pancreas Flashcards

1
Q

PANCREATITIS OCCURS WHEN?

A

the pancreas becomes damaged and malfunctions as a result of increased secretion and blockage of ducts

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2
Q

What is an acute attack of pancreatitis commonly related to?

A

alcoholism & biliary tract disease

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3
Q

Patients with pancreatitis typically present with

A

moderate to severe tenderness in the epigastrium radiating to teh back

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4
Q

when swelling does occur, the gland is hypoechoic to anechoic and is less echogenic than the liver becuase of the increased prominence of?

A

lobulations and congested vessels

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5
Q

the pancreatic duct may be obstructed in acute pancreatitis as a result of?

A

inflammation, spasm, edema, swelling of the papilla, and pseudocyst

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6
Q

fluid collections around the pancreatic ____, along the ____ spaces, within the ____ pouch, and around the ____ may be present in a patient with acute pancreatitis

A

*bed *pararenal *Morison’s *duodenum

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7
Q

patients with acute pancreatitis may develop complications, such as?

A

pseudocyst, phlegmon, abscess, hemorrhage, and duodenal obstruction

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8
Q

courvoisier’s gallbladder

A

enlargement of the GB caused by a slow, progressive obstruction of the distal CBD from an external mass, such as adenocarcinoma of the pancreatic head

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9
Q

cystic fibrosis

A

hereditary disease that causes excessive production of thick mucus by the endocrine glands

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10
Q

hypercalcemia

A

elevated levels of calcium in the blood

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11
Q

hyperlipidemia

A

congenital condition in which elevated fat levels cause pancreatitis

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12
Q

ileus

A

dilated loops of bowel without peristalsis; associated with various abdominal problems, including pancreatitis, sickle cell crisis, and bowel obstruction

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13
Q

leukocytosis

A

abnormal increase in WBC’s caused by infections

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14
Q

serum amylase

A

pancreatic enzyme that is elevated during pancreatitis

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15
Q

lipase

A

pancreatic enzyme that breaks down fats; enzyme is elevated in pancreatitis and remains increased longer than amylase

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16
Q

islets of Langerhans

A

portion of the pancreas that has an endocrine function and produces insulin, glucagon, and somatostin

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17
Q

insulin

A

hormone that causes glycogen formation from glucose in the liver and that allows circulating glucose to enter tissue cells

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18
Q

glucagons

A

stimulates the liver to convert the glycogen to glucose; produced by alpha cells

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19
Q

exocrine

A

the kind of pancreatic function that involves the production and digestion of pancreatic juice

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20
Q

endocrine

A

the kind of pancreatic function that involves the production of the hormone insulin

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21
Q

amylase

A

enzyme secreted by the pancreas to aid in the digestion of carbs

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22
Q

acini cells

A

cells that perform exocrine function

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23
Q

uncinate process

A

small, curved tip of the pancreatic head that lies posterior to the SMV

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24
Q

tail of the pancreas

A

tapered end of the pancreas that lies in the left hypochondrium near the hilus of the spleen and upper pole of the LT Kidney

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25
Q

superior mesenteric vein

A

lies posterior to the neck or body of the pancreas and anterior to the uncinate process of the gland

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26
Q

superior mesenteric artery

A

serves as the posterior border to the body of the pancreas

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27
Q

portal-splenic confluence

A

junction of the splenic and MPV; posterior border of the body of the pancreas

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28
Q

pancreaticoduodenal arteries

A

help supply blood to the pancreas along with the splenic artery

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29
Q

neck of the pancreas

A

small area of the pancreas between the head and the body; anterior to the SMV

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30
Q

head of the pancreas

A

lies in the C-loop of the duodenum; the gastroduodenal artery is the anterolateral border, and the CBD is the posterolateral border

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31
Q

duct of wirsung

A

largest duct of the pancreas that drains the tail, body, and head of the gland; it joins the CBD to enter teh duodenum through the amupulla of vater

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32
Q

duct of santorini

A

small accessory duct of the pancreas found in the head of the gland

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33
Q

dorsal pancreatic artery

A

branch of the splenic artery that supplies the body of the pancreas

34
Q

common hepatic artery

A

forms the right superior border of the body and head of the pancreas and gives rise to the GDA

35
Q

C-loop of the duodenum

A

forms the lateral border of the head of the pancreas

36
Q

caudal pancreatic artery

A

branch of the splenic artery that supplies the tail of the pancreas

37
Q

body of the pancreas

A

lies in the midepigastrium anterior to the SMA and SMV, AO, and IVC

38
Q

lymphoma

A

malignant neoplasm that arises from the lymphoid tissues

39
Q

obstructive jaundice

A

excessive bilirubin in the bloodstream caused by obstruction of bile from the liver.

