pancreas powerpoint Flashcards
endocrine meaning
secretion of hormones
directly into the blood
and lymph
exocrine meaning
secreting outwardly
via a duct
where is the endocrine function located
Islets of Langerhan
3 types of cells withing Islets of langerhan
alpha
beta
delta
which is the most prevalent cells in islet of langerhan and what do they produce
beta, insulin
What does alpha cells produce
glucagon
what does insulin do?
Facilitates transport of glucose across the cell membranes”:
Insulin enables cells in the body to take up
glucose, thereby decreasing blood sugar in the body. Therefore insulin is needed to
decrease/control blood sugar.
When blood glucose levels rise above 100
mg/dl, cells in the islet of Langerhans __________ insulin
exude
exocrine secretion is performed by ______– cells
acini
acini cells can produce up to _______ of pancreatic juice a day
2L
what is chyme
partially digested food
The hormones that act on pancreatic juice
formation are:
Gastrin
Cholecystokinin
Acetylcholine
secretin
what does amylase do?
- breaks down complex
carbohydrates into sugars
what does lipase do?
– responsible for 80% of all fat
digestion
what does trypsinogen do?
- reduces proteins to amino
acids
what does chymotrypsinogen do?
– activated by
trypsinogen and also reduces proteins to
amino acids
what is the most likely cause of significantly elevated amylase?
acute pancreatitis
but can also increase with pancreatic duct
obstruction, perforated peptic ulcer, partial
gastrectomy, alcohol poisoning, acute
cholecystitis, and intestinal obstruction or
ischemia (death)
how long is Urinary amylase elevated after serum levels return to normal in
pancreatitis
up to 7 days
when is lipase increased?
with pancreatitis, duct
obstruction, or pancreatic carcinoma
fecal fat values(grey/chalky white stool) means
fats are not being broken down so probably pancreatitis
types of pancreas pathology
Inflammatory diseases
acute pancreatitis
chronic pancreatitis
Neoplastic changes
Non-neoplastic cystic lesions
what is acute pancreatitis caused by and what does it look like
Usually caused by excessive intake of
alcohol or biliary tract disease
All or part of the pancreas is inflamed
Diffuse inflammatory edema of soft tissues
May appear hypoechoic with extension of
inflamed tissues beyond the gland margins
May involve the lesser sac and left pararenal space
phlegmon
Sonographic appearance:
◼ well-defined mass
◼ anechoic with low-level echoes
◼ echogenic margins (thicker than congenital cyst)
◼ ascites if ruptured
Pseudocysts
Sudden onset of severe midepigastric pain often radiating to the back
Relief of pain by sitting up or bending at the waist
Chills and fever
Nausea & vomiting
Serum amylase and WBC may be elevated
Abscess
Enlarged
Hypoechoic
May appear normal in some cases
Pancreatic duct may enlarge >2 mm
Presence of pancreatic pseudocysts
(encapsulated collections of tissue-
destruction by-products) seen in half the
patients - usually in tail of pancreas
abscess
____________ is characterized by
bleeding within or around the pancreas, and is usually
considered a rapid progression of acute pancreatitis
Hemorrhagic pancreatitis
difference sonographically from acute and chronic pancreatitis
acute is puffed up and might look normal
chronic has echogenic foci and calcifications
what pathology
Protein plugs develop in ducts, blocking
release of digestive enzymes leading to
interlobular fibrosis and destruction and
atrophy of functioning tissue
Chronic Pancreatitis
Pancreatic Cysts
True - congenital
(anomalous development of duct) or acquired (retention, parasitic, or neoplastic)
Polycystic – associated with renal disease
Pseudocysts - always acquired; result
from acute or chronic pancreatitis
inherited disease
characterized by presence of multiple small
cysts in the kidneys, liver, and pancreas
Polycystic disease
2 types of most common pancreatic tumors
Insulinoma or gastrinoma
2 types of pancreatic cancer
Adenocarcinoma and neuroendocrine tumore
where does neuroendocrine tumors begin?
in endocrine cells responsible for producing hormones
where does adenocarcinoma begin
in exocrine cells responsible for producing pancreatic enzymes
most common pancreatic neoplasm
adenocarcinoma (95%)
most common site for adenocarcinoma
the head but can occur in body and tail
patients with a tumor in the head of the pancreas presents with a painless jaundice and a palpable ____________ gallbladder
courvoisier
