Spleen, Pancrease, GI tract Flashcards
The most common benign tumor of the spleen
Hemangioma
The body of the pancreas lies anterior to the
Aorta
The main pancreatic duct is the
Duct of Wirsung
Stimulates gallbladder contraction and relaxation of the spincter of oddi
Cholecystokinin(CCK)
Clusters of tissues throughout the pancreas composed of alpha, beta, and delta cells
Islets of Langerhans
Produce digestive enzymes in the pancreas
Acinar cells
The arterial blood supply to the head of the pancreas is via the
GDA
The body & tail of the pancreas recieve blood from the splenic and
Superior mesenteric arteries
The most common cause of acute pancreatitis is?
Gallstones and then alcoholism
What lab value is more specific for diagnosing pancreatitis?
Lipase
Acute pancreatitis appears sonographically as what?
enlarged, hypoechoic
Chronic pancreatitis appears?
atrophied, heterogeneous
The procedure performed on patients with pancreatic adenocarcinoma is?
Whipple procedure
Removal of the head of the pancreas, GB, bile ducts, and proximal duodenum is called?
Pancreaticoduodenectomy/ Whipple procedure
A potentially malignant tumor typically found in the pancreatic body and tail is
Mucinous Cystadenocarcinoma
The most common islet cell tumor is?
Insulinoma
The right and left hepatic ducts unite to form the
Common hepatic duct
Which two ducts unite to form the CBD?
Common hepatic and Cystic ducts
Lymph nodes emerge from the splenic hilum and course along the
Splenic artery
Normal sonographic appearance of the spleen?
homogeneous
The left kidney lies ______ & _______ to the spleen?
Inferior, medial
Best position to scan the spleen…
Right decubitus
Major function of the spleen is
Filter peripheral blood
The head of the pancreas is inferior to the ______ lobe of the liver
caudate
What passes through the posterior aspect of the pancreatic head?
CBD
Patient has jaundice, weight loss, decrease in appetite
Adenocarcinoma of pancreas
Normal pancreatic head measurement is less than
2-3 cm
A serum ______ level of twice normal usually indicates acute pancreatitis
amylase
Dorsal and ventral pancreas with the head encircling the duodenum is
Annular pancreas
Gallstones are seen in 40-60% of patients with
acute pancreatitis
Enlarged, palpable gallbladder caused by a pancreatic head mass is termed:
Courvoisier Gallbladder
How is the appendix located?
McBurney’s point
The most common tumor of the stomach
Leiomyoma
What is an outgrowth of tissue from the gastric wall?
Gastric polyp
Where are duplication cysts found on the stomach?
Greater curvature
Does the duodenum make up the large intestine?
no
Is acute appendicitis compressible on ultrasound?
no
Parts of the stomach
Pylorus, body, fundus
Is the cecum part of the small intestine?
no
This allows the stomach to stretch
Rugae
Released from the small bowel to stimulate secretion of bicarbonate to decrease acid content in intestine
secretin
Most common lab data with GI issues
blood in stool
Air in the peritoneal cavity
pneumoperitoneum
innermost layer of bowel
mucosa
T/F The Jejunum is normally seen with ultrasound
false
Gastric bezoar made of sand or asphalt
concretions
Most gastric cancers are found in the
pylorus
T/F Mets to the stomach is rare
true
Dilation of bowel loops is ______ to the obstruction
proximal
The twisting of intestines
volvulus
Results from bowel that lacks normal peristalsis
nonmechanical obstruction
The most common cause of acute abdomen pain
acute appendicitis
Performs the phagocytic function of the spleen
red pulp
Accessory spleen is also referred to
splenunculus
Small, echogenic foci seen throughout the spleen on a pt with histoplasmosis is most likely
Granulomas
What is associated with Beckwith-Weidermann syndrome?
Splenic harmatoma
The most common malignancy of the spleen
lymphoma
Patients with this disorder have crescent-shaped RBC and are at risk for blindness
sickle-cell anemia
Congenital disease in which RBC appear small and spheriod
Spherocytosis
Storage disease, 50% of pts are younger than 8, bone pain, skin pigmentation changes
Gauchers
Most common cause of splenomegaly
portal hypertension
Peritoneal ligament that attaches the spleen to the stomach and the kidney
Splenorenal
Normal measurements of spleen
12cm long, 7cm wide, 3-4cm thick
Splenic vein travels along the _____ border of the pancreas
Posteromedial
A mass in the LUQ may displace the spleen ______
Inferiority
Accessory spleen(splenunculus) is normally found near the ______ or inferior border of the spleen
Hilum
Normal spleen contains about _____ to ______ ml of erythrocytes
20-30 ml
Process of removing the nuclei from the RBC
Pitting
Process by which the spleen removes abnormal RBC
Culling
Indicates the percentage of RBC per volume of blood.
