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Abdomen Section 1 > Pancreas > Flashcards

Pancreas Flashcards

(53 cards)

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1
Q

Pancreas Anatomy

A

retroperitoneal organ

lies posterior to the stomach, duodenum, proximal jejunum of the small bowel, also the transverse colon run horizontallyh acraoss the ab

contained in the anterior pararenal space

drapes across the mid aspect of the ab, just under the xyphoid process

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2
Q

pancreas segments

A

4 primary

head

neck

body

tail

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3
Q

pancreas head

A

cradled in the C-loop of the duodenum,

IVC posterior

GDA anterolateral border

CBD posterior and lateral

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4
Q

Pancreas Uncinate process

A

located anterior to the IVC and posterior to the SMV

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5
Q

Pancreas vascular landmarks

A

aorta

IVC

SMA

SMV

splenic vein

portal vein

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6
Q

Main pancreatic duct

A

duct of Wirsung

courses entire lenght of pancreas

enters duodenum via the ampulla of vater

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7
Q

pancrease accessory duct

A

Duct of Santori

drains the anterior segment of the head

>2mm internal measurment is abnormal

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8
Q

Vascular structure pancreatic head

A

right lateral to SMV

anterior to IVC

inferior to portal vein

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9
Q

Vascular structure Uncinate process

A

posterior to SMV

may completely surround SMV

anterior to aorta

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10
Q

vascular structure neck

A

anterior to portal confluence

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11
Q

vascular structure body

A

anterior to SMV

splenic vein

SMA

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12
Q

vascular structure tail

A

splenic vein marks posterior border

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13
Q

Duct of Wirsung

Main pancreatic duct

A

primary duct extending entire length of pancreas

seen as 2 echogenic lines especially in neck/body

receives tributaries from the lobules

enters the duodenum with the common bile duct at the ampulla of vater

sphincter of Oddi-small muscle that guards the ampulla of vater

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14
Q

duct of santorini

secondary duct

A

drains the upper anterior head

endters the duodenum at the minor papilla

2cm proximal to the ampulla of vater

just draions the head

not normally seen on ultrasound

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15
Q

Common bile duct

CBD

A

runs inferior in the free edge of the lesser omentum to level of the duodenum

travels posterior to the first portion of duodenum where it forms a common trunk with the pancreatic duct and opens into the duodenum

ducts have smooth muscle surrounding them to make it easier to transport the pancreatic fluid

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16
Q

Pancrease body

A

longest segment

antrum of the stomach lies anterior

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17
Q

pancreas tail

A

most difficult to visualize

course left lateral aspect of the body, extending to the hillum of the spleen

splenic vein serves as the posterior border

left kidney is posterior to the tail

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18
Q

Pancrease vascular supply

A

supplied by the splenic artery and the pancreaticoduodenal arteries

veinous drainage is through tributaries of the splenic and SMV

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19
Q

Panreatic congential anomilies

A

Agenisis

pancreas divisum

ectopic

annular

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20
Q

Agenesis

A

missing body and tail with a large (hypertropic) head

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21
Q

pancreas divisum

A

lack of fusion of the dorsal and ventral pancreatic buds

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22
Q

ectopic

Study These Flashcards
A

most common anomalie

pancreatic nodules are found throughout the GI tract

.5-2.0cm in size

acute pancreatitis and tumor may be found in these nodules

23
Q

annular

Study These Flashcards
A

head of the pancreas surrounds the second portion of the duodenum

male prevalence

24
Q

pancreas functions

Study These Flashcards
A

Exocrine

Endochrine

25
Exocrine
digestive function
26
Acini cells
produces up to 2 liters of pancreatic juice per day arranged in sac-like structures juice converges into the two ducts which drain the juice into the duodenum for digestion pancreatic juice enzymes capable of completing almost all of the digestion of our food
27
Excocrine function
produces pancreatic juice to aid in digestion enzymes lipase trypsin amylase nucleases sodium bicarbonate
28
lipase
breaks down fats
29
trypsin
digest proteins
30
amylase
digest carbohydrates
31
nucleases
digest nucleic acids
32
sodium bicarbonate
neutralizes gastric acids ph of juice needs to be almost neutral for best action
33
Exocrine enzyme triggers
chyme (partially digested food) in the duodenum triggers release of hormones that start pancreatic juice formation gastrin cholecystokinin aceytlcholine secretin (sodium bicarbonate) these now enter duodenum after allowing the sphincter of Oddi to relax
34
Endocrine function
produces glucagons and insulin
35
insulin production
alpha, beta and delta cells within the islets of Langerhans
36
Insulin
regulates the metabolism of sugars insufficient leads to diabetis mellitus hormone that causes glycogen formation from teh glucose stored within the liver
37
glucagon
changes the forms of sugar hormone that causes our cells to release glucose to meet the bodies energy needs stimulates the liver to convert glycogen to glucose and increase sugar levels
38
gastrin
autoregulator inhibits the production of both insulin and glucagon
39
Beta cells
most prevalent cells produces insulin enables cells within insulin receptors to take up clucose which lowers blood sugar
40
alpha cells
produce glucagon
41
delta cells
smallest number of cells produce gastrin
42
Amylase
digestive enzyme produced by the pancreas as well as the parotid glands, bowel and gynecological system certain types of pancreatic disease escapes into the surrounding tissue causing death of tissue, resulting in severe pain and inflammation
43
ANypase lab tests
blood test twice normal usually indicates acute pancretitis, or obstruction of panc duct, acute cholecystitis, perforated peptic ulcer, alcohol poisoning differentials include mumps, ischemic bowel disease, pelvic inflammatory disease
44
urine amylase
may be elevated in pancreatitis diseases not affectin the pancreas may cause an elevation of blood serum amylase with elevation
45
Lipase
enzyme excreted only by the pancreas small amounts pass into the blood used to assess damage to the pancreas rises at teh same rate as amylase, but persists for a longer period of time
46
lipase differentials
obstruction of panc duct pancreatic CA acute cholecystitis
47
glucose
controls the blood sugar lever in the body GTT performed to asses a disorder of glucose metablolism
48
elevated Glucose differentials
diabetes chronic liver disease overactivity of several of the endocrine glands
49
decreased glucose differential
tumor of the islets of langerhans
50
normal pancreatic tissue sonographically
echogenicity is caompared to liver echo intensity is slightly less than surrounding retroperitoneum and slightly greater than liver texture depends on amount of fat dispersed between the lobules fat is strongly echogenic so may be isoechoic with surround retroperitoneal fat echotexture-homogeneous surface smooth to slightly lobular
51
Scanning pancreas
NPO 6-8 hrs 2.5-5Mhz adults 5-7Mhz peadiatrics left lobe for window deep inspiration to allow liver to displace inferior supine, oblique and upright positions (distends vascular structures) also valsalva
52
Pancread normal size
head \<=3 cm Neck \<=2.5 cm Body \<=2.5 cm tail \<=2 cm
53
pancrease normal echogenicity
\>liver \<\>spleen (depends on fibrous/fatty content)

Abdomen Section 1 (10 decks)

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