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Sonographic Topics > Chapter 5: The Pancreas > Flashcards

Chapter 5: The Pancreas Flashcards

1
Q

the cells of the pancreas that carry out the exocrine function and, therefore, produce amylase, lipase, sodium bicarbonate, and other digestive enzymes

A

acinar cells

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2
Q

congenital anomaly of the pancreas that results in the maldevelopment of the pancreas in which the most ventral part of the pancreas encases the duodenum and may consequently lead to duodenal obstruction

A

annular pancreas

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3
Q

the recurring destruction of the pancreatic tissue that results in atrophy, fibrosis with scarring, and the development of calcification within the gland

A

chronic pancreatitis

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4
Q

inherited disorder that can affect the lungs, liver, pancreas, and other organs; this disorder changes how the body creates mucus and sweats

A

cystic fibrosis

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5
Q

coexisting enlargement of the common bile duct and pancreatic duct

A

double-duct sign

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6
Q

the accessory duct of the pancreas

A

duct of Santorini

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7
Q

the main pancreatic duct

A

duct of Wirsung

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8
Q

the first segment of the small intestine

A

duodenum

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9
Q

endoscopic procedure that utilize flouroscopy (radiographic imaging) to evaluate the biliary tree and pancreas

A

endoscopic retrograde cholangiopancreatography

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10
Q

form of pancreatitis associated with gallstones and pancreatic duct obstruction

A

gallstone pancreatitis

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11
Q

an islet cell tumor found within the cells of the pancreas that may produce an abundance of gastrin

A

gastrinoma

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12
Q

form of pancreatitis associated with bleeding within or around the pancreas

A

hemorrhagic pancreatitis

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13
Q

elevated amylase

A

hyperamylasemia

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14
Q

the presence of elevated parathyroid hormone

A

hyperparathyroidism

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15
Q

bowel obstruction caused by the lack of normal peristalsis

A

ileus

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16
Q

an islet cell tumor found within the beta cells of the pancreas that may produce an abundance of insulin

A

insulinoma

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17
Q

most common form of pancreatitis; associated with inflammation of the pancreas and peripancreatic tissue without necrosis

A

interstitial edematous pancreatitis

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18
Q

tumor found within the islets of Langerhans of the pancreas

A

islet cell tumors

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19
Q

small islands of tissue found within the pancreas that produce insulin and glucagon

A

islets of Langerhands

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20
Q

a peritoneal cavity located between the stomach and the pancreas where fluid can accumulate

A

lesser sac

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21
Q

death of tissue

A

necrosis

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22
Q

severe form of acute pancreatitis in which there is death of the pancreatic tissue

A

necrotizing pancreatitis

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23
Q

the most common form of pancreatic malignancy, typically found within the head of the pancreas

A

pancreatic adenocarcinoma

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24
Q

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

A

pancreatic divisum

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25
Q

the surgical procedure in which the head of the pancreas, the gallbladder, some of the bile ducts, and the proximal duodenum are removed because of a malignant pancreatic neoplasm; also referred to as the Whipple procedure

A

pancreaticduodenectomy

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26
Q

a cyst surrounded by fibrous tissue that consists of pancreatic enzymes that have leaked from the pancrea

A

pancreatic pseudocyst

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27
Q

fatty infiltration of the pancreas; may be classified as alcoholic or nonalcoholic; may also be referred to as a fatty pancreas

A

pancreatic steatosis

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28
Q

the peripancreatic fluid collection that results from inflammation of the pancreas

A

phlegmon

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29
Q

a posteromedial extension of the pancreatic head

A

uncinate process

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30
Q

a hereditary disease that includes the development of cysts within the pancreas and other organs

A

von Hippel-Lindau disease

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31
Q

Whipple procedure

A

pancreaticoduodectonomy

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32
Q

a group of clinical indicators of a functional insulinoma; includes hypoglycemia, low fasting glucose, and relief with intravenous glucose administration

A

Whipple triad

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33
Q

the syndrome that includes an excessive secretion of acid by the stomach caused by the presence of a functional gastrinoma within the pancreas`

A

Zollinger-Ellison syndrome

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34
Q

digests carbohydrates and converts starch to sugar

A

amylase

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35
Q

digests fat and converts fats to fatty acids and glycerol

A

lipase

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36
Q

neutralizes stomach acid

A

sodium bicarbonate

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37
Q

breaks down proteins

A

trypsin, chymotripsin, and caroboxypolypeptides

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38
Q

glucagon- promotes the release of glucose by the liver (increases blood sugar level)

