Chapter 97 Pancreas

Question 1

Describe the anatomy of the pancreas - right lobe, left lobe, body

Answer 1

Right lobe – associated with proximal duodenum and within the mesoduodenum
Left lobe – begins at the pylorus, extends along greater curvature of the stomach and within the dorsal leaf of the greater omentum (veil)
Body of the pancreas – associated with proximal duodenum

Question 2

Exocrine vs endocrine pancreatic mass

Answer 2

98% of total pancreatic mass is formed by the exocrine pancreas

Question 3

Which cells are responsible for synthesizing digestive enzymes in the pancreatic lobules

Answer 3

acinar cells

Question 4

Endocrine pancreas is composed of what

Answer 4

Islets of Langerhans

Question 5

What are the four cell types in the islets of Langerhans and what do they each produce

Answer 5

Alpha cells - Glucagon
Beta cells - Insulin
Delta cells - Somatostatin*
F or PP cells - pancreatic polypeptide

Question 6

What is the pancreatic blood supply

Answer 6

*Splenic artery is the primary blood supply to the left limb of the pancreas
Hepatic artery terminates as the cranial pancreaticoduodenal artery – supplies body and proximal right limb
Caudal pancreaticoduodenal artery – supplies distal right limb of the pancreas

Question 7

Dog vs cat pancreatic ducts

Answer 7

Dogs: Common bile duct enters duodenum at the major duodenal papilla NEXT to the pancreatic duct*
Accessory pancreatic duct (main duct in dogs) is the larger pancreatic excretory duct and enters at the minor duodenal papilla
68% of dogs transport pancreatic secretions to the duodenum

Cats: Common bile duct and pancreatic duct (main duct in cats) conjoin before entry into the duodenum at the major papilla*
Only 20% of cats have accessory pancreatic duct

Question 8

Cholecystokinin and secretin roles

Answer 8

Cholecystokinin stimulates secretion of digestive enzymes, gallbladder contraction and relaxation of the sphincter of Oddi

In the pancreas, secretin stimulates secretion of large amounts of bicarb rich fluid that helps neutralize gastric acid in the duodenum

Question 9

Gastrinoma - type of tumor, location, what does it secrete, side effects?

Answer 9

a non-β pancreatic islet cell tumor (endocrine pancreas), is associated with hypersecretion of gastrin from antral G cells, resulting in gastric hyperacidity and subsequent ulceration