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Flashcards in Spleen and pancreas Deck (29):
0

Where does the spleen sit in the abdominal cavity?

Left posterolateral abdominal wall, related to ribs 9-12

1

Which tissue type is the spleen derived from?

Mesoderm

2

What sort of injury can damage spleen?

Rib fractue, difficult to repair so common to have it removed

3

What can happen to the spleen in portal hypertension?

Splenomegaly, due to backing up of pressure along splenic vein. Spleen is soft and so tissue can expand easily

4

Which part of the spleen is most easy to palpate and when?

Splenic notch when spleen is enlarged

5

What is significant about the splenic artery?

Tortuous so can stretch and move with other organs around it
Has no anastamoses, so no back up supply if damaged

6

What are the 5 anatomical parts of the pancreas?

Tail
Body
Neck
Head
Uncinate process

7

What are the 3 main arteries that supply the pancreas and where do they originate?

Splenic artery - Coeliac trunk
Super pancreaticoduodenal - coeliac trunk
Inferior pancreaticoduodenal - SMA

8

Where does the pancreas sit?

Secondarily retroperitoneal
In C of duodenum
Behind stomach and lesser sac
Neck sits on transpyloric plane L1
Tail sits near splenic hilum
In epigastrium and extends to right hypochondrium

9

Why is a pancreatectomy a particularly difficult procedure?

Multiple blood supplies
Retroperitoneal

10

What guards the entrance to the major duodenal papilla?

Hepatopancreatic sphincter

11

Where does the neck of the pancreas sit?

Transpyloric plane L1

12

Where does pancreatitis pain refer to?

Back
Epigastric
Fluid accumulation in lesser sac

13

Which bud of the developing pancreas rotates to its adult position?

Ventral bud rotates 90 degrees clockwise

14

What is an annular pancreas?

Ring of pancreatic tissue surrounding duodenum which can cause blockage

15

What is the visceral afferent responsible for pancreatitis pain?

Greater splanchnic nerve T5-9

16

Where would fluid collect in pancreatitis?

Lesser sac, posterior to stomach

17

Why might pancreatic cancer cause jaundice?

Blocked bile duct

18

What are the relations of the spleen?

Stomach
Colon
Pancreas
Kidney
Diaphragm
Ribs 9-12
Costodiaphragmatic recess

19

What is the lymph drainage of the spleen?

Coeliac nodes

20

Where should an examination of the spleen start?

Right iliac fossa
If enlarged, won't feel splenic notch unless start down here

21

What would be a test for acute pancreatitis?

Amylase (lipase)

22

What are secretions of the exocrine pancreas?

Alkali - isotonic solution rich in HCO3
Digestive enzymes - Trypsin (endopeptidase), Chymotrypsin (endopeptidase), Carboxypeptidase (ectopeptidase), Pancreatic amylase (breaks down starches), Lipases (break down fats)
Other enzymes (phospholipase, cholesterol esterase, ribonuclease)

23

Which cells of the exocrine pancreas secrete enzymes?

Acinar cells

24

Which exocrine pancreas cells secrete alkali?

Duct cells

25

What converts Trypsinogen to trypsin?

Membrane bound enterokinase on epithelial cells

26

Describe the mechanism of pancreatic HCO3 secretion

Carbonic anhydrase converts H2O and CO2 into HCO3 and H+
HCO3 is antiported with Cl into duct lumen
H is antiported with Na out into blood

27

What controls enzymatic secretion from the exocrine pancreas?

CCK and ACh

28

What controls bicarbonate secretion in the exocrine pancreas?

Stimulated by secretin and potentiated by CCK and ACh (vagal tone)