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Chapter 8
The Pancreas
108
Anatomy
09/08/2011

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Term
Cells that perform exocrine function
Definition
Acini cells
Term
Enzyme secreted by the pancreas to aid in the digestion of carbohydrates
Definition
Amylase
Term
Lies in teh midepigastrium anterior to the superior mesenteric artery and vein, aorta and IVC
Definition
Body of the pancreas
Term
Branch of the splenic artery that supplies the tail of the pancreas
Definition
caudal pancreatic artery
Term
Forms the right superior border of the head of the pancreas
Definition
C-loop of the duodenum
Term
Forms the right superior border of the body and head of the gland and gives rise to the gastroduodenal artery
Definition
Common Hepatic Artery
Term
A hereditary disease that causes excessive production of thick mucus by the endocrine glands, identified as fatty replacement of the glands
Definition
Cystic Fibrosis
Term
Enlargement of the GB caused by a slow progressive obstructio of the distal CBD from an external mass
Definition
Courvoiser's GB
Term
Branch of the splenic artery that supplies the body of the pancreas
Definition
Dorsal pancreatic artery
Term
Small accessory duct of the pancreas found in the head of the pancreas
Definition
Santorini duct
Term
Largest duct of the pancreas that drains the tail, body, and head of the gland; it joins the CBD to enter the duodenum through the ampulla of vater
Definition
Wirsung duct
Term
The endocrine function is production of insulin
Definition
Endocrine
Term
Production and digestion of pancreatic juices; primary function of the pancreas
Definition
Exocrine
Term
Stimulates the liver to convert glycogen to glucose; produced by alpha cells
Definition
glucagon
Term
Lies in the C-loop of the duodenum; the gastroduodenal artery is the anterolateral border and the CBD is the posterolateral border
Definition
Head of pancreas
Term
Elevated levels of calcium in the blood
Definition
Hypercalcemia
Term
Congenital condition in which elevated fat levels cause pancreatitis
Definition
Hyperlipidemia
Term
Dialted loops of bowel w/ out peristalsis; associated with various abdominal problems, including pancreatitis, sickle cell crisis and bowel obstruction
Definition
Ileus
Term
Hormone that causes glycogen formation from glucose in the liver and allows cells within insulin receptors to take up glucose to decrease blood sugar
Definition
Insulin
Term
Small cells that comprise the endocrine portion of the pancreas for the production of insulin, glucagon and somatostratin
Definition
Islets of Langerhans
Term
An abnormal increase in WBC caused by infection
Definition
Leukocytosis
Term
Pancreatic enzyme that breaks down fats
Definition
Lipase
Term
What enzyme is pancreatitis and remains increased longer than amylase?
Definition
Lipase
Term
A malignant neoplasm that rises from the lymphoid tissues?
Definition
Lymphoma
Term
Small area of the pancreas between the head and the body; anterior to the superior mesenteric vein?
Definition
Neck of pancreas
Term
Small area of the pancreas between the head and the body; anterior to the superior mesenteric vein?
Definition
Neck of pancreas
Term
Excessive bilirubin in the bloodstream caused by an obstruction of bile from the liver; characterized by a yellow discoloration of the sclera of the eye, skin and mucous membranes?
Definition
Obstructive jaundice
Term
Occurs when the pancreatic pseudocyst ruptures into the abdomen; free-floating pancreatic enzymes are very dangerous to surrounding structures
Definition
Pancreatic ascites
Term
"Sterile Abscess" collection of pancreatic enzymes that accumulate in the available space in the abdomen?
Definition
Pancreatic Pseudocyst
Term
Help supple blood to the pancreas along with splenic artery?
Definition
Pancreaticoduodenal arteries
Term
Inflammation of the pancreas; may be acute or chronic?
Definition
Pancreatitis
Term
Junction of the splenic and main portal vein; posterior border of the body of the pancreas?
Definition
Portal-splenic confluence
Term
A space or cavity that contains fluid but has no true endothelial lining membrane?
