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Flashcards in Pancreas Deck (133)
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1

where is the pancreas?

retroperitoneal
behind posterior peritoneal membrane at level of L2

2

where does the head of the pancreas sit?

the duodenal C loop

3

where does the neck of the pancreas sit

over the superior mesenteric vein

4

where is the body of the pancreas?

left of the SMV

5

where is the tail of the pancreas

the distal-most portion and abuts the splenic hilum

6

_____ descends in the posterior surface of the pancreatic head to join the main pancreatic duct at the ampulla of Vater which is surrounded by the sphincter of Oddi

CBD

7

main pancreatic duct

Duct of Wirsung

8

lesser duct that drains the superior portion of the head through the lesser papilla

Duct of Santorini

9

what supplies the arterial supply of the head of the pancreas

Celiac trunk to the hepatic artery to the GDA to the superior pancreaticoduodenal artery
SMA to the inferior pancreaticoduodenal artery

10

what blood supply goes to the body and tail of the pancreas

Celiac trunk to the splenic artery

11

where do the veins of the pancreas drain?

portal vein

12

likely responsible for high incidence of metastases with pancreatic cancer

abundant and diffuse lymphatic drainage of the pancreas

13

what is 80-90% of the pancreatic mass?

exocrine
Amylases
Lipases
proteases
Secrete fluid and electrolytes and bicarbonate

14

what are the endocrine portions of the pancreas

Islets of Langerhans - secretes hormones that control glucose homeostasis

15

2 main causes of acute pancreatitis?

alcohol
gallstones

16

what cells are injuired in acute pancreatitis

acinar cell injury

17

____________ tends to have a higher mortality rate than alcoholic pancreatitis

biliary pancreatitis

18

the beta cells of the pancreas secrete what?

insulin and amylin

19

the delta cells of the pancreas secrete what?

somatostatin

20

what is the Ddx for acute pancreatitis?

Acute cholecystitis
Ascending cholangitis
Perforated peptic ulcer
Mesenteric ischemia
Esophageal perforation
MI

21

what bite can cause acute pancreatitis?

scorpion bites

22

what happens w/ amylase and lipase levels w/ pancreatitis?

will go up then back down

23

location of acute pancreatitis pain

Epigastric. May radiate to back, LUQ or RUQ

24

character of acute pancreatitis pain

Dull, boring, and steady. Usually, the pain is sudden in onset and gradually intensifies in severity until reaching a constant ache. Severity varies

25

associated symptoms w/ acute pancreatitis

N/V. Hematemesis or melena if severe

26

precipitating factors w/ acute pancreatitis

Large fatty meal if GS pancreatitis. Alcohol ingestion if EtOH pancreatitis

27

alleviating factors w/ acute pancreatitis?

sitting or standing

28

if acute pancreatitis is severe what 2 signs can you see?

grey turner's sign
cullen's sign

29

blood around flank (pancreatitis)

grey turner's signs

30

what will the abdominal exam look like w/ acute pancreatitis

Upper abdominal tenderness with distention +/- guarding and rebound