Pancreas Flashcards by Valery Dzev

What is the basic anatomy of the pancreas?

Non-encapsulated
Retroperitoneal
Made of head, uncinate process, neck, body, and tail

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Normal length of pancreas?

Between 12-15cm from head to tail

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Where does the pancreas lie and extend from?

Lies obliquely, generally transversely, extending from the duodenum and wrapping posteriorly to splenic hilum in the mid abdomen

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Describe the head of the pancreas and where it is located in relation to landmarks.

Largest rightmost portion of the pancreas, within duodenum
Ant to IVC
GDA anterolateral to head
CBD posterolateral to head

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Describe the neck of the pancreas and where it is located in relation to landmarks.

Next portion after the head
Ant to SMV
Ant to portal splenic confluence

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Describe the uncinate process of the pancreas and where it is located in relation to landmarks.

Projects from the head medially, triangular structure (we don’t see on US)
Ant to IVC
Post to SMV

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What are common within the uncinate process?

Lymph nodes

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Describe the body of the pancreas and where it is located in relation to landmarks.

Sup to head
Ant to:
- AO
-SMV
-SMA
-Splenic vein

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Describe the tail of the pancreas and where it is located in relation to landmarks.

Longest portion, lies within splenic hilum
Ant/med to left kidney
Post to stomach
Medial to spleen

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What are the pancreatic ducts and their normal measurements?

Duct of Wirsung (2mm)
Duct of Santorini (2mm)

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What is the duct of Wirsung?

AKA main pancreatic duct; arises in tail from smaller ducts in lobules and travels all the way to the head

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Where do the common bile duct and main pancreatic duct meet?

Ampulla of Vater, which is an opening

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What is the sphincter of Oddi?

Muscle around the ampulla of vater than allows flow of pancreatic juices and bile into the duodenum

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Can you see any of the ducts on ultrasound?

Possible the main pancreatic duct, but not the duct of Santorinii

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What is the duct of Santorinii?

Accessory duct found within the head of the pancreas

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How is blood supplied to the pancreas?

Supplied by:
-Splenic artery (body/tail)
-SMA (head)
-Hepatic artery
-GDA

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How is blood drained from the pancreas?

Portal splenic confluence (which is the SMV and splenic vein)

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What are the functions of the pancreas?

Exocrine (break down protein, carbs, lipids) and endocrine (secrete insulin and glucagon)

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How much of the pancreas functions as an exocrine vs endocrine organ?

98% exocrine, 2% endocrine

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What is the pancreas’s endocrine function most necessary for?

Metabolism of carbs and glucose

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What stimulates and regulates the production of insulin/glucagon?

Somatostatin

What does insulin stimulate?

For cells to use glucose and decrease blood sugar

What does glucagon stimulate?

Release of glucose into the bloodstream to increase blood sugar

What cells are responsible for the secretion of insulin and glucagon?

Islets of Langerhans

What produces digestive enzymes?

Acinar cells

Which digestive enzymes are produced by the pancreas?

Trypsin, Lipase, Amylase (which are also seen in blood work frequently)

What do pancreatic enzymes do?

Aid in digestion of proteins, fats, starches, lipids

What is the largest component of pancreatic juice?

Sodium Bicarbonate

What makes up pancreatic juice?

Trypsin, Lipase, Amylase, Nucleases, and Sodium Bicarbonate

What is the purpose of sodium bicarbonate in pancreatic juice?

Neutralize hydrochloric acid in the stomach

How is the pancreas imaged on ultrasound?

TRV, if head is not visible we can utilize sag to obtain a picture of the head alone

What is the location of the portal-splenic confluence?

Posterior to body and tail

What is the location of the SMV?

Between the head and uncinate process

How is the echogenicity of the pancreas affected by age?

It is usually isoechoic to the liver and less echogenic than the renal sinus, but increases with age due to fatty replacement of parencyma

The antrum of the stomach is ___________ to the pancreatic head.

The CBD is _______ to the body of the pancreas.

Posterolateral

The aorta is ________ to the body of the pancreas.

Posterior

The duodenum is _______ to the head of the pancreas.

Lateral

The GDA is ______ to the head of the pancreas.

Anterolateral

The hepatic artery is ______ to the head, neck, and uncinate process.

Superior

The IVC is ____ to the head of the pancreas.

Posterior

The main portal vein is _____ to the head of the pancreas.

Superior

The spleen is ________ to the tail of the pancreas.

Lateral

The splenic vein is ______ to the body and tail of the pancreas.

Posterior

The stomach is ______ to the body and tail of the pancreas.

The SMA is ____ to the body of the pancreas.

Posterior

The SMV is _____ to the neck and body of the pancreas and the splenic vein.

Posterior

The uncinate process is _____ to the IVC.

What forms the posterior border of the pancreas?

Splenic vein

The portal vein is _____ to the IVC and ______ to the SMA.

Anterior; posterior