Definition
Pseudocyst
Term
Pancreatic enzyme that is elevated during pancreatitis?
Definition
Amylase
Term
Serves as the posterior border to the body of the pancreas?
Definition
SMA
Term
Lies posterior to the neck/body of teh pancreas and anterior to the uncinate process of the pancreas?
Definition
SMV
Term
Tapered at the end of the pancreas that lies in the left hypochondrium near the hilus of the spleen and upper pole of the left kidney?
Definition
Tail of pancreas
Term
Small, curved tip of the pancreatic head that lies posterior to the SMV?
Definition
Uncinate Process
Term
The pancreas is located in the _______ cavity?
Definition
Retroperitoneal
Term
The pancreas appears sonographically ____________ than the hepatic parenchyma?
Definition
Isoechoic to hyperechoic
Term
The major posterior vascular landmarks of the pancreas are the ________ and ________?
Definition
Aorta
IVC
Term
The head of the pancreas lies _________ to the IVC?
Definition
Anterior
Term
What crosses anterior to the uncinate process of the head of the gland and posterior to the neck of the body?
Definition
SMV
Term
The tortuous ____________ is superior border of the pancreas?
Definition
Splenic artery
Term
The tail of the pancreas is more difficult to image because it lies anterior to the left kidney and posterior to the left ___________ and ___________?
Definition
Colic flexure
Transverse Colon
Term
The ___________ receives tributaries from the lobules at right angles and enters the medial second part of the duodenum with the CBD at the amupulla of vater?
Definition
Wirsung Duct
Term
The blood supply of the pancreas is from the _______ and __________ arteries?
Definition
Splenic
Pancreaticduodenal
Term
The _________ artery is seen along the anterolateral border of the pancreas as it travels a short distance along the anterior aspect of the pancreatic head?
Definition
Gastroduodenal
Term
The ________ duct crosses the anterior aspect of the portal vein to the right of the proper hepatic artery?
Definition
CBD
Term
The portal vein is ________ to the IVC?
Definition
Anterior
Term
What gland is digestive?
Definition
Exocrine gland
Term
What gland is hormonal?
Definition
Endocrine gland
Term
Failure of the pancreas to furnish sufficient insulin leads to __________?
Definition
Diabetes Mellitus
Term
Exocrine function is performed by ___________ of the pancreas?
Definition
Acini cells
Term
The endocrine function is located in the __________?
Definition
Islets of langerhans
Term
The beta cells are more prevelant and produce _________?
Definition
Insulin
Term
What hormone causes glycogen formation from glucose in the liver?
Definition
Insulin
Term
Alpha cells produce ________?
Definition
Glucagons
Term
What hormone causes the cells to release glucose to meet the energy needs of the body?
Definition
Alpha Cells
Term
What do delta cells produce?
Definition
Somatostatin
Term
There are specific enzymes of the pancreas that may become altered in the pancreatic disease which are?
Definition
Amylase
Lipase
Term
Both amylase and lipase rise at the same rate, but the elevation in ________ concentration persists for a longer period in pancreatitis?
Definition
Lipase
Term
What controls the blood sugar level in the body?
Definition
Glucose
Term
This occurs when the pancreas becomes damaged and malfunctions as a result of increased secretion and blockage of ducts?
Definition
Pancreatitis
Term
An acute attack of pancreatitis is commonly related to __________ and _________?
Definition
Alcholism
Biliary tract disease
Term
The patient with pancreatitis typically presents with moderate to severe tenderness int eh __________ radiating to the __________?
Definition
Epigastrium
Back
Term
When swelling does occur, the gland is hypoechoic to anechoic and is less echogenic than the liver because of the increased prominence of __________ and ________?
Definition
Lobulations
Congested vessels
Term
The pancreatic duct may be obstructed in acute pancreatitis as a result of?
Definition
Inflammatin
Spasm
Edema
Psuedocyst
Swelling of the papilla
Term
Fluid collection around the pancreatic duct, along the pararenal spaces, within the Morrison's pouch, and around the duodenum may be present in a patient with ___________?
