Pancreas Flashcards
pancreas starts as ___ separate pieces that fuse together
2
pancreas is intra/retroperitoneal
retro
pancreas lies in the (9 segments of the body)
epigastrium
left hypochondrium
pancreas is _____ to lesser sac, stomach, left lobe of liver
posterior
pancreas lies in the ____ ______ space (retroperitoneum)
anterior
pararenal
head of pancreas sits in the ____ of the duodenum
c loop
pancreas extends from the _____ to the _____
duodenal loop
splenic hilum
thin patient = head and tail more ____ to body and neck
increased retroperitoneal fat: all parts of panc = ____
posterior
same depth
length of panc
12-15cm
AP dimensions of each part
Head: 2-3 cm
body: 2-3 cm
neck: 1.5-2.5 cm
tail: 1-2 cm
shapes of panc (4)
comma
sausage
dumbbell
tadpole
panc head:
_____ to duodenum
_____ to IVC
_____ LRV
_____ to portal confluence
_____ to PV
_____ to stomach
_____ to HA
medial
anterior
anterior
lateral
inferior
posterior
inferior
panc head
____ anterolateral
____ posterolateral
GDA
CBD
Uncinate= _____ to SMV and possible SMA
posterior
panc neck:
____ to SMV/portal confluence
____ to CHA
anterior
inferior
panc body:
_____ to aorta
_____ LRV
_____ SV
_____ SMA
_____ CA
_____ SA
anterior
anterior
anterior
anterior
inferior
inferior
pan tail:
_____ to left adrenal
_____ to aorta
SA covers _____ border
SV covers _____ border
anterior
left
posterior/superior
posterior/inferior
duct of Wirsung (what, joins what/where, diameter)
main pancreatic duct
joins with CBD and enter ampulla of Vater
diameter should not exceed 2mm
duct of Santorini (what, enters what/where)
accessory duct
enters duodenum 2cm prox to main duct at minor duodenal papilla
the panc has both ____ and ____ functions
endocrine
exocrine
____ of panc tissue has exocrine function (____ and ____ cells)
80 percent
ductal
acini
endocrine =
exocrine =
(panc)
hormonal
digestive
pancreatic juice composed of (4)
enzymes
water
bicarbonate
salts
digestive enzymes in panc juice include (3)
amylase: acts on carbs
tripase: acts on fats
sodium bicarbonate: neutralizes HCL
what triggers the release of pancreatic juices
food ingested into the duodenum stimulates the release of 2 hormones: secretin and CCK
secretin stimulates:
CCK stimulates:
production of sodium bicarbonate
acinar cells to produce digestive enzymes (also stimulates GB to contract/release bile)
the _______ produce hormones (panc) which are released into the _____
islets of Langerhans
bloodstream
islets of langerhans are more numerous in pancreatic ____
tail
3 types of cells in endocrine function of panc
alpha: produce glucagon
beta: produce insulin
delta: produce somatostatin
The first 2 maintain glucose levels
Lab test: serum amylase (panc)
obstruction/necrosis can cause amylase to leak into the tissue spaces in the bloodstream (not specific to panc)
lab test: lipase (panc)
excreted in panc only
increased in inflammatory conditions and some neoplasms
lab tests: glucose (panc) (increased and decreased)
increase = diabetes chronic liver/panc disease
decrease: tumors of the islets of langerhans, hypoglycemia
what arteries supply the panc (2)
pancreaticoduodenal arteries
splenic artery
anterior and inferior pancreaticoduodenal arteries supple the ____ and part of ____
head
duodenum
spenic artery supplies the ____ and ___
body
tail
patient prep for kindey scan
NPO 6-12 hours before
no smoking/gum
scheduled in am (air ingested later)
patient position for panc scan
supine
use ____ as a window for panc
left lobe of liver
transverse plane at _____, ____ angulation, slightly ____ orientation (panc)
xiphoid
caudal
oblique
sonographic appearance of panc:
hetero/homogenous
slightly ____ than liver
hypo/hyper/isoechoic to liver
ducts may be visualized in the panc ___
homogenous
coarser
isoechoic to slightly more echogenic than liver
body
collapsed ______ may minic panc duct
pylorus
panc duct seen as a “_______”
double parallel line
