Duodenum, Pancreas, Spleen Flashcards

1
Q

Duodenum general characteristics

A
  • C or J shaped
  • Shortest/widest & most fixed part of SI
  • Made up by 4 parts
  • Both retroperitoneal & intraperitoneal
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2
Q

Superior part of duodenum

A
  • @ the level of L1
  • frist part connects with pyloric of stomach
  • Duodenal cap has mesentery
  • Distal half retroperitoneal
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3
Q

Descending part of duodenum

A
  • @ the level of L1-L3
  • 2nd part right of IVC
  • Bile & pancreatic ducts open here (ampulla of Vater)
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4
Q

Horizontal & Ascending part of duodenum

A
Horizontal = retroperitoneal @ the level L3
Ascending = Intraperitoneal @ the level L3, Duodenaljejunal flexure, which is supported by ligament of Trietz (connects to diaphragm & allows for widening of flexure to assist passing contents through)
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5
Q

Pancreas general characteristics

A
  • Retroperitoneal
  • Located @ L1
  • Wraps around SMA/SMV
  • 4 parts (Head,neck, body, tail)
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6
Q

Exocrine/Endrocrine function of Pancreas

A

Exocrine: Pancreatic juices @ pH 8, pancreatic enzymes-Trypsinogen (precursor of trypsin-protein), Amylase-carbohydrates (starch/glycogen), Lipase (breaks TAGs to mono/FFA)
Endocrine: Insulin, glucagon, somatostatin

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7
Q

Transpyloric plane (L1)

A
  • Pylorus (stomach)
  • Pancreas
  • Fundus of gallbladder
  • Hila of kidneys (center where vessels go in)
  • Hilum of spleen
  • SMA & HPV
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8
Q

Relations with pancreas

A
  • Head: located post. to 2nd & 3rd part of duodenum & SMV/SMA
  • Neck: Ant. to SMV/SMA & post to pyloric stomach
  • Body: ant. to hilum of left kidney & post to body of stomach
  • Tail: Ant. to left kidney & points left post to spleen
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9
Q

Vessel and pancreas

A
  • Head/neck wrap around SMV
  • Splenic vein with in pancreas and bifurcates @ body to IMV
  • Splenic vein end @ spleen
  • Body & tail = splenic artery
  • Head & neck = sup/inf pacreatoduodenal arteris
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10
Q

Pancreatic duct

A
  • Main pancreatic duct travels down tail to head where it joins with bile duct to ENTER the major duodenal papilla (Vater)
  • Minor duodenal papilla = Accessory pancreatic duct
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11
Q

General characteristics of the Spleen

A
  • Notched by 9,10,11 ribs
  • Hilum = where veins/arteries enter/exit
  • 3 major impressions (Gastric, renal, colonic)
  • Splenic artery
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12
Q

Functions of the Spleen

A
  • Filter: Removal of RBC & Removal of Leukocytes

- Immunological function: Removal of bacteria, antibody synthesis, protection from infection

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13
Q

Relations to the Spleen

A
  • Posterior: 8-10 ribs, Left kidney

- Anterior: Stomach, greater momentum

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14
Q

Blood supply Duodenum

A
  • Junction of foregut to midgut @ duodenum 4 parts lie in both areas
  • Duodenum (4 parts) received part of blood supply from celiac artery & SMA
  • watershed area (dual blood supply): 1/2 way along 2nd duodenum
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15
Q

Etiology of Haematemesis

A
  • Brownish/red vomit
  • Major 55% PUD (peptic ulcer disease)
  • Minor 10% Varices & Erosive gastritis
  • Bleeding: Blood color/volume, alcohol intake, previous ulcers, pervious vomiiting, NSAID use
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16
Q

Characteristics of Appendicitis

A

Pain: Upper abdomen, sharp, mild to severe, intermittent to constant, pain with meals/alcohol, pain relieved sitting forward?
-Presents w/fever, jaundice, vomiting, abdominal distention, weight loss, pale color stools

17
Q

Etiology of acute pancreatitis

A
  • G E T S M A S H E D
  • Major cause: Gall stones 40%
  • 2nd Major cause: Ethanol 35%
  • Elevated pancreatic enzymes (lipase, trypsinogen, etc..)
18
Q

Other side effects of pancreatitis

A
  • Pyrexia (76%) aka Fever
  • Tachycardia (65%)
  • Distension (65%)
  • Jaundice (28%)
19
Q

Body wall ecchymoses

A
  • Pancreas begins to liquify and break down into other surround tissues.
  • Grey Turners = Bruising
  • Cullen’s = Discoloring around umbilicus
  • Both can present together