Definition
Acute pancreatitis
Term
Patients with acute pancreatitis may develop complications such as?
Definition
Psuedocyst
Abscess
Hemorrhage
Duodenal obstruction
Phlegmon
Term
Necrosis of the blood vessels results in the development of hemorrhage areas referred to as___________ sign?
Definition
Grey Tumor's
Term
An inflammatory process that spreads along fascial pathways, causing localized areas of diffuse inflammatory edema of soft tissue is known as ?
Definition
Phlegmon
Term
The ___________ become obstructed with a buidup of protein plugs with resultant calcifications along the duct in chronic pancreatitis?
Definition
Pancreatic ducts
Term
The most common primary neoplasm of the pancreas is?
Definition
Adneocarcinoma
Term
What is the most common location of a psuedocyst?
Definition
In the lesser sac
Term
How does a psuedocyst develope?
Definition
When pancreatic enzymes escape from the gland and break down tissue to form a sterile abscess somewhere in the abdomen
Term
What are the clinical findings in a patient with carcinoma of the pancreas?
Definition
Weight loss
Painless jaundice
nausea, vomiting
Changes in the stool
Term
Cystadenoma
Definition
Rare
More common in women
Benign
Term
Cystadenocarcinoma
Definition
Rare
Middle aged women
Body & tail
foci of calcification
malignant
Term
Macrocystic adenoma
Definition
aka Mucinous Cystic Tumor
More common in women
Term
Adenocarcinoma
Definition
Most primary neoplasm of the pancreas
Term
Islet Cell Tumor
Definition
Insulinoma *most common
Gastrinoma
Term
Pancreas Abcess
Definition
puss filled
encapsulated
Term
Causes of acute pancreatitis
Definition
Trauma
Drugs
Thrombosis, embolism
Term
Symptoms of acute pancreatitis
Definition
Abdominal pain
fever
Leukocytes up
Amylase up
Lipase up
Term
Function of glucose
Definition
controls blood sugar levels in body
Term
Function of glucagon
Definition
glycogen to glucose
Term
Funtion of Insulin
Definition
Glucose to glycogen
Term
Normal measurements of the pancreas
Definition
12-18 (15) length
3 head
2.5 neck
2.5 body
2 tail
Term
Endocrine cells
Definition
Islets of langerhan
alpha
beta
somostatin
Term
Pancreas located
Posterior?
Anterior?
Inferior?
Definition
stomach
portal vein
Splenic vein
Term
Pancreas lies anatomically?
Definition
Horizontal & oblique
from duodenum to spleen
Term
Surrounding vasculature to pancreas?
Definition
Aorta
IVC
SMA
SMV
SPV
PV
CBD
GDA
LRV
Stomach
Deodenal bulb
Term
What is the growth for endocrine pancreatic neoplasm
Definition
slow growth
Term
Most common place for an aneurysm?
Definition
Splenic artery
Term
Specialized cell in the islets?
Definition
Alpha
Beta
Somatostatin
Term
Glucagon is what type of cell
Definition
Alpha
Term
What is the function for glucagon?
Definition
Glycogen to glucose
Term
What type of cell is Insulin?
Definition
Beta
Term
What is the function of insulin?
Definition
Glucose to glycogen
Term
what type of cell is somatostatin?
Definition
Delta
Term
What is the function of somatostatin?
Definition
Alph & Beta inhibitor
Term
Lipase levels rise in what diagnosis?
Definition
Acute pancreatitis
Carcinoma of the pancreas
Term
Increase is glucose is found in what diagnosis?
Definition
diabetes
chronic liver disease
over activity of endocrine glands
Term
Most common primary neoplasm of the pancreas is?
Definition
Adenocarcinoma
Term
What is the most functioning islet cell tumor?
Definition
Insulinoma
Term
2nd most functioning islet cell tumor?
Definition
Gastrinoma
Term
Most common stone formed in the body?
Definition
Calcium Carbonate