Hemacrit
Abnormally low values of hemacrit indicate ______
Hemorrhage or internal bleeding
Abnormal decrease in platelets, may be result of internal hemorrhage
Thrombocytopenia
The spleen is ____ compared to the liver
More echogenic
As the spleen enlarged, the echogenicity ______
Increases
Splenomegaly is diagnosed when the spleen measures more than ____
12cm
Wandering spleen is most common in _____ ?
Women with multiple pregnancies
Tuberculosis and histoplasmosis are common causes of _____
Granulomas
Systemic venous congestion is found in cardiac decompensation involving the _____ side of the heart
Right side of the heart
Disease when amyloid proteins build up in the organs. May be nodular or diffuse
Anyloidosis
Rapidly fatal disease that predominantly affects female infants
Neimann-Pick disease
In its early stages, the spleen is enlarged. Then the spleen undergoes infarction and fibrosis and decreases in size until only a small mass of fibrous tissue is left(autosplenectomy)
Sickle cell anemia
Fever, LUQ tenderness, left shoulder and flank pain, splenomegaly. Infection is spread from abdomen or from adjacent organs
Splenic abscess
May result from endocarditis
Splenic abscess
Most prominent feature of splenic infection is
Splenomegaly
May show irregular masses within the spleen, “wheels-within-wheels” pattern
Hepatosplenic candidiasis
Most common cause of focal splenic lesions is _____ of the major splenic artery or its branches
Occlusion
Echogenic, peripheral, hypoechoic wedge-shaped lesions
Splenic infarction
The spleen is most commonly injured as a result of
Blunt abdominal trauma
F.A.S.T. scan
Focused Assessment with Sonography in Trauma
- area around kidneys(Morisons pouch
- subdiaphragmatic areas
- liver and splenic capsule
- bladder and anterior rectal area to determine if free fluid is present
Only parasite that forms splenic cysts
Echinococcus
Increase in RBC mass and hemoglobin concentration. Weakness, fatigue, vertigo
Polycythemia Vera
The head of the pancreas lies anterior to the ____
IVC
Head of the pancreas lies _____ to the duodenum
Medial
Splenic artery is the _____ border of the pancreas
Superior
SMA is to the ____ of the SMV (in the body)
Left
What duct drains the head of the pancreas?
Duct of Santorini
Failure of dorsal and ventral pancreatic ductal systems to fuse, results in smaller santorini duct
Pancreatic divisum
Ventral surrounds duodenum
Annular pancreas
What pancreatic enzyme digests fats
Lipase
What pancreatic enzyme digests carbohydrates
Amylase
What pancreatic enzyme digests nucleic acids?
Nucleases
What pancreatic enzyme digests proteins?
Trypsin, chymotrypsinogen, carboxypeptidase
What is the action of insulin?
Glucose to glycogen
Action of glucagon?
Glycogen to glucose
Action of somatostatin?
Alpha and beta inhibitor
Insulin’s cell type
Beta
Glucagon cell type
Alpha
Somatostatin cell type
Delta
Most common location of a pseudocyst is in the _____
Lesser sac, anterior to the pancreas and posterior to the stomach
Most common cause of pseudocysts in children
Trauma
Mortality rate of ruptured pseudocyst
50%
If pancreatic enzymes are low, this indicates
Chronic pancreatitis
Most common cause of hyperechoic pancreas in children
Cystic fibrosis
Most common malignancy in pancreas
Adenocarcinoma
Most common location of adenocarcinoma
Pancreas head
Palpable, nontender gallbladder accompanied with jaundice(courvoisiers sign), “double duct” sign, is associated with what pancreatic pathology
Adenocarcinoma
“Cluster of grapes”, usually occurs in the body/tail.
Macrocystic adenoma(mucinous cystadenoma/cystadenocarcinoma)
2nd most common functioning islet cell tumor. Produces Zollinger-Ellison syndrome
Gastrinoma
Hair balls in young women
Tricho bezoars
Vegetable matter
Phyto bezoars
