Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HHD 2 > The Pancreas > Flashcards

The Pancreas Flashcards

1
Q

Where is the pancreas located in relation to the duodenum?

A

the duodenum is situated anteriorly and medially
it curves around the head of the pancrease in a “C”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does the pancreas lie in relation to the stomach?

A

the stomach lies anteriorly and superiorly to the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the pancreas located in relation to the spleen?

A

the spleen lies posteriorly and laterally to the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where is the vasculature for the pancreas located?

A

the aorta and IVC pass posteriorly to the head of the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the arterial supply of the pancreas?

A

the coeliac trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is BV provides venous drainage to the pancreas?

A

the hepatic portal vein
-carries blood to the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Parasympathetic innervation of the pancreas is performed by what cranial nerve?

A

vagus nerve
CNX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The pancreatic duct joins the common bile duct before draining into the 2nd part of the duodenum. What is the second part of the duodenum called?

A

Ampulla of vater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do the exocrine contents of the pancreas contain?

A

Pancreatic fluid
-enzyme rich (proenzyme, pepsinogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pancreatic fluid has an alkaline pH of 8. Why is this?

A

this is because it contains bicarbonate
this stabilised enzymes contained in pancreatic fluid

remember a change in pH (acidic) will disrupt enzyme function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the exocrine function of the pancreas?

A

aids digestion
breaks food down so that by the time they reach the jejunum and ileum it can be absorbed

B12 absorption occurs in the ileum
Folate and iron are absorbed in the jejunum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the rapid action of insulin (seconds)?

A

transport glucose into muscle and fat cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the intermediate action of insulin (minutes)?

A

increases protein synthesis in muscle and liver
decreases gluconeogenesis
increases glycogen synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the delayed action of insulin?

A

increase lipid synthesis in the liver and adipose tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Somatostatin is released by delta cells in the pancreas. What is its function?

A

inhibits insulin, glucagon and pancreatic polypeptides

stops many hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the function of pancreatic polypeptide?

A

inhibits exocrine secretion and reduces appetite

stops many enzymes contained in pancreatic fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the cells of the islets of langerhans?

A

Alpha cells - glucagon
Beta cells- insulin
Delta cells- somatostatin (inhibition of hormones)
F cells- pancreatic peptide (inhibition of enzymes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the function of acinar cells in the pancreas?

A

constitute 80% of pancreatic tissue
they are clustered around ducts and are responsible for the synthesis, secretion and storage of digestive enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is pancreatitis?

A
  • disorder of the exocrine function of the pancrease- affects the digestive functions
  • can be acute or chronic
  • refers to acinar cell injury (synthesis, secretion and storage of digestive enzymes impacted)
  • due to a local or systemic inflammatory respinse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the main causes of acute pancreatitis?

A

G- gallstones
E-ethanol (alcohol)
T-trauma

21
Q

What is the pathophysiology of acute pancreatitis?

A

-premature enzyme activation (enzymes are activated where they shouldn’t be); proenzymes produced by the acinar cells are activated and begin to destroy the pancreas
-known as auto-digestion

  • acinar cell injury
  • leakage of pro-enzymes into pancreatic tissue
  • disorderd enzyme cascade leads to activation of pro-enzymes
  • inflammatory cascade triggered- neutrophils, macrophages, cytokines
  • increased vascular permeability- haemorrhage oedema and pancreatic and peripancreatic fat necrosis
  • fat saponifiation will lead to hypocalcemia
  • systemic leakage of SIRs products
  • hypotension- > shock (Not enough blood flow/oxygen reaching tissues)
  • multiorgan failure
  • death
22
Q

What are the causes of acute pancreatitis ?

A
  • Idiopathic
  • gall stones
  • ethanol
  • trauma
  • steroids
  • mumps
  • autoimmune
  • scorpion venom
  • hyperlipidaemia, hypercalcaemia, parathyroidism
  • ERCP (access to ampulla of vater- 2nd part of duodenum)
  • drugs

Pneumonic: I GET SMASHED

23
Q

What is the consequence of gall stones in the gall bladder?

A
  • blocks bile contents from entering the blood; deconjugation and metabolism of bilirubin prevented and bilirubin becomes a component in gallstones which causes jaundice
  • pancreatitis
  • cholecystitis
  • biliary colic (right upper quandrant crampy pain, after meals)

colic- contraction and relaxation- in an attempt to remove the obstruct

24
Q

What are gallstones made of?

A
  • cholesterol
  • bilirubin
  • cholesterol and bilrubin
25
Q

What are the risk factors of gallstones?

