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165 Cards in this Set
- Front
- Back
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Where is the pancreas located?
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the retroperitoneal. Mid epigastrum.
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where does the head of the pancreas lie?
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it is the most inferior portion of the gland. lies anterior to the ivc, to the right of the portalsplenic confluence, inferior to the caudate, lies in the lap of the c loop of the duodenum.
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what is the uncinate process?
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the small curved tip at the end of the head of the pancreas.
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where is the neck of the pancreas located?
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directly anterior to the portal-splenic confluence or the smv. between the pancreas head and body.
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where is the body of the pancreas located?
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anterior to the aorta and celiac axis the splenic artery is the superior border. it is the largest part of the pancreas.
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where does the tail of the pancreas lie?
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anterior to the left kidney and posterior to the left colic flexure and transverse colon. Difficult to image.
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what are the size dimensions of the pancreas?
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3cm (L) x 2cm (H) x 2cm (W)
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what is the main duct of the pancreas?
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the duct of Wirsung
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what is the accessory duct in the pancreas?
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the duct of Santorini
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what are the measurements of the duct of Wirsung in the body and head?
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equal to or less than 2mm in the body an equal to or less thn 3mm in the head.
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what is the blood supply for the pancreas?
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the splenic and gastroduodenal arteries.
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what is the vascular supply that is the superior border of the pancreas?
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the splenic artery.
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what border is the common hepatic artery?
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forms the right superior border of the body and head of the gland and gives rise the gastroduodenal artery.
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what vessel is seen on the superior anterolateral border of the pancreas?
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the gda
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what is the course of the sma in relation to the pancreas?
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rises posterior to the lower portion of the pancreatic boy and courses anterior to the third portion of the duodenum.
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where is the main portal vein formed?
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posterior to the neck of the pancreas by the junction of the of the smv and splenic vein.
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which vessel courses posterior to the first portion of the duodenum and joins the pancreatic duct close to the ampulla of Vater?
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the common bile duct.
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Pancreatic agenesis is defined as?
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when the pancreas is missing the body, and tail wit hypertrophy of the head.
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what is the rare condition that is the lak of fusion of the dorsal and ventral pancreatic buds?
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Pancreas Divisum
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What is the most common pancreatic anomaly?
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ectopic pancreas
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a rare anomaly in which the pancreas surrounds the duodenum. More common in male.
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annular pancreas
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what are the labs associated with the pancreas?
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amylase, lipase
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what is an abnormal range for amylase?
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twice normal is considered abnormal.
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what kind of gland is the pancreas?
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endocrine (hormonal) and exocrine (digestive)
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which cells perform the exocrine function?
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the acini cells
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which cells perform the endocrine function?
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islet of Langerhans
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the islet of Langerhans secrete which hormones?
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insulin, glucagon, somatostatin
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the alpha cells secrete which hormone?
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glucagon
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the beta cells secrete which hormone?
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insulin
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the delta cells secrete which hormone?
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somatostatin
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Insulin is responsible for which action?
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turning glucose too glycogen
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Glucagon is responsible for which action?
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turning glycogen to glucose.
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Somatostatin is responsible for which action?
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inhibits the actions of both insulin and glucagon
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Lipase is associated with the breakdown of?
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fats
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Amylase is responsible for the breakdown of?
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carbohydrates
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what is the normal texture of the pancreas?
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has a homogeneous soft echo pattern in relation to the liver. the echo pattern is slightly more hyper echoic and finer in texture than that of the surrounding retroperitoneum.
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Inflammation of the pancreas is known as?
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pancreatitis
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inflamed acini releasing pancreatic enzymes into surrounding pancreatic tissue is known as?
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acute pancreatitis
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the most common cause of pancreatitis in the US?
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biliary tract disease
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the second most common cause of pancreatitis in the US?
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alcohol abuse
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Acute pancreatitis results in a leakage of secretions into the perpacreatic tissues, where does the fluid migrate to?
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the surface of the gland where it can break through to the lesser sac.
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what is the sequella of pancreatitis?
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acute, pseudocyst, hemorrhagic, phlegmon, abscess
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what are the sonographic findings of acute pancreatitis?
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normal size to enlarged, hypo echoic, irregular but distinct borders, depression of IVC, gallstones, enlarged duct, fluid collections
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what are some clinical signs of acute pancreatitis?
