Pancreas Flashcards
Pancreas
-an all _____ structure with an accessory ____ function that is partly _____ and partly _____
flesh
digestive
endocrine
exocrine
the exocrine secretion is the pancreatic juice from the ____ cells that enters the ____ through the _____ and ______ pancreatic ducts
acinar
duodenum
main and accessory
the endocrine secretion includes _____ and _____ from the _____ that enter the blood
glucagon and insulin
islets of Langerhans
LOCATION
- its (intraperitoneal or retroperitoneal?)
- found between _ and _ vertebrae
- divided into ____,____,____ and _____
retroperitoneal
L1-L2
neck, head , body and tail
the head of pancreas lies behind the _____ in the curvature of the ______ loop of the duodenum
stomach
descending
the tip of the tail of the pancreas faces the _____
spleen
HEAD OF PANCREAS
- embraced by the C-shaped curve of the duodenum to the right of the ______ vessels just (inferior or superior?) to the transpyloric plane
- firmly attaches to the (medial or lateral?) aspect of descending and _____ parts of the duodenum
Superior mesenteric
inferior
medial;horizontal
the head of pancreas rests posteriorly on the ____, ___ renal arteries and vein, ___ renal vein
IVC
right
left
towards the opening into the descending part of the duodenum , the bile duct lies in a groove on the _____ surface of the head or _____
posterosuperior
embedded in its substance
NECK OF PANCREAS
- (short or long?)
- __ to___cm
- overlies _____ vessels which form a groove in its (anterior or posterior?) aspect
short
1.5-2
Superior mesenteric
posterior
the Anterior part of the neck that is covered with _____ is adjacent to the _____ of the stomach
peritoneum
pylorus
the _____ vein joins the ____ vein posterior to the ____ of pancreas to form the hepatic portal vein
superior mesenteric
splenic
neck
BODY OF PANCREAS
-continues from the neck and lies to the ___ of the Superior mesenteric vessels, passing over the aorta and ___ vertebrae ,contrinuing just (above or below?) the transpyloric plane posterior to the _____
left
L2
above
omental bursa
the Anterior surface of the body of pancreas is covered with peritoneum and lies in the (roof or floor?) of the OMENTAL bursa
floor
Body of pancreas forms part of the stomach bed
T/F
T
the posterior surface is devoid of peritoneum and is in contact with the ___, ____ , left _____, left ____ and _____ vessels
aorta
SMA
suprarenal gland
kidney and renal
TAIL OF PANCREAS
-lies (Anterior or posterior?) to the left kidney where it is closely related to splenic _____ and the ____ flexure
Anterior
hilum
left colic
DUCTS
- has 2 ducts
- ___ pancreatic duct
- _____ pancreatic duct
main
accessory
main pancreatic duct
-begins in the ____ of the pancreas and runs through the parenchyma of the gland to the pancreatic ____ then turns (Inferiorly or superiorly?) and is closely related to the ____ duct
tail
head
Inferiorly
bile
Main pancreatic duct United with the bile duct to form the (long or short?) ____ hepatopancreatic ___ of ____
short
dilated
ampulla of vater
the ampulla of vater opens into the ____ part of the duodenum at the summit of the ____ duodenal papilla
descending
major
atleast ___% of the time, the duct opens into the duodenum separately from the bile duct
25
SPHINCTERS
- 3 _____ muscle sphincters that control the flow of the bile and pancreatic juice into the ampulla and prevent reflux of the duodenal content into the ampulla
(1) the sphincter of the _____ duct around the ____ part of the pancreatic duct
(2) the sphincter of the ___ duct that is around the _____ of the bile duct
(3) the _____ sphincter of ___ around the __________
smooth
pancreatic ; terminal
bile; termination
hepatopancreatic; oddi
hepatopancreatic ampulla of vater
The accessory pancreatic duct
-opens into the duodenum at the summit of the _____
minor duodenal papilla
usually the accessory duct doesn’t communicate with the main duct
T/F
F
in some cases the main duct is smaller than the accessory duct and the two may not be connected
T/F
T
in some cases the main duct is smaller than the accessory duct and the two may not be connected and in such cases , the ____ duct carries most of the pancreatic juice
accessory
ARTERIAL SUPPLY OF PANCREAS
- derived mainly from the branches of the markedly _____ —— artery
- multiple pancreatic arteries from several arcades pancreatic branches of ____ and _______ arteries
tortuous; splenic
gastroduodenal and superior mesenteric
as many as ____ branches may pass from the splenic artery to the ____ and ____ of pancreas
10
body and tail
the Anterior and posterior Superior pancreaticoduodenal arteries, branches of the ____ artery and the Anterior and posterior inferior pancreaticoduodenal arteries, branches of the ____ form anteriorly and posteriorly placed arcades that supply the ____ of the pancreas
gastroduodenal
SMA
head
VENOUS DRAINAGE OF THE PANCREAS
- occurs through _____ veins
- tributaries of the ____ and _____ parts of the hepatic portal vein
- most empty into ____ veiN
pancreatic
splenic and superior mesenteric
splenic
LYMPHATIC DRAINAGE
- they follow the blood vessels
- most vessels in the ______ lymph nodes which lie along the splenic artery
- some vessels end in the _____ lymph nodes
- efferent vessels from these nodes drain to the ______ lymph nodes or to the _____ lymph nodes through the ____ lymph nodes
pancreaticosplenic
pyloric
Superior mesenteric; coeliac; hepatic
NERVES OF THE PANCREAS
- are derived from ____ and __________ nerves passing through the diaphragm
- the parasympathetic and sympathetic fibers reach the pancreas by passing along the arteries from the ___ plexus and ______ plexus
vagus and abdominopelvic splanchnic
celiac
superior mesenteric
Only parasympathetic fibers are distributed to pancreatic acinar cells and islets
T/F
F
Both parasympathetic and sympathetic
the sympathetic fibers are secretomotor
T/F
F
Parasympathetic
pancreatic secretion is primarily mediated by ____ and _____ , hormones formed by the ____ cells of the ____ and proximal intestinal ____ under the stimulus of ____ contents from the stomach
secretin and cholecystokinin
epithelial; duodenum
Mucosa
acid
Pancreas
lies in the _____ and ____ regions.