A
  • obesity
  • female
  • fat
  • fertile
  • forty
  • fair
26
Q

What is the presentation of pancreatitis?

A
  • nausea
  • vomiting
  • anorexia
  • epigastric pain radiating to the back
  • pain improves leading forward
  • tachycardia
  • chovsteks sign
  • cardiovascular collape

Cullens sign
Grey turners sign

27
Q

What is chovsteks sign? How does it present?

A
  • sign that depicts an indication of hypocalcaemia
  • tap facial nerve; there is a urgent twitch in the case of hypocalcaemia

hypocalcaemia is due to saponification of pancreatic tissues; calcium used up

Hypocalcaemia causes tetany like symptoms

28
Q

What investigations can be carried out for the diagnosis of pancreatitis?

A
  • bloods: lipase, amylase, WCC, CRP, haematocrit, calcium
  • ABG: hypoxaemia, acid base disturbance
  • ultrasound- gall stones
  • abdominal CT: very sepcific and sensitive
29
Q

A glasgow prognostic score >2 is indicative of …

A

severe pancreatitis

30
Q

What is required for a clinical diagnosis of pancreatitis?

A
  • P- PaO2 <8kPa
  • A- age >55
  • N-neutrophils (WCC >15)
  • C-calcium <2mmol/L
  • Renal (urea)>16mmol/L
  • Enzymes (LDH- lactate dehydrogenase in liver >600 units/L)
  • A-albumin <32g/L
  • S-sugar (glucose>10mmol/L)
31
Q

Outline the management of pancreatitis

A
  • ABCDE resuscitation- lots of IV fluid
  • intensive care management
  • analgesia
  • antiemetic (nausea and vomiting)
  • nutritional support
  • calcium replacement
  • insulin replacement
  • gall stones- ERCP or cholecystectomy
  • alcogol- withdrawal regime
  • infected necrotic pancreatitis- necrosectomy
32
Q

What are the risk factors for chronic pancreatitis?

A

alcohol
smoking
family history

33
Q

What is the pathphysiology of chronic pancreatitis?

A

primary insults to ducts and not acinar cells
(unlike acute pancreatitis which is caused by acinar injury)

34
Q

What are the consequences of chronic pancreatitis?

A
  • reduced exocrine function
  • malabsorption (no enzymatic digestion of food so cannot be absorbed in jejunum and ileum)
  • diabetes
  • calcifications
35
Q

List potential causes of chronic pancreatitis

A

oxidative stress (chronic inflammatory state)
ductal obstruction
necrosis-fibrosis

36
Q

What is the presentation of chronic pancreatitis?

A
  • abdominal pain
  • steatorrhoea (present of fat in stool)
  • weight loss
  • malnutrition
37
Q

What are the complications of chronic pancreatitis?

A
  • pancreatic cancer
  • pseudocyst
  • GI bleed
  • diabetes
  • impaired digestion
38
Q

What is the management of chronic pancreatitis?

A
  • alcohol and smoking cessation
  • enzyme replacement
  • PPI (proton pump inhibitors (Block gastric secretions; parietal cells release HCl)
  • cyst decompression

chief cells of stomach secrete pepsinogen

39
Q

What part of the pancreas do majority of pancreatic cancers originate from?

A

the head of the pancreas
invasive ductal adenocarcinoma

40
Q

What is the presentation of pancreatic cancers?

A
  • jaundice
  • weight loss
  • abdominal pain
  • courvoisiers sign (jaundice with a gallbladder that is enlarged but not painful)
  • endocrine disturbance
41
Q

What are the risk factors for pancreatic cancer?

A

smoking
family history

42
Q

What investigations can be carried out for the diagnosis of pancreatic cancer?

A

LFTs (Liver function test)
ultrasound
CT
ERCP and biopsy
CA19-9
clotting

43
Q

What is the management of resectable pancreatic cancer?

A

surgery
enzyme replacement
biliary stent
radio/chemotherapy

stent to relieve obstruciton

44
Q

What is the management of unresectable pancreatic cancer?

A

stent
radio/chemotherapy

45
Q

What is the management of metastatic pancreatic cancer?

A

stent
chemotherapy
analgesia

46
Q

What dental consideration should be made for acute pancreatitis?

A

LA for emergency treatment only

47
Q

What dental consideration should be made for chronic pancreatitis?

A

consider underlying cause
bleeding risk
oral ulceration

48
Q

What dental consideration should be made for pancreatic cancer?

A

avoid GA
diabetic complications (healing)

HHD 2 (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions