Pancreas Review

85 Questions

Which cells produce pancreatic juice composed of enzymes to help digest fats, proteins, carbohydrates, and nucleic acids?

Acini Cells

What is the function of Alpha Cells in the pancreas?

Produce glucagon

Where is the Ampulla of Vater located?

Second portion of the duodenum

What do Beta Cells in the pancreas produce?

Insulin

Which vessel transports and discharges bile into the duodenum as needed to aid the digestive process?

Common Bile Duct (CBD)

What do Acini Cells produce?

Pancreatic juice

Which cells produce ghrelin and make up less than 1% of pancreatic endocrine cells?

Epsilon Cells

What is the main function of the duct of Wirsung?

Transport and discharge pancreatic juice into the duodenum

Which artery supplies the head of the pancreas and the duodenum as its first branch?

Gastroduodenal Artery

What is the primary function of insulin?

Causes glycogen formation from glucose in the liver

Which structure is difficult to image using sonography due to its close relationship to the stomach and small intestine?

Pancreatic Head

What is the function of glucagon produced by alpha cells?

Causes release of glucose for energy needs

Where are islets of Langerhans found in the pancreas?

In clusters throughout the pancreas

Which artery forms part of the pancreatic arcades and supplies the head of the pancreas?

Pancreaticoduodenal Arteries

What is the primary content of pancreatic juice?

Enzymes for digestion of fats, proteins, carbs, and nucleic acids

What is the function of somatostatin produced by delta cells?

Inhibits release of hormones like insulin and glucagon

What is the size range of the pancreatic tail?

1-2cm long

Where is the pancreatic head located?

Partly surrounded by the C-loop of the duodenum

What is the composition of the pancreas?

60% exocrine and 40% endocrine

Which gland is located in the abdomen, surrounded by the C-loop of the duodenum?

Pancreas

What is the function of pancreatic juice?

Aid in digestion

Which artery supplies the pancreatic head?

Superior mesenteric artery

Where does the pancreatic tail extend to?

Hilum of the spleen

What is the uncinate process of the pancreas?

A posterior projection of the pancreas head

Which vein follows the posterior superior surface of the pancreatic body?

Splenic vein

What percentage of the pancreas is endocrine?

10%

Which artery supplies blood to the pancreas?

Pancreaticoduodenal arteries

Which enzyme is NOT found in pancreatic juice?

Insulin

What structure lies directly posterior to the superior mesenteric vein?

Pancreatic head

Which of the following hormones stimulates the release of glucose from the liver?

Glucagon

What is the function of somatostatin, a hormone produced by delta cells in the pancreas?

Inhibits the production of insulin and glucagon

Which artery supplies blood to the prepancreatic section of the pancreas?

Hepatic artery

What is the function of pancreatic juice?

Aids in digestion of carbohydrates, fats, and proteins

Which cells in the pancreas produce insulin?

Beta cells

What is the sonographic appearance of the pancreas compared to the liver?

More echo-dense and smooth contour

What releases pancreatic juice into the duodenum?

Main pancreatic duct (duct of Wirsung)

Where is the endocrine portion of the pancreas located?

Islets of Langerhans

What is evaluated to determine the sonographic appearance of the pancreas?

Which vessel is most likely to receive drainage from the inferior mesenteric vein?

Splenic vein

What is the primary route for the common bile duct to enter the duodenum?

Passing through the pancreatic head

Which artery courses anterolaterally to the pancreas head and supplies the gastroduodenal artery?

Common hepatic artery

When is the most reliable time to take measurements of the pancreas?

In the morning after an overnight fast

Which structure provides essential information about evaluating the shape and size of the pancreas?

Uncinate process

What is located posterior to the superior mesenteric vein and anterior to the inferior vena cava or aorta?

Uncinate process

Where does the main pancreatic duct join before entering the duodenum?

Common bile duct

Which vessel is the pancreas located anterior to?

Inferior vena cava

Which cells are responsible for producing pancreatic juice composed of enzymes to help digest fats, proteins, carbohydrates, and nucleic acids?

Acini cells

Which artery forms part of the pancreatic arcades and supplies the head of the pancreas?

Gastroduodenal artery

What is a variable-shaped portion of the pancreas head located posterior to the superior mesenteric vein and anterior to the inferior vena cava or aorta?

'Uncinate process'

What is closely related to the biliary tract and portal venous system?

'Pancreas'

Which blood vessel is located in front of the head of the pancreas?

Common bile duct

Which structure marks the posterior boundary of the body and tail of the pancreas?

Left renal vein

Which vessel is described as appearing as a round or oval anechoic structure with thin, smooth walls?

Inferior vena cava

Which structure is located posterior to the inferior level of the neck of the pancreas?

Superior mesenteric vein

Which vessel is anterior to the body of the pancreas?

Superior mesenteric artery

Which structure is found closely following along the posterosuperior margin of the pancreas?

Uncinate process

Which structure is mentioned as surrounding the head of the pancreas?

Gastroduodenal mesenteric artery

Which vessel is located in front of the inferior vena cava?

Common bile duct

Which structure denotes the body and tail of the pancreas?

Splenic vein

Which structure is described as having small, anechoic structures with bright walls?

Common bile duct

Which structure is located posterior to a more superior level than the inferior level of the neck of the pancreas?

Portal splenic confluence

Which structure is mentioned as surrounding the body of the pancreas?

Aorta

Match the following pancreatic cells with their respective hormone production and percentage of pancreatic endocrine tissue:

Delta Cells = Produce somatostatin, 5% of pancreatic endocrine tissue Epsilon Cells = Produce ghrelin, less than 1% of pancreatic endocrine cells Gamma Cells = Produce mission and pancreatic polypeptide, less than 5% of pancreatic endocrine cells Alpha Cells = Produce glucagon, percentage not specified

Match the following pancreatic ducts/vessels with their description/location/function:

Duct of Santorini = Pancreatic accessory duct that enters duodenum above Wirsung's duct Duct of Wirsung = Main pancreatic duct that transports and discharges pancreatic juice into duodenum Gastroduodenal Artery = First branch of common hepatic artery, supplies head of pancreas and duodenum Portal Vein = Formed by confluence of splenic and superior mesenteric veins, carries blood from pancreas and intestines to liver

Match the following pancreatic structures with their respective locations/descriptions:

Islets of Langerhans = Clusters of alpha, beta, and delta endocrine cells in pancreas that produce insulin Pancreatic Arcades = Vascular connections between hepatic, splenic, and superior mesenteric arteries that supply blood to the head of the pancreas Pancreatic Tail = Left lateral to pancreas body and aorta, extends to hilum of spleen, has splenic vein running on its surface Pancreaticoduodenal Arteries = Supply head of pancreas and part of duodenum with blood, part of pancreatic arcades

Match the following parts of the pancreas with their anatomical descriptions:

Pancreatic head = Partly surrounded by the C-loop of the duodenum and supplied by the superior mesenteric artery Uncinate process = Posterior projection of the pancreas head lying directly posterior to the superior mesenteric vein and anterior to the inferior vena cava or aorta Pancreatic body = Lies anterior to the aorta, superior mesenteric artery, and splenic vein, with the splenic vein following its posterior superior surface Pancreatic tail = Extends to the hilum of the spleen, lying left lateral to the pancreas body and aorta, and bordered anteriorly by the posterior wall of the stomach

Match the following descriptions with their relation to the pancreas vascular system:

Superior mesenteric artery = Supplies blood to the pancreatic head Splenic artery = Supplies blood to the pancreas through its branches Pancreaticoduodenal arteries = Part of the complex vascular system supplying the pancreas Pancreatic arcades = Formed by branches of arteries supplying blood to the head of the pancreas

Match the following statements with their relation to the composition and function of the pancreas:

Exocrine gland = Produces approximately 90% of pancreatic juice containing digestive enzymes Endocrine gland = Produces hormones like insulin and glucagon Pancreatic juice = Contains enzymes like amylase, lipase, trypsin, chymotrypsin, carboxypeptidase, and nucleases for aiding digestion Insulin and glucagon = Hormones produced by the pancreas

Match the pancreatic cell type with its hormone production:

Acini Cells = Produce pancreatic juice that is composed of enzymes to help digest fats, proteins, carbohydrates, and nucleic acids Alpha Cells = Produce the hormone glucagon Beta Cells = Produce insulin Delta Cells = Produce somatostatin

Match the anatomical structure with its description:

