Pancreas Flashcards
What are the 4 parts of the pancreas?
head neck body tail
Major blood supply to pancreas supplied by what vessels?
celiac
SMA
Head and uncinate process of pancreas supplied by what arteries?
pancreaticoduodenal arteries (anterior/posterior)–> come from the GDA –> hepatic artery and SMA inferiorly
Neck, body, and tail of pancreas receive their blood supply from?
splenic artery
Dorsal pancreatic artery arises from?
splenic artery
dorsal pancreatic artery courses posterior to the body
What is the major duct of the pancreas?
duct of Wirsung
What is the accessory duct of the pancreas?
duct of Santorini
When do the ventral/dorsal buds of pancreas fuse?
8 weeks
ventral bud becomes inferior part of head and uncinate process
What’s pancreas divisum?
failure of organogenesis in pancreas development
(normally dorsal and ventral buds fuse and form a common duct with enters duodenum with CBD)
failure of dorsal and ventral buds to fuse–> divisum
ventral pancreatic duct and CBD drain via major papilla
dorsal pancreatic duct drains via minor papilla
(most pancreas secretions exit via dorsal duct, but small caliber of minor papilla causes partial obstruction)
buildup of back pressure causes relapsing acute or chronic pancreatitis
What is annular pancreas?
ventral pancreatic bud migrates and encircles 2nd portion of duodenum
Annular pancreas associated with what abnormalities?
Down’s
cardiac issues
malrotation
intestinal atresia
Sx tx for annular pancreas causing obstruction?
gastric bypass via duodenojejunostomy
Ventral or dorsal pancreatic duct wraps around 2nd portion of duodenum and causes annular pancreas?
ventral
Ectopic pancreas commonly found where?
stomach
duodenum
Meckel’s
What type of cells make up the pancreas?
acinar cells (85%)
islet cells (2%)
Acinar cells of the pancreas secrete what?
inactive zymogens in granules in response to food
What enzyme activates trypsinogen into trypsin?
enterokinase; made in duodenum
This enzyme, made in duodenum, stimulates trypsinogen to active trypsin:
enterokinase
Acinar cells produce two enzymes in active form:
pancreatic lipase
pancreatic amylase
SPINK-1 mutations are assc with development of what?
chronic pancreatitis
What’s the role of HCO3 secreted by pancreas acinar cells in duodenum?
neutralizes acid (HCL) from stomach
pancreatic enzymes are inactivated at low pH
What happens during cephalic phase of eating?
Ach is released
induces acinar cell secretion of enzymes
accnts for 20-25% of daily secretion of pancreatic juice
Phases of eating and pancreatic acid secretions?
cephalic phase–> 25%, mediated by ACh release of enzymes
gastric phase–> vasovagal reflexes due to gastric distention cause release of enzymes (10%)
intestinal phase–> 70% of pancreatic juice released during this phase, mediated by CCK release
What cells make CCK?
I cells of duodenum