Clinical anatomy and embryology of the pancreas Flashcards

1
Q

what are the endocrine and exocrine functions of the pancreas

A

The pancreas has two main functions: an exocrine function that helps in digestion and an endocrine function that regulates blood sugar.

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2
Q

what are the 3 primary embryonic germ layers

A

ectoderm
mesoderm
endoderm

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3
Q

What embryonic developmental process leads to the formation of the three primary germ layers?

A

gastrulation

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4
Q

What are the structures derived from the primary embryonic endodermal germ layer?

A

The main derivative of the endodermal germ layer is the epithelial lining of the Gastrointestinal Tract including the pharynx.

It also forms:
the epithelial lining of the respiratory tract, the urinary bladder and urethra, and the tympanic cavity and auditory tube.

the parenchyma (secretory tissues cells) of the thyroid, parathyroid, liver, and pancreas

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5
Q

what are the walls of the GIT smooth muscles and other connective tissues are derived from the

A

mesoderm.

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6
Q

the foregut Extends from the mouth to the point where the what enters the duodenum

A

hepatopancreatic ampulla enters the duodenum

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7
Q

at the 2nd part of the duodenum what becomes what

A

foregut and midgut

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8
Q

where does the midgut extend from

A

Extends from the point where the hepatopancreatic ampulla enters the duodenum to the junction between the proximal 2/3 and the distal 1/3 of the transverse colon.

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9
Q

where does the midgut become hindgut

A

2/3 along transverse colon

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10
Q

the hindgut extends from where to where

A

Extends from the junction between the proximal 2/3 and the distal 1/3 of the transverse colon to the anus.

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11
Q

exocrine enzymes

A
chymotrypsin 
amylase 
trypsin 
lipase 
nuclease
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12
Q

the pancreas if formed by two buds from the endodermal lining of the duodenum what are they

A

dorsal pancreatic bud

ventral pancreatic bud ( out pocket of th bile duct) - this also has the liver bud on It

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13
Q

the gut rotates and the dorsal pancreatic bud moves to the right and ventral bud moves dorsally ( duodenum flops over)
the ventral pancreatic bud fuses with the lower part of the dorsal pancreatic bud and lies post-inf. The ventral pancreatic bud forms the what of the pancreas

A

uncinate process

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14
Q

the rest of the pancreas is formed by what

as well as the the main pancreatic duct

A

dorsal pancreatic bud

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15
Q

proximal part of the duct may persist as what

A

accessory pancreatic duct

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16
Q

due to close proximity between the ventral pancreatic bud and duct with the proximal part of the bile duct the two duct fuse to together to from what

A

hepatopancreatic ampulla ( of vater) - gallstone here causing jaundice

17
Q

pancreatic islet of langerhans and the other secretory cells develop from the endodermal parenchymatoru tissue cell in the third month of fatal life. secretion of what begins at about the 5th month of fetal life.

A

insulin

18
Q

what is an annular pancreas

A

Formed as a result of improper rotation and migration of parts of the tissues of the ventral pancreatic bud with the rotation of the duodenum.

May constrict the duodenum

19
Q

accessory pancreatic tissue can form where

A

Ectopic pancreatic tissue may develop either in the oesophagus, stomach and duodenum or in the small intestine.

20
Q

where does the head of the pancreas sit

A

in the c of duodenum and tail at the spleen

IVC portal vein and SMA and aorta are behind it

21
Q

is the pancreas retro or intra peritoneal

A

retroperitoneal

22
Q

blood supply to pancreas

A

gastrodudodenal artery of the common hepatic
Ant nd post pancreaticoduodenal

splenic artery
SMA supplies vessels to

23
Q

venous drainage of pancreas

A

splenic and sup mesenteric vein and hepatic portal vein

24
Q

pancreatic cancer metastases early due to what

A

good blood supply

25
Q

lymphatic drainage too

A

pancreaticosplenic Los and pyloric nodes and SMln and colic lNs via hepatic nerves

26
Q

nerve supply of pancreas

A

vagus and abdominopelvic splenic nerves

27
Q

pancrea5ic secretion is primarily hormonally mediate by what hormones

A

secretin and cholecystokinin of the duodenal epithelium.

28
Q

centroacinar cells do what

A

Perform exocrine functions, synthesize and secrete the digestive enzymes, which include amylase, trypsin, chymotrypsin, lipase and nucleases.

29
Q

stellate cells do what

A

Perform functions relating to tissue repair and destruction of tumour cells.

in an islet - alpha cells inner ring, beta in middle with some L shaped delta cells , f cells in wall to

30
Q

Blockage of hepatopancreatic ampulla by …….. could lead to pancreatitis due to reflux of bile into the pancreatic duct.

A

gallstone- leads to obsturicve jaundice

hepatic caused by hepatitis and trans enzymes used

31
Q

what procedure using a fibre-optic endoscope passed through the mouth, oesophagus, stomach and duodenum and an injected radiographic contrast medium for the diagnosis of both pancreatic and biliary disease.

A

ERCP

endoscopic , retrograde cholangiopancreatogrpahy

32
Q

two types of pancreatic cancer

A

exocrine cancer -95% called adenocarcinoma originates mainly in the head of the pancreas

endocrine pancreatic cancer called pancreatic neuroendocrine tumours

33
Q

what is Courvoisier’s law;

A

if gallbladder is palpable in a jaundiced patient, it is unlikely to be due to gallstones, because stones would have given rise to chronic inflammation and subsequently fibrosis of gallbladder therefore, rendering it incapable of dilatation.

gallstones make the gallbladder shrink

34
Q

Cancer of the head of the pancreas often compresses and obstructs the bile duct, enlargement of the gallbladder and/or the hepatopancreatic ampulla because of its close relationships
this leads to what

head better than neck and body

A

obstructive jaundice

Cancer of the neck and body of the pancreas may cause hepatic portal or inferior vena cava obstruction.

The extensive lymphatic drainage of the pancreas into relatively inaccessible lymph nodes, and the fact that pancreatic cancer typically metastasizes to the liver early via the hepatic portal vein, make surgical resection of the cancerous pancreas a near futile exercise.

35
Q

what procedure involves removal of most of the pancreas for treatment of pancreatic cancer and pancreatitis

A

whipples procedure - pancreaticoduodenoctomy - tumours that haven’t spread

36
Q

steps in whipples procedure

A

surgeon removes head of pancreas and lower end of stomach.
the duodenum and gall bladder and some of the bile ducts are removed.
this includes lymph nodes

the remaining stomach and bile duct are joint to the small intestine and the pancreas is joined either to the small intestine and stomach too