Spleen and pancreas Flashcards

1
Q

Which tissue type is the spleen derived from?

A

Mesoderm

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2
Q

What sort of injury can damage spleen?

A

Rib fractue, difficult to repair so common to have it removed

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3
Q

What can happen to the spleen in portal hypertension?

A

Splenomegaly, due to backing up of pressure along splenic vein. Spleen is soft and so tissue can expand easily

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4
Q

Which part of the spleen is most easy to palpate and when?

A

Splenic notch when spleen is enlarged

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5
Q

What is significant about the splenic artery?

A

Tortuous so can stretch and move with other organs around it

Has no anastamoses, so no back up supply if damaged

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6
Q

What are the 5 anatomical parts of the pancreas?

A
Tail
Body
Neck
Head
Uncinate process
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7
Q

What are the 3 main arteries that supply the pancreas and where do they originate?

A

Splenic artery - Coeliac trunk
Super pancreaticoduodenal - coeliac trunk
Inferior pancreaticoduodenal - SMA

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8
Q

Where does the pancreas sit?

A
Secondarily retroperitoneal 
In C of duodenum
Behind stomach and lesser sac
Neck sits on transpyloric plane L1
Tail sits near splenic hilum
In epigastrium and extends to right hypochondrium
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9
Q

Why is a pancreatectomy a particularly difficult procedure?

A

Multiple blood supplies

Retroperitoneal

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10
Q

What guards the entrance to the major duodenal papilla?

A

Hepatopancreatic sphincter

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11
Q

Where does the neck of the pancreas sit?

A

Transpyloric plane L1

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12
Q

Where does pancreatitis pain refer to?

A

Back
Epigastric
Fluid accumulation in lesser sac

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13
Q

Which bud of the developing pancreas rotates to its adult position?

A

Ventral bud rotates 90 degrees clockwise

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14
Q

What is an annular pancreas?

A

Ring of pancreatic tissue surrounding duodenum which can cause blockage

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15
Q

What is the visceral afferent responsible for pancreatitis pain?

A

Greater splanchnic nerve T5-9

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16
Q

Where would fluid collect in pancreatitis?

A

Lesser sac, posterior to stomach

17
Q

Why might pancreatic cancer cause jaundice?

A

Blocked bile duct

18
Q

What are the relations of the spleen?

A
Stomach
Colon
Pancreas
Kidney
Diaphragm
Ribs 9-12
Costodiaphragmatic recess
19
Q

What is the lymph drainage of the spleen?

A

Coeliac nodes

20
Q

Where should an examination of the spleen start?

A

Right iliac fossa

If enlarged, won’t feel splenic notch unless start down here

21
Q

What would be a test for acute pancreatitis?

A

Amylase (lipase)

22
Q

What are secretions of the exocrine pancreas?

A
Alkali - isotonic solution rich in HCO3
Digestive enzymes - Trypsin (endopeptidase), Chymotrypsin (endopeptidase), Carboxypeptidase (ectopeptidase), Pancreatic amylase (breaks down starches), Lipases (break down fats)
Other enzymes (phospholipase, cholesterol esterase, ribonuclease)
23
Q

Which cells of the exocrine pancreas secrete enzymes?

A

Acinar cells

24
Q

Which exocrine pancreas cells secrete alkali?

A

Duct cells

25
What converts Trypsinogen to trypsin?
Membrane bound enterokinase on epithelial cells
26
Describe the mechanism of pancreatic HCO3 secretion
Carbonic anhydrase converts H2O and CO2 into HCO3 and H+ HCO3 is antiported with Cl into duct lumen H is antiported with Na out into blood
27
What controls enzymatic secretion from the exocrine pancreas?
CCK and ACh
28
What controls bicarbonate secretion in the exocrine pancreas?
Stimulated by secretin and potentiated by CCK and ACh (vagal tone)
29
Where does the spleen sit in the abdominal cavity?
Left posterolateral abdominal wall, related to ribs 9-12