Pancreas again Flashcards

1
Q

what are the 4 parts of the pancreas

A
  • head and uncinate process
  • neck
  • body
  • tail
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2
Q

what are the ducts of the pancreas

A

○ Main pancreatic duct joins the common bile duct at the hepatopancreatic ampulla (Ampulla of Vater)
○ Accessory pancreatic duct drains to the minor duodenal papilla (less important)

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3
Q

what are the arterial supplies to the pancreas

A

Head:
- Pancreaticoduodenal branches of the gastroduodenal artery
- Superior mesenteric artery
Neck, Body, Tail
- Branches of splenic artery (celiac trunk) supply neck, body and tail

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4
Q

what is the venous supply of the pancreas

A

Splenic vein & superior mesenteric vein

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5
Q

the exocrine function s of the pancreas are carried out by the ?

A

acini

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6
Q

Most of the cells making up the acinus =

A

acinar cells

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7
Q

40-50 acinar cells form a

A

spherical acinus

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8
Q

what are the general function of acinar cells:

A

○ Secretion of inactive pancreatic enzymes (zymogens)
○ Rich RER, lots of granules (filled with zymogens)
○ CCK major stimulator

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9
Q

what are the general function of centroacinar cells:

A

○ Secretion of HCO3-rich fluid
○ Secretin major stimulator

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10
Q

Centroacinar cells and intercalated duct cells can both secrete ? in response to ?

A

bicarbonate
secretin

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11
Q

what are the phases of pancreatic secretion

A
  • cephalic
  • gastric
  • intestinal
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12
Q

what are the regulation of pancreatic secretion

A

both neural and hormonal control

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13
Q

what does secretin do to the pancreas

A

stimulates fluid secretion (HCO3-)

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14
Q

what does CCK do to the pancreas

A

stimulates enzyme secretion

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15
Q

what does endopeptidases do?

A

through hydrolysis, cleave peptide bonds at certain amino acids

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16
Q

endopeptidases include

A

pepsin
trypsin
chymotrypsin
elastase

17
Q

what does exopeptidases do?

A

through hydrolysis, cleave peptide bonds at the carboxyterminus

18
Q

what do trypsin inhibitor do

A

prevents activation of trypsin inside secretory cell and in ducts of pancreas

19
Q

What is the role of trypsinogen activation in acute pancreatitis?

A
  • It’s a digestive enzyme (trypsin) capable of activating other zymogens
    ○ Reasonable to hypothesize that this leads to a straightforward autodigestion of the pancreas
20
Q

what is acute pancreatitis?

A

duct blockage and acinar cell injury result in profound pancreatic damage

21
Q

what are the pathophysiology for acute pancreatitis

A
  • alcohol ingestion
  • biliary tract obstruction
22
Q

alcohol ingestion leads to…

A

excessive protein in pancreatic secretions, “plugs” the ducts

23
Q

biliary tract obstruction means that

A

Pancreatic secretions are stuck in the ducts, due to a gallstone or sludge blocking outflow

24
Q

what is the common factor of acute pancreatitis

A

blockage of ducts

25
Q

what can be seen in any stage of acute pancreatitis

A

fat necrosis

26
Q

Free pancreatic lipases cleave triglycerides in the abdominal cavity -> fatty acids that combine with extracellular calcium. This is known as

A

Saponification

27
Q

what is chronic pancreatitis

A

Inflammation of the pancreas with irreversible destruction of exocrine parenchyma, fibrosis, and, in the late stages, the destruction of endocrine parenchyma

28
Q

what is thought to be related to multiple episodes of acute pancreatitis

A

chronic pancreatitis

29
Q

what are pseudocysts

A

Localized collections of necrotic-hemorrhagic material rich in pancreatic enzymes

30
Q

how are this pseudocysts formed

A

Formed by the walling off of fat necrosis with fibrous tissue