Chapter 12: The Pancreas

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1

acini cells

cells that perform exocrine function

2

amylase

enzyme secreted by the pancreas to aid in the digestion of carbohydrates

3

body of the pancreas

lies in the midepigastrium anterior to the superior mesenteric artery and vein, aorta, and inferior vena cava

4

caudal pancreatic artery

branch of the splenic artery that supplies the tail of the pancreas

5

C-loop of the duodenum

forms the lateral border of the head of the pancreas

6

common hepatic artery

artery arising from the celiac trunk to supply the liver; forms the right superior border of the body and head of the pancreas and gives rise to the gastroduodenal artery

7

Courvoisier’s sign

enlargement of the gallbladder caused by a slow, progressive obstruction of the distal common bile duct from an external mass such as adenocarcinoma of the pancreatic head

8

cystic fibrosis

inherited disorder of the exocrine glands; symptoms include mucous buildup within the lungs and other areas of the body; identified as fatty replacement of the glands

9

dorsal pancreatic artery

branch of the splenic artery that supplies the body of the pancreas

10

duct of Santorini

small accessory duct of the pancreas found in the head of the pancreas

11

duct of Wirsung

largest duct of the pancreas that drains the tail, body, and head of the gland; it joins the common bile duct to enter the duodenum through the ampulla of Vater

12

endocrine

endocrine function of the pancreas is production of the hormone insulin

13

exocrine

exocrine function of the pancreas is production and digestion of pancreatic juice; primary function of the pancreas

14

glucagon

hormone that stimulates the liver to convert glycogen to glucose; produced by alpha cells

15

head of the pancreas

lies in the C-loop of the duodenum; the gastroduodenal artery is the anterolateral border and the common bile duct is the posterolateral border

16

hypercalcemia

elevated levels of calcium in the blood

17

hyperlipidemia

congenital condition in which elevated fat levels cause pancreatitis

18

ileus

dilated loops of bowel without peristalsis; associated with various abdominal problems, including pancreatitis, sickle cell crisis, and bowel obstruction

19

insulin

hormone that causes glycogen formation from glucose in the liver and that allows circulating glucose to enter tissue cells

20

islets of Langerhans

portion of the pancreas that has an endocrine function and produces insulin, glucagon, and somatostatin

21

lipase

pancreatic enzyme that breaks down fats; enzyme is elevated in pancreatitis and remains increased longer than amylase

22

lymphoma

a malignant neoplasm that rises from the lymphoid tissues

23

neck of the pancreas

small area of the pancreas between the head and the body; anterior to the superior mesenteric vein

24

obstructive jaundice

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

25

pancreatic ascites

fluid accumulation caused by a rupture of a pancreatic pseudocyst into the abdomen; free-floating pancreatic enzymes are very dangerous to surrounding structures

26

pancreatic pseudocyst

“sterile abscess” collection of pancreatic enzymes that accumulate in the available space in the abdomen (usually in or near the pancreas)

27

pancreaticoduodenal arteries

help supply blood to the pancreas along with the splenic artery

28

pancreatitis

inflammation of the pancreas; may be acute or chronic

29

portal-splenic confluence

junction of the splenic and main portal vein; posterior border of the body of the pancreas

30

pseudocyst

a space or cavity that contains fluid but has no true endothelial lining membrane

31

serum amylase

pancreatic enzyme that is elevated during pancreatitis

32

superior mesenteric artery

serves as the posterior border to the body of the pancreas

33

superior mesenteric vein

lies posterior to the neck/body of the pancreas and anterior to the uncinate process of the gland

34

tail of the pancreas

tapered end of the pancreas that lies in the left hypochondrium near the hilus of the spleen and upper pole of the left kidney

35

uncinate process

small, curved tip of the pancreatic head that lies posterior to the superior mesenteric vein

36

The pancreas lies in the:

retroperitoneal

37

What part of the pancreas is located right lateral to the SMV?

head

38

What part of the pancreas is located anterior to the IVC?

head

39

Where does the gastroduodenal artery lie?

anterior lateral border of the head

40

Where does the CBD exit the pancreas

posterior lateral border of the head

41

Where is the uncinate process lie?

directly posterior to the SMV

42

Where is the neck of the gallbladder located?

directly anterior to the SMV

43

Where is the body of the pancreas

anterior to the aorta

SMA

left renal vein

splenic vein

44

Where does the splenic vein course?

along the posterior surface

45

What is the name of the main pancreatic duct?

wirsung

46

What is the name of the accessory pancreatic duct?

santorini

47

What is the exocrine function of the pancreas?

digestion enzymes

lipase - fat

amylase - carbs

trypsin - protein

48

What is the endocrine function of the pancreas?

A - glucagon - sugar up

B - insulin - sugar down

D - somatostatin - regulates

49

Acute pancreatitis is hyper or hypo echoic?

Hypoechoic

50

hemorrhagic pancreatitis

complication of acute pancreatitis

rupture of pancreas into pseudocyst

51

phlegmonous pancreatitis

complication of acute pancreatitis

with fat necrosis outside pancreas

52

Where is a pancreatic pseudocyst usually located?

lesser sac

53

When does a pancreatic pseudocyst require intervention?

over 6 weeks

larger than 5 cm

54

Chronic pancreatitis appears

hyperechoic

55

pancreatic cystadenoma

adenoma

multiple cystic masses containing serous or mucinous

56

pancreatic cystadenocarcinoma

malignant tumor from glandular tissue

secretions accumulate into cyst

57

pancreatic adenocarcinoma

arise from ductal epithelial

58

Islet cell tumors

functional or non functional

59

What is the most common islet cell tumor?

insulinoma

60

What is the 2nd most common islet cell tumor?

gastrinoma

61

What is a pancreatic divisum?

Dorsum and ventral anlage fail to fuse

62

What is the exocrine function of the pancreas?

...

63

An annular pancreas is more common in ____________.

Males

64

What vessel runs superior margin of the pancreas?

Splenic artery

65

Why are pancreas measurements not taken regularly?

contour and echogenicity are more important to determining pathology than measurement because size can vary due to body habitus and age

66

When is the main pancreatic duct considered abnormal?

when body measures greater than 2mm

non parallel walls

bulging walls