Pancreas Ch 12 study guide
The splenic artery is considered to be along the _________________ border of the pancreas. a. superior b. lateral c. posterior d. inferior
A The splenic artery follows a tortuous course along the superior border of the pancreas
A condition that causes increased secretion of thick mucus by the exocrine glands is: a. cystic fibrosis. b. fibrocystic disease of the pancreas. c. diabetes. d. cystic mucosal disease
A Cystic fibrosis is a hereditary disease that causes excessive production of thick mucus by the endocrine glands
An older man with a history of alcoholism is recently diagnosed with acute pancreatitis. His hematocrit and hypotension levels are decreased. Your differential diagnosis should include: a. hemorrhagic pancreatitis. b. cholecystitis. c. pseudocyst. d. chronic pancreatitis.
A Hemorrhagic pancreatitis may demonstrate symptoms that include a decrease in hematocrit and serum calcium levels, severe (intense) abdominal pain radiating to the back, and hypotension. Nearly one half of these patients have sudden necrotizing destruction of the pancreas after an alcohol binge or an excessively large meal.
The ___________ passes through a groove posterior to the pancreatic head. a. common bile duct b. gastroduodenal artery c. hepatic duct d. superior mesenteric vein
A The common bile duct passes through the first part of the duodenum and courses through the groove posterior to the pancreatic head.
The main pancreatic duct joins the __________ before entering the second part of the duodenum. a. common bile duct b. duct of Santolina c. cystic duct d. accessory duct
A The duct of Wirsung enters the medial aspect of the second part of the duodenum with the common bile duct at the ampulla of Vater
A patient with painless jaundice, weight loss, and a decrease in appetite should be evaluated for: a. cholecystitis. b. adenocarcinoma of the pancreas. c. pancreatitis. d. pancreatic pseudocyst
B Clinical findings of adenocarcinoma of the pancreas include weight loss, decreased appetite, nausea and vomiting, stool changes, pain radiating to the back, painless jaundice, and metastases
A serum ____________ level of twice normal usually indicates acute pancreatitis. a. lipase b. amylase c. alkaline phosphatase d. aspartate aminotransferase (AST)
B A serum amylase level of twice normal usually indicates acute pancreatitis. Lipase levels also increase with acute pancreatitis
Clinical signs and symptoms in acute pancreatitis include all of the following except: a. severe abdominal pain radiating to the back. b. severe abdominal pain radiating to the right shoulder. c. elevated amylase. d. nausea and vomiting
B Clinical signs and symptoms of acute pancreatitis include sudden onset of moderate-to-severe abdominal pain radiating to the back, nausea and vomiting, history of gallstones or alcoholism, mild fever, increase in pancreatic enzymes (amylase and lipase), leukocytes, and abdominal bloating
17. What are the microscopic collections of cells within the tissues of the pancreas called: a. Glucagon cells b. Islets of Langerhans c. Insulin d. Amylase cells
B Islets of Langerhans are specialized cells that produce insulin (alpha cells), glycogen (beta cells), and somatostatin (smallest delta cells)
The normal size of the pancreatic duct at the pancreatic head is less than _____ mm. a. 1 b. 3 c. 5 d. 6
B The duct should measure less than 2 to 3 mm with tapering as it reaches the tail
Which one of the following structures is located in the anterolateral border of the pancreas? a. Common bile duct b. Gastroduodenal artery c. Hepatic duct d. Superior mesenteric vein
B The gastroduodenal artery is located along the anterolateral border of the pancreas as it travels a short distance along the anterior aspect of the pancreatic head just to the right of the neck before it divides into the superior pancreaticoduodenal artery branches.
The head of the pancreas is inferior to the _____________ of the liver. a. right lobe b. caudate lobe c. right lateral fissure d. left lateral fissure
B The head of the pancreas is inferior to the caudate lobe of the liver and the main portal vein.
The normal dimension of the pancreatic head is usually less than ___________. a. 3 mm b. 2-3 cm ' c. 2 cm d. 1 cm
B The head of the pancreas is the thickest part of the gland, measuring 2 to 3 cm.
Which one of the following statements is false? a. The head of the pancreas is anterior to the inferior vena cava (IVC). b. The head of the pancreas is superior to the caudate lobe. c. The uncinate process is posterior to the superior mesenteric vein. d. The gastroduodenal artery is the anterolateral border of the head.
