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DMS 300 Abdomen & Small Parts > Pancreas A&P > Flashcards

Pancreas A&P Flashcards

1
Q

where is the pancreas located?

A

retroperitoneal
epigastric/solar plexus

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2
Q

what are the 4 segments of the pancreas?

A

head, neck, body, tail

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3
Q

where is the head located? (landmarks)

A

anterior to IVC
right of SMV
at c-loop of duodenum

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4
Q

where is the neck located?

A

directly anterior to SMV

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5
Q

where is the body located?

A

directly anterior to SV
anterior to AO & SMA
posterior to stomach wall

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6
Q

where is the tail located?

A

directly anterior to SV
anterior to left kidney
posterior to stomach
medial to spleen

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7
Q

normal size of the pancreas?

A

10-12 cm (adult)

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8
Q

normal size of head of pancreas (AP)?

A

< 3.5 cm

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9
Q

normal size of neck of pancreas (AP)?

A

< 1-2 cm

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10
Q

normal size of body of pancreas? (AP)

A

< 2.5 cm

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11
Q

normal size of tail of pancreas? (AP)

A

< 2.5 cm

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12
Q

what are the ducts of the pancreas?

A
  1. pancreatic duct/duct of wirsung
  2. accessory duct/duct of santorini
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13
Q

where does the duct of wirsung join the CBD?

A

ampulla of vater

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14
Q

mean diameter of pancreatic duct? (head & body)

A

3 mm @ head
2 mm @ body

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15
Q

what are the functions of pancreas?

A

exocrine: secretes digestive enzymes
endocrine: secretes hormones

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16
Q

which portion of the panc is the accessory duct located?

A

head of pancreas

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17
Q

where does the accessory duct enter the duodenum in comparison the the pancreatic duct?

A

enters duodenum superior to pancreatic duct

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18
Q

what are the functional cells for the exocrine portion of the pancreas? what do they do?

A

acinar cells secrete digestive enzymes

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19
Q

what digestive enzymes do acinar cells secrete?

A

amylase, lipase, trypsin

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20
Q

what does lipase break down?

A

fat

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21
Q

what does amylase break down?

A

carbs

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22
Q

what does trypsin break down?

A

proteins

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23
Q

where do digestive enzymes get secreted?

A

into the ducts & duodenum

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24
Q

where are hormones secreted?

A

bloodstream

25
Q

what are the functional cells of the endocrine portion of the pancreas?

A

islet of langerhaans/islet cells

26
Q

what pancreas cells release hormones?

A

alpha cells, beta cells, delta cells

27
Q

what do alpha cells secrete? what do they do?

A

glucagon is secreted to break down glycogen to glucose when body is hypoglycemic

28
Q

what do beta cells secrete? what do they do?

A

insulin is secreted to store glucose when body is hyperglycemic

29
Q

what do delta cells secrete? what do they do?

A

somatostatin is secreted as an autoregulator for glucagon & insulin

30
Q

what are the 3 lab values for the pancreas?

A

amylase, lipase, glucose

31
Q

what can elevated amylase indicate?

A

if it’s 2x the normal amount, it can indicate acute pancreatitis
other: intestinal obstruction, mumps, salivary gland disease, acute cholecystitis, perforated peptic ulcer, renal failure

32
Q

what can elevated lipase indicate?

A

acute pancreatitis/pancreatic carcinoma
other: cholecystitis, cirrhosis, severe renal disease

33
Q

what stays elevated longer? amylase or lipase?

A

lipase

34
Q

does glucose increase or decrease when you have a glucose metabolic disorder?

A

it can either increase or decrease

35
Q

what can cause an increase in glucose?

A

diabetes
chronic liver disease
overactive endocrine glands

36
Q

what can cause a decrease in glucose?

A

pancreatic (islet cell) tumors

37
Q

what are the 3 pancreatic variants?

A
  1. annular pancreas
  2. cystic fibrosis
  3. pancreatic cysts
38
Q

what does an annular pancreas look like? what can it lead to?

A

it’s a congenital anomaly where the pancreas head & UP wraps around the duodenum instead of the SMV. it can lead to obstruction.

39
Q

which part of the population do annular pancreases show up in more often?

A

males

40
Q

what is the variant that is hereditary & an autosomal recessive endocrine gland disease?

A

cystic fibrosis

41
Q

what happens when a patient has cystic fibrosis?

A

there’s an increase in mucous secretion in the exocrine glands of the pancreas. this leads to blocked ducts & delivery of digestive enzymes to the intestines

42
Q

how does the pancreas with cystic fibrosis look in US?

A

hyperechoic & smaller than normal

43
Q

what is the cause of pancreatic cysts? (variant)

A

ductal obstruction

44
Q

What type of patients can be seen with pancreatic cysts?

A

in patients with adult polycystic kidney disease (APKD)

45
Q

how does the pancreas’ echogenicity compare to liver?

A

iso or hyperechoic to liver

46
Q

how does the pancreas’ echogenicity change with age?

A

it becomes more echogenic with age

47
Q

what windows can you use to scan the pancreas?

A

LLL or stomach after drinking water through a straw

48
Q

what is adenopathy?

A

lymph node enlargement

49
Q

what do you scan for in the peri-pancreatic region?

A

adenopathy, fluid collection, vascularity

50
Q

what modalities are better for pancreas imaging?

A

CT*, MRI, ERCP

51
Q

what are the 3 spaces in the retroperitoneum?

A
  1. anterior pararenal space
  2. perirenal space
  3. posterior pararenal space
52
Q

where is the anterior pararenal space?

A

bw posterior parietal peritoneum & anterior renal fascia

53
Q

what is in the anterior pararenal space?

A

pancreas, parts of ASC & DESC colon, duod, great vessels

54
Q

where is the perirenal space?

A

bw anterior & posterior pararenal spaces

55
Q

what’s in the perirenal space?

A

adrenals, kidneys, renal vessels, proximal collecting sytems

56
Q

where is the posterior pararenal space?

A

bw posterior renal fascia & transversalis fascia

57
Q

what is in the posterior pararenal space?

A

retroperitoneal fat

58
Q

what structures are in the retroperitoneum? (9)

A

kidneys
adrenal glands
ureters
duodenum
asc colon
desc colon
pancreas
great vessels
nerves

DMS 300 Abdomen & Small Parts (14 decks)

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