Ampulla of Vater = Dilatation in the second portion of the duodenum, where the common bile duct and pancreatic duct(s) enter to discharge substances that aid in the digestive process Common Bile Duct (CBD) = Distal portion of the biliary tract that transports and then discharges bile (that was manufactured in the liver) into the duodenum as needed to aid the digestive process Uncinate Process = Part of the pancreas that is difficult to image using sonography due to its close relationship to the stomach and small intestine Islets of Langerhans = Areas in the pancreas where endocrine cells, including alpha, beta, and delta cells, are found

Match the vascular structure with its relationship to the pancreas:

Epigastric vessels = Surround the pancreas Superior mesenteric vein = Located posterior to the inferior level of the neck of the pancreas Gastroduodenal artery = Courses anterolaterally to the pancreas head and supplies the gastroduodenal artery Inferior vena cava = Located anterior to the pancreas

Match the anatomical relationship with its description:

Pancreas and duodenum = The pancreas is closely related to this structure Pancreatic tail = Extends to this part of the abdomen Head of pancreas = Located anterior to this blood vessel Biliary system = Closely related to this part of the anatomy

Match the sonographic appearance with its description:

Pancreatic juice = Primary content appears as a round or oval anechoic structure with thin, smooth walls Scanning plane in axial views = Uses vascular landmarks and adjacent anatomy for visualization Scanning plane in longitudinal views = Uses vascular landmarks and adjacent anatomy for visualization Size range of pancreatic tail = Evaluated to determine the sonographic appearance of this part of the pancreas

Match the pancreatic function with its description:

Function of pancreatic juice = Aids in digestion by containing enzymes to help digest fats, proteins, carbohydrates, and nucleic acids Function of insulin produced by beta cells = Regulates blood sugar levels by facilitating glucose uptake by cells Function of glucagon produced by alpha cells = Stimulates release of glucose from the liver when blood sugar levels are low Function of somatostatin produced by delta cells = Regulates endocrine and exocrine secretions in the pancreas

Match the following structures with their locations relative to the pancreas:

Inferior vena cava = Located in front of the head of the pancreas Splenic vein = Denotes the body and tail of the pancreas Superior mesenteric artery = Located anterior to the body of the pancreas Common bile duct = Located in front of the head of the pancreas

Match the following vessels with their sonographic appearances near the pancreas:

Inferior vena cava = Appears as a round or oval anechoic structure with thin, smooth walls Superior mesenteric vein = Posterior to the inferior level of the neck of the pancreas Portal vein = Surrounds the head of the pancreas Splenic vein = Clearly denotes the body and tail of the pancreas

Match the following structures with their locations relative to the pancreas body:

Aorta = Located anterior to the body of the pancreas Gastroduodenal artery = Located in front of the head of the pancreas Uncinate process = Located posterior to the superior mesenteric vein and anterior to the inferior vena cava or aorta Superior mesenteric vein = Posterior to a more superior level than the neck of the pancreas

Match the following structures with their relationships to surrounding vessels and organs:

Neck = Posterior to a more superior level than portal splenic confluence Anterior liver = Surrounding structure mentioned near the tail of the pancreas Left renal vein = Mentioned as a surrounding structure near the neck of the pancreas Gastroduodenal mesenteric artery = Surrounding structure mentioned near the tail of the pancreas

Match the following components with their composition in pancreatic juice:

Enzymes = Assist in the digestion of fats, proteins, and carbohydrates Sodium bicarbonate = Neutralizes stomach acid to create an optimal environment for enzyme activity Nucleic acids = Broken down into their constituent nucleotides for absorption by the small intestine Gastrin = Stimulates the release of pancreatic juice from the pancreas

Match the following hormones with their functions in regulating blood sugar levels:

Insulin = Promotes glycogen formation in the liver, lowering blood sugar levels Glucagon = Stimulates the release of glucose from the liver, raising blood sugar levels Somatostatin = Inhibits the production of insulin and glucagon, regulating blood sugar levels Cholecystokinin = Stimulates the release of digestive enzymes and bile from the pancreas and gallbladder

Match the following anatomical features with their sonographic appearance in the pancreas:

Islets of Langerhans = Endocrine portion containing beta, alpha, delta, gamma, and epsilon cells Main pancreatic duct (duct of Wirsung) = Seen in transverse scanning plane images and distinguished from adjacent structures Texture = Appears more echo-dense or hyper-echoic than the liver Contour = Described as smooth and curvilinear