B The head of the pancreas lies inferior to the caudate lobe of the liver and the main portal vein.
What vessel runs posterior to the neck of the pancreas and anterior to the uncinate process? a. Splenic vein b. Superior mesenteric vein c. Gastroduodenal artery d. Hepatic artery
B The superior mesenteric vein crosses anterior to the uncinate process and posterior to the neck and body of the pancreas
Which one of the following veins courses in a sagittal plane and passes posterior to the neck of the pancreas? a. Splenic b. Superior mesenteric c. Inferior mesenteric d. Main portal
B The superior mesenteric vein passes anterior to the third part of the duodenum and posterior to the neck of the pancreas.
The tail of the pancreas is located: a. posterior to the left kidney, near the splenic hilum. b. anterior to the left kidney, near the splenic hilum. c. posterior to the right kidney, near the liver hilum. d. anterior to the right kidney, near the liver hilum.
B The tail of the pancreas lies anterior to the left kidney and posterior to the left colic flexure and transverse colon, near the splenic hilum
The splenic vein courses along the ____________________ of the pancreas. a. anterior border b. superior border c. posteromedial border d. inferior posterior border
C The splenic vein courses across the posteromedial surface of the pancreas to join the main portal vein
The duct of Santorini is a(n): a. small accessory duct to the gallbladder. b. accessory duct to the cystic duct. c. accessory duct to the pancreas. d. small opening in the duodenum
C The duct of Santorini is a secondary duct that drains the uppermost anterior pancreatic head.
The exocrine function of the pancreas is performed by the: a. islets of Langerhans. b. Cooper ligaments. c. acini cells. d. fat between the lobules
C The acini cells of the pancreas can produce up to 2 L of pancreatic juice per day, which is considered an exocrine function
If the celiac axis is well visualized, the sonographer should move the transducer in the __________ direction to image the pancreas. a. superior b. anterior c. inferior d. posterior
C The celiac axis serves as the superior border of the pancreas; therefore, the sonographer should move inferiorly to image the pancreas.
A common course of enzyme destruction via the pancreas is fluid accumulation in the: a. greater omentum. b. lesser omentum. c. lesser sac. d. greater sac
C The common course is for fluid to break through the pancreatic connective tissue layer and the thin posterior layer of the peritoneum and enter the lesser sac
The head of the pancreas lies: a. anterior to the liver. b. posterior to the aorta. c. medial to the duodenum. d. lateral to the inferior vena cava.
C The head of the pancreas lies medial to the duodenum (in the C-loop of the duodenum)
A most common cause of acute pancreatitis in the United States is: a. colitis. b. alcohol intake. c. biliary tract disease. d. pancreatic malignancy
C The most common cause of acute pancreatitis is gallstone(s) and biliary tract disease. Alcohol abuse is the second most common cause
1. The majority of the pancreas lies within which abdominal cavity? a. Perineum b. Intraperitoneum c. Retroperitoneum d. Pericardium
C The pancreas is located in the retroperitoneal cavity.
In cases of acute pancreatitis, the parenchyma of the pancreas generally appears: a. homogeneous. b. echogenic. c. calcified. d. hypoechoic.
D Early stages of acute pancreatitis may appear sonographically normal. When swelling of the pancreas occurs, the pancreas is hypoechoic to anechoic and is less echogenic because of the increased prominence of lobulation and congested vessels
Gallstones are present in 40% to 60% of patients with: a. chronic pancreatitis. b. annular pancreas. c. cystic fibrosis. d. acute pancreatitis
D Gallstones are present in 40% to 60% of patients with acute pancreatitis. Of the patients with gallstones, 5% develop acute pancreatitis
The persistence of the dorsal and ventral pancreas with the head encircling the duodenum is called: a. hypoplasia. b. cystic fibrosis. c. agenesis. d. annular pancreas.
D Annular pancreas is a rare anomaly in which the head of the pancreas surrounds the second part of the duodenum. This condition is more common in men and may be associated with a complete or partial atresia of the duodenum
The primary pancreatic duct is the duct of ______________. a. Santorini b. Ampulla c. Vater d. Wirsung
D The duct of Wirsung is a primary duct of the pancreas. It extends the entire length of the gland.
The pancreas is found behind the ___________ omental sac. a. greater b. inferior c. superior d. lesser
D The pancreas lies behind (posterior to) the lesser omental sac.