Week 3: Pancreas Flashcards
Function of the pancreas
- endocrine (hormone)
- produce chemicals/ hormones to regulate BS - exocrine (digestion)
- produce enzymes for digestion
what genetic disease affects the pancreas
cystic fibrosis
how should a patient prepare for pancreas US
fasting, no gum, no tobacco, no smoking
location of pancreas
left hypochondrium & epigastrium
T/F majority of the pancreas is covered in peritoneum
FALSE. only small portion of head is, rest is retroperitoneal
head of pancreas is ANTERIOR to
IVC
head of pancreas is POSTERIOR to
peritoneum, superior duodenum
uncinate process is anterior to
IVC
uncinate process is posterior to
SMV
pancreas body is anterior to
splenic vein, SMA, AO
pancreas body is posterior to
stomach, splenic A
tail of pancreas is anterior to
splenic vein, L kidney
tail of pancreas is posterior to
stomach, splenic artery, lateral L lobe of liver
what structure causes obscured view of pancreas
transverse colon, duodenum
pancreas is ___ to IVC, AO, SMA, confluence, diaphragm
anterior
pancreas is ___ to C-loop of duodenum, splenic hilum
medial
pancreas is __ to stomach, lesser omental sac, transverse colon, liver
posterior
pancreas is ___ to Celiac trunk, liver
inferior
T/F: the pancreas lies in the anterior pararenal space
TRUE
___ wraps around the head of the pancreas
duodenum
the gastroduodenal artery is ___ ____ border of the head
anterior lateral
landmark for head of pancreas
IVC
landmark for body of pancreas
Aorta, SMA, confluence
landmark for tail of pancreas
splenic vein
the superior mesenteric vein is ___ to the neck and ___ to the uncinate process
- posterior
2. anterior
which part of the pancreas is covered in peritoneum
anterior surface of body
name the two vessels that are identified in the pancreas head
- anterior - GDA
2. posterior - CBD
courses along anterolateral aspect, supplies pancreas head & duodenum, branches off CHA
gastroduodenal artery (GDA)
runs on posterolateral surface of pancreas, joins with main pancreatic duct to enter duodenum at Ampulla of Vater
CBD
pancreas tail is typically more ___ than the head
superior
2 pancreatic ducts
- duct of Wirsung/ main pancreatic duct
2. duct of santorini/ accessory duct
function of duct of wirsung / Main Pancreatic Duct
transport and discharge panc juices into duodenum via ampulla of vater
-aid in digestion
max measurement of the duct of wirsung / pancreatic duct
3.0mm
location of duct of santorini
-accessory duct 2cm superior to duct of Wirsung (closer to duodenum)
opening in the second portion of duodenum where CBD and pancreatic ducts enter to discharge substances that aid in digestion
ampulla of vater
muscle surrounding the ampulla of vater that controls flow of pancreatic juice from the biliary tract into the duodenum
sphincter of oddi
opening into the duodenum
ampulla of vater
supply the head and part of duodenum
pancreaticoduodenal artery
-branch of gastroduodenal artery (further branch of CHA)
supplies the body and tail of pancreas
splenic artery
venous drainage of pancreas
splenic vein and SMV
cells that carry out exocrine function of pancreas
acinar cells
what percentage of pancreatic tissue performs exocrine function
80%
2 enzymes specific for pancreatic disease, name them and their role
- amylase - break down sugars
2. lipase - break down fats
hormone released by duodenum when food is ingested, stimulates acini cells to produce digestive enzymes
cholecystokinin
when __ relaxes, bile and digestive enzymes pass into the duodenum
sphincter of oddi
tiny clusters of cells throughout pancreas secrete hormones directly into blood stream (endocrine function)
islets of langerhans
alpha cells secrete ___
glucagon to increase BS levels
beta cells secrete ___
insulin to lower BS levels
___ controls regulation of insulin and glucagon level
islet cells
what two veins form the confluence
superior mesenteric vein (SMV) & splenic vein
sagittal pancreas head is __ and ___ to liver
inferior and posterior
sagittal pancreas head is ___ to IVC
anterior
___ can be seen in short axis superior to the head
main portal vein
neck and uncinate process are separated by the ___
SMV
in sagittal, Neck is ___ to SMV
anterior
in sagittal, uncinate process is ___ to SMV
posterior
calliper AP placement for pancreatic duct is placed __ to __
inner to inner
dorsal and ventral pancreatic anlage fuse at ___ weeks
6-8
dorsal (cranial) pancreatic anlage forms ___ & ___ of pancreas
- body
2. tail
ventral (caudal) pancreatic anlage forms ___ & ___ of pancreas
- head
2. uncinate process
transducer used for scanning pancreas
curved linear 3-5MHz
what structure is seen in the body of the pancreas as a thin, bright line
pancreatic duct / duct of wirsung
echotexture of pancreas
homogeneous, can appear heterogeneous depending on interlobular fat (mottled)
shape of pancreas
sideways apostrophe
T/F: pancreas has reflective capsule on US
FALSE
echogenicity of pancreas__ with age
increase
bulging structure with same echogenicity and texture as pancreas that is NOT REAL
pseudomasses
normal variants of pancreas
- annular pancreas
- cysts
- agenesis (absent body & tail)
- pancreatic divisum (when signle pancreatic duct is not formed - stays as 2 distinct ventral and dorsal ducts )
