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abdominal liver/billiary/panc > pancreas > Flashcards

pancreas Flashcards

1
Q

average size of pancreas

A

12-18 cm

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2
Q

uncinate process

A

anterior to IVC
posterior to SMV
right lateral to SMA
hook like extension

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3
Q

main pancreatic duct normal diameter

A

<2mm

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4
Q

main pancreatic duct enters into what part of the duodenum

A

the 2nd part

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5
Q

accessory duct drains what

A

drains the head

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6
Q

celiac artery branches

A

left gastric , splenic, and common hepatic artery

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7
Q

the GDA is a branch of

A

the common hepatic artery

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8
Q

insulin is released by the

A

islets of langerhans

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9
Q

which cells release insulin

A

beta cells

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10
Q

which cells release glucagon

A

alpha cells

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11
Q

glycogenesis

A

formation of glycogen from glucose, controlled by insulin

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12
Q

glycogenolysis

A

conversion of glycogen back into glucose

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13
Q

blood sugar levels should not exceed

A

100mg/100dl

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14
Q

acini glands secrete…

A

trypsin, amylase, and lipase

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15
Q

what does amylase do

A

digest carbohydrates

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16
Q

what stimulates pancreatic just production

A

cholecystokinin

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17
Q

delta cells produce….

A

somatostatin

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18
Q

symptoms that indicate a scan for the pancreas

A

epigastric pain
nausea/vomiting
alcoholism
hypoglycemia
hyperinsulinism
hyperglycermia

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19
Q

what is hyperinsulism

A

increased insulin production
less common than diabetes
can be caused by insulinoma
insulin shock

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20
Q

what is hyperglycemia

A

increased blood sugar
diabetes mellitus
diminished rate of insulin secretion
can be hereditary or acquired
diagnosed by blood test urine. test and glucose tolerance

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21
Q

lipase does…?

A

digest fats
increase with acute pancreatitis & ductal obstruction

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22
Q

trypsin increases w/?

A

increase with acute pancreatitis & ductal obstruction

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23
Q

WBC increase with

A

infection

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24
Q

blood glucose increases with

A

decreased pancreas function

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25
Q

land marks for the pancreas

A
  1. Aorta - posterior to body
  2. Celiac axis - superior to the head
  3. Splenic artery - travels posterior and superior to the body and tail
    4.gastroduodenal artery - seen entering the anterior head
  4. IVC - posterior to the head/neck
    6.Left renal vein - inferior to the body and tail
  5. Splenic vein - inferior and posterior to the body and tail
    8.Superior mesenteric vein - joins the splenic vein posterior to the head/neck, uncinate process posterior to the confluence
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26
Q

pancreas divisum

A

most common congenital pancreatic anomaly
2 embryonic pancreas buds do not fuse properly
separate ductal systems

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27
Q

annular pancreas

A

head surrounds 2nd portion of duodenum
complete or partial obstruction of duodenum

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28
Q

how cystic fibrosis effects the pancreas

A

causes pancreas to secrete a thick mucous
inhibits exocrine function, decreased lipase levels
organ shrinks, duct obstruction may occur

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29
Q

pancreas ductal stones

A

can be associated with biliary obstruction
stone in pancreatic duct

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30
Q

acute pancreatitis lab values

A

increased lipase, amylase, WBC
decreased hematocrit if bleeding
REVERSIBLE CONDITION
lipase more specific for pancreatitis

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31
Q

most common cause of pancreatitis

A

biliary tract disease

32
Q

acute pancreatitis symptoms

A

sudden abdomen pain or back pain
nausea vomiting weight loss
fever

33
Q

pancreas pseudocyst

A

accumulation of pancreatic juices that is walled off and appears to be a cyst

34
Q

pancreas phlegmon

A

solid inflammatory mass that infiltrates surrounding structures

35
Q

acute pancreatitis complication

A

pseudocyst MOST COMMON
phlegmon
abscess
hemorrhage
ascites
dilated biliary system

