Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
31 Cards in this Set
- Front
- Back
|
MEN stands for what?
|
multiple endocrine neoplasias
|
|
|
the pancreas is how many organs?
|
in reality, 2
|
|
|
what % of pancreatic parenchyma is exocrine (w/ lobular units of acini)?
|
85-90%
|
|
|
what are the 4 parts/regions of the pancreas (all distinct & uniform lobulation)?
|
head (including uncinate process), neck, body, & tail
|
|
|
what is the most prominent part of the pancreas?
|
the head
|
|
|
the pancreas is what type of organ?
|
retroperitoneal
|
|
|
most adenoCAs of the pancreas arise where? how does it manifest clinically?
|
at the junction of the bile duct
(jaundice clinically) |
|
|
secretin is produced from the stomach in the presence of what?
|
HCl
|
|
|
secretin is carried by the blood, then stimulates the pancreas to produce what?
|
pancreatic juices
(amylases, lipases) |
|
|
the acinar cells are large, granular, and polarized, nuclei are where? whats apical, whats basal?
|
apical: cytoplasm, eosinophilic, abundant zymogen granules
basal: nuclei, basophilic, abundant RER |
|
|
in the exocrine pancreas, acinar cells drain into where?
|
into the intercalated ducts
|
|
|
what % of pancreas is endocrine component, and what are the 4 major cell types?
|
1-2% islets of Langerhans
1.(60-70%) beta cells -insulin 2. alpha cells- glucagon 3. gamma- somatostatin 4. PP cells- pancreatic polypeptide |
|
|
biopsy specimens are obtained form pancreas how?
|
FNA & brushing cytology
(thru the duct of Wirsung) percutaneously, intraoperatively, or via ERCP endoscopic retrograde cholangiopancreatography |
|
|
what is the Whipple procedure? when is it performed?
|
most difficult, 6-8 hrs
for tumors of the pancreatic HEAD, common bile duct, ampullary or periampullary region...excise portions of all, and duodenum, distal stomach, and gall bladder |
|
|
what is a distal pancreatectomy?
|
basically a splenectomy w/ removal of the pancreas tail
so, pancreatic tail w/ attached spleen & portion of pancreatic body |
|
|
pancreatic secretion of enzymes & zymogens depends on what?
|
intestinal contents
|
|
|
Regulate what pancreatic secretion:
secretin from duodenum--> CCK from duodenum--> neural stim.--> |
water & bicarb from duct cells
discharge of digestive enzs comes from vagal Ns |
|
|
pancreatic fxn:
acid load from stomach, luminal FA--> FA & protein digestives--> enzs include--> trypsin--> |
stim. secretin production
trigger release of CCK trypsin, chymotrypsin, aminopeptidases, elastase, amylases, lipases, & phospholipases activates other enzs |
|
|
give 5 ways the pancreas protects itself from autodigestion?
|
1. enzs elaborated as inactive precursors, these are sequestered in memb-bound granules in acinar cells
2. protease inhibitors w/in acinar & ductal secretions 3. trypsin activates enz to degrade other zymogens 4. lysosomal hydrolases to degrade zymogen granules (as back up) 5. acinar cells resistant to trypsin, chymotrypsin, PlipaseA2 |
|
|
what is Heterotropic pancreas?
|
freq. congenital anomaly, MC in 2nd portion of duodenum (pancreatic rests), stomach & jejunum, Meckel's diverticulum, ileum, biliary tract, gallbladder, colon, spleen, omentum, ABD wall, etc.
(can see every pathologic change in heterotopia) |
|
|
what is annular pancreas?
|
rare, congenital anomaly
gross: pancreatic tissue encircling duodenum micro: PP cells ventral primordium of pancreas fails to rotate properly (can be assoc. w/ Down's) |
|
|
what is pancreatitis (definition)?
|
inflammation of the pancreas w/ acinar cell injury
|
|
|
acute condition
ABD pain elevated pancreatic enzymes in blood & urine necrosis of pancreatic tissue |
acute pancreatitis!
|
|
|
what is the spectrum of acute pancreatitis?
|
mild, self-limited, interstitial/edematous pancreatitis-->severe, hemorrhagic, necrotizing pancreatitis w/ extensive fat necrosis
|
|
|
in acute pancreatitis, fat necrosis can occur...often seen where?
|
in females would be seen in breast, pt. would present w/ breast mass
|
|
|
what is the gross appearance of acute pancreatitis?
|
Gray-white proteolytic destruction of parenchyma
hemorrhage chalky-white fat necrosis, hard nodular micro has PMNs |
|
|
what does the peritoneal fluid look like for acute pancreatitis?
|
turbid, brownish, with fat globules floating in it
|
|
|
80% of acute pancreatitis cases are assoc w/ what 2 things?
|
1. 15% biliary tract dz, female 3:1 pancreatitis w/ stones 60%, 5% w/ stones-->get pancreatitis
2. 65% alcoholism, male 6:1 |
|
|
in alcoholic, repetitive bouts of acute pancreatitis can lead to what?
|
chronic pancreatitis
|
|
|
DDX of acute ABD
|
acute appendicitis
perforated peptic ulcer acute cholecystitis w/ rupture occlusion of mesenteric vessels w/ bowel infarction pancreatitis (post-prandial or after alcoholic binge, no prodrome) |
|
|
the intense pain (referred to upper back) of acute pancreatitis may be assoc. w/ what?
|
peripheral vascular collapse d/t release of bradykinin & PGEs (vasodilators), and endotoxemia w/ complement
|
