Pancreas Test

How long does the pancreas measure

12-15 cm long

what are the four areas of the pancreas

head, neck, body, and tail

what is the location of the pancreas

Non-encapsulated, Retroperitoneal Organ, Anterior pararenal space, Epigastric region, Lies Horizontal-oblique plane, Between C-loop of duodenum (2nd portion) and splenic hilum

what are the structures anterior to the pancreas

Stomach, portion of duodenum, transverse colon, GDA

what are the structures posterior to the pancreas

Common bile duct, Portal-splenic confluence (union of splenic vein and SMV), Aorta, IVC, Splenic vein, SMA & SMV (except for uncinate process)

where is the pancreas head located

Anterior to the inferior vena cava (IVC) and left renal vein, Most inferior portion of the gland, Inferior to the caudate lobe of the liver and the main portal vein

what does the pancreas head measure

2-3 cm AP

where does the common bile duct pass through the pancreas

passes through a groove posterior to the pancreatic head, and the GDA gastroduodenal artery passes through the anterior aspect of the head.

where is the uncinate process located

Medial, posterior extension of the head. It lies anterior to the IVC and posterior to SMV.

what is the uncinate process

Curved tip at the end of the pancreatic head.

where is the pancreas neck found

directly anterior to the portal-splenic confluence or superior mesenteric vein.

where is the portal vein formed

posterior to the neck by the junction of the superior mesenteric vein and splenic vein

what does the pancreas neck measure

1.5-2.5 cm AP

what is the largest and most anterior section

body of the pancreas

where does the body of the pancreas lie

anterior to the Aorta and Superior Mesenteric Artery

The tortuous splenic artery is usually the ___ of the pancreatic body

superior border

The splenic vein courses the ___ surface of the pancreas

posterior

what does the pancreas body measure

2-2.5 cm AP

where does the tail of the pancreas lie

Anterior to the left kidney, Posterior to left colic flexure & transverse colon

Splenic artery forms the ____ of the tail of pancreas

superior border

Splenic vein forms the ____ of the pancreas tail

posterior border

Stomach forms the ____ of the tail of the pancreas

anterior border

what does the tail of the pancreas measure

1-2 cm AP

what is the primary duct extending the entire length of the gland.

wirsung’s duct

what does the wirsung’s duct do

It receives tributaries from lobules at right angles and enters the duodenum with the common bile duct at major papilla--Ampulla of Vater (guarded by the sphincter of Oddi).

what is the sonographic appearance of wirsung’s duct

visualized coursing through the midline of the pancreas. It should measure < 2 mm

what is the accessory duct in the upper portion of the pancreatic head

santorini’s duct

what enters the duodenum at the minor papilla approximately 2 cm proximal to ampulla of Vater.

santorini’s duct

where is Blood supply to the head of the pancreas is supplied from

the GDA

The splenic artery and several smaller branches as well as the SMA supply blood to the

body and tail

what is venous drainage is through

tributaries of the splenic (SV) and superior mesenteric veins (SMV)

What are the superior border vascular and ductal landmarks

celiac axis (left gastric, common hepatic, splenic), GDA, and splenic artery

___ is a branch of the common hepatic artery and can be entering the anterior portion of the pancreatic head

GDA

Splenic artery is seen running along the ___ portion of the pancreas

superior

what is on the posterior border of the vascular and ductal landmarks

SMA, portal vein, and CBD

where can the SMA be seen

can be seen posterior to the pancreatic body

what is formed by the confluence SMV and splenic vein

portal vein

where is the CBD seen

Seen at the posterior portion of the pancreatic head

Where is the endocrine portion of the pancreas located

islets of langerhans

What is the primary function of the exocrine process

digestion

Acini cells are connected to what function

exocrine

Approxixmately how much pancreatic juice is produced per day

2L

What does sodium bicarbonate do in pancreatic juice

neutralize gastric acid

What enzyme breaks down fats

lipase

which enzyme breaks down proteins

trypsin

Which enzyme breaks down carbohydrates

amylase

which enzyme breaks down nucleic acids

nucleases

what are two main components of pancreatic juice mentioned on the slide

digestive enzymes and sodium bicarbonate

Is the endocrine portion of the pancreas ductal or non ductal

non ductal

where does the endocrine portion of the pancreas release hormones

directly into the bloodstream

which three types of cells are found in the islets of langerhans

alpha, beta, delta cells

which cells produce glucagon

alpha cells

what is the primary function of glucagon

converts glycogen to glucose to increase sugar levels

what cells produce insulin

beta

what is the primary effect of insulin in blood sugar

converts glucose to glycogen to decrease sugar levels

which cells inhibit the production of glucagon and insulin

delta

What happens when there is failure to produce adequate hormones

diabetes mellitus

what two main enzymes are affected with pancreatic disease

amylase and lipase

what does 2x normal level of amylase indicate

acute pancreatitis