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Terms in this set (80)
The head of the pancreas is __________ to the inferior vena cava.
The pancreatic head is __________ to the portal vein.
The head of the pancreas is __________ to the second portion of the duodenum.
The common bile duct is __________ to the head of the pancreas.
The gastroduodenal artery is __________ to the head of the pancreas.
The superior mesenteric artery and vein are __________ to the neck of the pancreas.
The uncinate process is __________ to the superior mesenteric artery and vein.
The aorta is __________ to the body of the pancreas.
The celiac axis arises from the aorta __________ to the pancreas.
The gastroduodenal artery and common bile duct run __________ to the first portion of the duodenum.
The splenic vein is __________ to the pancreas.
The superior mesenteric artery arises from the aorta __________ to the pancreas.
The superior mesenteric artery and vein are __________ to the uncinate process of the pancreas.
The superior mesenteric artery and vein are __________ to the third portion of the duodenum.
The superior mesenteric vein is to the __________ of the superior mesenteric artery.
The portal vein is the result of the combination of the __________ and the __________.
superior mesenteric vein and splenic vein
What are the two most common causes of pancreatitis?
alcohol abuse and biliary calculi
What is the sonographic appearance of acute pancreatitis?
decreased echogenicity and increased gland size
What are the sonographic signs of chronic pancreatitis? (4)
Small echogenic gland
Pancreatic duct dilatation
Pancreatic adenocarcinoma is sonographically seen as a solid focal hypoechoic mass typically (70%) in the head of the pancreas. What additional findings are associated with pancreatic adenocarcinoma? (6)
Dilated biliary system
Dilated pancreatic duct
What sign is associated with an adenocarcinoma of the pancreatic head resulting in extrinsic compression of the common bile duct and an enlarged gallbladder?
Courvoisier's sign is a palpable, nontender gallbladder due to an adenocarcinoma of the pancreatic head obstructing the biliary tract resulting in jaundice.
The pancreas is a nonencapsulated, retroperitoneal structure located between the second portion of the duodenum and the splenic hilum. What space in the retroperitoneum is the pancreas located?
anterior pararenal space
Name 5 different parts of the pancreas.
Head, neck, body, tail, uncinate process
What is the endocrine function of the pancreas?
Islet cells of Langerhans which secretes insulin
What are the branches of the celiac axis?
Left gastric, common hepatic, splenic arteries
What are the branches of the common hepatic artery?
hepatic proper and the gastroduodenal arteries
What two veins join to form the main portal vein?
Superior mesenteric vein and splenic vein
What are Islet Cell Tumors?
Small, well circumscribed masses, found within the pancreatic body and tail
Are Islet Cell Tumors benign or malignant?
They are the most common benign tumors of the pancreas but they can also be malignant.
Name the two most common Islet Cell Tumors, and describe the symptoms related to each.
Insulinoma: hyperinsulinism and hypoglycemia
Gastrinomas: gastric hypersecretions and peptic ulcer disease (Zollinger-Ellison Syndrome)
Name six tumors associated with Multiple Endocrine Neoplasia syndrome.
Medullary thyroid carcinoma
Pancreatic islet cell tumors
What are pancreatic pseudocysts?
Collections of pancreatic fluid encapsulated by fibrous tissue
What are some causes of pancreatic pseudocysts? (4)
What is the most common location of a pancreatic pseudocysts?
Within the anterior pararenal space of the retroperitoneum and the lesser sac of the peritoneum
Name three exocrine functions of the pancreas
production of lipase
production of amylase
production of sodium bicarbonate
What is an additional name for the accessory duct of the pancreas?
Duct of Santorini
Which of the following is associated with development of cysts within the pancreas?
Von Hippel-Lindau disease
The most common form of malignancy of the pancreas is
The most common location of adenocarcinoma of the pancreas is within the
head of the pancreas
The most common location of focal pancreatitis is within the
neck of the pancreas
Name 3 clinical features of acute pancreatitis
leukocytosis, back pain, fever
Which laboratory value is more specific for acute pancreatitis?
What is the most common islet cell tumor?
The muscle that controls the emptying of the bile and pancreatic juices into the duodenum is the
Sphincter of Oddi
What is the name for the main pancreatic duct?
Duct of Wirsung
Name 3 clinical findings associated with pancreatic adenocarcinoma
Epigastric pain, weight loss, jaundice
The portion of bowel that encompasses the head of the pancreas is the
Which cells carry out the exocrine function of the pancreas?
The most common echogenicity of an acutely inflamed pancreas is
The arterial blood supply to the head of the pancreas is via the
One clinical sign of an insulinoma is the presence of
low blood sugar symptoms
Mucinous cystadenocarcinomas of the pancreas are most often located within which parts of the pancreas?
Body and tail
Co-existing obstruction of the common bile duct and pancreatic duct may be referred to as the:
double duct sign
Which part of the pancreas is located right lateral to superior mesenteric vein, anterior to inferior vena cava, and inferior to portal vein?
The pancreatic tail is outlined posteriorly by what vascular structure?
Which part of the pancreas is located anterior to portal confluence?
Which hormone is released by the pancreas that encourages the body's use of glucagon?
True pancreatic cysts are uncommon. Multiple pancreatic cysts are associated with what two syndromes?
Autosomal dominant (adult) polycystic kidney disease and Von Hippel-Lindau syndrome
Cystic fibrosis is characterized by viscous secretions leading to pancreatic insufficiency. When severely affected, what is the sonographic appearance of the pancreas in a patient with cystic fibrosis?
Name four sonographic indications of portal vein thrombosis
Increase in portal vein diameter
Portosystemic collateral circulation
A patient presents with hypoglycemia and a hypoechoic mass in the tail of the pancreas. What is the mass in the pancreas?
Islet cell tumor (insulinoma)
Seen in body or tail
Causes hypersecretions of insulin which causes hypoglycemia
Name two cystic masses associated with the pancreas in patients without a history of autosomal dominant (adult) polycystic kidney disease.
Pseudocysts and Cystadenomas
What lab value is increased with the presence of pseudocyst(s)?
Increased levels of serum amylase
Name 4 characteristics of cystadenomas.
Rare fluid collections
Arise from epithelium of the pancreatc duct
Primarily cystic with septations and thick walls
Increased levels of serum amylase
What two vessels form the main portal vein?
Splenic vein and superior mesenteric vein join at the confluence adjacent to the head of the pancreas
Exocrine Function of the pancreas produces:
amylase, lipase, carboxypeptidase, trypsin, and chymotrypsin
Name two structures posterior to the inferior vena cava.
Right renal artery, right adrenal gland
Name two structures posterior to the first portion of the duodenum.
Common bile duct and gastroduodenal artery
The third portion of the duodenum passes between the _____ and the ______.
superior mesenteric artery, aorta
Name the structure posterior to the head of the pancreas.
inferior vena cava
Which is the landmark for the anterior-lateral aspect of the pancreas?
Enlargement of the pancreatic head may cause:
Which vessel courses adjacent to the posterior and inferior surface of the pancreatic body?
The normal AP measurement of the duct of Wirsung at the level of the body is:
less than or equal to 2mm
In cases of acute pancreatitis, which lab value rises significantly in the early phase and decreases within a few days?
A 60-year-old patient presents with painless jaundice and weight loss. The pancreatic head measures 4cm with an enlarged pancreatic duct. This is most likely:
Stomach is _____ and _____ to the splenic hilum.
Tail of the pancreas is ______ to the stomach.
Tail of the pancreas is ______ to the upper pole of the left kidney.
Splenic artery is ______ and _______ to the pancreas.
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