A

alpha cells

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39
Q

insulin- stimulates the body’s use of glucagon

A

beta cells

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40
Q

somatostatin- restrains insulin and glucose levels

A

Delta cells

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41
Q

The pancreatic head is located right lateral to the _______

A

SMV

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42
Q

The pancreatic head is ____ to the IVC and _____ to the portal vein

A

anterior
posterior

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43
Q

The unicinate process is ______ to SMV

A

posterior

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44
Q

The uncinate process is anterior to the _____

A

aorta

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45
Q

The pancreatic neck is anterior to the ______

A

portal confluence

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46
Q

The pancreatic tail is marked by the posterior border of the ____

A

splenic vein`

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47
Q

pancreatitis associated with gallstones and concurrent obstruction of the pancreatic duct

A

gallstone pancreatitis

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48
Q

pancreatitis associated with bleeding in or around the pancreas; high rate or morbidity and mortality

A

hemorrhagic pancreas

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49
Q

Form of chronic pancreatitis that results from the body’s immune system attacking the pancreas

A

autoimmune pancreatitis

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50
Q

Uncommon form of chronic pancreatitis found in the head of the pancreas with associated inflammation of the CBD and second portion of the duodenum`

A

groove pancreatitis

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51
Q

Form of acute pancreatitis results in the necrosis of the pancreatic parenchyma and the tissue surrounding the pancreas; high rate of morbidity and mortality

A

Necrotizing pancreatitits

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52
Q

Most common form of acute pancreatitis; associated with inflammation of the pancreatic parenchyma and peripancreatic tissues; necrosis is not present

A

interstitial edematous pancreatitis

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53
Q

elevated amylase
elevated lipase
leukocytosis
elevated ALT and other liver function labs when biliary obstruction is present
abdominal pain
back pain
fever
nausea and vomiting

A

acute pancreatitis

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54
Q

pancreas may appear normal
diffusely, enlarged, hypoechoic pancreas (diffuse manifestation)
focal hypoechoic area within the pancreas (total manifestation)
unencapsulated anechoic fluid collection surrounding all or part of the pancreas (peripancreatic fluid)
pancreatic pseudocyst
abscess formation can occur
biliary obstruction may be present

A

acute pancreatitis

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55
Q

asymptomatic
persistent epigastric pain
jaundice
back pain
possible elevation in amylase or lipase (but they may remain normal)
possible elevation in ALP
anorexia
vomiting
weight loss
constipation

A

chronic pancreatitis

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56
Q

heterogenous, or hyperechoic, atrophic gland with poor margins
calcifications within the gland
pancreatic pseudocyst
dilated pancreatic duct
stone(s) within the pancreatic duct that may lead to biliary obstruction
possible portosplenic vein thrombosis

A

chronic pancreatitis

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57
Q

elevated amylase and/or lipase
loss of appetite
weight loss
jaundice
courvoisier gallbladder
epigastric pain
elevated ALP and, possibly, other liver function labs associated with biliary obstruction
History of cigarette smoking, diabetes mellitus, or chronic pancreatitis

A

Pancreatic Adenocarcinoma

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58
Q

hypoechoic mass in the head of the pancreas
dilated CBD and pancreatic duct (double-duct sign)
liver and other abdominal organs should be evaluated for possible metastasis
enlarged hydropic gallbladder

A

pancreatic adenocarcinoma

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59
Q

may be asymptomatic initially
epigastic pain
weight loss
palpable mass
jaundice

A

cystadenomas and cystadenocarcinoma

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60
Q

cystic mass
may actually appear solid and echogenic secondary to the small size of the cysts

A

serous cystadenoma

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61
Q

multilocular cystic masses that may contain mural nodules and calcifcations
there may be associated dilation of the pancreatic duct

A

mucinous cystadenoma and cystadenocarcinoma

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62
Q

hypoglycemia, low fasting glucose, and relief with intravenous glucose administration (Whipple triad)

A

Insulinoma islet cell tumor

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63
Q

Zollinger-Ellison syndrome

A

Gastrinoma islet cell tumor

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64
Q

hypoechoic mass that may contain calcifications
hypervascularity may be present with color Doppler
visualization is challenging because of their small size

A

islet cell tumors

65
Q

possible history of von -Hippel Lindau disease or cystic fibrosis
possible history of ADPKD

A

true pancreatic cysts

66
Q

well-defined anechoic mass with posterior enhancement

A

true pancreatic cyst

67
Q

hyperechoic echotexture
atrophy
pancreas may contain calcifications

A

chronic pancreatitis transplant rejection

68
Q

hypoechoic or heterogenous gland
elevated resistive indices

A

acute pancreatic transplant rejection

69
Q

pancreatic transplant fluid collections

A

abscess
ascites
hematoma
urinoma
pseudocysts

70
Q

arterial stenosis
arterial thrombosis
graft thrombosis
pseudoaneurysms
splenic vein thrombosis
stricutes

A

pancreatic transplant vascular complications

71
Q

Where is the pancreas located?

