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MIDS 127 > Pancreas > Flashcards

Pancreas Flashcards

1
Q

Where is the pancreas located?

A

-Anterior portion retroperitoneum
-Not an encapsulated organ

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2
Q

What are the portions of the pancreas?

A

-Head/uncinate process
-Neck
-Body
-Tail

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3
Q

What does endocrine produce?

A

Hormone production
-into blood or soft tissue

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4
Q

What does exocrine produce?

A

Produces digestive enzymes
-into a duct

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5
Q

Head measurement?

A

2-3.5cm AP

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6
Q

Location of head?

A

-Anterior to IVC
-Right and inferior to body/tail
-Right of SMV/SV confluence
-Inferior to MPV and caudate
-Medial to duodenum

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7
Q

Where is the uncinate process?

A

-Curved tip at the head
-Posterior/behind and medial to head
-Anterior to IVC
-Posterior to SMV

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8
Q

Location of neck?

A

-Between head and body
-Anterior to SMV/SV confluence

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9
Q

Location of body?

A

-Anterior to AO, SMA, LRV
-Posterior to antrum of stomach

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10
Q

Body measurement?

A

2-3cm AP

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11
Q

Tail measurement?

A

1-2cm AP

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12
Q

Location of tail?

A

-Bordered posteriorly by SV
-Anterior to stomach
-Lateral to LK
-Extends into splenic hilum
(Obstructed by gas b/c close to stomach)

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13
Q

What does the pancreatic duct do?

A

Transports digestive enzymes from pancreatic tissue to duodenum via the ampulla of vater

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14
Q

Pancreatic duct measurements?

A

-Head is 3mm
-Body is 2.1mm
-Tail is 1.6mm

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15
Q

What is the duct of santorini?

A

Smaller accessory duct off main pancreatic duct that makes a hole (perforates) into duodenum separately

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16
Q

What arteries supply the head?

A

-GDA (gastroduodenal artery)
-SPDA (superior pancreaticoduodenal artery)

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17
Q

What arteries supply the body/tail?

A

IPDA (inferior pancreaticoduodenal artery)

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18
Q

What veins supplies the venous drainage?

A

-SMV
-SV

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19
Q

What hormones does endocrine/islets of Langerhans produce?

A

-Insulin (beta cells - metabolism of carbs into energy)
-Glucagon (alpha cells - conversion into glucose)
-Somatostatin (delta cells - regulates insulin and glucagon)

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20
Q

Diabetes is an imbalance in?

A

Insulin

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21
Q

What hormones do exocrine/acini cells produce?

A

-Amylase (carb digestion)
-Lipase (fat digestion)
-Trypsinogen (protein digestion)
-Chymotrypsinogen (protein digestion)
-Bicarbonate (neutralizes acidic gastric enzymes and triggers pancreatic enzymes into duodenum)

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22
Q

When will amylase be increased/decreased?

A

-Increased when there is a disease
-Decreased when there is permanent damage

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23
Q

When will lipase be increased?

A

-With inflammatory diseases

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24
Q

What is steatorrhea?

A

Increased fat in stool

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25
Q

Will the echogenicity of the liver be the same in adults vs pediatrics?

A

No, it will look hypoechoic in pediatrics because they have less fat

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26
Q

What do acini cells do?

A

Perform exocrine functions (digestive enzymes)

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27
Q

What do alpha cells do?

A

Perform endocrine functions (secretes glucagon)

28
Q

What do beta cells do?

A

Perform endocrine functions (secretes insulin)

29
Q

What do delta cells do?

A

Performs endocrine functions (secretes somatostatin)

30
Q

What does endocrine do?

A

Secretes into blood or tissue

31
Q

What does exocrine do?

A

Secretes into a duct

32
Q

What artery does NOT supply the pancreas with blood?

A

SMA

33
Q

Where does the pancreatic head lie in relation to the surrounding veins?

A

Lies anterior to the SMV/SV confluence

34
Q

What is the m/c anomaly?

A

Panc divisum

(when dorsal + ventral don’t fuse together into 1 duct, now 2 ducts)

35
Q

What is annular process?

A

-M/c males
-Associated with congenital anomalies
-Occurs when head panc surrounds 2nd part duodenum

36
Q

What is hypoechoic ventral head?

