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39 Cards in this Set
- Front
- Back
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location: |
mostly retroperitneal structure epigastrium lt hydochondrium (middle to left) position variable behind duodenum & stomach |
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Relational to anatomy location: |
horizontal across AO level of L1 & L2 inferior of SMA head peaks into periotenum |
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divided into DESCRIPTIVE PARTS: |
head uncinte process neck body tail |
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size: |
L: 12-18 cm W: 3-5 cm Th: 2.5cm A/P: head-3 cm neck 1 cm body 2.2 cm taili 2.8 cm |
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weight: |
60-80 g |
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Four MAIN PARTS: |
head neck body tail |
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Normal anaotmy of head: |
pass within CBD & gastroduodenal artery (two vessels) |
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Normal anatomy of neck: |
portion beween head & body anterior SMV |
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Normal anatomy pancreas body: |
largest portin of structure anterior SMA, AO, Splenic vein before it starts to curve, end of body |
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Normal anatomy pancreas tail: |
extend from body to hilum spleen |
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Normal anatomy of uncinate process: |
Belongs to the head projection posterior SMV & superior IVC SMV forms confluence, comes from feet |
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what are the two main pancreatic ducts? |
Duct of Wirsung Duct of Santorini |
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Normal anatomy of Duct of Wirsung: |
primary duct extending length of pancreatic glan contains ampulla of Vater (meets w/ CBD & connects duodenum |
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Normal anatomy duct of Santorini: |
accessory duct, won't always see enters 2 cm above main duct, empties to small intestine not everyone has one |
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Vasculature of pancreas: |
pancreaticduodenal arteries splenic artery branches pancreatic arcades |
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pancreaticduodenal arteries: |
supply the head of pancreas, duodenum, and common bile duct |
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vasculature of splenic artery branches: |
supplies blood to pancreas body & tail |
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pancreatic arcades vasculature |
pathways/connection of blood supplying hepatic, SMA, splenic arteries supplies head of pancreas |
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Physiology of pancreas: |
exocrine endocrine |
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Exocrine |
digestive contains acini cells contains hormomes |
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acini cells |
sac like clusters produce pancreatic juice, 2L per day |
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pancreatic juice: |
helps digestion (fats, nucleic acids) contains enzymes made of sodium bicarbonate (neutralizes) |
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what are the exocrine enzymes for pancreas? |
amlyase lipase tripin, chymotrypsin, cabyoxypeptidase nucleases sodium bicarbonate |
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what do the following enzymes act on: 1) amylase 2) lipase 3) trypsin (chymorypsin, carboxypeptidase) 4) nucleases 5) sodium bicarbnate |
1) carbs 2) fats 3) proteins 4) nucleic acids 5) hydrochloric acid |
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what are the exocrine hormones? |
CCK gastrin acetylocholine secretin |
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what does cholecystokinin, gastrin, & acetylchoine stimulate? |
acini cells to produce digestive enzymes |
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what does secretin stimulate? |
production of sodium bicarbnate |
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endocrine contains: |
within Islets of Langerhans alpha beta delta gamma epsiolon |
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Gamma cells: |
secrete pancreatic polypeptide less than 5% of endocrine cells |
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Alpha cells: |
produce glucagon cells release glucose to meed energy needs of body stimulates liver to convert glycogen to glucose, increase blood glucose levels comprised of 15-20% hormone: glucagon; action: glycogen --> glucose |
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Beta cells: |
produce insulin hormone causes glycogen form glucose in liver comprised of 60-70% hormone: insulin; action: glucose --> glycogen |
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Delta cells: |
produce somatostatin inulin & glucagon inhibitor comprised 5% hormone: somatostatin; action: alpha/beta inhibitor |
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sonographic appearance pancreas: |
variable echtexture generally heterogenous more hyperechoic than liver & spleen |
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sonographic appearance of pancreatic duct: |
2 relfective lies separated by 2 mm anechoic space |
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Normal variants pancreas: |
annular (circular/surrounds duodenum) ectopic (abnormal tissue outside, no vascular) partial duplication of tail |
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serum lab tests for pancreas: |
amylase lipase glucose (fasting) |
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UA lab tests: |
amylase alkaline phosphatase |
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Vasculature arterial supply to head & neck of pancreas: |
gastroduodenal artery --> pancreaticoduodenal arteries --> pancreatic arcades |
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vasculature arterial supple body & tail of pancreas: |
pancreatic splenic artery --> suprapancreatic splenic artery --> pancreatic splenic artery -> prepancreatic splenic artery --> prehilar splenic artery |
