PANCREAS PPT

The pancreas is ___-________

non-encapsulated

Location of pancreas?

Retroperitoneal, epigastrium and left hypochondrium

Shape of pancreas?

Comma-shape with largest portion being head of pancreas

Regions of pancreas?

Head, uncinate process, neck, body, tail

Pancreatic head located

inferiorly

The pancreatic head is directly anterior to?

IVC

What two vessels does the pancreatic head contain?

GDA- anterolateral, CBD-posterolateral

Uncinate process

triangular structure that arises from left lateral portion of pancreatic head

The uncinate process is located most

inferiorly

Relationship of uncinate process with IVC?

anterior

Relationship of uncinate process with smv/pc

posterior

Neck of pancreas relationship with SMV/PC

anterior

Is the pancreas neck anterior or posterior to the pylorus of stomach?

Posterior

Pancreas neck in relationship with hepatic artery?

Inferior

Pancreas body relationship to pancreatic head

superior and anterior

pancreas body is anterior to

splenic vein, SMA, aorta

pancreas body is posterior to

left lobe of liver, stomach

Pancreas body is inferior to

splenic artery/ hepatic artery

The pancreas tail is located most

superiorly

Main pancreatic duct?

Duct of Wirsung

Where does the duct of wirsung travel from?

pancreatic tail to head

The duct of wirsung joins

distal CBD at ampulla of vater

Size of duct of wirsung

normal less than or equal to 2mm

What does the Duct of Wirsung do?

Transports pancreatic juice to the duodenum

Duct of santorini is what kind of duct?

Accessory duct

Duct of santorini enters duodenum

approximately 2 cm superior to duct of Wirsung

Ampulla of Vater is

dilatation in the 2nd portion of the duodenum

What empties in the Ampulla of Vater

cbd and pancreatic ducts

What does the ampulla of vater do?

Releases bile and pancreatic juices to help digestion

Sphincter of Oddi

Muscle surrounding the ampulla of Vater

What does sphincter of oddi do?

Controls the flow of pancreatic juice and bile into the duodenum

Vascular Anatomy of Pancreas – What blood vessels supply & drain it?

Pancreaticoduodenal arteries and branches of splenic artery, Splenic vein and superior mesenteric vein

Pancreas exocrine produces

[90%] pancreatic juices that aid in digestion of fats, proteins, and carbohydrates

Pancreas endocrine function

[10%] No ducts, glands produce hormones which are released directly into the bloodstream

Amylase acts on

carbohydrates

Lipase acts on

Fats

Trypsin acts on

proteins

Chymotrypsin acts on

proteins

Carboxypeptidase acts on

Proteins

Nucleases acts on

nucleic acids

Sodium bicarbonate acts on

hydrochloric acid

Beta cells make

Insulin

Alpha cells make

glucagon

Delta cells make

Somatostatin

Gamma cells make

pancreatic polypeptide

epsilon cells make

ghrelin

Beta cells make Insulin through this action

glucose —> glycogen

Alpha cells make Glucagon through this action

glycogen—> glucose

Delta cells make somatostatin through this action

alpha/beta inhibitor

Gamma cells make pancreatic polypeptide through this action

related to blood sugar regulation

Epsilon cells make ghrelin through this action

blood sugar regulation

Lab values: serum

amylase, lipase, glucose (fasting)

Lab values: urine

amylase, alkaline phosphatase

Texture of pancreas

Homogeneous, coarse echoes

Borders of pancreas

smooth, contour curvilinear

Pancreas is usually less _____ in young people

echogenic

younger pancreas=

darker

more fat on pancreas=

brighter

Annular pancreas

Ring of pancreatic tissue that surrounds the 2nd portion (C-loop) of the duodenum

Ectopic pancreas

Pancreatic tissue that has no vascular or structural connection to the pancreas

Where is an ectopic pancreas usually found?

GI tract

Partial duplication of the pancreatic tail

Rare

Associated tests with pancreas

general radiography, ERCP, CT Scans, MRI, Angiography

What organ curves around the pancreas head?

Duodenum

What hormones does the endocrine produce?

insulin, glucagon, and somatostatin