A

When the head is diminished by fat

37
Q

Where are the m/c sites for ectopic panc tissue to grow to?

A

-Stomach
-Duodenum
-Lg/sm intestines

38
Q

What is panc agenesis?

A

When dorsal (M/C) or ventral section is missing during development

39
Q

SF of dorsal agenesis?

A

Round head with absence of neck/body/tail, as bowel moves into this area

40
Q

M/c cause of pancreatolithiasis?

A

Chronic pancreatitis
(appears as many small hyperechoic dots in panc)

41
Q

What are the m/c causes of acute pancreatitis?

A

-Biliary tract disease (cholelithiasis)
-Excessive alcohol intake

42
Q

What is the m/c complication of acute pancreatitis?

A

Fluid collections

43
Q

Lightbulbs for acute pancreatitis?

A

-Pain radiating to back (relieved by sitting/bending at waist)
-Less than 5 days
-Possibly enlarged, or can look normal
-Associated with gallstones
-Leukocytosis

44
Q

What is the m/c location for panc pseudocyst?

A

Tail!
(make up 75% of cystic lesions in panc)

45
Q

M/c complications with chronic pancreatitis?

A

-Pseudocysts
-Venous thrombosis
-Increased risk panc cancer

46
Q

Lightbulbs for chronic pancreatitis?

A

-Greater than 5 days
-Atrophied + fibrotic
-Repreated attacks acute
-Calcifications
-Increased amylase + bilirubin

(image looks like very small hyperechoic dots in panc representing calcifications)

47
Q

What is polycystic disease?

A

-Multiple cysts in kidney, liver, and in last stage will show up in panc

(if no cysts present in kidney/liver - think inflammation + not polycystic)

48
Q

M/c cause of polycystic disease?

A

Family history

49
Q

What is von Hippel Lindau disease?

A

Affects CNS by developing cysts in several parts of body

(peripheral calcifications)

50
Q

Lightbulbs for cystic fibrosis?

A

-Steatorrhea
-Correlates to pancreatitis
-M/c in children
-Due to excess production of thick mucous by endocrine glands

51
Q

Who is m/c to get neoplastic disease?

A

African American men

52
Q

Is it common to have panc cancer?

A

Yes!
Often caught late stages tho

53
Q

Are most panc tumours solid or cystic?

A

Solid (m/c involved panc head)

54
Q

Are malignant cystic neoplasms common?

A

No, 1% malignant, 75% benign pseudocysts!

55
Q

Is exocrine or endocrine the largest group of panc tumours?

A

Exocrine

56
Q

What is the m/c panc malignancy?

A

Adenocarcinoma (in head)

57
Q

SF of adenocarcinoma?

A

Often hypoechoic, solid, in head

58
Q

Lightbulb for serous cystadenoma?

A

-Women
-Head
-Cystic
-Calcifications
-Less than 2cm

59
Q

Lightbulb for mucinous adenoma?

A

-Women
-Cystic
-Body/tail
-Big (1-36cm)

60
Q

Lightbulb for IPMN (intraductal papillary mucinous neoplasms)?

A

-Elderly men
-Malignant potential (“mucinous” in title)
-Head
-Ductal dilatation

61
Q

Lightbulb for solid pseudopapillary?

A

-Young women
-Head/tail
-Mass has cystic + solid components*
-Low malignant potential

62
Q

Another name for endocrine neoplasms?

A

-Neuroendocrine tumours
-Islet cell tumours

63
Q

Types of endocrine neoplasms?

A

-Insulinomas
-Gastroinomas
-Glucagonomas (uncommon)

64
Q

Lightbulb for insulinoma?

A

-B cell tumour
-Benign
-Hyperinsulinism (b/c too much insulin) + hypoglycemia (b/c not enough glucose)
-Body/tail
-Hyperechoic, 1-2cm

65
Q

Lightbulb for gastrinoma?

A

-G cell tumour
-Malignant (most)
-Tail
-Hypoechoic
-Excess gastrin
-Multile sm tumours

66
Q

Are metastases to the panc common?

A

Nope

Primaries: melanoma, breast, GIT, lung

MIDS 127 (14 decks)

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