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pain radiating to the back, nausea, vomitng, stones, increased amylase initially then lipase too, increased leukocytosis
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what is the number one cause of pancreatitiis in children?
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trauma
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where is the most common site for fluid collections?
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lesser sac, pararenal spaces, perirenal spaces & mesocolon
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the most common complication of pancreatitis?
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pseudocyst(10-20%)
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A pseudocyst is defined as?
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a collection of fluid that arises from the loculation of inflammatory processes, necrosis or hemorrhage. Usu 4-6 weeks after pancreatitis. Does not have a true wall
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A pseudocyst is normally located?
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in the lesser sac between the pancreas and stomach and are always acquired!
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sonographically pseudocysts appear?
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sonolucent mass with echo free interiors. calcifications may develop within the walls.
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what causes pancreatic ascites?
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when the pseudocyst ruptures
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Hemorrhagic pancreatitis is defined as?
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acute pancreatitis with rupture of the pancreatic vesses. there is diffuse enzyme destructtion causing necrosis
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phlegmon is defined as?
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an inflammatory process that spreads along fascial pathways causing edema of soft tissue that may proceed to necrosis and suppuration.
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what is the sonographic appearance of a phlegmon?
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hypo echoic with good through transmission, has a fluffy appearance.
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Has a high mortality rate, rare, a complication of pancreatitis,
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pancreatic abscess.
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what are the causes of chronic pancreatitis?
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biliary obstruction, alcoholism & patients with hypercalcemia and hyperlipidemia are predisposed to chronic pancreatitis.
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what is chronic pancreatitis a result from??
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recurrent attacks of acute pancreatitis.
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what are the sonographic findings for chronic pancreatitis?
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appears as a mixed pattern. Increased echogenicity with hyper echoic foci from calcificationss. Over size is reduced and borders are irregular.
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at what size does a pseudocyst need to be decompression?
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5cm
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Autosomal dominant polycystic disease
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extrarenal cysts commonly found in the liver but can be in the pancreas. cysts vary from microscopic to several centimers.
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what is Von Hippel-Lindau Syndrome?
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An autosomal dominant condition characterized by central nervous system ad retinal hemangioblastomas. Pancreatic cysts are found in 75% of cases at autopsy.
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Congenital cystic lsions of the pancreas are a result from??
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anaamalous development of the pancreatic ducts. they are usually multiple in number. solitary cysts are rare.
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Cystic Fibrosis affects the pancreas in what manner?
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CF is a hereditary disease that causes excessive production of thick mucus by the endocrine glands. Fatty replacement is a common occurrence. cysts are usually microscopic.
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What is fibrocystic disease?
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a hereditary disorder of the exocrine gland seen in children and young adults. the acini ducts are dilated and replaced by fibrous tissue.
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True cysts of the pancreas
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congenital or acquired.
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what are congenital cysts of the pancreas a result from?
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anomalous development of the pancreatic duct and may be single, but are usually multiple w/o septation.
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where do true cysts of the pancreas arise from?
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within the gland, more commonly in the head,then body, then tail. they have a lining and are assoc with the pancreatic area.
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Lymphoepitheilia cysts
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rare, in elderly males, 1-17cm in size, squamous lining, contain keratinous material
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what is the most common primary neoplasm of the pancreas?
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adenocarcinoma
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which portion does an adenocarcinoma affect?
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the exocrine function of the gland and accounts for 90% of all malignant neoplasms of the pancreas. Fatal!
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where are most tumors located in the pancreas?
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the head
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what are the sonographic findings of adenocarcinoma?
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poorly defined mass. usually hypoechoic or isoechoic, irregular gland borders and enlargement of gland
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what other areas should the sonographer check when adenocarcinoma is suspected?
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metastatic spread into liver, para-aortic nodes of sma,
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what are the two types of cystic pancreatic neoplasms?
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microcystic (serous) and
macrocystic (mucinous) |
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microcysttic adenoma is more commonly found in males or females? benign or malignant?
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elderly females and benign. Rare. usually a large mass with multiple tiny cysts.
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macro cystic adenocarcinoma or adenoma
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malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
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what are the four types of macrocystic neoplasms?
