Pancreas WB Flashcards
cells that perform exocrine function
acini cells
enzyme secreted by the pancreas to aid in the digestion of carbohydrates
amylase
lies in the midepigastrium anterior to the superior mesenteric artery and vein, aorta, and inferior vena cava
body of the pancreas
branch of the splenic artery that supplies the tail of the pancreas
caudal pancreatic artery
forms the lateral border of the head of the pancreas
C-loop of the duodenum
artery arising from the celiac trunk to supply the liver; forms the right superior border of the body and head of the pancreas and gives rise to the gastroduodenal artery
common hepatic artery
enlargement of the gallbladder caused by a slow, progressive obstruction of the distal common bile duct from an external mass such as adenocarcinoma of the pancreatic head
Courvoisier’s sign (Courvoisier’s gallbladder)
inherited disorder of the exocrine glands; symptoms include mucous buildup within the lungs and other areas of the body; identified as fatty replacement of the glands
cystic fibrosis
branch of the splenic artery that supplies the body of the pancreas
dorsal pancreatic artery
small accessory duct of the pancreas found in the head of the pancreas
duct of Santorini
largest duct of the pancreas that drains the tail, body, and head of the gland; it joins the common bile duct to enter the duodenum through the ampulla of Vater
duct of Wirsung
function of the pancreas is production of the hormone insulin
endocrine
function of the pancreas is production and digestion of pancreatic juice; primary function of the pancreas
exocrine
hormone that stimulates the liver to convert glycogen to glucose; produced by alpha cells
glucagon
lies in the C-loop of the duodenum; the gastroduodenal artery is the anterolateral border and the common bile duct is the posterolateral border
head of the pancreas
elevated levels of calcium in the blood
hypercalcemia
congenital condition in which elevated fat levels cause pancreatitis
hyperlipidemia
dilated loops of bowel without peristalsis; associated with various abdominal problems, including pancreatitis, sickle cell crisis, and bowel obstruction
ileus
hormone that causes glycogen formation from glucose in the liver and that allows circulating glucose to enter tissue cells
insulin
portion of the pancreas that has an endocrine function and produces insulin, glucagon, and somatostatin
islets of Langerhans
pancreatic enzyme that breaks down fats; enzyme is elevated in pancreatitis and remains increased longer than amylase
lipase
a malignant neoplasm that rises from the lymphoid tissues
lymphoma
small area of the pancreas between the head and the body; anterior to the superior mesenteric vein
neck of the pancreas
excessive bilirubin in the bloodstream caused by an obstruction of bile from the liver; characterized by a yellow discoloration of the sclera of the eye, skin, and mucous membranes
obstructive jaundice
fluid accumulation caused by a rupture of a pancreatic pseudocyst into the abdomen; free-floating pancreatic enzymes are very dangerous to surrounding structures
pancreatic ascites
“sterile abscess” collection of pancreatic enzymes that accumulate in the available space in the abdomen (usually in or near the pancreas)
pancreatic pseudocyst
help supply blood to the pancreas along with the splenic artery
pancreaticoduodenal arteries
inflammation of the pancreas; may be acute or chronic
pancreatitis
junction of the splenic and main portal vein; posterior border of the body of the pancreas
portal-splenic confluence
a space or cavity that contains fluid but has no true endothelial lining membrane
pseudocyst
pancreatic enzyme that is elevated during pancreatitis
serum amylase
serves as the posterior border to the body of the pancreas
superior mesenteric artery
lies posterior to the neck/body of the pancreas and anterior to the uncinate process of the gland
superior mesenteric vein
tapered end of the pancreas that lies in the left hypochondrium near the hilus of the spleen and upper pole of the left kidney
tail of the pancreas
small, curved tip of the pancreatic head that lies posterior to the superior mesenteric vein
uncinate process
abnormal increase in white blood cells caused by infections
leukocytosis
The pancreas is located in the _______________ cavity posterior to the stomach, duodenum, and proximal jejunum of the small bowel.
retroperitoneal
The pancreatic gland appears sonographically _______________ to slightly more _______________ than the hepatic parenchyma.
isoechoic; hyperechoic
The major posterior vascular landmarks of the pancreas are the _______________ and _______________.
aorta; IVC
The head of the pancreas lies _______________ to the IVC.
anterior
The _______________ crosses anterior to the uncinate process of the head of the gland and posterior to the neck and body.
SMV
The tortuous _______________ is the superior border of the pancreas.
splenic artery
The tail of the pancreas is more difficult to image because it lies anterior to the left kidney and posterior to the left _______________ and _______________.
colic flexure; transverse colon
The _______________ receives tributaries from lobules at right angles and enters the medial second part of the duodenum with the CBD at the ampulla of Vater.
duct of Wirsung
The blood supply for the pancreas is from the _______________ artery and the _______________ arteries.
splenic; pancreaticoduodenal
The _______________ artery is seen along the anterolateral border of the pancreas as it travels a short distance along the anterior aspect of the pancreatic head.
gastroduodenal
The _______________ duct crosses the anterior aspect of the portal vein to the right of the proper hepatic artery.
common bile
The portal vein is _______________ to the IVC.
anterior
The pancreas is both a digestive (_______________) and a hormonal (_______________) gland.
digestive (exocrine); hormonal (endocrine)
Failure of the pancreas to furnish sufficient insulin leads to _______________.
diabetes mellitus
Exocrine function is performed by _______________ of the pancreas.
acini cells
The _______________ is a muscle surrounding the ampulla of Vater that relaxes to allow pancreatic juice and bile to empty into the duodenum.
