Endo: Pancreas

Question 0

Weight of pancreas in adult

Answer 0

75-100 grams

Question 1

Retroperitoneal. Oblique position, sloping upward. Duodenum C-loop to Splenic hilum.

Answer 1

Pancreas

Question 2

Size of the pancreas in adult

Answer 2

15-20cm long

Question 3

Pancreas is situated _______ in the abdomen. Sealed in the ________. Poorly localized, ill defined symptoms.

Answer 3

Deeply. Retroperitoneum.

Question 4

Four regions of the pancreas

Answer 4

Head, Neck, Body & Tail.

Question 5

Head of the pancreas in nestled in the ______ of the ______. Posterior to the _________.

Answer 5

C-loop. Duodenum. Transverse mesocolon.

Question 6

Lies behind the head of the pancreas

Answer 6

Both renal veins, Vena cava & Right renal artery “BVR”

Question 7

Neck of the pancreas lies directly over the ________. Overlies the ___________. At the inferior border, the _____ joins the ______ as the portal vein.

Answer 7

Portal vein. Vertebral body of L1 & L2. SMV & Splenic vein.

Question 8

The body and tail of the pancreas lie just anterior to the ___________. The _____ runs in the groove on the back, fed by multiple fragile venous branches from the ___________.

Answer 8

Splenic artery and vein. Vein. Pancreatic parenchyma.

Question 9

Wrap around the right side of the portal vein.

Answer 9

Uncinate process

Question 10

The uncinate process, end posteriorly near the space between ____ & _____. Venous draining the pancreatic head and uncinate process enter along the right _____ & ______ sides of the portal vein. There are no _________.

Answer 10

SMV & SMA. Lateral & Posterior. Anterior venous tributaries.

Question 11

Embryology: from the ventral bud connects the bile duct.

Answer 11

Duct of Wirsung

Question 12

Embryology: from the larger dorsal bud connects to the duodenum

Answer 12

Duct of Santorini

Question 13

Embryology: with gut rotation, two ducts fuse. Majority drains through the duct of ______ to the major papilla.

Answer 13

Wirsung

Question 14

Embryology: duct of Santorini persist as a ___________. Or drain through the __________.

Answer 14

Blind accessory duct. Lesser papilla.

Question 15

Embryology: In a minority, duct remain separated, and the majority of the pancreas drains through the duct of Santorini, a condition referred to as

Answer 15

Pancreas Divisum

Question 16

Passes behind the neck of pancreas, it gives off the _________. Divides into the ______________ arteries.

Answer 16

SMA. Inferior pancreaticoduodenal artery. Anterior & Posterior inferior pancreaticoduodenal arteries.

Question 17

_________ in the head and body of the pancreas provide a rich blood supply. The head of the pancreas.

Answer 17

Multiple arcades

Question 18

From the splenic artery

Answer 18

Dorsal pancreatic artery, Great pancreatic artery & Caudal pancreatic artery “DGC”

Question 19

Venous drainage of the pancreas, follows the pattern of the arterial supply. ______ usually superficial to the arteries. _______ on the transverse colon can tear fragile branches along the __________ of the pancreas which the retract into the parenchyma of pancreas.

Answer 19

Veins. Anterior traction. Inferior border

Question 20

Venous branches draining the pancreatic head and uncinate process enter along the right lateral and posterior sides of the

Answer 20

Portal vein

Question 21

No anterior _________, and a plane can usually be developed between the _________, _______ & ________.

Answer 21

Venous tributaries. Neck of pancreas, Portal vein & SMV

Question 22

Antero/posterosuperior pancreaticoduodenal vein drains into the

Answer 22

Portal vein

Question 23

Antero/posteroinferior pancreaticoduodenal vein drains into the

Answer 23

SMV

Question 24

Venous drainage of the pancreas

Answer 24

Spleenic vein, Inferior mesenteric vein & SMV "SIS"

Question 25

The SMV joins the splenic vein and continues towards the the porta hepatis as the

Answer 25

Portal vein

Question 26

The ____ often joins the _______ near its junction with the portal vein, but sometimes joins the SMV; or the three veins merge as a trifurcation to form the portal vein,

Answer 26

IMV & splenic vein

Question 27

The lymphatic drainage of the pancreas is ______ & _______. High incidence of lymph node metastases and local recurrence of _______.

Answer 27

Diffuse and widespread. Pancreatic cancer

Question 28

Lymphatics communicate with lymph nodes in the _______ and mesentery of proximal _______.

Answer 28

Transverse mesocolon. Jejunum

Question 29

________ in the body & tail of the pancreas are often unresectable due to metastasis to these lymph nodes.

Answer 29

Tumors

Question 30

Innervation of pancreas: rich supply in sensory fibers that travel superiorly to the ________. Interruption of these somatic fibers with a __________ can interfere with transmission of pancreatic pain.

Answer 30

Celiac ganglia. Celiac plexus block.

Question 31

In ultrasound, pancreas is anterior to the two vessels identified

Answer 31

Portal vein & Spleenic vein

Question 32

A retroperitoneal structure, note the different organs surrounding it.

Answer 32

CT scan

Question 33

Cluster of pale staining polyhedral cells. >tail. Fenestrated capillaries automimic innervation.

Answer 33

Islets of Langerhans

Question 34

Cells found in the pancreas

Answer 34

Alpha, Beta & Delta

Question 35

10-15% found in the periphery

Answer 35

Alpha & Delta cells

Question 36

70% found in the center

Answer 36

Beta cells

Question 37

Beta cells secrete

Answer 37

Insulin

Question 38

Alpha cells secrete

Answer 38

CCK, Glucagon, ACTH & GIP "CGAG"

Question 39

Delta cells secrete

Answer 39

Somatostatin & Gastrin"SG"

Question 40

Control of Endocrine pancreas: parasympathetic increases secretion of

Answer 40

Insulin & Glucagon

Question 41

Control of endocrine pancreas: sympathetic increases

Answer 41

Glucagon but inhibits Insulin

Question 42

Exocrine secretion: hormonal in nature

Answer 42

Secretin & CCK

Question 43

Exocrine secretion: Neuronal. ________ regulation pancreatic blood flow. Parasympathetic _______ & ________.

Answer 43

Sympathetic. Acinar & Centroacinar cells

Question 44

Exocrine secretion: _____ & _____. Ductal & centroacinar cells. Vagal cholinergic hormonal secretin.

Answer 44

HCO3 @ H20

Question 45

Exocrine secretion: enzymes acinar cells. Vagal cholinergic hormonal ____.

Answer 45

CCK

Question 46

Pyramindal, purplish red with basal basophilia, round basal nucleus. Cells outline not clear, lumen distinct, zymogenic granules and myoepithelial cells are prominent.

Answer 46

Serous

Question 47

Columnar, lightly eosinophilic, flattened peripheral nucleu. Clear, distinct, Mucinogen vesicles and not prominent

Answer 47

Mucous

Question 48

Apical plasma membrane smooth, intercellular canaliculi rare. Dense large closely packed & Ill defined. >AGAGS

Answer 48

Mucous

Question 49

Apical microvilli, laterally intercellular canaliculi, junctional complexes, infoldings. Golgi complex, RER. Small discrete granules secretion

Answer 49

Serous