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hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
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macro cystic adenocarcinoma or adenoma
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malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
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what is intraductal papillary mutinous tumor (IPMT)?
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a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
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what are the four types of macrocystic neoplasms?
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hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
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what is the most common functioning islet cell tumor?
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Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
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what is intraductal papillary mutinous tumor (IPMT)?
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a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
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what is the second most common functioning islet cell tumor?
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gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
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what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
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what are some rare islet cell tumors?
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glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and gluagonomas.
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macro cystic adenocarcinoma or adenoma
|
malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
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where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
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|
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what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
what are the four types of macrocystic neoplasms?
|
hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
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|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
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|
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what is intraductal papillary mutinous tumor (IPMT)?
|
a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
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|
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what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and gluagonomas.
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|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
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where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
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What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
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|
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Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
macro cystic adenocarcinoma or adenoma
|
malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and glucagonomas.
|
|
|
what are the four types of macrocystic neoplasms?
|
hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
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|
|
what is intraductal papillary mutinous tumor (IPMT)?
|
a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
|
|
|
where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
|
|
|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
|
|
|
what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and glucagonomas.
|
|
|
where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
|
|
|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
|
|
|
macro cystic adenocarcinoma or adenoma
|
malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
|
|
|
macro cystic adenocarcinoma or adenoma
|
malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
|
|
|
macro cystic adenocarcinoma or adenoma
|
malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
|
|
|
macro cystic adenocarcinoma or adenoma
|
malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
|
|
|
what are the four types of macrocystic neoplasms?
|
hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
|
|
|
what are the four types of macrocystic neoplasms?
|
hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
|
|
|
what are the four types of macrocystic neoplasms?
|
hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
|
|
|
what are the four types of macrocystic neoplasms?
|
hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
|
|
|
what is intraductal papillary mutinous tumor (IPMT)?
|
a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
|
|
|
what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
|
|
|
what is intraductal papillary mutinous tumor (IPMT)?
|
a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
|
|
|
what is intraductal papillary mutinous tumor (IPMT)?
|
a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
|
|
|
what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
what is intraductal papillary mutinous tumor (IPMT)?
|
a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
|
|
|
what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
|
|
|
what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and glucagonomas.
|
|
|
what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
|
|
|
what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
|
|
|
where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
|
|
|
what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and glucagonomas.
|
|
|
what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
|
|
|
what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and glucagonomas.
|
|
|
what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and glucagonomas.
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
|
|
|
where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
|
|
|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
|
|
|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
|
|
|
macro cystic adenocarcinoma or adenoma
|
malignant or benign. usually in middle aged females. slow growing, uncommon. arises from the ducts, usually in the tail with calcifications.
|
|
|
what are the four types of macrocystic neoplasms?
|
hypechoic cysts, echogenic cysts containing debris, cysts with solid mural vegetations, solid looking cysts
|
|
|
what is intraductal papillary mutinous tumor (IPMT)?
|
a type of mucinous tumor that originates from the main pancreatic duct. can be benign or malignant. best seen with ERCP. vascular nodules differentiate malignant or benign.
|
|
|
what is the most common functioning islet cell tumor?
|
Insulinoma (b-cell tumor). usually small, well encapsulate and hyper vascular. some contain calcifications.
|
|
|
what is the second most common functioning islet cell tumor?
|
gastrinoma (g-cell tumor). associated with Zollinger-Ellison syndrome. Excessive amounts of gastrin being secreted leading to peptic ulceration. Usually in the pancreas, but can be in the duodenum.
|
|
|
what are some rare islet cell tumors?
|
glucagonoma, lipoma somatostatinoma,carcinoid, and multi hormonal tumors. Highest malignancy with Vipomas (Gallbladder) and glucagonomas.
|
|
|
where do nonfunctioning islet cell tumors normally present?
|
the head of the pancreas with a high incidence of malignancy.
|
|
|
Is metastasis to the pancreas common?
|
no it is uncommon, but does occur in 10% of patients with cancer.
|
|
|
Metastasis to the pancreas from primary tumors usually occurs from?
|
melanomas, breast, gastrointestinal, lung
|
|
|
What are lymphomas?
|
a malignant tumor that arises from the lymphoid tissue. they are the most frequent parapancreatic neoplasm.
|
