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Abdominal Sonography > Pancreas > Flashcards

Pancreas Flashcards

(75 cards)

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1
Q

Is the pancreas encapsulated?

A

NO

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2
Q

Where does the pancreas lie in the abdomen?

A

Retroperitoneal

Between the duodenal loop and the splenic hilum

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3
Q

What are the different parts of the pancreas?

A

Head, uncinate process, neck, body, and tail

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4
Q

What is the exocrine function of the pancreas?

A

Secrete trypsin, lipase and amylase

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5
Q

What is the endocrine function of the pancreas?

A

Secrete insulin via islets of Langerhans

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6
Q

What is the normal size of the pancreas in AP dimension?

A

<3 cm

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7
Q

What overlies the anterior border of the pancreatic body and tail?

A

Posterior wall of the stomach

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8
Q

Where is the head of the pancreas?

A

Anterior to the IVC and medial to the duodenum

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9
Q

Where is the CBD in relation to the pancreas?

A

Posterior and lateral to the pancreatic head

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10
Q

Where is the gastroduodenal artery in relation to the pancreas?

A

Anterior and lateral to the pancreatic head

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11
Q

Where is the SMA/V in relation to the pancreas?

A

Posterior to the neck of the pancreas and anterior to the uncinate process

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12
Q

Where is the pancreatic tail located?

A

Anterior and medial to splenic hilum

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13
Q

Where does the aorta lie in relation to the pancreas?

A

Posterior to the body of the pancreas

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14
Q

What does the celiac axis divide into?

A

Left gastric artery then divides into the common hepatic artery and splenic artery

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15
Q

What does the common hepatic artery divide into?

A

Proper hepatic and gastroduodenal arteries

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16
Q

Where does the proper hepatic artery travel towards?

A

Travels superiorly toward the liver, anterior to the portal vein, and left of the bile duct

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17
Q

Where does the right gastric artery come from?

A

Proper hepatic artery

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18
Q

Where does the gastroduodenal artery travel?

A

Posterior to the first portion of the duodenum then anterior to head of pancreas

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19
Q

What does the GDA divide into?

A

Right gastroepiploic artery

Superior pancreaticoduodenal artery

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20
Q

Where is the SMA located?

A

Inferior to pancreas
Anterior to uncinate process
Anterior to 3rd portion of the duodenum

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21
Q

Where is the splenic vein located?

A

Posterior aspect of the pancreas

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22
Q

What 2 veins make up the main portal vein?

A

Superior mesenteric vein and splenic vein

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23
Q

Where is the SMV located?

A

Right of the SMA
Anterior to the 3rd portion of the duodenum
Anterior to uncinate process

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24
Q

What does the IMV drain?

