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ARRT > Pancreas > Flashcards

Pancreas Flashcards

1
Q

the head of the pancreas is the most _____ portion

A

inferior; lies in the C loop of the duodenum

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2
Q

the _____ of the pancreas is directly anterior to the portal-splenic confluence or superior mesenteric vein

A

neck

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3
Q

the _____ of the pancreas is the largest section of the gland

A

body

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4
Q

the _____ of the pancreas lies anterior to the left kidney and posterior to the left colic flexure and transverse colon

A

tail

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5
Q

what 2 ducts are seen in the pancreas?

A

duct of Wirsung and duct of Santorini

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6
Q

the duct of _____ is the primary duct extending the length of the pancreas; enters the medial second part of the duodenum with the CDB

A

Wirsung; should measure less and 2mm and tapers as it reaches the tail

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7
Q

the duct of _____ is a secondary duct that drains the upper anterior head; it enters the duodenum at the minor papilla about 2 cm proximal to the ampulla of Vater

A

Santorini

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8
Q

normal pancreas head to tail measure _____, head measures _____, neck _____, body _____, tail _____

A

15cm; 3cm; 1.5-2.5cm; 2-2.5cm; 1-2cm; decreases in size as you age

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9
Q

_____ of the body and tail, with hypertrophy of the pancreas head is a congenital defect

A

agenesis

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10
Q

_____ is a rare condition caused by the lack of fusion of the dorsal and ventral pancreatic buds; drainage of the dorsal and ventral pancreas is through the minor papilla

A

pancreas divisum

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11
Q

_____ is the most common pancreas anomaly, usually in the form of intramural nodules

A

ectopic pancreas tissue; tissue may be found in various places in the GI tract

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12
Q

_____ pancreas is a rare anomaly in which the head of the pancreas surrounds the second portion of the duodenum

A

annular; more common in males; may be associated with duodenum atresia

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13
Q

the pancreas is both a digestive ____ and hormonal _____ gland

A

exocrine (produce pancreatic juice); endocrine (controls the secretion of glucagons and insulin in the blood)

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14
Q

exocrine functions is performed by _____ of the pancreas; can produce up to 2L per day

A

acini cells; the enzymes of the pancreas juice that aid digestion includes lipase (digest fat), amylase (digest carbs), carbozypeptidase and trypsin (digest proteins)

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15
Q

the endocrine function is located in the _____ in the pancreas

A

islets of Landerhans; cells within the islets are called alpha (produce glucagons), beta (produce insulin), and delta (produce somatostatin) cells

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16
Q

a _____ level of twice normal usually indicates acute pancreatitis; as wall as urine amylase

A

serum amylase; other reasons could be chronic pancreatitis, obstruction of the prancreatic duct, perforated peptic ulcer, acute cholecystitis, and alcohol poisoning

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17
Q

the _____ test is performed to assess damage to the pancreas

A

lipase; rise in acute pancreatitis and carcinoma; lipase elevation persists longer than amylase

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18
Q

the _____ tolerance test if performed to discover whether there is a disorder of glucose metabolism

A

glucose; may be a decrease in blood sugar levels in tumors of the islets of Langerhans

19
Q

_____ occurs when the pancreas becomes damaged and malfunctions as a result of increased secretion and blockage of ducts; when this occurs the pancreas tissue may be digested by its own enzymes

A

pancreatitis

20
Q

____ pancreatitis is caused by the inflamed acini releasing pancreatic enzymes into the surrounding pancreatic tissue; hypoechoic (edema); borders irregular; head causes depression of IVC; parapancreatic fluid

A

acute; sudden onset of moderate to severe abdominal pain with radiation to back; nausea and vomiting; history of gallstones or alcoholism; mild fever; abdominal distention

21
Q

the most common cause of pancreatitis in the united states is _____

A

biliary tract disease; second common is alcohol abuse

22
Q

these extrapancreatic fluid collections occur within _____ from the acute onset of the pancreatitis and may resolve spontaneously

A

4 weeks

23
Q

_____ are always acquired, they result from trauma to the gland or acute or chronic pancreatitis; defined as a collection of fluid that arises from the loculation of inflammatory processes, necrosis, or hemorrhage

A

pseudocyst; develops over 4 to 6 weeks after pancreatitis; well-defined mass, usually in area of pancreas, may have debris at bottom; develops when pancreatic enzymes escape from the gland and break down tissue to forma sterile abscess

24
Q

the most common location of a pseudocyst is in the _____ anterior to the pancreas and posterior to the stomach

A

lesser sac; second most common is the anterior pararenal space

25
Q

_____ pancreatitis is a rapid progression of acute pancreatitis with rupture of pancreatic vessels and subsequent hemorrhage; well defined homogenous mass in mass; foci of extravasated blood and fat necrosis are seen

