Chapter 5: The Pancreas Flashcards
(159 cards)
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
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
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
4
Q
inherited disorder that can affect the lungs, liver, pancreas, and other organs; this disorder changes how the body creates mucus and sweats
A
cystic fibrosis
5
Q
coexisting enlargement of the common bile duct and pancreatic duct
A
double-duct sign
6
Q
the accessory duct of the pancreas
A
duct of Santorini
7
Q
the main pancreatic duct
A
duct of Wirsung
8
Q
the first segment of the small intestine
A
duodenum
9
Q
endoscopic procedure that utilize flouroscopy (radiographic imaging) to evaluate the biliary tree and pancreas
A
endoscopic retrograde cholangiopancreatography
10
Q
form of pancreatitis associated with gallstones and pancreatic duct obstruction
A
gallstone pancreatitis
11
Q
an islet cell tumor found within the cells of the pancreas that may produce an abundance of gastrin
A
gastrinoma
12
Q
form of pancreatitis associated with bleeding within or around the pancreas
A
hemorrhagic pancreatitis
13
Q
elevated amylase
A
hyperamylasemia
14
Q
the presence of elevated parathyroid hormone
A
hyperparathyroidism
15
Q
bowel obstruction caused by the lack of normal peristalsis
A
ileus
16
Q
an islet cell tumor found within the beta cells of the pancreas that may produce an abundance of insulin
A
insulinoma
17
Q
most common form of pancreatitis; associated with inflammation of the pancreas and peripancreatic tissue without necrosis
A
interstitial edematous pancreatitis
18
Q
tumor found within the islets of Langerhans of the pancreas
A
islet cell tumors
19
Q
small islands of tissue found within the pancreas that produce insulin and glucagon
A
islets of Langerhands
20
Q
a peritoneal cavity located between the stomach and the pancreas where fluid can accumulate
A
lesser sac
21
Q
death of tissue
A
necrosis
22
Q
severe form of acute pancreatitis in which there is death of the pancreatic tissue
A
necrotizing pancreatitis
23
Q
the most common form of pancreatic malignancy, typically found within the head of the pancreas
A
pancreatic adenocarcinoma
24
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
25
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
pancreaticduodenectomy
26
a cyst surrounded by fibrous tissue that consists of pancreatic enzymes that have leaked from the pancrea
pancreatic pseudocyst
27
fatty infiltration of the pancreas; may be classified as alcoholic or nonalcoholic; may also be referred to as a fatty pancreas
pancreatic steatosis
28
the peripancreatic fluid collection that results from inflammation of the pancreas
phlegmon
29
a posteromedial extension of the pancreatic head
uncinate process
30
a hereditary disease that includes the development of cysts within the pancreas and other organs
von Hippel-Lindau disease
31
Whipple procedure
pancreaticoduodectonomy
32
a group of clinical indicators of a functional insulinoma; includes hypoglycemia, low fasting glucose, and relief with intravenous glucose administration
Whipple triad
33
the syndrome that includes an excessive secretion of acid by the stomach caused by the presence of a functional gastrinoma within the pancreas`
Zollinger-Ellison syndrome
34
digests carbohydrates and converts starch to sugar
amylase
35
digests fat and converts fats to fatty acids and glycerol
lipase
36
neutralizes stomach acid
sodium bicarbonate
37
breaks down proteins
trypsin, chymotripsin, and caroboxypolypeptides
38
glucagon- promotes the release of glucose by the liver (increases blood sugar level)
alpha cells
39
insulin- stimulates the body's use of glucagon
beta cells
40
somatostatin- restrains insulin and glucose levels
Delta cells
41
The pancreatic head is located right lateral to the _______
SMV
42
The pancreatic head is ____ to the IVC and _____ to the portal vein
anterior
posterior
43
The unicinate process is ______ to SMV
posterior
44
The uncinate process is anterior to the _____
aorta
45
The pancreatic neck is anterior to the ______
