Pancreas Anatomy Flashcards

1
Q

what are the pacreatic buds. what do they turn into?

A

Ventral - smaller - duct of Wirsung. Main duct <2mm

Dorsal - lgr - duct of santorini. secondary or accessory duct

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2
Q

What do find in the pancreas parenchyma?

A

Acini cells (provide exocrine function)

isles of langerhauns (provide endocrine functions)

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3
Q

What does the pancreas lie anterior to?

A

lumbar vertebrae #1 and 2

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4
Q

what plane is the pancreas in?

A

deep epigastirium and lt hypochondrium

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5
Q

what are the pancreas posterior landmarks?

A

IVC and Aorta

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6
Q

how does the pancreas sit?

A

extens horizontally/oblique

2nd part of duodenum to splenic hilum

its head is inferior to its tail

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7
Q

where is the pancreas head in relationship to the duodenum?

Where is it’s tail?

A

2nd portion of duodenum (2nd/3rd parts are retroperitoneal). head sits in c-loop

tail is superior and posterior to head

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8
Q

in relation to the PV confluence, AO, SMV, SV or AO

where is the head of the pancreas?

where is the uncinate portion of the head of the pancreas?

where is the neck of the pancreas?

where is the body?

tail?

A

lat to PV confluence and ant to IVC

posterior to the PV Confluence/SMV

ant to PV confluence

ant to SV

side of AO laterally

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9
Q

what is the duct of wirsung?

A

Major papilla – opening where bile and pancreatic juice flow into duodenum

Ampulla of Vater – Area where PD and DCBD join

Sphincter of Oddi – The Sphincter of Oddi is a muscular valve that controls the flow of digestive juices (bile and pancreatic juice) through the ampulla of Vater

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10
Q

Duct of Santorini

A

Minor Papilla

Drains into duodenum

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11
Q

what size is the head, neck, body and tail of the pancreas in AP?

A

head 2-3 cm

neck 1.5-2.5 cm

body 2-2.5 cm

tail 1-2 cm

*all measurements taken perpendicular to panc

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12
Q

what bud does the duct of wirsung arise from?

A

ventral bud

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13
Q

what bud does the duct of santorini arise from?

A

the larger bud

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14
Q

what portion of the duodenum is the c-loop in?

A

2nd

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15
Q

the pancreatic head is typically more __ than its tail?

A

anterior

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16
Q

what is the lgst part of the pancreas?

A

head

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17
Q

what is the area where the bile and pancreatic ducts meet?

A

ampulla of vater

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18
Q

wher is the c-loop of the dodenum?

A

retroperitoneal

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19
Q

whre are the hepatic and splenic arteries?

A

peritoneal. aorta is retroperitoneal, but not these branches.

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20
Q

what feeds the pancreas?

what drains it?

A

Splenic Artery: feeds body, tail
GDA: branch superior Pancreaticoduodenal branches: feeds head and neck
SMA: branch inferior Pancreaticoduodenal: feeds head

Splenic Vein and SMV tributaries

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21
Q

what are the vascular landmarks of the pancreas

A

CA, CHA, SA form the superior border

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22
Q

what vascular landmarks can you see here?

A

GDA: Anterior / Lateral border of head

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23
Q

where is the SMA?

A

posterior to the pancreatic body

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24
Q

where is the PV confluence?

A

posterior to the neck of the pancreas

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25
Q

where is the splenic vein?

A

posterior to the pancreatic body/tail

26
Q

where is the SMV/PV confluence?

A

anterior to the uncinate process of the pancreas

27
Q

what is the arrow pointing to?

A

the ivc. posterior to the head

28
Q

where is the aorta?

A

posterior to the pancreatic body.

29
Q

where is the DCBD?

A

Travels in the posterior / lateral border of the pancreatic head

30
Q

where is the seagull sign in relation to the pancreas?

A

superior.

31
Q

what is the arrow pointing to?

A

GDA

32
Q

what part of the pancreas is the arrow pointing to?

A

neck

33
Q

the uncinate process is ___ to the PV confluence?

A

posterior

34
Q

In a longitudinal view of the pancreatic body, which vessels is seen directly posterior to the pancreas?