A

Left lower quadrant sigmoid and descending colon into the splenic vein

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25
Where does the CBD travel?
Posterior to 1st portion of the duodenum and head of pancreas Right of main pancreatic duct
26
Where does the ampulla of Vater open into?
2nd portion of duodenum at major papilla
27
Where does the accessory pancreatic duct (duct of Santorini) open into?
2nd portion of duodenum at minor papilla
28
How many portions does the duodenum divide into?
4 1st and 3rd - transverse 2nd and 4th - longitudinal
29
At what size is the pancreatic duct considered abnormal?
>2.0 mm
30
What structures are in contact with the pancreatic head?
``` IVC CBD Ampulla of Vater Gastroduodenal artery Duodenal C loop (2nd portion) ```
31
What are the most common causes of acute pancreatitis?
Gallstones | Alcohol abuse
32
What are sonographic findings of acute pancreatitis?
Enlarged hypoechoic gland
33
What are some complications of acute pancreatitis?
``` Pseudocyst formation Abscess Pancreatic necrosis Hemorrhage Venous hemorrhage Pseudoaneurysm formation ```
34
What is a pancreatic phlegmon?
Focal pancreatitis | Inflammatory mass formed by edema and leakage of pancreatic enzymes
35
What are causes of chronic pancreatitis?
``` Alcoholic chronic pancreatitis Autoimmune Hereditary CF Congenital abnormalities Abdominal trauma Idiopathic ```
36
What are sonographic findings of chronic pancreatitis?
``` Small and echogenic gland Calcifications Pancreatic duct dilatation Bile duct dilatation Portal vein thrombosis ```
37
What diseases are multiple pancreatic cysts associated with?
Adult PCKD | Von Hippel-Lindau syndrome
38
What are US findings of CF of the pancreas?
Increase pancreatic echogenicity Gland atrophy Fibrosis and fatty replacement Cysts due to ductal obstruction
39
What condition is associated with CF?
Meconium ileus
40
What are pancreatic pseudocysts?
Accumulation of pancreatic fluid and necrotic debris confined by the retroperitoneum
41
What causes pancreatic pseudocysts?
``` Acute pancreatitis Chronic pancreatitis Pancreatic trauma Pancreatic ductal obstruction Pancreatic neoplasms ```
42
Where in the retroperitoneum is the pancreas located?
Anterior pararenal space
43
What is the most common cause of a pancreatic pseudocyst in children?
Trauma
44
What is a pancreas divisum?
Failure of the dorsal and ventral pancreatic ductal systems to fuse during embryonic development which results in the smaller Santorini's duct draining the pancreas
45
What is an annular pancreas?
Congenital anomaly where the ventral pancreas encircles the second portion of the duodenum
46
What may present as a "double-bubble" sign?
Annular pancreas - dilated stomach and duodenal bulb
47
How do pts with pancreatic CA present?
Lymphatic and metastatic spread of tumor Mean pt age 55yo 80% arise from pancreatic head
48
What are sonographic findings of pancreatic adenoCA?
Solid hypoechoic mass
49
What are associated findings of pancreatic adenoCA?
``` Courvoisier's GB Bile duct dilatation Dilated pancreatic duct Liver mets Ascites Lymphadenopathy Pseudocyst formation ```
50
What is the Whipple procedure?
Pancreaticoduodenectomy | Head of pancreas, portion of bile duct, the GB and duodenum are removed
51
Are pancreatic serous cysteadenomas malignant?
NO | Formerly microcystic cystadenomas
52
What do pancreatic serous cystadenomas look like on US?
Cluster of grape-like cysts | External lobulation
53
What do mucinous cystic neoplasms look like on US?
Large multicystic mass with numerous septations and debris
54
What is increased in mucinous cystic neoplasm?
CEA levels
55
What are islet cell tumors associated with?
MEN-1 | Von Hippel-Lindau disease
56
What are the islet cell tumors?
``` Insulinoma - most common Gastrinoma - Zollinger-Ellison Syndrome Glucagonoma Vipoma Somatostinoma ```
57
What is Multiple Endocrine Neoplasia?
Inherited endocrine disorder MEN type 1 - Wermer's syndrome MEN type 2 - Sipple's syndrome
58
What organs does MEN affect?
``` Parathyroids Pancreatic islet cells Pituitary glands Adrenal glands Thyroid ```
59
Where does amylase come from?
Digestive enzyme for carbs, produced by pancreas and salivary glands; also kidneys
60
Head of pancreas is anterior to?
IVC
61
Head of pancreas is medial to?
2nd portion of duodenum
62
CBD is posterolateral to?
Head of pancreas
63
GDA is anterolateral to?
Head of pancreas
64
SMA and SMV are posterior to?
Neck of pancreas
65
Uncinate process is posterior to?
SMA and SMV
66
Aorta is posterior to?
Body of pancreas
67
Celiac axis is superior to?
Pancreas
68
Splenic vein is posteroinferior to?
Pancras
69
SMA and SMV are anterior to?
3rd portion of the duodenum
70
SMV is to the right of?
SMA
71
Stomach is anteromedial to?
Splenic hilum
72
Stomach is anterior to?
Pancreas body and tail
73
Tail of pancreas is posterior to?
Stomach
74
Tail of pancreas is anterior to?
Upper pole of left kidney
75
Splenic artery is superior/anterior to?
Pancreas

Abdominal Sonography (12 decks)

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