Pancreas Anatomy, Pathology, and Ultrasound Landmarks for Medical Students
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72 Terms
What are the four parts of the pancreas?
Head, neck, body, and tail.
What is the basic layout of the pancreas?
Head -> Neck -> Body -> Tail.
What wraps around the head of the pancreas?
The duodenum.
What does the tail of the pancreas point toward?
The spleen.
What organ sits in front of most of the pancreas?
The stomach.
What two major vessels sit behind the pancreas?
The aorta and IVC.
What part of the pancreas sits inside the C-loop of the duodenum?
The head.
What is the main landmark for the pancreatic head?
The duodenum.
What artery is a landmark for the pancreatic head?
The gastroduodenal artery (GDA).
What duct runs behind the pancreatic head?
The common bile duct (CBD).
What vein sits behind the pancreatic head?
The inferior vena cava (IVC).
What part of the pancreas connects the head and body?
The neck.
What vein sits behind the neck of the pancreas?
The superior mesenteric vein (SMV).
Where is the portal vein formed?
Behind the neck of the pancreas.
What two veins form the portal vein?
The splenic vein and SMV.
What organ sits in front of the pancreatic body?
The stomach.
What artery runs along the top of the pancreatic body?
The splenic artery.
What vein runs behind the pancreatic body?
The splenic vein.
What large artery lies behind the body?
The aorta.
What organ does the pancreatic tail point toward?
The spleen.
What organ sits behind the pancreatic tail?
The left kidney.
What artery runs above the pancreatic tail?
The splenic artery.
What vein runs behind the pancreatic tail?
The splenic vein.
What is the main pancreatic duct called?
Duct of Wirsung.
Where does the duct of Wirsung run?
Through the entire pancreas from tail to head.
What duct joins the pancreatic duct?
The common bile duct.
Where do the pancreatic duct and common bile duct join?
The ampulla of Vater.
Where do the pancreatic duct and bile duct empty?
The duodenum.
What is the accessory pancreatic duct called?
Duct of Santorini.
What part of the pancreas does the duct of Santorini drain?
The upper anterior pancreatic head.
What is pancreas divisum?
A failure of the pancreatic ducts to fuse.
In pancreas divisum, where does the dorsal pancreas drain?
The minor papilla.
In pancreas divisum, where does the ventral pancreas drain?
The major papilla.
What is the normal pancreatic head measurement?
Less than 3 cm.
What is the normal pancreatic neck measurement?
Less than 2.5 cm.
What is the normal pancreatic body measurement?
Less than 2.5 cm.
What is the normal pancreatic tail measurement?
Less than 2.0 cm.
What is the normal pancreatic duct measurement?
Less than 3 mm at the head.
What is the most common cause of acute pancreatitis?
Gallstones.
What enzyme levels are elevated in acute pancreatitis?
Amylase and lipase.
What symptoms are common in acute pancreatitis?
Severe abdominal pain, nausea, and vomiting.
What does acute pancreatitis look like on ultrasound?
Enlarged hypoechoic pancreas.
What does hypoechoic mean?
Darker than normal on ultrasound.
What is hemorrhagic pancreatitis?
Severe pancreatitis with bleeding from damaged vessels.
What symptoms occur with hemorrhagic pancreatitis?
Pain, hypotension, shock, and decreased hematocrit.
What does hemorrhagic pancreatitis look like on ultrasound?
Enlarged echogenic pancreas due to blood.
What is chronic pancreatitis usually associated with?
Alcoholism and recurrent acute pancreatitis.
What does chronic pancreatitis look like on ultrasound?
Increased echogenicity and a dilated pancreatic duct.
What causes the pancreas to look brighter in chronic pancreatitis?
Fibrosis and fatty change.
What is a pancreatic pseudocyst?
A fluid collection caused by pancreatitis or trauma.
Are pancreatic pseudocysts congenital or acquired?
Acquired.
How long after pancreatitis does a pseudocyst usually form?
4-6 weeks.
Where is the most common location for a pancreatic pseudocyst?
The lesser sac.
What is the second most common location for a pancreatic pseudocyst?
The anterior pararenal space.
What is the most common pancreatic cancer?
Adenocarcinoma.
What percentage of malignant pancreatic tumors are adenocarcinomas?
More than 90%.
What symptoms are common with pancreatic adenocarcinoma?
Weight loss, pain, jaundice, and vomiting.
What does pancreatic adenocarcinoma look like on ultrasound?
A hypoechoic mass.
Why do tumors in the pancreatic head often cause jaundice?
They obstruct the common bile duct.
What is the most common functioning islet-cell tumor?
Insulinoma.
What symptoms occur with insulinoma?
Hypoglycemia, confusion, sweating, headache, and palpitations.
Are most insulinomas benign or malignant?
Benign.
What is the second most common functioning islet-cell tumor?
Gastrinoma.
What syndrome is caused by gastrinoma?
Zollinger-Ellison syndrome.
What symptoms are associated with gastrinoma?
Peptic ulcer disease.
What vessel combination forms the portal vein?
SMV plus splenic vein.
What vessel is the best landmark for the top of the pancreas?
The splenic artery.
What vessel is the best landmark behind the pancreas?
The splenic vein.
What vessel helps identify the pancreatic head?
The gastroduodenal artery (GDA).
What duct helps identify the pancreatic head?
The common bile duct (CBD).
What are the 4 most important organs near the pancreas?
Duodenum, stomach, spleen, and left kidney.
What are the 4 most important vessels near the pancreas?
GDA, splenic artery, splenic vein, and portal vein.