Pancreas

Question 1

location of pancreas

Answer 1

retroperitoneal space
LV2
oblique/transverse in position

Question 2

origin of pancreas?

Answer 2

endoderm

develops from ventral and dorsal pancreatic buds

pair of evaginations off of primitive gut tube

Question 3

pancreatic head

Answer 3

includes uncinate process

attached to 2nd and 3rd portions of duodenum

Question 4

function of pancreas

Answer 4

both exocrine and endocrine

only 1% is endocrine

Question 5

blood supply to pancreas

Answer 5

gastroduodenal artery (branch of common hepatic)
-to pancreatic head

splits to posterior and anterior superior pancreaticoduodenal artery

anastomose with inferior pancreaticoduodenal artery

Question 6

pancreatic neck

Answer 6

straddles SMV and portal vein

Question 7

pancreatic body

Answer 7

longest segment of organ

Question 8

location of pancreatic body

Answer 8

-

Question 9

pancreatic tail

Answer 9

lies at level of TV12

may be injured during splenectomy

Question 10

duct of santorini

Answer 10

accessory duct

drains superior portion of head and empties separately into duodenum

Question 11

duct of wirsung

Answer 11

main duct

merges with common bile duct to ampulla of vater

Question 12

why accessory duct?

Answer 12

because pancreas formed from two buds

Question 13

arterial supply of pancreas

Answer 13

superior pancreaticoduodenal - from gastroduodenal

inferior pancreaticoduodenal - from superior mesenteric

both anastomose (anterior and posterior branches)

Question 14

from splenic artery?

Answer 14

dorsal, great, caudal pancreatic arteries

Question 15

venous drainage of pancreas

Answer 15

follows arterial supply

• anterior and posterior arcades drain head and body
• to SMV and then to portal vein

splenic vein drains body and tail - to portal vein

Question 16

exocrine anatomy of pancreas?

Answer 16

secretory acini and ducts

acini - 20-40 secretory cells coalesce into sac like unit (cells secrete digestive enzymes)

ducts - tubular network delivers exocrine secretions to duodenum

Question 17

acinar cells

Answer 17

secrete digestive enzymes
-packed in zymogen granules, released into acinar lumen

amylase, lipase, and trypsinogen

Question 18

ductal cells

Answer 18

secretes water and electrolytes

centroacinar and intercalated duct cells
secrete bicarbonate

in larger ducts, some cells secrete mucins

Question 19

digestive juice

Answer 19

alkaline fluid
-colorless, odorless, isosmotic

enzymes activated in duodenum by acidic environment

pH neutralizes gastric aid and buffers intestinal pH

Question 20

endocrine pancreas anatomy

Answer 20

less than 2% of pancreatic cells

-islands of cells (islets of langerhans)

Question 21

major cell types in islets of langerhans

Answer 21

alpha cells 25-35%
beta cells 55-65%
delta cells 5-15%
PP cells <2%

Question 22

alpha cells

Answer 22

produce glucagon

Question 23

beta cells

Answer 23

produce insulin and amylin

Question 24

delta cells

Answer 24

produce somatostatin

Question 25

PP cells

Answer 25

produce pancreatic polypeptide

Question 26

minor cell types in islets of langerhans

Answer 26

delta-1 EC cells epsilon cells

Question 27

delta-1 cells

Answer 27

produce VIP | -also in exocrine acini and ductal epithelium

Question 28

EC cells

Answer 28

produce secretin, motilin, and substance P also in exocrine acini and ductal epithelium

Question 29

epsilon cells

Answer 29

produce ghrelin

Question 30

insulin

Answer 30

released in response to glucose | -promotes glucose uptake (liver, muscle, fat)

Question 31

glucagon

Answer 31

released in response to low glucose | -promotes production of glucose from liver glycogen and glucose precursors

Question 32

stimulatory inputs?

Answer 32

``` glucose amino acids glucagon GIP CCK sulfonylurea compounds beta-sympathetics ```

Question 33

inhibitory inputs?

Answer 33

somatostatin amylin pancreastatin alpha-sympathetics

Question 34

pancreatic polypeptide

Answer 34

stimulates gastric chief cells inhibits bile secretion and intestinal mobility inhibits pancreatic enzymes and bicarbonate secretion

Question 35

vasoactive intestinal peptide (VIP)

Answer 35

similar action to glucagon also affect secretory activity and motility of gut stimulates pancreatic exocrine secretion

Question 36

secretin

Answer 36

acts locally -simulates bicarbonate secretion stimulates pancreatic enxyme secretion

Question 37

motilin

Answer 37

increases gastric and intestinal motility

Question 38

substance P

Answer 38

neurotransmitter properties

Question 39

ghrelin

Answer 39

stimulates appetite

Question 40

pancreatic islet organization

Answer 40

animals are mantle -beta in medulla and other in cortex humans are different - all cells randomly distributed - are arrayed along vessels so all cells see blood

Question 41

intercellular communication

Answer 41

via blood supply, paracrine relationships, gap junctions, innervation (S and PS)

Question 42

islet-acinar axis

Answer 42

islet acinar portal system mechanism??**