Pancreas A&P

Question 1

The _______ is a nonencapsulated organ located in the _________ and lies between the c-loop of the duodenum and extends to the splenic hilum.

Answer 1

pancreas, retroperitoneum

Question 2

What are th 5 parts of the pancreas?

Answer 2

Head (often nestled into the uncinate process)
uncinate process
neck
body
tail

Question 3

Endocrine function of the pancreas

Answer 3

secrete indlulin via the islets of Langerhans directly into the bloodstream (non-ductal)

Question 4

Exocirne function of the pancreas

Answer 4

secrete trysin, lipase, amylase directly through the ductal system

Question 5

The normal pancreas measures < _____ cm when measuring A/P dimension.

Answer 5

3cm

Question 6

What vessels provide blood to the pancreas?

Answer 6

celiac axis, SMA, splenic artery (supplies the head, body, tail)

Question 7

The posterior wall of the stomach overlies which parts of the pancreas?

Answer 7

anterior border of the pancreatic body and tail

-have to get around the air in the GI structures

Question 8

General pproaches to imaging the pancreas

Answer 8

TDx ML and anterior to the LLL, angle inferior to avoid STO and first part of duodenum
or
go inferior and point upward

Question 9

Describe technique to better visulaize the pancreatic tail

Answer 9

PT drinks H2O in LLD position

then turn PT supine or RLD to scan COR from the SPL, H2O should fill the STO and duodenum and act as an acoustic window

Question 10

Head of the pancreas is ______ to the IVC.

Answer 10

anterior

Question 11

HEad of the pancreas is ______ to the duodenum.

Answer 11

medial

Question 12

CBD is _____/______ to the pancreatic head.

Answer 12

posterior/lateral

Question 13

GDA is _____/_____ to the pancreatic head.

Answer 13

anterior/lateral

Question 14

The SMA and SMV are _____ to the neck of the pancreas.

Answer 14

posterior

Question 15

SMA and SMV are ______ to the uncinate process.

Answer 15

anterior

Question 16

The pancreatic tail is located ____ and _____ to the splenic hilum.

Answer 16

anterior and medial

Question 17

Aorta is ______ to the body of the pancreas.

Answer 17

posterior

Question 18

Celaic axis arises from the Ao at the ______ border of the pancreas.

Answer 18

superior border

Question 19

SMA arises from the Ao at the _____ border of the pancreas.

Answer 19

inferior border

Question 20

Branches of the celiac axis

Answer 20

left gastric artery then divides into the common hepatic artery and splenic artery

Question 21

Spelnic artery follows a tortuous course along the _____ border of the ____ and _____ of the pancreas.

Answer 21

superior
body
tail

Question 22

The common hepatic artery divides into

Answer 22

proper heaptic artery

gastroduodenal arteries

Question 23

The proper hepatic artery travels ______ toward the liver and _____ to the portal vein and to the _____ of the bile duct.

Answer 23

superiorly
anterior
left

Question 24

The right gastric artery is a branch of the ____ _____ ____.

Answer 24

Proper heaptic artery

Question 25

GDA travels _____ to the first portion of the duodenum then _____ to the head of the pancreas.

Answer 25

posterior | anterior

Question 26

GDA divides into

Answer 26

right gastroepiploic artery | superior pancreaticoduodenal artery

Question 27

SMA is located ______ to the pancreas, ______ to the uncinate process, and ______ to the 3rd portion of the duodenum.

Answer 27

posterior anterior anterior

Question 28

The splenic vein is located on the _____ aspect of the pancreas.

Answer 28

posterior

Question 29

The ____ _____ joins the _____ _____ ___ to create the main portal vein.

Answer 29

splenic vein | superior mesenteric vein

Question 30

The SMV is located to the ____ of the SMA, _____ to the 3rd portion of the duodenum, and ____ to the uncinate process.

Answer 30

right anterior anterior

Question 31

The _____ ____ ____ drains the left lower quadrant sigmoid and descending colon and drains directly into the _____ _____.

Answer 31

inferior mesenteric vein | splenic vein

Question 32

CBD travels _____ to the 1st portion of the duodenum and the head of the pancreas to lie to the ____ of the main pancreatic duct.

Answer 32

posterior | right

Question 33

The CBD and duct of Wirsung (main pancreatic duct) join to become the ______ ____ _____, which opens into the 2nd portion of the duodenum at the _____ _____.

Answer 33

ampulla of Vater (hepaticopancreatic ampulla) | major papilla

Question 34

What is the accessory pancreatic duct?

Answer 34

duct of Santorini

Question 35

The duct of Santorini open into the ____ portion of the duodenum at the _____ _____, approx. ____cm proximal to the ampulla of Vater.

Answer 35

2nd minor papilla 2cm

Question 36

Describe the lie of the 4 portions of the duodenum.

Answer 36

1st and 3rd are transverse | 2nd and 4th are longitudinal

Question 37

The pancreatic duct is considered abnormal if it is >_____mm

Answer 37

2.0mm

Question 38

T/F - Pancreatic duct dilatation is typically due to stones within the duct of Wirsung from chronic pancreatitis or a stone at the ampulla of Vater.

Answer 38

T

Question 39

What 5 structures are in contact with the pancreatic head?

Answer 39

``` IVC CBD GDA Ampulla of Vater (terminal end of CBD) Duodenal C loop (2nd portion) ```

Question 40

Digestive enzyme for carbohydrates produced by the pancrease and salivary glands

Answer 40

Amylase

Question 41

T/F - amylase is also secreted by the kidneys, so increased levels may be seen with renal disease.

Answer 41

T | slower rate of amylase clearance

Question 42

Digestive enzyme for fat.

Answer 42

Lipase

Question 43

Serum lipase levels _____ the amylase levels, although lipase rises ____ and _______ _______.

Answer 43

parallel | later, persists longer

Question 44

What 8 structures/vessels are seen in the longitudinal plane in the long axis at the pancreas.

Answer 44

``` Ao IVC SMA SMV IMV Left gastric artery GDA CBD ```

Question 45

What 8 structure/vessels are seen in the transverse plane in their long axis at the pancreas?

Answer 45

``` RT/LT Renal Arteries RT/LT Renal Veins Splenic artery splenic vein IMA MPV Duct of Wirsung Common Hepatic Artery ```