Flashcards in Pancreas Deck (133)
where is the pancreas?
behind posterior peritoneal membrane at level of L2
where does the head of the pancreas sit?
the duodenal C loop
where does the neck of the pancreas sit
over the superior mesenteric vein
where is the body of the pancreas?
left of the SMV
where is the tail of the pancreas
the distal-most portion and abuts the splenic hilum
_____ 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
main pancreatic duct
Duct of Wirsung
lesser duct that drains the superior portion of the head through the lesser papilla
Duct of Santorini
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
what blood supply goes to the body and tail of the pancreas
Celiac trunk to the splenic artery
where do the veins of the pancreas drain?
likely responsible for high incidence of metastases with pancreatic cancer
abundant and diffuse lymphatic drainage of the pancreas
what is 80-90% of the pancreatic mass?
Secrete fluid and electrolytes and bicarbonate
what are the endocrine portions of the pancreas
Islets of Langerhans - secretes hormones that control glucose homeostasis
2 main causes of acute pancreatitis?
what cells are injuired in acute pancreatitis
acinar cell injury
____________ tends to have a higher mortality rate than alcoholic pancreatitis
the beta cells of the pancreas secrete what?
insulin and amylin
the delta cells of the pancreas secrete what?
what is the Ddx for acute pancreatitis?
Perforated peptic ulcer
what bite can cause acute pancreatitis?
what happens w/ amylase and lipase levels w/ pancreatitis?
will go up then back down
location of acute pancreatitis pain
Epigastric. May radiate to back, LUQ or RUQ
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
associated symptoms w/ acute pancreatitis
N/V. Hematemesis or melena if severe
precipitating factors w/ acute pancreatitis
Large fatty meal if GS pancreatitis. Alcohol ingestion if EtOH pancreatitis
alleviating factors w/ acute pancreatitis?
sitting or standing
if acute pancreatitis is severe what 2 signs can you see?
grey turner's sign
blood around flank (pancreatitis)
grey turner's signs