Pancreas

Chapter 14 curry

Alcini cells

cells that produce pancreatic juice that is composed of enzymes to help digest fats, proteins, carbohydrates, and nucleic acids.

alpha cells

cells that account for 15% to 20% of pancreatic endocrine tissue and produce the hormone glucagon.

ampulla of vater

dilation in the second portion of the duodenum, where the common bile duct and pancreatic duct(s) enter to discharge substances that aid int he digestive process

beta cells

constitute 60% to 70% of the pancreatic endocrine cells that produce insulin

CBD

distal portion of the biliary tract that transports and then discharges bile (that was manufactured in the liver) into the duodenum as needed to aid the digestive process

delta cells

cells that account for approximately 5% of pancreatic endocrine tissue that produces the hormone somatostatin

duct of santorini

pancreatic accessory duct that enter the duodenum approximately 2cm superior to the duct of Wirsung

Duct or Wirsung

main pancreatic duct. transports and discharges pancreatic juice into the duodenum through the ampulla of vater to aid the digestive process

endocrine

produces and secretes hormones directly into the bloodstream with a ductal system

epsilon cells

cells that account for less than 1% of pancreatic endocrine cells and produce the hormone ghrelin, which may affect blood sugar regulation.

exocrine

produces and transports pancreatic juice via ducts to aid in digestion

gamma cells

pancreatic polypeptide (Pp) cells that comprise less than 5%of pancreatic endocrine cells and may affect blood sugar regulation

gastroduodenal artery

first branch of the common hepatic artery. courses along the anterolateral aspect of the pancreas head just right lateral to the pancreas neck, where it divides into anterior and posterior superior pancreaticoduodenal branches. supplies blood to the head of the pancreas and the duodenum

glucagon

hormone produced by alpha cells in the pancreas that causes the release of glucose to meet the immediate energy needs of the body

insulin

hormone produces by beta cells in the pancreas that causes glycogen formation from glucose in the liver

islets of Langerhans

groups of alpha beta, and delta endocrine cells in the pancreas that produce insulin

pancreatic arcades

vascular connections between the pancreaticoduodenal, hepatic, splenic, and superior mesenteric arteries that supply blood to the head of the pancreas

pancreatic body

bordered right laterally by the pancreas nek, left laterally by the pancreas tail, anteriorly by the posterior wall of the stomach, and posteriorly by the splenic vein. considered the largest portion of the pancreas.

pancreatic head

lies right lateral to the superior mesenteric vein; cradled in the C-loop of the duodenum; directly anterior to the IVC

pancreatic juice

composed of enzymes produced by acini cells in the pancreas that help digest fats, proteins, carbohydrates, and nucleic acids.

pancreatic neck

situated between the pancreatic head and body immediately anterior to the superior mesenteric vein. at a slightly higher level, it lies anterior to the portal splenic confluence

pancreatic splenic artery

section of the artery located within the pancreas

pancreatic tail

left lateral to the pancreas body and aorta and extends to the hilum of the spleen. situated between the stomach anteriorly and left kidney posteriorly. the splenic vein runs along its posterosuperior surface. may lie higher, lower, or on an even level with the body

pancreaticoduodenal arteries

arteries that supply the head of the pancreas and part of the duodenum with blood. part of the pancreatic arcades (the vascular connections between the hepatic, splenic and superior mesenteric arteries that also supply blood to the head of the pancreas)

portal splenic confluence

area just posterior to the neck of the pancreas, where the splenic vein meets the superior mesenteric vein. together, these veins for the portal vein

portal vein

formed by the confluence of the splenic vein and superior mesenteric vein just posterior to the neck of the pancreas

pre-hilar splenic artery

section of the artery before it enters the hilum of the spleen

pre-pancreatic splenic artery

supplies the body and tail of the pancreas with blood. from its origin at the celiac axis it runs along the superior edge of the pancreas body and tail parallel to the splenic vein

splenic vein

along with tributaries of the smv, serves as the venous drainage for the pancreas

superior mesenteric vein

along with tributaries of the splenic vein, serves as venous drainage for the pancreas

supra-pancreatic artery

first 3 cm section of the artery as it originates from the celiac axis

uncinate process

posteromedial projection of the pancreas head that lies directly posterior to the superior mesenteric vein and directly anterior to the ivc or in some cases, due to its size, the abdominal aorta

caudal pancreatic artery

rises from the prepancreatic or prehilar section

C-loop of the duodenum

where the head of pancreas lies inferior to the IVC, to the right of portal splenic confluence, inferior to the main portal vein and caudate lobe of the liver, and medial to the duodenum as it “lies in the lap” of the C-loop of the duodenum

courvoisier sign

a palpable, non-tender gallbladder accompanied by jaundice is present in 25% of patients pancreatic carcinoma.

dorsal pancreatic artery

rises from the suprapancreatic section, the pancreatica magna artery rises from the pancreatic section

hypercalcemia

elevated calcium levels; could be due to alcoholism or biliary disease. alcoholic intake causes increased pancreatic protein secretion with subsequent ductal obstruction resulting in chronic calcifying pancreatitis

hyperlipidemia

elevated fat levels;

lipase

enzyme of the pancreatic juice that aids in digestion; digests fats. lipase test is performed to assess damage to the pancreas

pancreatic ascites

occurs when the pancreatic pseudocyst ruptures into he abdomen

pancreatic pseudocyst

collection of fluid that arises from the loculation of inflammatory processes, necrosis, trauma, or hemorrhage. occurring int 5% of patients; spontaneous rupture is the most common complication.

pancreatitis

serum amylase

a level of twice normal usually indicates acute pancreatitis

amylase

enzyme of the pancreatic juice that aids digestion; digests carbohydrates. secreted by the pancreas, parotid glands, gynecologic system, and bowel