醫(yī)學(xué)保健]胰腺疾病-展示頁
2025-01-13 04:09本頁面
【正文】 usea and vomiting: without relief to abdominal pain after vomiting ? Signs of peritoneal irritation: tenderness, rebound pain, rigidity, guarding ? Distention: bowel paralysis, decreased or absent bowel sounds, silent abdomen, failure to pass either gas or feces. Clinical Findings Symptoms and signs: ? High T without chilling, press CBD ? jaundice, decreased BP, and shock。 a few result from hypercalcemia, trauma, hyperlipidemia, and geic predisposition。精品 PPT課件 瀏覽免費(fèi) 下載后可以編輯修改。 l xh aner2022 Pancreas 胰腺疾病 Department of Surgery Ma Qingyong Anatomy ? The pancreas lies within the retroperitoneum in the upper abdomen, lying in front of the second lumber vertebra and ending in the splenic hilum. ? The gland can be divided into four portionshead, neck, body, and tail. ? uncinate process Anatomy ? The main pancreatic duct (the duct of Wirsung, 2~3 mm in diameter) courses along the gland from the tail to the head and joins the mon bile duct just before entering the duodenum at the ampulla of Vater (85%). ? The accessory pancreatic duct (the duct of Santorini) enters the duodenum 2~ cm proximal to the Vater. the duct of Wirsung Santorini ampulla of Vater uncinate process Anatomy Blood supply ? The superior pancreaticoduodenal artery arises from the gastroduedenal artery, runs parallel to the duodenum, and eventually meets the inferior pancreaticoduodenal artery, a branch of the superior mesenteric artery, to form an arcade. ? The splenic artery provides tributaries that supply the body and tail of the pancreas. pancreatic magna A superior mesenteric artery splenic artery arcade superior pancreaticoduodenal artery inferior pancreaticoduodenal artery dorsal pancreatic A pancreatic magna A superior mesenteric V Physiology Exocrine Function ? The external secretion consists of a clear, alkaline (pH ~) solution of 750~1000 ml/d containing digestive enzymes. ? Secretion is stimulated by the hormones secretin and cholecystokinin (CCK) and by parasympathetic vagal discharge. ? Secretin and CCK are synthesized, store, and released from duodenal mucosal cells in response to specific stimuli. ? Acid in the lumen of the duodenum causes the release of secretin, and luminal digestion products of fat and protein cause the release of CCK. Physiology Exocrine Function ? enzymes synthesized, stored (as zymogen granules), and released by the acinar cells of the gland, in response to CCK and vagal stinulation. ? Pancreatic enzymes are proteolytic, lipolytic, and emylolytic. Lipase and amylase are stored and secreted in active forms.
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