Section 1 test study guide Flashcards
Main pancreatic duct
Duct of Wirsung
accessory pancreatic duct
duct of santorini
pancreatitis signs
n/v
pain abd
mild fever
amylase/lipase up
leukocytes up
adenocarcinoma signs
weight loss
decresed appetite
n/v
pain radiating to back
stool changes
painless jaundice
pancreatic cells
alpha
beta
delta
acini cells
produce up to 2 liters of pancreatic juice per day
arranged in sac-like structures
juice converges into the two ducts which drain into the duodenum for digestion
juice enzymes capable of completeing almost all of the digestoin of our food
Pancreas Anatomy
retroperitoneal organ
lies posterior to the stomach, duodenum, proximal jejunum of the small bowel, also the transverse colon run horizontallyh acraoss the ab
contained in the anterior pararenal space
drapes across the mid aspect of the ab, just under the xyphoid process
Vascular structure pancreatic head
right lateral to SMV
anterior to IVC
inferior to portal vein
Vascular structure Uncinate process
posterior to SMV
may completely surround SMV
anterior to aorta
vascular structure neck
anterior to portal confluence
vascular structure body
anterior to SMV
splenic vein
SMA
vascular structure tail
splenic vein marks posterior border
Pancrease main parts
head
Neck
Body
tail
normal pancreatic tissue sonographically
echogenicity is caompared to liver
echo intensity is slightly less than surrounding retroperitoneum and slightly greater than liver
texture depends on amount of fat dispersed between the lobules
fat is strongly echogenic so may be isoechoic with surround retroperitoneal fat
echotexture-homogeneous
surface smooth to slightly lobular
Aorta
carries blood from heart
enclosed in sheath containing nerve and vein
3 layers
tunica intima
tunica media
tunicat adventitia
tunica intima
inner vessel wall
tunica media
middle vessel wall
arteries have thicker to allow for great elasticity
tunica adventitia
outer vessel wall
Arteries arising from aortic arch
brachiocephalic
commom carotid
subclavian
Anatomy of Abdominal aorta
endters through aortic hiatus of diaphragm
descends anteriorly and slightly left of vertebral bodies
posterior and left of gastroesophogeal junction
flanked on either side by diaphragmatic crura
Aortic branches
Celiac Trunk
SMA
Left & Right Renal A
Left & Right Gonadal A
Root of IMA
Left & Right Common Iliac
Atheromatous disease factors
incidence increases with age
affects more men than women
smoking
hyperlipidemia
diabetes
HBP
Aneurysm
swelling in bloos vessel with focal or diffuse
2 types
true
false (pseudo)
abdomial aorta aneurysm
AAA
95% are infrarenal
30-60% are assymptomatic
may have ab, leg or back pain
higher ince=idence in Men over 60
incidence of AAAis 70-90% in men over 65
Sonographic appearance of AAA
focal dilation of aorta larger than 3cm
elongate as the grow
most deflect to left or kink anteriorly or both
aventitia is generallly echogenic from adjacent fibrofatty tissue
mural thrombus is usually low to med echogenicity and makes up most of wall
intimal lining may be smooth or irregula with calcifications
AAA measurement
measure outer to outer
maximum true lenght and width and transvers dimensions
document locatoin include suprarenal extension or iliac involvement
document wall type: calcified plaque, flowing blood, soft plaque or well established plaque
Descriptive terms for AAA
Bulbous
fusiform
saccular
dumbell
berry
Bulbous AAA
sharp junction between normal and abnormal
Fusiform AAA
gradual transition between normal and abnormal
Saccular AAA
sharp sudden transition between normal and abnormal
Dumbell AAA
figure 8 appearance
berry
rippled appearcance
mostly in cephalic region