36
Q

sono appearance for chronic pancreatitis

A

dilated pancreatic duct
calcifications in the gland
hyperechoic
heterogenous
irregular

37
Q

chronic pancreatitis lab values

A

not helpful

38
Q

chronic pancreatitis may develop

A

jaundice
diabetes
permanent damage to cells

39
Q

chronic pancreatitis #1 cause

A

alcohol abuse

40
Q

pancreatic abscess symptoms

A

fever
pain
increased WBC

41
Q

pancreatic abscess sono appearance

A

complex cystic mass
ring down artifacts from air produced in bacteria

42
Q

what is a pseudocyst

A

attempt of the body to to wall off pancreatic juices
no epithelial lining

43
Q

where is a pseudocyst most commonly found

A

lesser sac
or anterior pararenal space

44
Q

a pseudocyst can be caused by

A

trauma
carcinoma
chronic or acute pancreatitis #1
9 times more common

45
Q

most common benign tumor of the pancreas

A

islet cell tumor

46
Q

where is a islet cell tumor usually found

A

body and tail

47
Q

lab values for islet cell tumors

A

increased amylase
and associated hormones with tumor tyoe

48
Q

2 types of islet cell tumors

A

insulinoma
gastrinoma

49
Q

most common islet cell tumor

A

isulinoma

50
Q

what is insulinoma associated w/

A

von hippel landau syndrome

51
Q

insulinoma produces …

A

hyperinsulinism which causes hypoglycemia

52
Q

gastrinomas secrete the hormone…

A

gastrin which causes over production of the gastric acid

53
Q

size of a islet cell tumor

A

<3cm diameter

54
Q

what type of cells is the pancreatic adenoma composed of

A

beta cells

55
Q

lab values for pancreatic adenoma

A

increased amylase, lipase

56
Q

sono appearance of pancreatic adenoma

A

solid
posterior enhancement

57
Q

Serous Cystadenoma is usually found in which part of the pancreas

A

body and tail

58
Q

Serous Cystadenoma microcystic

A

<2cm
tiny cyst

59
Q

Serous Cystadenoma macrocystic

A

over 2 cm
strong risk for malignancy

60
Q

lab values for Serous Cystadenoma

A

increased amylase

61
Q

sono findings for Serous Cystadenoma

A

cluster grape like cyst
external lobulation
thick walls
pap projections

62
Q

Mucinous Cystadenoma

A

usually larger
have greater risk for malignant transformation
cystic mass w/ debris and calcifications

63
Q

Adenocarcinoma usually occurs in which part of the pancreas

A

the head

64
Q

Adenocarcinoma risk factors

A

high fat diet
smoking
chronic pancreatitis
cholangitis
diabetes

65
Q

common clinical findings for Adenocarcinoma

A

palpable GB and obstructive jaundice

66
Q

enzyme levels for Adenocarcinoma

A

normal

67
Q

90% of Adenocarcinoma originate in the

A

ductal system

68
Q

sono appearance Adenocarcinoma

A

mass usually in the head
double duct sign
courvoisier GB
ascites

69
Q

Mucinous Cystadenocarcinoma

A

slow growing
rare

70
Q

Mucinous Cystadenocarcinoma symptoms

A

jaundice
weight loss
couvoisier sign
abdnominal mss

71
Q

Mucinous Cystadenocarcinoma lab values

A

increased amylase
billirubin and ALP
carcinoembryonic antigen

72
Q

where is Mucinous Cystadenocarcinoma most commonly found

A

body and tail

73
Q

whipple procedure

A

removal of the head, and sometimes the body of the pancreas, the duodenum and gallbladder, part of the jejunum, stomach, bile duct and lymph nodes near the pancreas

74
Q

most common panc variant

A

tadpole

75
Q

normal size of the head of pancreas

A

2-3 cm

76
Q

pancreaticduodenal artery is a branch of the

A

gda

77
Q

von hippel lindau syndrome

A

development of benign and malignant tumors

abdominal liver/billiary/panc (5 decks)

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