The Pancreas Flashcards

1
Q

___: the cells of the pancreas that carry out the exocrine function and therefore produce amylase, lipase, sodium bicarbonate, and other digestive enzymes

A

acinar cells

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2
Q

___: congenital anomaly of the pancreas that results in the maldevelopment of the pancreas in which the most ventral part of the pancreas encases the duodenum and may consequently lead to duodenal obstruction

A

annular pancreas

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3
Q

___: the recurring destruction of the pancreatic tissue that results in atrophy, fibrosis with scarring, and the development of calcification within the gland

A

chronic pancreatitis

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4
Q

___: inherited disorder that can affect the lungs, liver, pancreas, and other organs; this disorder changes how the body creates mucus and sweat

A

cystic fibrosis

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5
Q

___: coexisting enlargement of the common bile duct and pancreatic duct

A

double-duct sign

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6
Q

___: the accessory duct of the pancreas

A

duct of Santorini

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7
Q

___: the main pancreatic duct

A

duct of Wirsung

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8
Q

___: the first segment of the small intestine

A

duodenum

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9
Q

___: endoscopic procedure that utilizes fluoroscopy to evaluate the biliary tree and pancreas

A

endoscopic retrograde cholangiopancreatography

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10
Q

___: an islet cell tumor found within the pancreas

A

gastrinoma

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11
Q

___: elevated amylase

A

hyperamylasemia

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12
Q

___: the presence of elevated parathyroid hormone

A

hyperparathyroidism

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13
Q

___: bowel obstruction caused by the lack of normal peristalsis

A

ileus

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14
Q

___: an islet cell tumor found within the pancreas

A

insulinoma

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15
Q

___: small islands of tissue found within the pancreas that produce insulin and glucagon

A

islets of Langerhans

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16
Q

___: tumor found within the islets of Langerhans of the pancreas

A

islet cell tumors

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17
Q

___: a peritoneal cavity located between the stomach and pancreas where fluid can accumulate

A

lesser sac

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18
Q

___: the most common form of pancreatic malignancy, typically found within the head of the pancreas

A

pancreatic adenocarcinoma

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19
Q

___: congenital anomaly of the pancreas that results in a shortened main pancreatic duct that only works to drain the pancreatic head and not the entire pancreas

A

pancreatic divisum

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20
Q

___: the surgical procedure in which the head of the pancreas, the gallbladder, some of the bile ducts, and the proximal duodenum are removed because of a malignant pancreatic neoplasm; also referred to as the Whipple procedure

A

pancreaticoduodenectomy

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21
Q

___: a cyst surrounded by fibrous tissue that consists of pancreatic enzymes that have leaked from the pancreas

A

pancreatic pseudocyst

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22
Q

___: the peripancreatic fluid collection that results from the inflammation of the pancreas

A

phlegmon

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23
Q

___: a posteromedial extension of the pancreatic head

A

uncinate process

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24
Q

___: a hereditary disease that includes the
development of cysts within the pancreas and other organs

A

von Hippel–Lindau disease

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25
Q

___: the syndrome that includes an excessive secretion of acid by the stomach caused by the presence of a functional gastrinoma within the pancreas

A

Zollinger–Ellison syndrome

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26
Q

the pancreas is considered a ____ organ

A

retroperitoneal

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27
Q

the pancreas is both ___ and ___ gland

A

exocrine and endocrine gland

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28
Q

what are the exocrine functions of the pancreas

A
  • digests carbs and converts starch to sugar
  • digests fats and converts fats to fatty acids and glycerol
  • neutralizes stomach acids
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29
Q

the ___ cells of the pancreas carry out the exocrine function of the gland

A

acinar

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30
Q

at the ___ the pancreatic digestive enzymes are mixed with bile from the liver

A

ampulla of vater

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31
Q

the opening of the sphincter of odd is triggered by what

A

cholecystokinin

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32
Q

the endocrine functions of the pancreas is performed by ____

A

islets of langerhans

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33
Q

the islets of langerhancs are composed of what cells

A
  • alpha
  • beta
  • delta cells
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34
Q

the islets of langerhans produce what vital hormones

A

insulin and glucagon

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35
Q

what does glucagon do?