40
Q

pancreatic ascites

A

fluid accumulation by a rupture of a pancreatic pseudocyst into the abdomen (very dangerous)

41
Q

pancreatic pseudocyst

A

-“sterile abscess” - enzymes accumulate in available space in the abdomen

42
Q

pancreatitis

A

-inflammation of the pancreas -may be acute or chronic

43
Q

pseudocyst

A

contains fluid but has no true endothelial lining membrane

44
Q

The pancreas is located in the ________

A

retroperitoneal cavity

45
Q

the pancreas is located posterior to the

A

-stomach -duodenum -proximal jejunum of the small bowel

46
Q

pancreatic glad appears sonographically ________to slightly more ________ than the ____________.

A

-isoechoic -hyperechoic -hepatic parenchyma

47
Q

posterior vascular landmarks of the pancreas are

A

-aorta -IVC

48
Q

The head of the pancreas lies _____ to the ______

A

-anterior -IVC

49
Q

SMV crossed ______ to the ______ of the head of the gland

A

-anterior -uncinate process

50
Q

SMV crosses posterior to the _______ and ______ of the pancreas

A

-neck -body

51
Q

the tortuous _________ is the ______ border of the pancreas.

A

-splenic artery -superior

52
Q

the tail of the pancreas lies ______ to the _______

A
  • anterior - left kidney
53
Q

the tail of the pancreas is ______ to the left ________ and __________.

A

-posterior -colic flexure -transverse colon

54
Q

the _______ enters the medial second part of the duodenum with the CBD at the ampulla of vater

A
  • duct of wirsung
55
Q

the ______ receives tributaries from lobules at right angle

A

duct of wirsung

56
Q

blood supply for the pancreas is from the _______ and the __________

A
  • splenic artery - pancreaticoduodenal arteries
57
Q

the ______ is seen along the _______ border of the pancreas as it travels along the _______ aspect of the pancreas head

A
  • gastroduodenal artery (GDA) - anterolateral - anterior
58
Q

the CBD crosses the _____ aspect of the PV to the ____ of the proper hepatic artery

A

-anterior -right

59
Q

the PV is ______ to the IVC

A

anterior

60
Q

the pancreas is a _______ ( exocrine) and a _______ (endocrine) gland.

A
  • digestive - hormaonal
61
Q

diabetes mellitus

A

failure of the pancreas to furnish insulin

62
Q

exocrine function is perform by _______ of the pancreas

A

acini cells

63
Q

Sphincter of Oddi

A

-muscle surrounding the ampulla of vater - relaxes to allow pancreatic juices & bile to empty into the duodenum

64
Q

the endocrine function is located in the _______ in the pancreas

A

islets of langerhans

65
Q

beta cells are most prevalent and produce _______, a hormone that causes _______ formation from _______ to the liver

A
  • insulin - glycogen - glucose
66
Q

alpha cells produce _______, a hormone that causes the cells to release ________ to meet energy needs

A

-glucagons -glucose

67
Q

_____ are the smallest composition of the endocrine tissue and produce __________

A
  • delta cells - somatostatin
68
Q

enzymes of the pancreas that become altered in pancreatic disease are

A

-amylase -lipase

69
Q

the elevation in ________ concentration persists for a longer period in pancreatitis

A

lipase

70
Q

_______ controls the blood sugar level in the body

A

glusose

71
Q

what is the water technique used to image the pancreas with ultrasound.

A
  • pt. drinks 32-300ml through a straw - in an erect or lateral decubitus - fluid dills the duodenal cap - outlines the lateral margin of the head of the pancreas - upright position allows air to move from the gastric antrum to the fundus of the stomach - causes the upper viscera to move downward for a better sonograhic window
72
Q

when the pancreas is enlarged, the ______ border of the _____ may depict’a slight indentation

A
  • anterior - IVC
73
Q

Grey Turner’s sign

A

NECROSIS of the blood vessels results in the development of HEMORRHAGIC areas

74
Q

phlegmon

A
  • spread along facial pathways - causes diffuse inflammatory edema of soft tissue
75
Q

chronic pancreatitis

A
  • obstructed pancreatic duct -with a buildup of protein plugs -results in calcifications along the duct
76
Q

how does a pseudocyst develops

A

pancreatic enzymes that escape the ductal system cause enzymatic digestion of surrounding tissue & pseudocyst development. The walls of the pseudocyst from various potential spaces in which escaped pancreatic enzymes are found. pseudocyst usually presents few symptoms until it becomes large enough to cause pressure on surrounding organ

77
Q

the most common pseudocyst is in the

A

lesser sac

78
Q

the lesser sac is ______ to the pancreas and ______ to the stomach

A
  • anterior - posterior
79
Q

A pseudocyst develops when ________ escape from the gland break down tissue to form _______ somewhere in the _______.

A
  • pancreatic enzymes - sterile abscess - stomach
80
Q

adenocarcinoma

A

the most common primary neoplasm of the pancreas

81
Q

what are the clinical findings in a patient with carcinoma of the pancreas

A
  • wt loss - painless jaundice - nausea - vomiting - changes in stool
82
Q

lymphoma

A

the most frequent parapancreatic neoplasm