The pancreas is probably one of the few organs that we really do not pay close attention to, but it is a very vital organ. The pancreas is a part of the digestive system. It is the largest organ in its system. It plays life sustaining roles in the regulation of food digestion and blood glucose levels. The anatomy of the pancreas helps us to understand each part and each section and how it pertains to the body. It is also very to study the physiology, because it tells us the functions of the pancreas and how it works.
Disease states and laboratory testing are important because it they give us the different aliments and the different testing required to properly diagnose and treat a patient. In this paper, we will discuss the anatomy, physiology, disease state and laboratory testing of the pancreas. Anatomy The anatomy of the pancreas is very simple but important. The size of the pancreas is about half the size of the average hand not, including the thumb, which is probably about 14-20 cm long, and it only weighs about 100 grams (Longnecker, 2014).
It is a strange shaped organ because of its lopsided triangular- form. The pancreas is found behind the peritoneum between the stomach and the duodenum. It is an organ that has three parts: the head, body, and tail (Sunheimer & Graves, 2011, pg. 378). The pancreas head is found in the duodenal C loop in front of the inferior vena cava and the left renal vein (Sunheimer & Graves, 2011, pg. 378). Because the pancreas is behind the stomach, the stomach can be found lying of the body of the pancreas (Longnecker, 2014).
The last part is the tail, and it can be seen near the hilum of the spleen (Longnecker, 2014). Physiology The pancreas has two main functions, and they consist of the endocrine and exocrine glands. The majority of the pancreas is composed of exocrine cells called acini. Acini produces pancreatic juice, this juice produces enzymes to help with the digestion of food, like amylase and lipase (Sunheimer & Graves, 2011, pg. 378). Exocrine cells release their enzymes into a series of progressively larger tubes called ducts that eventually join together to form the main pancreatic duct.
The main pancreatic duct runs the length of the pancreas and drains the fluid from the exocrine cells into the duodenum (Hoad-Robson & Henderson, 2015). The second portion of the pancreas is the endocrine portion. There is only a small number of the endocrine cells are in the pancreas. The endocrine cells are made up of small cells, called the islets of Langerhans (Sunheimer & Graves, 2011, pg. 378). There are four different cells have made of each islet they are: alpha, beta delta, and F cells. The alpha cells synthesize glucagon. The beta cells produce proinsulin. The delta cells secrete somatostatin.
The F cells secrete pancreatic polypeptide. These endocrine cells do not release their secretions into the pancreatic ducts, instead they release hormones the insulin and glucagon into the blood stream, and these hormones in turn help control blood sugar glucose levels. Disease state Many things can go wrong with the pancreas, one of the main diseases states the pancreas can go through is pancreatitis. Pancreatitis comes from inflammation of the pancreas that happens as an effect of auto digestion. With acute pancreatitis, the pancreas makes enzymes too early and begins to digest the pancreatic cells.
It happens abruptly and only last for a brief period. Things that can trigger acute pancreatitis are smoking, alcohol, diets high in fat proteins, and obstructive liver disease. Some symptoms of pancreatitis include upper right abdominal pain after a heavy meal or alcoholic binge, and the pancreas can become edematous, enlarged, steatorrhea, and malabsorption (Sunheimer & Graves, 2011, pg. 382). The hallmark symptom is vomiting with a decrease of pain. It can develop to necrosis, begin hemorrhaging, and eventually can be fatal.
Treatment goals are to provide supportive care, decrease and prevent further local pancreatic necrosis and the inflammatory process and recognize and treat complications, prevent future attacks (Sunheimer & Graves, 2011, pg. 383). A complication of acute pancreatitis is adult respiratory distress syndrome (ARDS). Another state of pancreatitis is chronic pancreatitis. Chronic pancreatitis is permanent damage to the tissue with sign of inflammation and fibrosis (Sunheimer & Graves, 2011, pg. 383). It usually can be see after recurring instances of acute pancreatitis and pancreatic cells are now scar tissue.
Because of the damage that chronic pancreatitis results in, the endocrine and exocrine portions of the pancreas are completely destroyed. Alcohol abuse is the most common cause of chronic pancreatitis. Symptoms are constant abdominal pain but some do not experience pain at all. Patients have also been found to display nausea, vomiting, and fatty stool (Sunheimer & Graves, 2011, pg. 383). Pseudocyst formation and obstruction of the duodenum and common bile duct can be results of complications of chronic pancreatitis (Sunheimer & Graves, 2011, pg. 383). Another disease of the pancreas is pancreatic cancer.
Most of the pancreatic neoplasms are exocrine cancers. Pancreatic cancer is difficult to detect in its early stages. Cancer patients may experience pain, weight loss for no reason, and jaundice may appear (Ryan, 2015). According to the National Cancer Institute (2015), risk factors for pancreatic cancer are tobacco, age, and predisposing health conditions. Treatment options for this type of cancer include surgically taking out the pancreas, radiation, and chemotherapy (NCI, 2015). The pancreas can also be noted to have different types of tumors. One group of tumors is called insulinomas.
They are tumors of the pancreatic islets. Theses tumors cells produce excessive amounts of insulin (Sunheimer & Graves, 2011, pg. 385). Somatostatinomas are tumors secrete too much somatostatin (Sunheimer & Graves, 2011, pg. 385). Glucagonomas are glucagon producing tumors (Sunheimer & Graves, 2011, pg. 385). Testing In order to diagnose a disease state you have to have laboratory testing. In the laboratory, we have many tests to assess the function of the pancreas. Since the pancreas has two functions, it requires different laboratory testing for each side.
The exocrine portion has many laboratory tests. Some of these tests can be categorized as invasive and noninvasive. The fecal elastase test is a noninvasive test of pancreatic function. This is a test that is sure to measures adequate levels of elastase which is the enzyme found in fluids that the pancreas produces. Elastase digests breaks down proteins. The Canadian Cancer Society (2015) found, in this test, a patient’s stool sample is analyzed for the presence of elastase. Amylase and lipase are the pancreatic enzymes that are routinely to evaluate pancreatic function.
These enzymes provide valuable information in distinguishing between different conditions from each other (Sunheimer & Graves, 2011, pg. 379). A laboratory tests used to diagnose patients of pancreatic cancer is blood chemistry study. It is procedure where the amount bilirubin in a blood sample is monitored its, release into the blood by organs and tissues in the body (NCI, 2015). Abnormal results could be an indication of cancer. Tumor markers are also used in the monitoring of patients with pancreatic cancer. CA 19-9 and carcinoembryonic antigen are measured (NCI, 2015).
The pancreas is categorized one of the organs in the body that goes unnoticed. It is a part of the digestive system and it is a key organ. Its function helps sustain life roles by helping with food digestion and blood glucose levels. In researching the pancreas, it is imperative to look at the anatomy, physiology, disease states, and laboratory test of it. Each section gives us a better understanding the deeper we get into it. The pancreas is a hidden organ but when something goes wrong it effects are manifested. Without this organ our bodies would not properly function.
