Exocrine Pancreas Flashcards
What are the causes of pancreatitis?
- Something that causes the release of enzymes from the pancreas
- Tissue injury
- Enzymes released into tissues
What are signs and symptoms of pancreatitis?
- Pain (often preceded by heavy drinking or a heavy meal)
- N & V
- Fever and sweating
- Tachycardia
- Malaise and weakness
- Mild jaundice
- Tetany
What are potential complications of pancreatitis?
- Shock*
- ARDS* = adult respiratory distress syndrome
- Acute renal failure
- Hypercalcemia
- Pancreatic pseudocysts
- Abscess
- Chemical or septic peritonitis
- Usually NO endocrine problems
What are treatments for pancreatitis?
- If due to food, decrease food intake
- if due to alcoholism, stop drinking
- Analgesics for pain
- Surgery if due to gallstones
PTs wil see pts with acute pancreatitis due to _____ or ____.
Back pain; ARDS
Inflammation and scarring can result in decreased ________.
Spinal extension, esp at thoracolumbar jxn
What positions would relieve and aggregate pain with someone who has acute pancreatitis?
Trunk flexion will relieve, trunk extension will aggregate
What are the two types of chronic pancreatitis?
- Juvenile form = ~25 y/o (associated with CF)
2. Adult form = ~60 y/o (associated with alcoholism or gallstones)
What is the pathogenesis of chronic pancreatitis?
- Functional or structural impairment
2. Progressive destruction of pancreas (fibrosis, chronic inflammation)
What are the causes of chronic pancreatitis?
- obstruction of pancreatic duct (CF, Gallstones, Cancer)
2. Alcoholism
What are S and S for chronic panchreatits?
- Alcohol-associated = 24-48 hrs after heavy alcohol consumption
- gall-stone associated = after heavy meal
- Attacks last from a few hours to as long as 2 weeks
- Similar to Acute Pancreatitis PLUS weight loss, flatulence, diarrhea or constipation, and decreased vitamin absorption
What happens if 90% of the pancreas us destructed?
Endocrine sx occur (diabetes) due to loss of islet cells
Syndrome occurs as a result of not making enzymes to break down food, so we aren’t absorbing the nutrients
Malabsorption syndrome
What is chronic pancreatitis associated with?
Pancreatic cancer
What kind of cancer is pancreatic cancer?
Adenocarcinoma of ductal origin
__% of pancreatic cancer is in the pancreas head, and __% is in the body and tail.
75; 25
What are risk factors of pancreatic cancer?
- Smoking
- Diabetes mellitus – especially in women
- Prior gastrectomy
- Genetic basis?
- Alcohol and coffee?
What are S and S of pancreatic cancer?
Initially, nonspecific and vague
- Weight loss
- Loss of appetite
- N & V
- Light colored stools
- Weakness
- Epigastric pain radiating to the thoracic region of the back (L region if in body and tail)
- Low back pain alone may be the only symptom
- Jaundice and pruritis from obstruction of the bile duct
__% of pancreatic cancer has metastasized at time of diagnosis
80
The 5 yr mortality rate of pancreatic cancer is almost __%. __% of tumors are suitable for surgery. __% of people who have surgery are alive after 5 yrs post surgery.
100; 15; 5-10
What are the first signs of distal metastasis of pancreatic cancer?
Cervical lymphadenopathy, usually on the left
What are paraneioplastic syndromes of pancreatic cancer?
- Neuromyopathy
- Dermatomyositis
- Thrombophlebitis
What treatment is used for back pain in patients diagnosed with pancreatic cancer (usual role of PT will be for pain control)?
- TENS
- Biofeedback
- Analgesics
- Other pain control techniques
Tumor of the exocrine pancreas that secretes insulin; most common; usually benign; picked up fairly quick due to hypoglycemia
Insulinomas
Tumor of the exocrine pancreas that secretes gastrin; causes peptic ulcers in stomach; tend to be benign tumors
Gastrinomas
What syndrome causes gastrinomas?
Zollinger Ellison Syndrom
