Chapter 5: The Pancreas Flashcards
the cells of the pancreas that carry out the exocrine function and therefore produce amylase, lipase, and sodium bicarbonate
acinar cells
inflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acinar cells into the parenchyma of the organ
acute pancreatitis
the merging point of the pancreatic duct and common bile duct just before the sphincter of Oddi; also referred to as the hepatopancreatic ampulla
ampulla of Vater
an inherited disease that results in the development of renal, liver, and pancreatic cysts late in life; also referred to as adult polycystic kidney disease
autosomal dominant polycystic kidney disease
the recurring destruction of the pancreatic tissue that results in atrophy, fibrosis, scarring, and the development of calcification within the gland
chronic pancreatitis
the clinical detection of an enlarged, palpable gallbladder caused by a biliary obstruction in the area of the pancreatic head
Courvoisier gallbladder
co-existing enlargement of the common bile duct and pancreatic duct
double-duct sign
the accessory duct of the pancreas
duct of Santorini
the main pancreatic duct
duct of Wirsung
2 islet cell tumors found within the pancreas
gastrinoma and insulinoma
small islands of tissue found within the pancreas that produce insulin and glucagon
isles of Langerhans
tumor found within the isles of Langerhans of the pancreas
islet cell tumors
a peritoneal cavity space located between the stomach and pancreas where fluid can accumulate
lesser sac
the most common form of pancreatic malignancy; typically found within the head of the pancreas
pancreatic adenocarcinoma
a cyst surrounded by fibrous tissue that consists of pancreatic enzymes that have leaked from the pancreas
pancreatic pseudocyst
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
pancreaticoduodenectomy
the peripancreatic fluid collection that results from the inflammation of the pancreas
phlegmon
the muscle that controls the emptying of bile and pancreatic juices into the duodenum; also referred to as the hepatopancreatic sphincter
sphincter of Oddi
a posteromedial extension of the pancreatic head
uncinate process
a hereditary disease that includes the development of cysts within the pancreas and other organs
von Hippel-Lindau disease
the syndrome that includes an excessive secretion of acid by the stomach caused by the presence of a functional gastrinoma within the pancreas
Zollinger-Ellison syndrome
the pancreas is both an ________ and _________ gland
exocrine (primarily)
endocrine
4 main parts of the pancreas
head
neck
body
tail
the pancreas is considered to be a ___________ organ
retroperitoneal
primary function of the pancreas
aids in digestion
3 types of cells that compose isles of Langerhans
alpha
beta
delta
what performs the endocrine function of the pancreas?
isles of Langerhans
the isles of Langerhans produce:
vital hormones (insulin and glucagon)
artery that supplies the head of the pancreas
gastroduodenal artery
arteries that supply the body and tail of the pancreas
splenic and superior mesenteric arteries
2 structures that may be seen within the pancreatic head
gastroduodenal artery and CBD
the diameter of the pancreatic duct should not exceed ____
2 mm
normal measurement of the pancreatic head and body
2-3 cm
normal measurement of the pancreatic tail
1-2 cm
leads to an enlargement of the pancreas in a particular segment, most often the head
focal pancreatitis
Clinical findings: elevated amylase (within 24 hours) elevated lipase (within 72 hours) abdominal pain back pain fever nausea and vomiting leukocytosis severe cases may lead to hemorrhage and decreased hematocrit
acute pancreatitis
Sonographic findings:
pancreas may appear normal
diffusely enlarged, hypoechoic pancreas (diffuse manifestation)
focal hypoechoic area within the pancreas (focal manifestation)
unencapsulated anechoic fluid collection surrounding all or part of the pancreas
pancreatic pseudocyst
abscess formation can occur and is seen as echogenic fluid containing gas bubbles
biliary obstruction may be present
vascular complications such as thrombosis (splenic vein) and pseudoaneurysms (splenic artery)
acute pancreatitis
Clinical findings: asymptomatic persistent epigastric pain jaundice back pain possible elevation in amylase or lipase (but they may remain normal)
chronic pancreatitis
Sonographic findings:
heterogeneous, 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
chronic pancreatitis
Clinical findings: elevated amylase and/or lipase loss of appetite weight loss jaundice Courvoisier gallbladder epigastric pain
pancreatic adenocarcinoma
Sonographic findings:
hypoechoic mass in the head of the pancreas
dilated common bile duct and pancreatic duct (double-duct sign)
liver and other abdominal organs should be evaluated for possible metastasis
enlarged gallbladder
pancreatic adenocarcinoma
2 types of pancreatic cystadenomas
(microcystic) serous cystadenoma (always benign)
macrocystic) mucinous cystadenoma (potentially malignant
malignant mucinous cystadenocarcinomas are most often found in the:
body and tail of the pancreas
Sonographic appearance:
cystic mass that may actually appear solid and echogenic secondary to the small size of the cysts
pancreatic serous cystadenoma
Sonographic appearance:
multilocular cystic masses that may contain mural nodules and calcifications
there may be associated dilatation of the pancreatic duct
pancreatic mucinous cystadenoma/cystadenocarcinoma
which islet cell tumor is most common?
