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Flashcards in Endo: Pancreas Deck (50)
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0
Q

Weight of pancreas in adult

A

75-100 grams

1
Q

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

A

Pancreas

2
Q

Size of the pancreas in adult

A

15-20cm long

3
Q

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

A

Deeply. Retroperitoneum.

4
Q

Four regions of the pancreas

A

Head, Neck, Body & Tail.

5
Q

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

A

C-loop. Duodenum. Transverse mesocolon.

6
Q

Lies behind the head of the pancreas

A

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

7
Q

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

A

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

8
Q

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 ___________.

A

Splenic artery and vein. Vein. Pancreatic parenchyma.

9
Q

Wrap around the right side of the portal vein.

A

Uncinate process

10
Q

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 _________.

A

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

11
Q

Embryology: from the ventral bud connects the bile duct.

A

Duct of Wirsung

12
Q

Embryology: from the larger dorsal bud connects to the duodenum

A

Duct of Santorini

13
Q

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

A

Wirsung

14
Q

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

A

Blind accessory duct. Lesser papilla.

15
Q

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

A

Pancreas Divisum

16
Q

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

A

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

17
Q

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

A

Multiple arcades

18
Q

From the splenic artery

A

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

19
Q

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.

A

Veins. Anterior traction. Inferior border

20
Q

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

A

Portal vein

21
Q

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

A

Venous tributaries. Neck of pancreas, Portal vein & SMV

22
Q

Antero/posterosuperior pancreaticoduodenal vein drains into the

A

Portal vein

23
Q

Antero/posteroinferior pancreaticoduodenal vein drains into the

A

SMV

24
Q

Venous drainage of the pancreas

A

Spleenic vein, Inferior mesenteric vein & SMV “SIS”

25
Q

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

A

Portal vein

26
Q

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,

A

IMV & splenic vein

27
Q

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

A

Diffuse and widespread. Pancreatic cancer

28
Q

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

A

Transverse mesocolon. Jejunum

29
Q

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

A

Tumors

30
Q

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.

A

Celiac ganglia. Celiac plexus block.

31
Q

In ultrasound, pancreas is anterior to the two vessels identified

A

Portal vein & Spleenic vein

32
Q

A retroperitoneal structure, note the different organs surrounding it.

A

CT scan

33
Q

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

A

Islets of Langerhans

34
Q

Cells found in the pancreas

A

Alpha, Beta & Delta

35
Q

10-15% found in the periphery

A

Alpha & Delta cells

36
Q

70% found in the center

A

Beta cells

37
Q

Beta cells secrete

A

Insulin

38
Q

Alpha cells secrete

A

CCK, Glucagon, ACTH & GIP “CGAG”

39
Q

Delta cells secrete

A

Somatostatin & Gastrin”SG”

40
Q

Control of Endocrine pancreas: parasympathetic increases secretion of

A

Insulin & Glucagon

41
Q

Control of endocrine pancreas: sympathetic increases

A

Glucagon but inhibits Insulin

42
Q

Exocrine secretion: hormonal in nature

A

Secretin & CCK

43
Q

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

A

Sympathetic. Acinar & Centroacinar cells

44
Q

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

A

HCO3 @ H20

45
Q

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

A

CCK

46
Q

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

A

Serous

47
Q

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

A

Mucous

48
Q

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

A

Mucous

49
Q

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

A

Serous