Sphincter of Oddi
The endocrine function is located in the _______________ in the pancreas.
islets of Langerhans
The beta cells are most prevalent and produce _______________, a hormone that causes glycogen formation from glucose in the liver.
insulin
Alpha cells produce _______________, a hormone that causes the cells to release glucose to meet the energy needs of the body.
glucagons
Delta cells are the smallest composition of endocrine tissue and produce _______________.
somatostatin
There are specific enzymes of the pancreas that may become altered in pancreatic disease, namely _______________ and _______________.
amylase; lipase
Both amylase and lipase rise at the same rate, but the elevation in _______________ concentration persists for a long period in pancreatitis.
lipase
_______________ controls the blood sugar level in the body.
Glucose
Name the structures that should be identified as landmarks to locate the pancreas.
SMA, SMV, portal vein, splenic vein, Aorta, IVC CBD, GDA, left renal vein, duodenal bulb, posterior wall of the stomach
When the pancreas is enlarged, the anterior border of the _______________ may depict a slight indentation.
IVC
When the pancreas becomes damaged and malfunctions as a result of increased secretion and blockage of ducts, _______________ occurs.
pancreatitis
what vasculature structure is the arrows pointing to?
SMV is seen along the posterior border of the pancreas
is this image trans or long and what are the arrows pointing to?
sagittal
arrows- IVC
what are the arrows pointing to?
the spenic artery rises from the celiac axis and is seen as the posterior border of the neck of the pancreas
what are the arrows pointing to?
hepatic artery
(this is the mickey mouse sign
what are the arrows pointing to?
pancreatic duct
45 year old male presents w/ midepigastric pain, elevated amylase and lipase levels, and tenderness. Id the sonographic findings.
sonographic findings consist of an enlarged, edematous pancreas –pancreatitis
a patient w/ known acute pancreatitis presents with continued pain. describe sonographic findings.
sonographic findings consist of pancreatitis w/ a pancreatic pseudocyst
*a 56 year old male w/ a 1 week Hx of jaundice & pain has reported a 3 month Hx of N&V, weight loss, and diarrhea. given the info what are the sonographic findings?
sonographic findings consist of adenocarcinoma of the pancreas with a dilated pancreatic duct
diagram
diagram
PANCREATITIS OCCURS WHEN?
the pancreas becomes damaged and malfunctions as a result of increased secretion and blockage of ducts
What is an acute attack of pancreatitis commonly related to?
alcoholism & biliary tract disease
Patients with pancreatitis typically present with
moderate to severe tenderness in the epigastrium radiating to teh back
when swelling does occur, the gland is hypoechoic to anechoic and is less echogenic than the liver becuase of the increased prominence of?
lobulations and congested vessels
the pancreatic duct may be obstructed in acute pancreatitis as a result of?
inflammation, spasm, edema, swelling of the papilla, and pseudocyst
fluid collections around the pancreatic ____, along the ____ spaces, within the ____ pouch, and around the ____ may be present in a patient with acute pancreatitis
*bed *pararenal *Morison’s *duodenum
patients with acute pancreatitis may develop complications, such as?
pseudocyst, phlegmon, abscess, hemorrhage, and duodenal obstruction
courvoisier’s gallbladder
enlargement of the GB caused by a slow, progressive obstruction of the distal CBD from an external mass, such as adenocarcinoma of the pancreatic head
cystic fibrosis
hereditary disease that causes excessive production of thick mucus by the endocrine glands
posterior vascular landmarks of the pancreas are
-aorta -IVC
what is the water technique used to image the pancreas with ultrasound.
- pt. drinks 32-300ml through a straw - in an erect or lateral decubitus - fluid dills the duodenal cap - outlines the lateral margin of the head of the pancreas - upright position allows air to move from the gastric antrum to the fundus of the stomach - causes the upper viscera to move downward for a better sonograhic window
when the pancreas is enlarged, the ______ border of the _____ may depict’a slight indentation
- anterior - IVC
Grey Turner’s sign
NECROSIS of the blood vessels results in the development of HEMORRHAGIC areas
phlegmon
- spread along facial pathways - causes diffuse inflammatory edema of soft tissue
chronic pancreatitis
- obstructed pancreatic duct -with a buildup of protein plugs -results in calcifications along the duct
how does a pseudocyst develops
pancreatic enzymes that escape the ductal system cause enzymatic digestion of surrounding tissue & pseudocyst development. The walls of the pseudocyst from various potential spaces in which escaped pancreatic enzymes are found. pseudocyst usually presents few symptoms until it becomes large enough to cause pressure on surrounding organ
the most common pseudocyst is in the
lesser sac
the lesser sac is ______ to the pancreas and ______ to the stomach
- anterior - posterior
A pseudocyst develops when ________ escape from the gland break down tissue to form _______ somewhere in the _______.
- pancreatic enzymes - sterile abscess - stomach
adenocarcinoma
the most common primary neoplasm of the pancreas
what are the clinical findings in a patient with carcinoma of the pancreas
- wt loss - painless jaundice - nausea - vomiting - changes in stool
lymphoma
the most frequent parapancreatic neoplasm