portal confluence
46
The pancreatic tail is marked by the posterior border of the ____
splenic vein`
47
pancreatitis associated with gallstones and concurrent obstruction of the pancreatic duct
gallstone pancreatitis
48
pancreatitis associated with bleeding in or around the pancreas; high rate or morbidity and mortality
hemorrhagic pancreas
49
Form of chronic pancreatitis that results from the body's immune system attacking the pancreas
autoimmune pancreatitis
50
Uncommon form of chronic pancreatitis found in the head of the pancreas with associated inflammation of the CBD and second portion of the duodenum`
groove pancreatitis
51
Form of acute pancreatitis results in the necrosis of the pancreatic parenchyma and the tissue surrounding the pancreas; high rate of morbidity and mortality
Necrotizing pancreatitits
52
Most common form of acute pancreatitis; associated with inflammation of the pancreatic parenchyma and peripancreatic tissues; necrosis is not present
interstitial edematous pancreatitis
53
elevated amylase
elevated lipase
leukocytosis
elevated ALT and other liver function labs when biliary obstruction is present
abdominal pain
back pain
fever
nausea and vomiting
acute pancreatitis
54
pancreas may appear normal
diffusely, enlarged, hypoechoic pancreas (diffuse manifestation)
focal hypoechoic area within the pancreas (total manifestation)
unencapsulated anechoic fluid collection surrounding all or part of the pancreas (peripancreatic fluid)
pancreatic pseudocyst
abscess formation can occur
biliary obstruction may be present
acute pancreatitis
55
asymptomatic
persistent epigastric pain
jaundice
back pain
possible elevation in amylase or lipase (but they may remain normal)
possible elevation in ALP
anorexia
vomiting
weight loss
constipation
chronic pancreatitis
56
heterogenous, or hyperechoic, atrophic gland with poor margins
calcifications within the gland
pancreatic pseudocyst
dilated pancreatic duct
stone(s) within the pancreatic duct that may lead to biliary obstruction
possible portosplenic vein thrombosis
chronic pancreatitis
57
elevated amylase and/or lipase
loss of appetite
weight loss
jaundice
courvoisier gallbladder
epigastric pain
elevated ALP and, possibly, other liver function labs associated with biliary obstruction
History of cigarette smoking, diabetes mellitus, or chronic pancreatitis
Pancreatic Adenocarcinoma
58
hypoechoic mass in the head of the pancreas
dilated CBD and pancreatic duct (double-duct sign)
liver and other abdominal organs should be evaluated for possible metastasis
enlarged hydropic gallbladder
pancreatic adenocarcinoma
59
may be asymptomatic initially
epigastic pain
weight loss
palpable mass
jaundice
cystadenomas and cystadenocarcinoma
60
cystic mass
may actually appear solid and echogenic secondary to the small size of the cysts
serous cystadenoma
61
multilocular cystic masses that may contain mural nodules and calcifcations
there may be associated dilation of the pancreatic duct
mucinous cystadenoma and cystadenocarcinoma
62
hypoglycemia, low fasting glucose, and relief with intravenous glucose administration (Whipple triad)
Insulinoma islet cell tumor
63
Zollinger-Ellison syndrome
Gastrinoma islet cell tumor
64
hypoechoic mass that may contain calcifications
hypervascularity may be present with color Doppler
visualization is challenging because of their small size
islet cell tumors
65
possible history of von -Hippel Lindau disease or cystic fibrosis
possible history of ADPKD
true pancreatic cysts
66
well-defined anechoic mass with posterior enhancement
true pancreatic cyst
67
hyperechoic echotexture
atrophy
pancreas may contain calcifications
chronic pancreatitis transplant rejection
68
hypoechoic or heterogenous gland
elevated resistive indices
acute pancreatic transplant rejection
69
pancreatic transplant fluid collections
abscess
ascites
hematoma
urinoma
pseudocysts
70
arterial stenosis
arterial thrombosis
graft thrombosis
pseudoaneurysms
splenic vein thrombosis
stricutes
pancreatic transplant vascular complications
71
Where is the pancreas located?