Match the following vessels with their relationships to the pancreas:

Splenic artery = Supplies various sections including suprapancreatic, pancreatic, prepancreatic, and prehilar areas Splenic vein = Important to distinguish from the main pancreatic duct in sonographic imaging Gastroduodenal artery = Courses anterolaterally to supply the head of the pancreas Inferior mesenteric vein = Receives drainage from this vessel

Match the following structures with their locations relative to the pancreas:

Superior mesenteric vein = Located posterior to the uncinate process Common bile duct = Joins the main pancreatic duct before entering the duodenum Inferior mesenteric vein = Most often empties into the splenic vein Gastroduodenal artery = Courses anterolaterally to the pancreas head

Match the following statements with their corresponding descriptions about pancreatic measurements:

12 cm to 18 cm long, 2.5 cm thick, 3 to 5 cm wide = Describes the size of the pancreas Variable sizes, and the uncinate process is a topic of debate in relation to measurements of the pancreas head = Refers to variability in head sizes and measurement challenges Most reliable measurements taken in the morning after an overnight fast = Describes optimal timing for measurements Correct caliper placement for measuring each segment shown in Figure 16-3 = Illustrates proper technique for measuring each segment

Match the following vessels with their relationships to the pancreas:

Inferior vena cava = Located anterior to the pancreas Splenic vein = Located posterior to the pancreas Portal venous system = Closely related to the pancreas Celiac axis = Originates from and supplies blood to the pancreas head

Study Notes

The pancreas is surrounded by several epigastric vessels: inferior vena cava, common bile duct, gastroduodenal artery, superior mesenteric vein, portal splenic confluence, portal vein, splenic vein, superior mesenteric artery, and aorta
The head of the pancreas is located in front of the inferior vena cava, common bile duct, and gastroduodenal artery
The inferior vena cava appears as a round or oval anechoic structure with thin, smooth walls, while the common bile duct and gastroduodenal artery are small, anechoic structures with bright walls
The superior mesenteric vein is posterior to the inferior level of the neck of the pancreas, and the portal splenic confluence is posterior to a more superior level
The pancreas body is located anterior to the splenic vein, superior mesenteric artery, and aorta, and is described as projecting more anteriorly than the other segments
The splenic vein clearly denotes the body and tail of the pancreas and can be seen closely following along the posterosuperior margin
The gastroduodenal artery, left renal vein, neck, splenic vein, superior mesenteric artery, aorta, uncinate process, tail, anterior liver, and Gastroduodenal mesenteric artery are also mentioned as surrounding structures.
The uncinate process is a variable-shaped portion of the pancreas head located posterior to the superior mesenteric vein and anterior to the inferior vena cava or aorta.
The pancreas is closely related to the biliary tract and portal venous system, and its main pancreatic duct (Wirsung duct) joins the common bile duct before both vessels enter the duodenum.
The pancreas is approximately 12 cm to 18 cm long, 2.5 cm thick, 3 to 5 cm wide, and weighs between 60 g and 80 g. Its shape and size, including any enlarged portions, are essential when evaluating it.
The pancreas is located anterior to the inferior vena cava, superior mesenteric vein, uncinate process, and splenic vein, among other structures. It is surrounded by peritoneum in a small portion of its head.
The inferior mesenteric vein, which drains the large intestine, most often empties into the splenic vein but may join the portal system at various locations.
The pancreas's head has variable sizes, and the uncinate process is a topic of debate in relation to measurements of the pancreas head.
The most reliable measurements of the pancreas are taken in the morning after an overnight fast. The correct caliper placement for measuring each segment of the pancreas is shown in Figure 16-3.
The common bile duct runs posterior to the first part of the duodenum and then either passes through the pancreatic head or runs along its posterolateral surface, joining the main pancreatic duct and entering the duodenum at the ampulla of Vater.
The gastroduodenal artery, the first branch of the common hepatic artery, originates from the celiac axis and courses anterolaterally to the pancreas head.
The pancreas's size decreases with age.

Test your knowledge of the anatomy and relationships of the pancreatic duct with neighboring structures such as the gallbladder, duodenum, and hepatic ducts. Identify the different portions and branches of the pancreatic duct.

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