A

promotes the release of glucose by the liver which in turn increases blood sugar

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36
Q

the arterial blood supply to the head of the pan is via the ___

A

GDA

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37
Q

how do the body and tail of the pancreas review their blood

A

splenic and superior mesenteric arteries

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38
Q

venous drainage of the pancreas is achieved by ___

A

splenic vein, SMV, IMV, and portal vein

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39
Q

what cells promote the release of glucose by the liver

A

Alpha cells

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40
Q

alpha cells secrete ___

A

glucagon

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41
Q

beta cells secrete ___

A

insulin

42
Q

delta cells secrete ____

A

somatostatin

43
Q

normal echogenecity of the pancreas compared to the liver

A

slightly more echogenic than the liver

44
Q

the AP diameter if the main pancreatic duct should not exceed ___

A

2mm

45
Q

normal pancreatic measurements

A
  • head and body: 2-3cm
  • tail: 1-2cm
46
Q

list vasculature adjacent to pancreas head

A
  • rt lateral to SMV
  • anterior to IVC
  • Inf to PV
47
Q

list vasculature adjacent to uncinate process

A
  • post to SMV
  • ant to aorta
48
Q

list vasculature adjacent to pancreas neck

A

-anterior to portal confluence

49
Q

list vasculature adjacent to pancreas body

A

-anterior to SMV, splenic vein and SMV

50
Q

list vasculature adjacent to pancreas tail

A

splenic vein marks the posterior border of pancreatic tail

51
Q

what are the two most common congenital anomalies of the pancreas

A
  • pancreatic divisum
  • annular pancreas
52
Q

what is the most common congenital variant of the pancreas

A

pancreatic divisum

53
Q

___: results from abnormal fusion of the pancreatic ducts during the embryologic development

A

pancreatic divisum

54
Q

pancreatic dives results in what

A

shortened pancreas duct which only drains the head leading the accessory duct to drain the rest of the pancreas

55
Q

pancreatic divisor increases the risk for what

A

pancreatic inflammation secondary to obstruction

56
Q

___: results from the maldevelopment of the two embryologic elements of the pancreas

A

annular pancreas

57
Q

annular pancreas may lead to what

A

duodenal obstruction

58
Q

what happens with annular pancreas

A

the most ventral part of the pancreas encases the duodenum

59
Q

___: inflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acing cells into the parenchyma of the organ

A

acute pancreatitis

60
Q

what is the most common cause of acute pancreatitis

A

alcohol abuse and biliary tract disease such as choledocholithiasis

61
Q

what levels rise with acute pancreatitis

A

-amylase levels will rise within the first 72 hours lipase will also rise

62
Q

what lab is most specific for diagnosing pancreatitis

A

lipase

63
Q

___: peripancreatic fluid collection

A

phlegmon

64
Q

where is one of the most common locations for a pancreatic pseudocyst

A

lesser sac

65
Q

S/S acute pancreatitis

A
  • elevated amylase and lipase
  • leukocytosis
  • elevated ALT and other liver function labs when biliary obstruction is present
  • back pain
  • fever
  • n/v
66
Q

S/A acute pancreatitis

A
  • may appear normal
  • diffusely enlarged hypoechoic pancreas
  • focal hypoechoic area within pancreas
  • peripancreatic fluid
  • abscess formation may occur
  • biliary obstruction may be present
  • vascular complications may be seen
67
Q

chronic pancreatitis is often caused by what

A

alcohol abuse

68
Q

other than alcohol abuse what are some other causes of chronic pancreatitis

A
  • hyperparathyroidism
  • congenital anomalies
  • genetic disorders
  • pancreatic duct obstruction
  • trauma
69
Q

S/S chronic pancreatitis

A
  • asymptomatic
  • epigastric pain
  • jaundice
  • back pain
  • possible elevation in amylase, lipasa, or ALP
  • anorexia
  • weight loss
  • vomiting
  • constipation
70
Q

