Chapter 5: The Pancreas Flashcards by Samantha Lockridge

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

acinar cells

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

acute pancreatitis

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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

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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

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

chronic pancreatitis

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the clinical detection of an enlarged, palpable gallbladder caused by a biliary obstruction in the area of the pancreatic head

Courvoisier gallbladder

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co-existing enlargement of the common bile duct and pancreatic duct

double-duct sign

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the accessory duct of the pancreas

duct of Santorini

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the main pancreatic duct

duct of Wirsung

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2 islet cell tumors found within the pancreas

gastrinoma and insulinoma

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

isles of Langerhans

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tumor found within the isles of Langerhans of the pancreas

islet cell tumors

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

lesser sac

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

pancreatic adenocarcinoma

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

pancreatic pseudocyst

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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

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

phlegmon

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the muscle that controls the emptying of bile and pancreatic juices into the duodenum; also referred to as the hepatopancreatic sphincter

sphincter of Oddi

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a posteromedial extension of the pancreatic head

uncinate process

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

von Hippel-Lindau disease

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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

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the pancreas is both an ________ and _________ gland

exocrine (primarily)

endocrine

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4 main parts of the pancreas

head
neck
body
tail

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the pancreas is considered to be a ___________ organ

retroperitoneal

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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