Pancreas - Anatomy, Function, Pathology and Imaging Flashcards

Question-and-answer style flashcards covering pancreas anatomy, function, pathologies, imaging, and common clinical concepts from the lecture notes.

Where are the major posterior vascular landmarks of the pancreas?

Aorta and inferior vena cava.

Which organs form the superior and lateral borders of the pancreas?

Stomach, duodenum, and transverse colon.

How is the pancreas anatomically divided?

Head and uncinate process; neck; body; tail.

What forms the posterior border of the pancreas?

The portal venous system (the splenic vein forms the posterior medial border).

What are the two pancreatic ducts and their drainage paths?

Duct of Wirsung (main pancreatic duct) drains into the second part of the duodenum at the ampulla of Vater; Duct of Santorini (accessory duct) drains the upper anterior head.

What are the normal size criteria for the head, neck, body, and tail of the pancreas?

Head < 3 cm; neck < 2.5 cm; body < 2.5 cm; tail < 2.0 cm.

How does pancreatic echogenicity compare to the liver and spleen?

Typically echogenicity is greater than the liver; comparison to the spleen depends on fat/fibrous content.

Which arteries supply the head/duodenum and which supply the body/tail of the pancreas?

Anterior and inferior pancreaticoduodenal arteries supply the head; splenic artery supplies the body and tail.

Which part of the pancreas is the largest?

The body.

What borders the body anteriorly?

The posterior wall of the stomach (antrum).

Where is the neck of the pancreas in relation to the SMV and portal confluence?

The neck lies anterior to the portal-splenic confluence (superior mesenteric vein).

How is the portal vein formed?

Posterior to the neck by the junction of the superior mesenteric vein and the splenic vein.

Where is the uncinate process located and what are its relations?

A small curved extension at the end of the head; lies anterior to the IVC and posterior to the SMV.

What forms the superior border of the pancreatic body?

The tortuous splenic artery.

Describe the tail of the pancreas and its relationships.

Begins to the left of the aorta and extends toward the splenic hilum; the splenic vein forms the posterior border and the splenic artery the superior border; stomach lies anterior to the tail.

Name common congenital anomalies of the pancreas.

Agenesis; pancreas divisum; ectopic pancreatic tissue; annular pancreas.

What is pancreas divisum?

Failure of the dorsal and ventral pancreatic buds to fuse.

What is annular pancreas and its potential consequence?

Ventral pancreatic bud encircles the duodenum, which can cause duodenal obstruction.

What is the fundamental difference between endocrine and exocrine pancreas?

Endocrine pancreas secretes hormones into the bloodstream; exocrine pancreas secretes digestive enzymes into ducts.

Which cells produce insulin, glucagon, and somatostatin?

Insulin—beta cells; glucagon—alpha cells; somatostatin—delta cells.

What is MEN1 and its triad?

Multiple endocrine neoplasia type 1; triad of parathyroid, pituitary, and pancreatic lesions.

What is the most common functioning islet cell tumor?

Insulinoma.

What syndrome is associated with gastrin-secreting pancreatic tumors?

Zollinger-Ellison syndrome.

What are the two main cystic neoplasms of the pancreas?

Microcystic serous cystadenoma and macrocystic mucinous cystadenoma/cystadenocarcinoma.

What is the prognosis for pancreatic adenocarcinoma?

Poor; median survival 2–3 months; about 8% 1-year survival.

Where do pseudocysts most commonly occur anatomically?

Less­er sac anterior to the pancreas and posterior to the stomach (second most common in the anterior pararenal space).

What is a pancreatic pseudocyst and when does it typically develop?

A sterile fluid collection from inflammatory/necrotic processes; develops 4–6 weeks after pancreatitis; not a true cyst and may contour to surrounding spaces.

List common complications of pancreatitis.

Pseudocyst, hemorrhage, necrosis, abscess, venous thrombosis, pseudoaneurysm.

What are the chronic pancreatitis sonographic findings?

Small gland, hyperechoic texture, calcifications, and possible ductal dilation.

What are the major pancreatic ducts and their drainage sites?

Duct of Wirsung (main duct) drains into the second part of the duodenum at the ampulla of Vater; Duct of Santorini (accessory) drains the upper head.

What are the indications for ultrasound evaluation of the pancreas?

Abdominal pain; acute or chronic pancreatitis; abnormal labs; cholecystitis; obstructive jaundice.