Lesson 3A (Part 1)

Question 1

Int he pancreas intra or retroperitoneal?

Answer 1

Retroperitoneal

Question 2

What are the 3 vascular landmarks for the pancreas?

Answer 2

1. Splenic vein
2. SMA
3. IVC

Question 3

Where does the CBD run compared to the head of the pancreas?

Answer 3

Posterior to it

Question 4

Where does the GDA run compared to the head of the pancreas?

Answer 4

Anterior lateral to it

Question 5

What are the 2 ducts in the pancreas?

Answer 5

1. Main pancreatic duct
   - duct of wirsung
2. Accessory duct
   - duct of santorini

Question 6

What are the 2 functions of the pancreas?

Answer 6

1. Endocrine
2. Exocrine
   - this is the main one

Question 7

What is the endocrine functions of the pancreas?

Answer 7

Islet cells of Langerhans secrete hormones directly into the bloodstream

Question 8

What do the alpa cells from the islet cells of Langerhans secrete?

Answer 8

Glucagon

- increases blood glucose

Question 9

What do the beta cells from the islet cells of Langerhans secrete?

Answer 9

Insulin

- decreases blood glucose

Question 10

What does failure to secrete sufficient insulin leads to?

Answer 10

Diabetes

Question 11

What is the exocrine functions of the pancreas?

Answer 11

Digestive enzymes secreted by the acinar cells drain into the duodenum through pancreatic ducts

Question 12

What does amylase break down?

Answer 12

Carbohydrates

Question 13

What does lipase break down?

Answer 13

Fats

Question 14

What does trypsin break down?

Answer 14

Proteins

Question 15

What is the normal range of serum amylase?

Answer 15

25-125 U/L

Question 16

What does serum amylase increase with? (4)

Answer 16

1. Acute pancreatitis
2. Pancreatic pseudocyst
3. Intestinal obstruction
4. Peptic ulcer disease

Question 17

What does serum amylase decrease with? (2)

Answer 17

1. Hepatitis

2. Cirrhosis

Question 18

How long does serum amylase remains elevated for in episodes of acute pancreatitis?

Answer 18

Approximately 24 hours

Question 19

What remains increased longer than serum amylase in episodes of acute pancreatitis?

Answer 19

Urine amylase

Question 20

What is the normal range of serum lipase?

Answer 20

10-140 U/L

Question 21

What remains elevated for a longer period (up to 14 days?)

Answer 21

Serum lipase

Question 22

What does serum lipase increase with? (6)

Answer 22

1. Pancreatitis
2. Obstruction of the pancreatic duct
3. Pancreatic carcinoma
4. Acute cholecystitis
5. Cirrhosis
6. Severe renal disease

Question 23

What is the normal range of glucose when fasting?

Answer 23

< 100mg/dL

Question 24

What is the normal range of glucose 2 hours post prandial?

Answer 24

< 145mg/dL

Question 25

What does glucose increase with? (3)

Answer 25

1. Severe diabetes mellitus
2. Chronic liver disease
3. Overactivity of endocrine glands

Question 26

What does glucose decrease with?

Answer 26

Tumours of islet cells of Langerhans in the pancreas

Question 27

Where do tumours normally occur in the pancreas?

Answer 27

In the head

Question 28

Why do tumours normally occur in the head of the pancreas?

Answer 28

Because it has the largest AP measurement

Question 29

What is the echogenicity of the uncinate process?

Answer 29

Hypoechoic

Question 30

What is a normal varient of the pancreas?

Answer 30

Pseudomass

- larger head bulging to the right of the GDA