Pancreas Flashcards
Body of pancreas
Lies in the midepigastrium anterior to the superior mesenteric artery and vein, aorta, and ivc.
Caudal pancreatic artery
Branch of splenic artery that supplies the tail of pancreas
C-loop of the duodenum
Forms the lateral border of the head of pancreas
Common hepatic artery
Forms the right superior border of the body and head of the pancreas and gives rise to the gastroduodenal artery.
Dorsal pancreatic artery
Branch of splenic artery that supplies the body of the pancreas
Duct of Santorini
Small accessory duct of pancreas found in head of the gland
Duct of Wirsung
Largest duct of pancreas that drains the tail, body, and head of the gland. It joins the common bile duct to enter the duodenum through the ampulla of Vater.
Head of pancreas
Lies in the c-loop of the duodenum; the gastroduodenal artery is the anterolateral border, and the CBD is the posterolateral border
Neck of pancreas
Small area of the pancreas between the head and body; anterior to the superior mesenteric vein
Pancreaticoduodenal arteries
Help supply blood to the pancreas along with the splenic artery
Portal-splenic confluence
Junction of the splenic and main portal vein; posterior border of the body of the pancreas
Superior mesenteric artery
Serves as the posterior border to the body of pancreas
Superior mesenteric vein
Lies posterior to the neck or body of the pancreas and anterior to the uncinate process of the gland
Tail of pancreas
Tapered end of the pancreas that lies in the left hypochondrium near the hilus of the spleen and upper pole of the left kidney
Uncinate process
Small, curved tip of the pancreatic head that lies posterior to the superior mesenteric vein (SMV)
Acini cells
Cells that perform exocrine function
Amylase
Enzyme secreted by the pancreas to aid in the digestion of carbohydrates.
Endocrine
The kind of pancreatic function that involves the production of hormone insulin
Exocrine
The kind of pancreatic function that involves the production and digestion of pancreatic juice
Glucagons
Stimulates the liver to convert the glycogen to glucose; produced by alpha cells
Insulin
Hormone that causes glycogen formation from glucose in the liver and that allows circulating glucose to enter tissue cells
Islets of Langerhans
Portion of the pancreas that has an endocrine function and produces insulin, glucagon, and somatostatin
Lipase
Pancreatic enzyme that breaks down fats; enzyme is elevated in pancreatitis and remains increased longer than amylase
Serum amylase
Pancreatic enzyme that is elevated during pancreatitis
Courvoisier’s gallbladder
Enlargement of the gallbladder caused by a slow, progressive obstruction of the distal CBD from an external mass, such as adenocarcinoma of the pancreatic head
Cystic fibrosis
Hereditary disease that causes excessive production of thick mucus by the endocrine glands
Hypercalcemia
Elevated levels of calcium in blood
Hyperlipidemia
Congenital condition in which elevated fat levels cause pancreatitis
Ileus
Dilated loops of bowel w/ o peristalsis; associated with variou abdominal problems, including pancreatitis sickle cell crisis, and bowel obstruction
Leukocytosis
Abnormal increase in white blood cells caused by infection
Lymphoma
Malignant neoplasm that arises from the lymphoid tissues
Obstructive jaundice
Excessive bilirubin in the bloodstream cause by an obstruction of bile from the liver; characterized by yellow discoloration of the sclera of the eye, skin, and mucous membranes
Pancreatic ascites
Fluid accumulation caused by a rupture of a pancreatic
pseudocyst into the abdomen; free floating pancreatic enzymes are very dangerous to surrounding structures
Pancreatic pseudocyst
“Sterile abscess” collection of pancreatic enzymes that accumulate in the available space in the abdomen, usually in or near the pancreas
Pancreatitis
Inflammation of the pancreas; may be acute or chronic
Pseudocyst
Space or cavity that contains fluid but has no true endothelial lining membrane
Where is pancreas located
Retroperitonel cavity posterior to stomach, duodenum, and proximal jejunum of small bowel
How does pancreas gland appear sonographicaly
Isoechoic to slightly more hyperechoic than the hepatic parenchyma
Major posterior vascular landmarks of pancreas
Aorta and IVC
Where does the head of the pancreas lie to the IVC
Anterior
What is the superior border of the pancreas
Tortuous splenic artery
The tail is harder to image why.
It lies anterior to the left kidney and posterior to the left colic flexure and transverse colon
What receives tributaries from lobules at right angles and enters the medial second part of the duodenum with the common bile duct at the ampulla of Vater
Duct of Wirsung
What is the blood supply for the pancreas
From the splenic artery and the pancreatiduodenal arteries
Which artery is seen along the anterolateral border of the pancreas as it travels a short distance along the anterior aspect of the pancreatic head
Gastroduodenal artery
What crosses the anterior aspect of the portal vein to the right of the proper hepatic artery
Common bile duct
The portal vein is where in reference to the IVC
Anterior
The pancreas is both digestive (?) and a hormonal (?) gland
Exocrine and endocrine
Failure of the pancreas to furnish sufficient insulin leads to what
Diabetes millitus
Exocrine function is performed by what cells of the pancreas
Acini cells
What muscle surrounding the ampulla of Vater that relaxes to allow pancreatic juice and bile to empty into the duodenum
Sphincter of Oddi
Where is the endocrine function located
Islets of Langerhans in the pancreas
The beta cells are more prevalent and produce what ( a hormone that causes glycogen formation from glucose in the liver)
Insulin
Alpha cells produce what ( a hormone that causes the cells to release glucose to meet the energy needs of the body)
Glucogens
Delta cells are the smallest composition of endocrine tissue and produce what
Somatostatin
What two enzymes of the pancreas may become altered in pancreatic disease
Amylase, lipase
Both amylase and lipase rise at the same rate, but in which one does the elevation persist for a longer period in pancreatitis
Lipase
What controls the blood sugar level in the body
Glucose
What occurs when the pancreas becomes damaged and malfunctions as a result of increased secretion and blockage of ducts
Pancreatitis
Acute attack of pancreatitis is commonly related to to what
Alcoholism and biliary tract disease
A patient with pancreatitis typically presents with moderate to severe tenderness where?
Epigastrium radiating to the back
When swelling occurs the gland is hypoechoic to anechoic and is less echogenic than the liver because of what
Increased prominence of labulations and congested vessels
The pancreatic duct may be obstructed in acute pancreatitis as a result of what
Inflammation, spasm, edema, swelling of papilla, and pseudo cysts
Where is fluid collection (maybe) in a patient with acute pancreatitis
Around pancreatic bed, along the pararenal spaces, w/i morrisons pouch and around the duodenum
Complications a patient may develop when they have acute pancreatitis
Pseudocysts, phlegmon, abscess, hemorrhage, duodenal obstruction
Necrosis of the blood vessels results in the development of hemorrhaged areas referred as what
Grey Turner’s sign
An inflammatory process that spreads along fascial pathways, causing localized areas of diffuse inflammatory edema of soft tissue (sometimes pus) is what
Phlegmon
What ducts become obstructed with a buildup of protein plugs with resultant calcifications along ducts in chronic pancreatitis
Pancreatic ducts
Where is the most common location of a pseudocyst
In the lesser sac, anterior to the pancreas and posterior to the stomach
What develops when pancreatic enzymes escape from the gland and break down tissue to form a sterile abscess somewhere in the abdomen
Pseudocyst
The most common primary neoplasm of the pancreas is what
Adenocarcinoma
Clinical findings in a patient with carcinoma of the pancreas
Weight loss, painless jaundice, nausea, vomiting, change in stool
Most frequent parapancreatic neoplasm
Lymphoma
