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ARRT (Abdominal US) > Chapter 5 The Pancreas > Flashcards

Chapter 5 The Pancreas Flashcards

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1
Q

The sonographic assessment of a pancreatic transplant includes:

A

•evaluation of vascularity
•pancreatic parenchyma
•search for fluid collections

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2
Q

With ______, the donors duodenum is anastomosed to a loop of the jejunum

A

Exocrine enteric drainage

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3
Q

With ______, the vasculature of the donor pancreas is anastomosed to the recipients common iliac vessels and the donors duodenum is anastomosed to the bladder

A

Exocrine bladder drainage

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4
Q

The anteroposterior diameter of the main pancreatic duct should not exceed ______

A

2mm

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5
Q

______position May help improve visualization of the pancreatic head

A

LLD

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6
Q

Sonographic findings of chronic pancreatitis

A

•heterogenous or hyperechoic atrophic gland
•calcifications
•pancreatic pseudocyst
•dilated pancreatic duct
•stones within the pancreatic duct
•portosplenic vein thrombosis

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7
Q

Clinical findings of chronic pancreatitis

A
  1. Asymptomatic
  2. Epigastric pain
  3. Jaundice
  4. Back pain
  5. Elevation in amylase or lipase
  6. Elevation in ALP
  7. Anorexia
  8. Vomiting
  9. Weight loss
  10. Constipation
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8
Q

____is the removal of the head of the pancreas, the gallbladder, some of the bile ducts and the proximal duodenum

A

Whipple procedure

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9
Q

The surgical procedure that is performed on patients with pancreatic adenocarcinoma is called

A

Whipple procedure

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10
Q

The most common location of pancreatic adenocarcinoma is

A

pancreatic head

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11
Q

____is the most primary pancreatic malignancy and it is most commonly discovered in men

A

Pancreatic adenocarcinoma

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12
Q

Mucinous tumor are

A

•large
•malignant potential

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13
Q

Serous tumors are

A

•small
•always benign

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14
Q

Mucinous cystadenocarcinoma are found

A

body and tail of the pancreas

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15
Q

Unencapsulated anechoic fluid collection surrounding all our part of the pancreas is called

A

Peripancreatic fluid

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16
Q

The body and tail of the pancreas receive their blood supply from the

A

Splenic artery and SMA

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17
Q

The arterial blood supply to the head of the pancreas is via

A

Gastroduodenal artery

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18
Q

The two most common congenital anomalies of the pancreas are

A

• Pancreatic divisum
• Annular pancreas

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19
Q

The pancreatic tail should measure between

A

1-2cm

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20
Q

The normal measurement of the pancreatic head and body is between

A

2-3cm

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21
Q

______results from abnormal fusion of the pancreatic duct during embryologic development

A

Pancreatic divisum

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22
Q

With _______, the most ventral part of the pancreas encases the duodenum and May consequently lead to duodenal obstruction

A

Annular pancreas

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23
Q

The most common cause of acute pancreatitis are

A

•alcohol abuse
•biliary tract disease

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24
Q

With diffuse enlargement of the pancreas it will become:

A

Enlarged and hypoechoic

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25
Q

______will lead to an enlargement of the gland in a particular segment, most often in the head, appearing as a hypoechoic region

A

Focal pancreatitis

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26
Q

The opening of the sphincter of oddi is triggered by ______released by the duodenum as a result of the presence of chyme

A

Cholecystokinin

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27
Q

Endocrine tumors Can be found within the

A

Islets of langerhans

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28
Q

Insulin stimulates the body to use up:

A

glucagon to produce energy

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29
Q

____is the hormone released by the pancreas that encourages the body’s use of glucagon

A

Insulin

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30
Q

Which part of the pancreas is located anterior to portal confluence

A

Pancreatic neck

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31
Q

What vascular structure outlines the pancreatic tail posteriorly

A

Splenic vein

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32
Q

Which part of the pancreas is located right lateral to superior mesenteric vein, anterior to IVC and inferior to portal vein

A

Head

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33
Q

The pancreas is a:

A

Retroperitoneal organ

34
Q

Courvoisier gallbladder is the

A

Enlarged GB caused by pancreatic head mass

35
Q

Coexisting obstruction of the common bile duct and pancreatic duct may be referred to as

A

Double duct sign

36
Q

Within which parts of the pancreas are mucinous cystadenocarcinomas most often located

A

Body and tail

37
Q

What is the early sonographic appearance of acute pancreatitis

A

Normal

38
Q

The arterial blood supply to the head of the pancreas is via the

A

Gastroduodenal artery

39
Q

The most common echogencity of a acutely inflamed pancreas is

A

Hypoechoic

40
Q

Which cells perform the exocrine function of the pancreas

A

Acinar cells

41
Q

The portion of the bowel that encompasses the head of the pancreas is the

A

Duodenum

42
Q

What is the name of the main pancreatic duct

A

Duct of wirsung

43
Q

The muscle that controls the emptying of bile and pancreatic juices into the duodenum is the