within the epigastrium between C-loop of duodenum and splenic hilum
72
The pancreas consists of 4 main parts
head
neck
body
tail
73
posteromedial expansion of the pancreatic head
uncinate process
74
The pancreas is a ____-peritoneal organ
retro
75
The pancreas functions as an _____ and _____ gland.
endocrine
exocrine
76
The main exocrine function of the pancreas:
aids in digestion
77
produce vital digestive enzymes
acinar cells
78
vital digestive enzymes produced by the acinar cells
amylase
lipase
sodium bicarbonate
trypsin
chymotrypsin
carboxypolypeptidase
79
main pancreatic duct
duct of Wirsung
80
accessory duct
duct of Santorini
81
minor sphincter in accessory duct into duodenum
minor duodenal papilla or accessory papilla
82
From the main pancreatic duct, enzymes collect in the
ampulla of Vater
83
The ampulla of Vater is also referred to as the
hepatopancreatic ampulla
84
pancreatic digestive enzymes mixed with bile from liver are released into the duodenum through the major sphincter:
Sphincter of Oddi
85
major duodenal papilla
papilla of Vater
86
Relaxation and opening of Sphincter of Oddi is controlled by:
cholecystokinin
87
The endocrine function of the pancreas is performed by:
islets of Langerhans
88
Islets of Langerhans are composed of:
alpha, beta, delta cells
89
The islets of Langerhans produce _____ and ____ directly into the bloodstreem
insulin
glucagon
90
promotes release of glucose by the liver which in turn increases blood sugar levels
glucagon
91
stimulates body to use up glucagon to produce energy
insulin
92
The head of the pancreas is supplied by the ______ artery.
gastroduodenal
93
The body and tail of the pancreas are supplied by the _____ and _____ arteries
splenic
superior mesenteric
94
Venous drainage for the pancreas is performed by _____, ______, and ______ veins.
splenic
superior mesenteric
portal
95
Normal echogenicity of the pancrease
greater than the liver
96
diffusely hyperechoic pancreas
pancreatic steatosis
97
The pediatric patient's pancreas is more _____ because of lack of fat.
hypoechoic
98
anechoic tube, consists of two parallel lines, with an anechoic lumen
main pancreatic duct
99
The main pancreatic duct AP should not exceed ___ mm
2
100
Normal measurement of the pancreatic head and body
2-3 cm
101
Normal measurement of the pancreatic tail
1-2 cm
102
Two most common pancreatic anomalies are
pancreatic divisum
annular pancreas
103
most common congenital variant of the pancreas
pancreatic divisum
104
results from abnormal fusion of the pancreatic ducts during embryologic development
pancreatic divisum
105
results in a shortened main pancreatic duct that only drains the pancreatic head
pancreatic divisum
106
results from maldevelopment of the two embryologic elements of the pancreas
annular pancreas
107
the most ventral part of the pancreas encases the duodenum and may consequently lead to duodenal obstruction
annular pancreas
108
inflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acinar cells into the parenchyma of the organ
acute pancreatitis
109
Most common causes of acute pancreatitis are
alcohol abuse
biliary tract diseases
110
Acute pancreatitis is often divided into either _______ pancreatitis or _______ pancreatitis
interstital edematous
necrotizing
111
peripancreatic fluid collection
phlegmon
112
lead to enlargment of the head; appear as hypoechoic region; pancreatic margins ill-defined with areas of fluid collections
focal pancreatitis
113
body will attempt to encapsulate damaging digestive enzymes that leak from the pancreas
pancreatic pseudocyst
114
The most common location for a pancreatic pseudocyst is:
lesser sac
115
The lesser sac is located between the _____ and ____
pancreas
stomach
116
repeated bouts of pancreatic inflammation; often caused by chronic alcohol abuse
chronic pancreatitis
117
most common primary pancreatic malignancy
pancreatic adenocarcinoma
118
4th most common cause of cancer-related deaths in men
pancreatic adenocarcinoma
119
Most common location of pancreatic adenocarcinoma is