-Its left extremity ,the __, lies in the ____ ligament.
epigastric and left hypochondriac
tail; lienorenal
Pancreas
The pancreas is ____ located in the ___ part of the abdomen
upper
Deeply
Pancreas is hidden by many organs
T/F
T
Pancreas is easily accessible for physical examination
T/F
F
It’s not
The pancreas is “___-shaped or ___ shaped
J
retort
Pancreas
Length: ____ cm
Width: _____ cm.
Thickness: _____ cm.
Weight: _____g
12–15
3–4
1.5–2
80–90
Pancreas has head with one process, ____
And body with one process , _____
uncinate process
tuber OMENTALe
HEAD OF PANCREAS
-___ vertebra.
L2
Uncinate process is a ____-like process from the (upper or lower?) and (left and right?) part of the head.
It extends toward the (left or right?) behind the ______, in front of ______
hook
lower
right
left
superior mesenteric vessels
abdominal aorta
Superior border of head of pancreas is related to:
a) ____ part of the ____
b) _________ artery.
first; duodenum
superior pancreaticoduodenal
Inferior border of head of pancreas is related to
a) _____ part of the _____
- b) ______ artery
third; duodenum
inferior pancreaticoduodena
Right lateral border of head of pancreas is related to:
a) ______ part of the _______
b) ____ arterial arcades.
second; duodenum
anterior and posterior pancreaticoduodenal
Anterior surface of head of pancreas is related from above downward to:
a) ____ artery
b) ____ colon
c) ____ of the _____
d) _______.
gastroduodenal
transverse
root of the transverse mesocolon
jejunum
Upper border of neck of pancreas is related to the ____ part of the _____.
-Lower border of neck of pancreas is related to the _____ of the _____
first
duodenum
root
transverse mesocolon.
Anterior border of body of pancreas provides the attachment to the _____ of _____
root of transverse mesocolon.
Superior border of body of pancreas is related to the ____ artery above the ______ , _____ artery to the (right or left?), and _____ artery to the left of _____
coeliac
tuber omentale
hepatic; right
splenic; tuber omentale.
Inferior border of body of pancreas is related to ______ at its right end
superior mesenteric vessels
Inferior surface of body of pancreas covered by peritoneum is related to: (a) _____ flexure, (b) coils of ______, and(c) _______ flexure.
duodenojejunal
jejunum
left colic
Tail of pancreas is mobile
T/F
T
_____ of the pancreas contains the largest number of islets of Langerhans per unit of tissue as compared to other parts of the gla
Tail
the major duodenal papilla,_____ cm distal to the pylorus.
8–10
Main pancreatic duct receives tributaries (smaller ducts) throughout its length, at ___ angle to its ___ axis in a “______ pattern.”
right
long
herringbone
Main pancreatic duct is the only duct in 90% of cases.
T/F
T
minor duodenal papilla is about ____ cm above the opening of main pancreatic duct and _____ cm distal to pylorus
2–3
6–8
main source of blood supply to the pancreas is the ____ artery
splenic
Blood supply of pancreas
Two branches of splenic artery are named: One large branch which arises near the ____ and runs toward the _____ is called _______.
Another relatively small branch, which runs toward the ____ of the ____, is termed ______
tail
neck
arteria pancreatica magna
tip of the tail
arteria caudae pancreatica.
The sympathetic supply of pancreas is ___motor
vaso
Carcinoma of the head of pancreas is (common or rare?)
It compresses the bile duct leading to ______.
It may press the ____ or may involve the ____ due to close vicinity of these structures to the head of pancreas.
common
persistent obstructive jaundice
portal vein
stomach
Acute pancreatitis
- is the acute inflammation of the pancreas.
- It occurs due to obstruction of _____, ingestion of ____, ___ infections (mumps), or trauma.
- It is serious condition because _____ leak into the substance of pancreas and initiates the ____ of the gland.
- Clinically, it presents as very severe pain in the _____ region radiating to the ____, fever, nausea, and vomiting.
pancreatic duct
alcohol
viral; mumps
activated pancreatic enzymes
autodigestion
epigastric; back
In acute pancreatitis
The serum amylase, level is raised 2 times.
T/F
F
4 times
Commonest sites of accessory pancreatic tissue is ______
Duodenum