A

hemorrhagic; decreased hematocrit and serum calcium levels; intense, severe pain radiating to back, with subsequence shock and ileus; hypotension

26
Q

a _____ is an inflammation process that spreads along fascial pathways, causing localized ares of diffuse inflammatory edema of soft tissue that may proceed to necrosis and suppuration

A

phlegmon; appears hypoechoic with good through-transmission

27
Q

the majority of patients develop _____ secondary to pancreatitis that develops from postoperative procedures; unilocular or multilocular and can spread superiorly into the mediastinum

A

abscess; hypotension; tender abdomen; hypoechogenic mass with smooth borders; thick walls; echo-free to echogenic

28
Q

______ pancreatitis results from recurrent attacks of acute pancreatitis and causes continuing destruction of the pancreatic parenchyma; malabsorption; fatty stools; signs of diabetes; weight loss; jaundice

A

chronic; the ducts become obstructed with a build-up of protein plugs with resultant calcifications along the duct; small and fibrotic gland; irregular borders; mixed echogenicity; dilated pancreatic duct

29
Q

_____ disease has cysts that vary from microscopic to several centimeters in diameter and have an epithelial lining; often found in patients with polycystic renal disease

A

autosomal dominate polycystic; well-defined mass with serous fluid

30
Q

_____ is an autosomal dominant condition characterized by central nervous system and retinal hemangioblastomas, visceral cysts, pheochromocytomas, and renal cell carcinoma

A

Von Hippel-Liudau Disease; well-defined mass with thick fluid; calcifications; single or multiple; size varies from microscopic to several cm

31
Q

_____ cysts of the pancreas result from the anomalous development of the pancreatic duct

A

congenital; usually multiple and range from small to 3 to 5 cm in size

32
Q

______ is a hereditary disease that causes excessive production of thick mucus by the endocrine gland; most common pancreatic abnormality found is fatty replacement of pancreas

A

cystic fibrosis; well-defined mass with serous fluid; size varies; fibrous replacement will occur throughout the parenchyma

33
Q

_____ cysts are microscopic sacs that may be congenital or acquired; often found in infants

A

true; well-defined mass with serous fluid; unilocular or multilocular

34
Q

the most common primary neoplasm of the pancreas is _____; loss of normal pancreatic parenchyma; hypoechoic poorly defined mass; focal mass with irregular borders; enlargement of pancreas; if located in the head look for hydrops

A

adenocarcinoma; involves the exocrine portion of the gland; wight loss; nausea vomiting, stool changes, pain radiating to back, painless jaundice; matastasizes to lymph nodes, liver, lung, bone, duodenum, peritoneum, and adrenal gland

35
Q

enlargement of the _____ in the pancreatic area may lead to encasement of the celiac axis or SMV artery

A

lymph node

36
Q

dilation of the pancreatic and common duct is common with the _____ tumor

A

ampullary

37
Q

what are the 2 types of cystic pancreatic neoplasms?

A

microcyctic (serous) adenoma and macrocystic (mucinous) adenoma

38
Q

the _____ adenoma is one of the pancreatic lesions found in von Hippel-Lindau disease; vary from 1 to 20 mm

A

microcystic; well-defined tumors with external lobulation; cyst walls thicker than the membranes between miltilocular cysts; hypervascular

39
Q

______ adenocarinoma is an uncommon, slow-growing tumor that rises from the duct as a cystic neoplasm; large cyst; significant malignant potential

A

macrocystic; more common in the tail and body; foci and calcification may be seen; smooth surfaced; irregular lobulated cystic tumor; hypoechoic mass; thick walls

40
Q

_____ is the most common functioning islet cell tumor

A

insulinoma (B-cell tumor); hypoglycemic symptoms; palpitations; headaches; confusion; pallor; sweating; coma; small, well encapsulated, and hypervascular

41
Q

______ is the second most common functioning islet cell tumor and produces the Zollinger-Ellison syndrome; caused by non-insulin secreting pancreatic tumors but secretes excessive amounts of gastrin

A

Gastrinoma (G-cell tumor); diarrhea; multiple; extrapancreatic; malignant

42
Q

______ tumors have a tendency to present as large tumors in the head of the pancreas with high incidence of malignancy

A

nonfunctioning islet-cell tumors

43
Q

______ is uncommon but primary tumors that can include melanomas, breast, gastrointestinal, and lung

A

metastasis

44
Q

_____ are malignant neoplasms that rise from the lymphoid tissue; most frequent parapancreatic neoplasm

A

lymphomas; hypoechoic mass or with necrosis a cystic mass in the pancreas; multiple nodes are seen

ARRT (9 decks)

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