pancreatic head
120
hypoechoic mass in the head of the pancreas; double-duct sign
pancreatic adenocarcinoma
121
obstruction of both CBD and pancreatic duct
double-duct sign
122
stage 1 pancreatic adenocarcinoma
mass confined to pancreas
123
Stage 2 pancreatic adenocarcinoma
involves local lymph node involvement
124
Stage 3 pancreatic adenocarcinoma
evidence of distant metastasis
125
surgical procedure performed on patients with pancreatic adenocarcinoma
whipple procedure
126
pancreaticoduodenectomy
Whipple procedure
127
Removal of head of pancreas, the gallbladder, some of the bile ducts, and proximal duodenum
Whipple procedure
128
small almost always benign cystadenomas
serous cystadenoma
129
larger; malignant potential; most often found within the body and tail of pancreas
mucinous cystadenomas
130
Symptoms of cystadenomas
epigastric pain, weight loss, palpable mass, jaundice
131
may actually appear solid and echogenic secondary to small size of cysts
serous cystadenomas
132
most often appears as a multilocular cystic mass that may contain mural nodules and calcifications
mucinous cystadenomas
133
house endocrine tissue of the pancreas
Islets of Langerhans
134
endocrine tumors of the pancreas
Islet cell tumors or pancreatic neuroendocrine tumors
135
Two most common types of islet cell tumors
insulinomas
gastrinomas
136
signs of insulinomas
Whipple triad (hypoglycemia, low fasting glucose, relief with intravenous glucose administation)
137
Whipple triad
hypoglycemia, low fasting glucose, relief with intravenous glucose administation
138
Islet cell tumor associated with Zollinger-Ellison Syndrome
Gastrinoma
139
excessive secretion of acid by stomach that leads to peptic ulcers
Zollinger-Ellison syndrome
140
small, hypoechoic mass that may contain calcifications
islet cell tumors
141
True pancreatic cysts may be associated with:
von Hippel-Lindau disease
cystic fibrosis
autosomal polycystic kidney disease
142
Most common reason for pancreatic transplant
severe type I diabetes
143
2 common techniques of pancreatic transplant
exocrine bladder drainage
exocrine enteric drainage
144
Acute rejection of pancreas sonographic appearance
heterogenous, hypoechoic
145
Chronic rejection of pancreas sonographic appearance
hyperechoic, atrophic, contains calcifications
146
Most common complication of pancreatic transplant
thrombosis of graft
147
An _____ gland uses ducts to transport digestive juices.
exocrine
148
An ______ gland releases hormones directly into the bloodstream.
endocrine
149
The ______ artery, which takes a similar path within the abdomen, may be confused for a dilated pancreatic duct, and thus, Color Doppler should be utilized to differentiate the two structures.
splenic
150
_______, which is the most common congenital variant of the pancreas, can lead to both acute and chronic pancreatitis
pancreatic divisum
151
Acute pancreatitis will cause a rise in amylase first and then a rise in lipase, with ______ being the most helpful lab finding for diagnosis of the disease
lipase
152
_________ will result in a diffusely, enlarged, hypoechoic pancreas.
diffuse acute pancreatitis
153
_______ can result in an atrophic, hyperechoic pancreas with calcifications and a prominent pancreatic duct.
Chronic pancreatitis
154
Pancreatic adenocarcinoma is most commonly found in the ____ of the pancreas.
head
155
_______ occurs when the gallbladder is palpable because it is enlarged. This is due to the presence of a (potentially malignant) pancreatic head mass that leads to biliary obstruction and the backup of a large amount of bile in the gallbladder.
Courvoisier gallbladder
156
Pancreatic cystadenocarcinoma is most commonly found in the ____ or ____ of the pancreas.
body
tail
157
Functional gastrinomas can produce _______ syndrome, which is described as the excessive secretion of acid by the stomach that leads to peptic ulcers.
Zollinger-Ellison
158
_______ disease is associated with cysts in the pancreas.
von Hippel Lindau
159
