Pancreas Flashcards
What kind of organ is the pancreas?
It is mostly retroperitoneal, but the tail can be intraperitoneal
What is the normal size of the pancreas?
12-15 cm
What are the locations of the pancreas tail and head?
The tail is cephalad and superior
The head is caudal and inferior
Where does the distal CBD run?
Through or behind the pancreas head
What are the two ducts that make up the ampulla of Vater?
Common bile duct and pancreatic duct
What is the exocrine function of the pancreas?
Secretion of digestive enzymes for different classes of molecules
Lipase, amylase, trypsin, chymotrypsin, and nucleases for digestion
Sodium bicarbonate for buffering gastric hydrochloride acid
What are the endocrine functions of the pancreas?
Glucose level regulation by release of insulin, glucagon, and somatostatin
What are the pancreatic cells that deal with the endocrine functions?
Islets do langerhans
Where are pancreatic islet cells located?
In the tail
What is the common disease that results from disruption of pancreatic endocrine functions?
Diabetes mellitus
What are the structures and vessels that can be used to identify the pancreas?
Left liver lobe, splenic vein, SMA, AO with left renal a. and IVC with left renal v
What is the normal echogenicity of the pancreas?
Uniform, homogenous, and slightly more echogenic than the liver
What is the normal diameter of the pancreatic duct?
Less than or equal to 2 mm
How do you obtain a long axis view of the pancreas?
In the transverse imaging plane
Why is it difficult to image the entire long pancreas?
The transverse lie in the body
Posterior to the stomach
Duodenal segments w/ gas at head and tail
How can a sonographic scan the entire pancreas?
Start midline and subxiphoid with left side of transducer angled down
Bring the probe inferior and can or rotate, even oblique if needed
Extra pressure and LLD
Liver as acoustic window
What may be used for better visualization of the pancreas?
Water and contrast agents
What portions of the pancreas should be scanned (AIUM)?
Head, uncinate process, body, tail
What should assessment of the pancreas include?
Parenchyma abnormality
Pancreas head w/ CBD
Measurement and abnormalities of pancreatic duct
Peripancreatic region fluid assessment
What upside down letter is the pancreas shaped like?
U
What structures are posterior to the pancreas?
IVC, AO, diaphragm
What structures enter the duodenum?
CBD, accessory pancreatic duct, duct of Wirsung
What structures are the body of the pancreas is anterior to m?
SMA, SV, AO
What is the tail of the pancreas medial to?
Splenic hilum
What is the celiac trunk made up of?
Hepatic and splenic arteries
What supply blood flow to the pancreas?
The common hepatic and splenic arteries and their branches
What enzymes are released by the pancreas into the duodenum?
Lipase
Amylase
Trypsin
Bicarbonate
On CT, where is the pancreas tail in relation to the liver?
The head is close to the liver and the tail is farther
What does the stomach look like on CT?
It is anechoic
It can interfere with pancreas imaging
What kind of transducer is required for pancreas scanning?
Low frequency curvillinear
What serves as an acoustic window for scanning the pancreas?
Liver
How should the pancreas be imaged?
In two orthogonal planes
In long axis, transducer indicator is to pt right
On CT, how are the major vessels seen?
IVC to anatomic right (liver)
AO to anatomic left
How is the retroperitoneal cavity formed?
Subdivided into several spaces
Bordered ant by posterior parietal peritoneum
Contains the pancreas, ascending and descending colon, IVC, AO
What are the two circles on the head of the pancreas?
Anterior - gastroduodenal a.
Posterior - common bile duct
What percentage of the US population has diabetes?
10.5%
What is the role of the pancreas in type 1 diabetes?
Islet cells that produce insulin are attacked by the body and not enough insulin is produced
What is the role of the pancreas in type 2 diabetes?
Insulin resistance causes body cells to not respond to insulin. Blood sugar rises and pancreas has to work harder but is unable to keep up