A

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

72
Q

The pancreas consists of 4 main parts

A

head
neck
body
tail

73
Q

posteromedial expansion of the pancreatic head

A

uncinate process

74
Q

The pancreas is a ____-peritoneal organ

A

retro

75
Q

The pancreas functions as an _____ and _____ gland.

A

endocrine
exocrine

76
Q

The main exocrine function of the pancreas:

A

aids in digestion

77
Q

produce vital digestive enzymes

A

acinar cells

78
Q

vital digestive enzymes produced by the acinar cells

A

amylase
lipase
sodium bicarbonate
trypsin
chymotrypsin
carboxypolypeptidase

79
Q

main pancreatic duct

A

duct of Wirsung

80
Q

accessory duct

A

duct of Santorini

81
Q

minor sphincter in accessory duct into duodenum

A

minor duodenal papilla or accessory papilla

82
Q

From the main pancreatic duct, enzymes collect in the

A

ampulla of Vater

83
Q

The ampulla of Vater is also referred to as the

A

hepatopancreatic ampulla

84
Q

pancreatic digestive enzymes mixed with bile from liver are released into the duodenum through the major sphincter:

A

Sphincter of Oddi

85
Q

major duodenal papilla

A

papilla of Vater

86
Q

Relaxation and opening of Sphincter of Oddi is controlled by:

A

cholecystokinin

87
Q

The endocrine function of the pancreas is performed by:

A

islets of Langerhans

88
Q

Islets of Langerhans are composed of:

A

alpha, beta, delta cells

89
Q

The islets of Langerhans produce _____ and ____ directly into the bloodstreem

A

insulin
glucagon

90
Q

promotes release of glucose by the liver which in turn increases blood sugar levels

A

glucagon

91
Q

stimulates body to use up glucagon to produce energy

A

insulin

92
Q

The head of the pancreas is supplied by the ______ artery.

A

gastroduodenal

93
Q

The body and tail of the pancreas are supplied by the _____ and _____ arteries

A

splenic
superior mesenteric

94
Q

Venous drainage for the pancreas is performed by _____, ______, and ______ veins.

A

splenic
superior mesenteric
portal

95
Q

Normal echogenicity of the pancrease

A

greater than the liver

96
Q

diffusely hyperechoic pancreas

A

pancreatic steatosis

97
Q

The pediatric patient’s pancreas is more _____ because of lack of fat.

A

hypoechoic

98
Q

anechoic tube, consists of two parallel lines, with an anechoic lumen

A

main pancreatic duct

99
Q

The main pancreatic duct AP should not exceed ___ mm

A

2

100
Q

Normal measurement of the pancreatic head and body

A

2-3 cm

101
Q

Normal measurement of the pancreatic tail

A

1-2 cm

102
Q

Two most common pancreatic anomalies are

A

pancreatic divisum
annular pancreas

103
Q

most common congenital variant of the pancreas

A

pancreatic divisum

104
Q

results from abnormal fusion of the pancreatic ducts during embryologic development

A

pancreatic divisum

105
Q

results in a shortened main pancreatic duct that only drains the pancreatic head

A

pancreatic divisum

106
Q

results from maldevelopment of the two embryologic elements of the pancreas

A

annular pancreas

107
Q

the most ventral part of the pancreas encases the duodenum and may consequently lead to duodenal obstruction

A

annular pancreas

108
Q

inflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acinar cells into the parenchyma of the organ

A

acute pancreatitis

109
Q

Most common causes of acute pancreatitis are

A

alcohol abuse
biliary tract diseases

110
Q

Acute pancreatitis is often divided into either _______ pancreatitis or _______ pancreatitis

A

interstital edematous
necrotizing

111
Q

peripancreatic fluid collection

A

phlegmon

112
Q

lead to enlargment of the head; appear as hypoechoic region; pancreatic margins ill-defined with areas of fluid collections

A

focal pancreatitis

113
Q

body will attempt to encapsulate damaging digestive enzymes that leak from the pancreas

A

pancreatic pseudocyst

114
Q

The most common location for a pancreatic pseudocyst is:

A

lesser sac

115
Q

The lesser sac is located between the _____ and ____

A

pancreas
stomach

116
Q

repeated bouts of pancreatic inflammation; often caused by chronic alcohol abuse

A

chronic pancreatitis

117
Q

most common primary pancreatic malignancy

A

pancreatic adenocarcinoma

118
Q

4th most common cause of cancer-related deaths in men

A

pancreatic adenocarcinoma

119
Q

Most common location of pancreatic adenocarcinoma is

A

pancreatic head

120
Q

hypoechoic mass in the head of the pancreas; double-duct sign

A

pancreatic adenocarcinoma

121
Q

obstruction of both CBD and pancreatic duct

A

double-duct sign

122
Q

stage 1 pancreatic adenocarcinoma

A

mass confined to pancreas

123
Q

Stage 2 pancreatic adenocarcinoma

A

involves local lymph node involvement

124
Q

Stage 3 pancreatic adenocarcinoma

A

evidence of distant metastasis

125
Q

surgical procedure performed on patients with pancreatic adenocarcinoma

A

whipple procedure

126
Q

pancreaticoduodenectomy

A

Whipple procedure

127
Q

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

A

Whipple procedure

128
Q

small almost always benign cystadenomas

A

serous cystadenoma

129
Q

larger; malignant potential; most often found within the body and tail of pancreas

A

mucinous cystadenomas

130
Q

Symptoms of cystadenomas

A

epigastric pain, weight loss, palpable mass, jaundice

131
Q

may actually appear solid and echogenic secondary to small size of cysts

A

serous cystadenomas

132
Q

most often appears as a multilocular cystic mass that may contain mural nodules and calcifications

A

mucinous cystadenomas

133
Q

house endocrine tissue of the pancreas

A

Islets of Langerhans

134
Q

endocrine tumors of the pancreas

A

Islet cell tumors or pancreatic neuroendocrine tumors

135
Q

Two most common types of islet cell tumors

A

insulinomas
gastrinomas

136
Q

signs of insulinomas

A

Whipple triad (hypoglycemia, low fasting glucose, relief with intravenous glucose administation)

137
Q

Whipple triad

A

hypoglycemia, low fasting glucose, relief with intravenous glucose administation

138
Q

Islet cell tumor associated with Zollinger-Ellison Syndrome

A

Gastrinoma

139
Q

excessive secretion of acid by stomach that leads to peptic ulcers

A

Zollinger-Ellison syndrome

140
Q

small, hypoechoic mass that may contain calcifications

A

islet cell tumors

141
Q

True pancreatic cysts may be associated with:

A

von Hippel-Lindau disease
cystic fibrosis
autosomal polycystic kidney disease

142
Q

Most common reason for pancreatic transplant

A

severe type I diabetes

143
Q

2 common techniques of pancreatic transplant

A

exocrine bladder drainage
exocrine enteric drainage

144
Q

Acute rejection of pancreas sonographic appearance

A

heterogenous, hypoechoic

145
Q

Chronic rejection of pancreas sonographic appearance

A

hyperechoic, atrophic, contains calcifications

146
Q

Most common complication of pancreatic transplant

A

thrombosis of graft

147
Q

An _____ gland uses ducts to transport digestive juices.

A

exocrine

148
Q

An ______ gland releases hormones directly into the bloodstream.

A

endocrine

149
Q

The ______ artery, which takes a similar path within the abdomen, may be confused for a dilated pancreatic duct, and thus, Color Doppler should be utilized to differentiate the two structures.

A

splenic

150
Q

_______, which is the most common congenital variant of the pancreas, can lead to both acute and chronic pancreatitis

A

pancreatic divisum

151
Q

Acute pancreatitis will cause a rise in amylase first and then a rise in lipase, with ______ being the most helpful lab finding for diagnosis of the disease

A

lipase

152
Q

_________ will result in a diffusely, enlarged, hypoechoic pancreas.

A

diffuse acute pancreatitis

153
Q

_______ can result in an atrophic, hyperechoic pancreas with calcifications and a prominent pancreatic duct.

A

Chronic pancreatitis

154
Q

Pancreatic adenocarcinoma is most commonly found in the ____ of the pancreas.

A

head

155
Q

_______ occurs when the gallbladder is palpable because it is enlarged. This is due to the presence of a (potentially malignant) pancreatic head mass that leads to biliary obstruction and the backup of a large amount of bile in the gallbladder.

A

Courvoisier gallbladder

156
Q

Pancreatic cystadenocarcinoma is most commonly found in the ____ or ____ of the pancreas.

A

body
tail

157
Q

Functional gastrinomas can produce _______ syndrome, which is described as the excessive secretion of acid by the stomach that leads to peptic ulcers.

A

Zollinger-Ellison

158
Q

_______ disease is associated with cysts in the pancreas.

A

von Hippel Lindau

159
Q
A

Sonographic Topics (35 decks)

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