S/A chronic pancreatitis

A
  • heterogenous or hyperechoic atrophic gland
  • calcifications within gland
  • pancreatic pseudocyst
  • dilated pancreatic duct
  • stones within duct may lead to obstruction
  • possible portosplenic vein thrombosis
71
Q

what is the most common primary pancreatic malignancy

A

pancreatic adenocarcinoma

72
Q

pancreatic adenocarcinoma is the __ most common cancer related death in men

A

4th

73
Q

where is the most common location for pancreatic adenocarcinoma

A

head

74
Q

pancreatic adenocarcinoma will most often lead to what things?

A
  • obstruction of CBD
  • courvoisier GB
75
Q

obstruction of both the CBD and the pancreatic duct is known as what

A

double duct sign

76
Q

what is the surgical procedure that is performed on patients with pancreatic adenocarcinoma

A

Whipple procedure

77
Q

describe what a Whipple procedure is

A

procedure that removes the head of the pancreas, the gallbladder, some of the bile ducts and the proximal duodenum

78
Q

S/S pancreatic adenocarcinoma

A
  • elevated amylase or lipase
  • loss of appetite
  • weight loss
  • jaundice
  • courvoisier GB
  • epigastric pain
79
Q

S/A pancreatic adenocarcinoma

A
  • hypoechoic mass in head of pancreas
  • double duct sign
  • enlarged GB
80
Q

cystadenoma within the pancreas may be referred to as either ___ or ___

A
  • serous cystadenoma (microcytic)
  • mucinous cystadenoma (macrocystic)
81
Q

which has more malignant potential serous or mucinous cyst adenomas

A

mucinous

82
Q

the malignant form of cystadenoma is termed ____

A

ctstadenocarcinoma

83
Q

S/S cyst adenomas and cystadenocarcinomas

A
  • may be asymptomatic
  • epigastric pain
  • weight loss
  • palpable mass
  • jaundice
84
Q

S/S serous cystadenoma

A
  • cystic mass
  • may appear solid and echogenic secondary to the small size of the cyst
85
Q

S/S mucinous cystadenoma and cystuadenocarcinoma

A
  • multilocular cystic mass may contain mural nodules and calcifications
  • may be associated dilated pancreatic duct
86
Q

what are the two types of islet cell tumors

A
  • insulinoma
  • gastrinoma
87
Q

islet cell tumors can either be ___ or ___

A

functional or non functional

88
Q

___: excessive secretion of acid by the stomach that leads to peptic ulcers

A

Zollinger Ellison syndrome

89
Q

functional insulimoas can cause what

A

hypoglycemia

90
Q

S/S islet cell tumors

A
  • insulinoma: low blood sugar symptoms
  • gastrinoma: Zollinger Ellison syndrome
91
Q

S/A islet cell tumors

A
  • hypoechoic mass that may contain calcs
  • small
  • may be hyper vascular
92
Q

true pancreatic cysts may be seen with what

A
  • von hippel Lindau disease
  • cystic fibrosis
  • autosomal dominant PKD
93
Q

S/S true pancreatic cyst

A

-possible history of von hippie Linda disease or CF, or ARPKD

94
Q

S/A true pancreatic cyst

A
  • well defined anechoic mass
  • posterior enhancement
95
Q

what are the two different types of transplant techniques

A
  • exocrine bladder drainage
  • exocrine enteric drainage
96
Q

label the surrounding vasculature

A
  1. IVC
  2. RRA
  3. Aorta
  4. SMV
  5. SV
97
Q

what pancreatic abnormality is shown here

A

annular pancreas

98
Q

what pancreatic pathology is shown here

A

acute pancreatitis

99
Q

what pancreatic pathology is shown here

A

chronic pancreatitis

100
Q

what pancreatic pathology is shown in the head of the pancreas in this iamge

A

pancreatic adenocarcinoma

101
Q

what pancreatic pathology is shown in these two images

A

islet cell tumors