Pancreas Flashcards
What is the pancreas formed by?
The ventral and dorsal diverticula of the foregut
What does dorsal bud form?
Forms Neck, body, and tail
What does the Ventral bud form?
Forms head and uncinate process
What is the location of the pancreas?
- Retroperitoneal
- Epigastrium/ Left hypochondrium
Anatomically what is the Pancreas located in terms of lesser sac, stomach, and liver?
Posterior to
1. Lesser sac
2. Stomach
3. Left lobe of the liver
Where does the head of the pancreas lie in relation to the duodenum?
The C loop of the duodenum
The pancreas extends from the duodenal loop to what other structure?
Splenic hilum
The size and shape of pancreas shrinks with what?
Age, 12-15 cm in length
What does the outline of the pancreas look like?
Smooth, no focal enlargements
What are the AP dimensions of the Pancreas?
Head (2-3), Body (2-5), tail (1-2)
What are some common shapes of the pancreas? 3
- Common
- Sausage
- Dumbbell tadpole
Where is the head of the Pancreatic head located?
- Medial to duodenum
- Anterior to IVC
- Anterior to LRV
- Lateral to confluence
- Inferior to portal vein
- Posterior to stomach
- Inferior to HA
Where is the GDA and theCBD located?
In the head of the pancreas
Where is the uncinate located in relation into the SMV?
Posterior to SMV
Where is the neck of the pancreas located in relation to the SMV, Portal confluence, and the CHA? 2
- Anterior to SMV and portal confluence
- Inferior to CHA
What structures are posterior to the body of the pancreas? 4
- Aorta
- LRV
- Splenic vein
- SMA
What portion of the pancreas is located inferior to the celiac axis?
Body of the pancreas
What are some things to remember in terms of the pancreatic tail and the Left adrenal, Aorta, splenic artery, And Splenic vein? 4
- It is anterior to left Andrenal
- Left of aorta
- Splenic artery is posterior/superior
- Splenic vein is posterior/ inferior boarder
What are the two pancreatic ducts?
- Duct of Wirsung
- Duct of Santorini
What is the Duct of Wirsung? Where does it extend?
- Main pancreatic duct
- Extends along the length of the gland
What does the Duct of Wirsung join with? What does it enter?
Joins with the CBD and enters the ampulla of vater
What should the diameter of the duct of Wirsung be?
Not to extend 2mm
What is the Duct of santorini?
Accessory pancreatic duct
What does the duct of santorini enter? 2
Enters
1. The duodenum ~2 cm proximal to main duct
2. Enters the minor duodenal papilla
The pancreas has both _________ functions?
- Endocrine - Hormonal
- Exocrine - digestive
How much of the pancreas tissue is exocrine tissue?
About 80%
The exocrine functions of the pancreas does what?
Produces pancreatic juices which are liberated into the pancreatic duct
The pancreatic exocrine juice is composed of what? 4
- Enzymes
- Water
- Bicarbonate
- Salts
What are some examples of the Exocrine enzymes for the pancreas? 5
- Amylase: acts on carbs
- Lipase: acts of fats
- Trypsin: chymotrypsin: acts on proteins
- Protease: acts on nucleic acids
- Sodium bicarbonate: Neutralizes HCL
What triggers the release of pancreatic juices?
Food ingested into the duodenum stimulates the release of hormones
What is Secretin?
Stimulates the production of sodium bicarbonate
What does CCF do?
Stimulates the acinar cells to produce digestive enzymes
What takes care of the endocrine function of the pancreas?
The islets of Langerhans Produce hormones which are related into the pancreatic tail
What are three types of endocrine cells in the pancreas?
- Alpha
- Beta
- Delta
What does alpha do?
Produce glucagon
What does the beta cells do?
Produces insulin
What does the delta cells do?
Produce somatostatin
What is the serum amylase lab test?
- Obstruction/ necrosis which cause amylase to leak into the tissue spaces and bloodstream
For the serum amylase exam what happens to the blood levels?
It increases within 3-6 hours, can persist for 24 hours
What is the lipase excreted from?
Excreted by pancreas by pancreas only.
What is one of the causes of Lipase?
Increased inflammatory conditions and some neoplasms
Levels can stay elevated for how long?
Up to 14 days, after amylase has dropped
What is an increase of glucose an indicator for?
Diabetes, chronic liver and pancreatic disease
What does a decrease of glucose indicate?
tumours of the islets of langerhands Hypoglycemia
What is glucose tolerance?
Measures the abilities ability to process sugar
Where is urine amylase found? What does urine amylase do? 2
- Generally parallel level found in blood
- Urinary levels return to normal more slowly than blood
After the urine amylase the levels may remain elevated for how many days?
7-10 days in chronic and acute pancreatitis
Where does the pancreas get blood?
- Pancreaticoduodenal Arterials and splenic artery
- Anterior and inferior pancreaticodundenal
What is the patient prep for pancreas exams?
- Nothing to eat or drink for 6-12 hours prior
- Avoid chewing gum and smoking
What time of the day should we schedule pancreas exams?
Schedule exam in AM
When do we scan the pancreas during exam?
In the AM
What is the Sonographic appearance of the Pancreas ?
Slightly coarser than liver isoechoic»_space;> slightly more echogenicity than liver duct to be
What is the double parallel line sine?
Two ducts in the head of the pancreas
