Lesson 3A (Part 1) Flashcards
Int he pancreas intra or retroperitoneal?
Retroperitoneal
What are the 3 vascular landmarks for the pancreas?
- Splenic vein
- SMA
- IVC
Where does the CBD run compared to the head of the pancreas?
Posterior to it
Where does the GDA run compared to the head of the pancreas?
Anterior lateral to it
What are the 2 ducts in the pancreas?
- Main pancreatic duct
- duct of wirsung - Accessory duct
- duct of santorini
What are the 2 functions of the pancreas?
- Endocrine
- Exocrine
- this is the main one
What is the endocrine functions of the pancreas?
Islet cells of Langerhans secrete hormones directly into the bloodstream
What do the alpa cells from the islet cells of Langerhans secrete?
Glucagon
- increases blood glucose
What do the beta cells from the islet cells of Langerhans secrete?
Insulin
- decreases blood glucose
What does failure to secrete sufficient insulin leads to?
Diabetes
What is the exocrine functions of the pancreas?
Digestive enzymes secreted by the acinar cells drain into the duodenum through pancreatic ducts
What does amylase break down?
Carbohydrates
What does lipase break down?
Fats
What does trypsin break down?
Proteins
What is the normal range of serum amylase?
25-125 U/L
What does serum amylase increase with? (4)
- Acute pancreatitis
- Pancreatic pseudocyst
- Intestinal obstruction
- Peptic ulcer disease
What does serum amylase decrease with? (2)
- Hepatitis
2. Cirrhosis
How long does serum amylase remains elevated for in episodes of acute pancreatitis?
Approximately 24 hours
What remains increased longer than serum amylase in episodes of acute pancreatitis?
Urine amylase
What is the normal range of serum lipase?
10-140 U/L
What remains elevated for a longer period (up to 14 days?)
Serum lipase
What does serum lipase increase with? (6)
- Pancreatitis
- Obstruction of the pancreatic duct
- Pancreatic carcinoma
- Acute cholecystitis
- Cirrhosis
- Severe renal disease
What is the normal range of glucose when fasting?
< 100mg/dL
What is the normal range of glucose 2 hours post prandial?
< 145mg/dL
What does glucose increase with? (3)
- Severe diabetes mellitus
- Chronic liver disease
- Overactivity of endocrine glands
What does glucose decrease with?
Tumours of islet cells of Langerhans in the pancreas
Where do tumours normally occur in the pancreas?
In the head
Why do tumours normally occur in the head of the pancreas?
Because it has the largest AP measurement
What is the echogenicity of the uncinate process?
Hypoechoic
What is a normal varient of the pancreas?
Pseudomass
- larger head bulging to the right of the GDA