insulinoma
which islet cell tumor will cause low blood sugar symptoms?
insulinoma
which islet cell tumor will cause Zollinger-Ellison syndrome?
gastrinoma
Sonographic findings:
hypoechoic mass that may contain calcifications
visualization is hard because of their small size
islet cell tumors
Sonographic findings:
well-defined, anechoic mass with posterior enhancement
true pancreatic cyst
All of the following are part of the exocrine function of the pancreas except for the: A. production of lipase B. production of glucagon C. production of amylase D. production of sodium bicarbonate
production of glucagon
What is an additional name for the accessory duct of the pancreas? A. duct of Santorini B. duct of Langerhans C. duct of Oddi D. duct of Wirsung
duct of Santorini
Which of the following is associated with development of cysts within the pancreas?
A. autosomal recessive polycystic kidney disease
B. Von Hippel-Lindau disease
C. Zollinger-Ellison syndrome
D. endoscopic retrograde cholangiopancreatography
Von Hippel-Lindau disease
The most common form of malignancy of the pancreas is: A. cystadenocarcinoma B. islet cell tumors C. cystadenoma D. adenocarcinoma
adenocarcinoma
The most common location of adenocarcinoma of the pancreas is within the: A. head of the pancreas B. neck of the pancreas C. body of the pancreas D. tail of the pancreas
head of the pancreas
The most common location of focal pancreatitis is within the: A. head of the pancreas B. neck of the pancreas C. body of the pancreas D. tail of the pancreas
head of the pancreas
All of the following are sonographic features of chronic pancreatitis except: A. dilated pancreatic duct B. calcifications within the pancreas C. pancreatic pseudocyst D. diffusely hypoechoic pancreas
diffusely hypoechoic pancreas
Which laboratory value listed below appears to be more specific for acute pancreatitis? A. amylase B. lipase C. AST D. SGOT
lipase
One of the most common locations for a pancreatic pseudocyst is within the: A. paracolic gutters B. groin C. spleen D. lesser sac
lesser sac
Which of the following is the most common islet cell tumor? A. granuloma B. gastrinoma C. insulinoma D. cystadenoma
insulinoma
Courvoisier gallbladder is found in the presence of:
A. hepatitis
B. cholecystitis and chronic pancreatitis
C. adenocarcinoma in the head of the pancreas
D. islet cell tumor in the tail of the pancreas
adenocarcinoma in the head of the pancreas
A gastrinoma of the pancreas can produce:
A. autosomal recessive polycystic kidney disease
B. Von Hippel-Lindau disease
C. Zollinger-Ellison syndrome
D. hyperinsulinemia
Zollinger-Ellison syndrome
What is the name for the main pancreatic duct? A. duct of Santorini B. duct of Langerhans C. duct of Oddi D. duct of Wirsung
duct of Wirsung
All of the following are clinical findings associated with pancreatic adenocarcinoma except: A. epigastric pain B. weight loss C. jaundice D. decreased amylase and lipase
decreased amylase and lipase
Which cells carry out the exocrine function of the pancreas? A. Whipple cells B. isles of Langerhans C. delta cells D. acinar cells
acinar cells
The most common echogenicity of an acutely inflamed pancreas is: A. anechoic B. hyperechoic C. hypoechoic D. calcified
hypoechoic
The arterial blood supply to the head of the pancreas is via the: A. superior mesenteric artery B. splenic artery C. gastroduodenal artery D. hepatic artery
gastroduodenal artery
Mucinous cystadenocarcinomas of the pancreas are most often located within which parts of the pancreas? A. uncinate process and neck B. head and neck C. body and tail D. fundus and neck
body and tail
Which part of the pancreas is located right lateral to the superior mesenteric vein, anterior to the IVC, and inferior to the portal vein? A. head B. neck C. body D. tail
head
The pancreatic tail is outlined posteriorly by what vascular structure? A. superior mesenteric artery B. inferior mesenteric vein C. portal confluence D. splenic vein
splenic vein
Which part of the pancreas is located anterior to the portal confluence? A. uncinate process B. pancreatic body C. pancreatic neck D. pancreatic tail
pancreatic neck
Which of the following is the hormone released by the pancreas that encourages the body's use of glucagon? A. insulin B. somatostatin C. glycogen D. sodium bicarbonate
insulin
