Pancreas A&P Flashcards

1
Q

where is the pancreas located?

A

retroperitoneal
epigastric/solar plexus

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2
Q

what are the 4 segments of the pancreas?

A

head, neck, body, tail

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3
Q

where is the head located? (landmarks)

A

anterior to IVC
right of SMV
at c-loop of duodenum

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4
Q

where is the neck located?

A

directly anterior to SMV

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5
Q

where is the body located?

A

directly anterior to SV
anterior to AO & SMA
posterior to stomach wall

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6
Q

where is the tail located?

A

directly anterior to SV
anterior to left kidney
posterior to stomach
medial to spleen

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7
Q

normal size of the pancreas?

A

10-12 cm (adult)

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8
Q

normal size of head of pancreas (AP)?

A

< 3.5 cm

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9
Q

normal size of neck of pancreas (AP)?

A

< 1-2 cm

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10
Q

normal size of body of pancreas? (AP)

A

< 2.5 cm

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11
Q

normal size of tail of pancreas? (AP)

A

< 2.5 cm

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12
Q

what are the ducts of the pancreas?

A
  1. pancreatic duct/duct of wirsung
  2. accessory duct/duct of santorini
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13
Q

where does the duct of wirsung join the CBD?

A

ampulla of vater

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14
Q

mean diameter of pancreatic duct? (head & body)

A

3 mm @ head
2 mm @ body

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15
Q

what are the functions of pancreas?

A

exocrine: secretes digestive enzymes
endocrine: secretes hormones

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16
Q

which portion of the panc is the accessory duct located?

A

head of pancreas

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17
Q

where does the accessory duct enter the duodenum in comparison the the pancreatic duct?

A

enters duodenum superior to pancreatic duct

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18
Q

what are the functional cells for the exocrine portion of the pancreas? what do they do?

A

acinar cells secrete digestive enzymes

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19
Q

what digestive enzymes do acinar cells secrete?

A

amylase, lipase, trypsin

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20
Q

what does lipase break down?

A

fat

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21
Q

what does amylase break down?

A

carbs

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22
Q

what does trypsin break down?

A

proteins

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23
Q

where do digestive enzymes get secreted?

A

into the ducts & duodenum

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24
Q

where are hormones secreted?

A

bloodstream

25
what are the functional cells of the endocrine portion of the pancreas?
islet of langerhaans/islet cells
26
what pancreas cells release hormones?
alpha cells, beta cells, delta cells
27
what do alpha cells secrete? what do they do?
glucagon is secreted to break down glycogen to glucose when body is hypoglycemic
28
what do beta cells secrete? what do they do?
insulin is secreted to store glucose when body is hyperglycemic
29
what do delta cells secrete? what do they do?
somatostatin is secreted as an autoregulator for glucagon & insulin
30
what are the 3 lab values for the pancreas?
amylase, lipase, glucose
31
what can elevated amylase indicate?
if it's 2x the normal amount, it can indicate acute pancreatitis other: intestinal obstruction, mumps, salivary gland disease, acute cholecystitis, perforated peptic ulcer, renal failure
32
what can elevated lipase indicate?
acute pancreatitis/pancreatic carcinoma other: cholecystitis, cirrhosis, severe renal disease
33
what stays elevated longer? amylase or lipase?
lipase
34
does glucose increase or decrease when you have a glucose metabolic disorder?
it can either increase or decrease
35
what can cause an increase in glucose?
diabetes chronic liver disease overactive endocrine glands
36
what can cause a decrease in glucose?
pancreatic (islet cell) tumors
37
what are the 3 pancreatic variants?
1. annular pancreas 2. cystic fibrosis 3. pancreatic cysts
38
what does an annular pancreas look like? what can it lead to?
it's a congenital anomaly where the pancreas head & UP wraps around the duodenum instead of the SMV. it can lead to obstruction.
39
which part of the population do annular pancreases show up in more often?
males
40
what is the variant that is hereditary & an autosomal recessive endocrine gland disease?
cystic fibrosis
41
what happens when a patient has cystic fibrosis?
there's an increase in mucous secretion in the exocrine glands of the pancreas. this leads to blocked ducts & delivery of digestive enzymes to the intestines
42
how does the pancreas with cystic fibrosis look in US?
hyperechoic & smaller than normal
43
what is the cause of pancreatic cysts? (variant)
ductal obstruction
44
What type of patients can be seen with pancreatic cysts?
in patients with adult polycystic kidney disease (APKD)
45
how does the pancreas' echogenicity compare to liver?
iso or hyperechoic to liver
46
how does the pancreas' echogenicity change with age?
it becomes more echogenic with age
47
what windows can you use to scan the pancreas?
LLL or stomach after drinking water through a straw
48
what is adenopathy?
lymph node enlargement
49
what do you scan for in the peri-pancreatic region?
adenopathy, fluid collection, vascularity
50
what modalities are better for pancreas imaging?
CT*, MRI, ERCP
51
what are the 3 spaces in the retroperitoneum?
1. anterior pararenal space 2. perirenal space 3. posterior pararenal space
52
where is the anterior pararenal space?
bw posterior parietal peritoneum & anterior renal fascia
53
what is in the anterior pararenal space?
pancreas, parts of ASC & DESC colon, duod, great vessels
54
where is the perirenal space?
bw anterior & posterior pararenal spaces
55
what's in the perirenal space?
adrenals, kidneys, renal vessels, proximal collecting sytems
56
where is the posterior pararenal space?
bw posterior renal fascia & transversalis fascia
57
what is in the posterior pararenal space?
retroperitoneal fat
58
what structures are in the retroperitoneum? (9)
kidneys adrenal glands ureters duodenum asc colon desc colon pancreas great vessels nerves