Pancreas again

Question 1

what are the 4 parts of the pancreas

Answer 1

• head and uncinate process
• neck
• body
• tail

Question 2

what are the ducts of the pancreas

Answer 2

○ 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)

Question 3

what are the arterial supplies to the pancreas

Answer 3

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

Question 4

what is the venous supply of the pancreas

Answer 4

Splenic vein & superior mesenteric vein

Question 5

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

Answer 5

acini

Question 6

Most of the cells making up the acinus =

Answer 6

acinar cells

Question 7

40-50 acinar cells form a

Answer 7

spherical acinus

Question 8

what are the general function of acinar cells:

Answer 8

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

Question 9

what are the general function of centroacinar cells:

Answer 9

○ Secretion of HCO3-rich fluid
○ Secretin major stimulator

Question 10

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

Answer 10

bicarbonate
secretin

Question 11

what are the phases of pancreatic secretion

Answer 11

• cephalic
• gastric
• intestinal

Question 12

what are the regulation of pancreatic secretion

Answer 12

both neural and hormonal control

Question 13

what does secretin do to the pancreas

Answer 13

stimulates fluid secretion (HCO3-)

Question 14

what does CCK do to the pancreas

Answer 14

stimulates enzyme secretion

Question 15

what does endopeptidases do?

Answer 15

through hydrolysis, cleave peptide bonds at certain amino acids

Question 16

endopeptidases include

Answer 16

pepsin
trypsin
chymotrypsin
elastase

Question 17

what does exopeptidases do?

Answer 17

through hydrolysis, cleave peptide bonds at the carboxyterminus

Question 18

what do trypsin inhibitor do

Answer 18

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

Question 19

What is the role of trypsinogen activation in acute pancreatitis?

Answer 19

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

Question 20

what is acute pancreatitis?

Answer 20

duct blockage and acinar cell injury result in profound pancreatic damage

Question 21

what are the pathophysiology for acute pancreatitis

Answer 21

• alcohol ingestion
• biliary tract obstruction

Question 22

alcohol ingestion leads to…

Answer 22

excessive protein in pancreatic secretions, “plugs” the ducts

Question 23

biliary tract obstruction means that

Answer 23

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

Question 24

what is the common factor of acute pancreatitis

Answer 24

blockage of ducts

Question 25

what can be seen in any stage of acute pancreatitis

Answer 25

fat necrosis

Question 26

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

Answer 26

Saponification

Question 27

what is chronic pancreatitis

Answer 27

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

Question 28

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

Answer 28

chronic pancreatitis

Question 29

what are pseudocysts

Answer 29

Localized collections of necrotic-hemorrhagic material rich in pancreatic enzymes

Question 30

how are this pseudocysts formed

Answer 30

Formed by the walling off of fat necrosis with fibrous tissue