascular landmarks for the pancreas body and tail?
the Aorta, SMA, and Splenic vein are posterior.
What are the 4 vascular landmarks for the pancreas head and where are they?
The SMV is to the left, IVC is posterior, and the Common Bile Duct and Gastroduodenal Artery are landmarks for the head.
What are the vascular landmarks for the pancreas neck and where are they?
The SMV and Portal-Splenic Confluence are posterior.
Even though the AP measurement is small, what is considered the largest part of the pancreas?
The body
What small vessels supply the pancreas and what arteries do they come from?
The splenic artery, Superior pancreaticoduodenal from the GDA, and Inferior pancreaticoduodenal from SMA
When looking at the transverse aorta at the level of the celiac axis, can we see the pancreas? Why?
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.
What 2 veins drain the pancreas?
Splenic vein and SMV
What is the measurement of the pancreatic duct?
less than 2 mm
What vessel does the GDA branch off of?
The Common Hepatic Artery
What 2 patient positions would we use to scan the pancreas? Why might we need to do this?
Supine and Upright. The pancreas is posterior to the stomach so it can be hard to visualize.
Hypertrophy in the head of the pancreas might lead to what obstruction?
Portal or Bile Duct
Degeneration of the islets of Langerhans might lead to what disease?
Diabetes
What is Pancreatitis?
serious inflammatory condition of the exocrine pancreas
Where is cancer of the pancreas typically found? Is it common or fatal?
It is found in the body or tail. It is common and very fatal.