A

SV

35
Q

what part of the * pancreas is on

A

body.

36
Q

The order of the vessels posterior to the body of the pancreas that fall along the line would be…

A

SV, SMA, LRV, AO

37
Q

what part of the panc is the line on?

A

head

38
Q

what vessel is posterior to the panc head in longitudinal?

A

IVC

39
Q

This is a longitudinal view of the panc. head, what is the arrow pointing to?

A

SMV

40
Q

what is the arrow pointing to?

A

panc neck

41
Q

what vessel is the arrow pointing to?

A

SA

42
Q

what is often confused w/ the pancreatic duct?

A

post wall of stomach, splenic artery and retroperitoneal fat

43
Q

what is this?

A

the antrum of the stomach (ant and post walls) looks like pancreatic duct (see panc duct below)

44
Q

pacreatic congenital anamolies (5)

A

Ectopic tissue

Annular pancreas

Fibrocystic disease

Congenital cysts

Pancreatic Divisum

45
Q

what is the most common anomaly where ____ is intramural, within the wall of the stomach, duodenum, small bowel, large bowel. These aberrant (deviating from normal) tissues usually mostly acini cells and less islet of Langerhauns cells. Theses tissues are susceptible to pancreatitis and tumors.

A

ectopic tissue

46
Q

what congenital anamoly is rare. The head of the panc. surrounds the second portion of the duodenum. Can be associated with complete or partial atresia of the duodenum.

A

Annular Pancreas

Atresia = Absence or closure

47
Q

what is a hereditary disorder of the exocrine glands. This is cystic fibrosis of the pancreas. Other abdominal organs affected by this dz. include liver , biliary. Problems tend to increase as the CF pt. ages.

A

Fibrocystic Disease

48
Q

what results from anomalous development of the pancreatic ducts. Usually multiple in number and vary in size from 3-5 cm?

A

Congenital Cyst

49
Q

what literally means divided pancreas

Not seen with US, dx is by ERCP

Results from a failure of the buds to fuse.

Panc. enzymes can not drain well from the smaller duct.

Pt.’s will have recurrent bouts of pancreatitis.

A

Pancreatic Divisum

50
Q

Name the 3 major arteries which form landmarks for the superior border of the pancreas.

A

a. Celiac Axis
b. Common Hepatic Artery
c. Splenic Artery

51
Q

Name the terms used to describe the two embryonic buds from which the pancreas develops from.

A

a. Ventral Bud
b. Dorsal Bud

52
Q

Name the two cell types which compose the pancreatic parenchyma.

A

Acini cells
Islets of Langerhans

53
Q

Which cells perform the exocrine functions?

A

Acini cells

54
Q

Which cells perform the endocrine functions?

A

Islets of Langerhans

55
Q

Acini cells produce digestive enzymes used in digestion.

A

true

56
Q

name

A

14 Pancreatic head
15 P. neck
16. P. body
17. Portal confluence
18. IVC
19. SMA
20. Aorta
21. Splenic vein

  1. p tail
57
Q

what plane is this image drawn in?

A

long

  1. Hepatic artery
  2. IVC
  3. Rt. Renal Artery
58
Q
  1. Find the SMA
  2. Find the AO
  3. Find the IVC
  4. Find the DCBD
  5. Find the GDA
  6. Find the Pancreatic head
  7. Find the Pancreatic neck
  8. Find the Uncinate process of the pancreas
  9. Name this vessel
A
59
Q
  1. Find the GB
  2. Where is the notch on the probe facing?
  3. Name this portion of the pancreas
  4. Name this portion of the pancreas
  5. Name this anatomy
  6. Name this anatomy
  7. Name this anatomy
  8. Name this anatomy
A
  1. GB
  2. To pt. Lt.
  3. P. neck
  4. P. tail
  5. Lt. lobe of liver
  6. GDA
  7. DCBD
  8. Spine
60
Q

name this anatomy

A
  1. Ligament of teres
  2. Stomach with fluid within
  3. SMA
  4. Aorta
  5. Posterior wall of the stomach
  6. GDA
  7. P. head
  8. Lt. renal vein