A

Sphincter of oddi

44
Q

A gastrinoma of the pancreas can produce

A

Zollinger-Ellison syndrome

45
Q

Courvoisier gallbladder is found in the presence of

A

Adenocarcinoma in the head of the pancreas

46
Q

______is the most common islet cell tumor

A

Insulinoma

47
Q

One of the most common locations for a pancreatic pseudocyst is within the

A

Lesser sac

48
Q

Which type of pancreatic transplantation is more common

A

Exocrine enteric drainage

49
Q

Clinical findings of acute pancreatitis

A
  1. Elevated labs
  2. Leukocytosis
  3. Pain
  4. Fever
  5. Nausea
50
Q

The most common location of focal pancreatitis is within the

A

Head of the pancreas

51
Q

_____is a peripancreatic fluid collection that results from the inflammation of the pancreas

A

Phlegmon

52
Q

The most common location of adenocarcinoma of the pancreas is within the

A

Head of the pancreas

53
Q

_____is the enzyme released by the pancreas that neutralizes stomach acid

A

Sodium bicarbonate

54
Q

The whipple procedure is performed on patients who have

A

Pancreatic carcinoma

55
Q

The most common form of malignant of the pancreas is

A

Adenocarcinoma

56
Q

What is another name for the accessory duct of the pancreas

A

Duct of santorini

57
Q

What results in a shortened main pancreatic duct that works to drain only the pancreatic head and not the entire pancreas

A

Pancreatic divisum

58
Q

______is located within the epigastrium between the C-loop of the duodenum and the splenic hilum

A

Pancreas

59
Q

The pancreas consists of four main parts

A

•head
•neck
•body
•tail

60
Q

The pancreas is considered to be a _______organ

A

Retroperitoneal

61
Q

In some individuals, there exists a posteromedial extension of the pancreas head, referred to as

A

Uncinate process

62
Q

The endocrine function of the pancreas is performed by the

A

Islets of langerhans

63
Q

The ______of the pancreas carry out the exocrine function because they produce viral digestive enzymes (amylase, lipase, sodium bicarbonate)

A

Acinar cells

64
Q

Primarily, the pancreas is an exocrine gland that aids in _____

A

Digestion

65
Q

Sonographic findings of chronic pancreatic transplant rejection

A
  1. Hyperechoic echotexture
  2. Atrophy
  3. Pancreas may contain calcifications
66
Q

Sonographic findings of acute pancreatic transplant rejection

A
  1. Hypoechoic or heterogenous gland
  2. Elevated resistive indices
67
Q

Sonographic findings of true pancreatic cysts

A
  1. Well-defined, anechoic mass with posterior enhancement
68
Q

Clinical findings of true pancreatic cysts

A

•possible history of von hippel-lindau disease or cystic fibrosis
•possible history of ADPKD

69
Q

Sonographic findings of islet cell tumors

A

•hypoechoic mass that may contain calcifications

70
Q

Clinical findings of islet cell tumors

A

•insulinoma: low blood sugar symptoms
•gastrinoma: Zollinger-Ellison syndrome

71
Q

Clinical findings of acute pancreatitis

A

•elevated amylase (within 24hrs)
•elevated lipase (within 72 hrs)
•elevated ALT and other labs with biliary obstruction
•leukocytosis
•abdominal pain (supine)
•back pain
•fever
•nausea and vomiting
•hemorrhage and low hematocrit

72
Q

Sonographic findings of acute pancreatitis

A

•normal pancreas
•diffused pancreas
•focal pancreas
•peripancreatic pseudocyst
•abscess formation (fluid gas bubbles)
•biliary obstruction
•splenic vein thrombosis and psedoaneurysm of the splenic artery

73
Q

Sonographic findings of serous cystadenoma (2):

A
  1. Cystic mass
  2. Solid and echogenic secondary to the small size of the cysts
74
Q

Sonographic findings of mucinous cystadenoma and cystadenocarcinoma

A
  1. Multilocular cystic masses that may contain mural nodules and calcifications
  2. Dilation of the pancreatic duct
75
Q

There are two common types of transplantation techniques

A

•exocrine bladder drainage
•exocrine enteric drainage

76
Q

______is described as the excessive section of acid by the stomach that leads to peptic ulcers

A

Zollinger-Ellison syndrome

77
Q

_____is a branch of the main pancreatic duct, had a separate minor sphincter into the duodenum

A

Duct of santorini

78
Q

At the ______the pancreatic digestive enzymes are mixed with bile from the liver and released into the duodenum through the______

A

•ampulla of vater
•sphincter of oddi

79
Q

Clinical findings of pancreatic adenocarcinoma (7):

A
  1. Elevated amylase and lipase
  2. No appetite
  3. Weight loss
  4. Jaundice
  5. Courvoiser gallbladder
  6. Epigastric pain
  7. Elevated ALP and other liver function labs associated with biliary obstruction
80
Q

Sonographic findings of pancreatic adenocarcinoma

A
  1. hypoechoic mass
  2. head of the pancreas
  3. dilated CBD and pancreatic duct (double duct sign)
  4. Elevated labs
  5. enlarged gallbladder (hydropic)
81
Q

Clinical findings of cystadenoma and cystadenocarcinoma

A

•May be asymptomatic initially
• epigastric pain
•weight loss
•palpable mass
•jaundice

ARRT (Abdominal US) (14 decks)

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