Anatomy - Duodenum, Pancreas, Spleen

Question 1

describe the anatomical regions of the duodenum, pancreas and spleen

Answer 1

duodenum - epigastric/umbilical
pancreas - epigastric/umbilical/l.hypo
spleen - l.hypo/protected by ribs 9-11

all in RUQ/LUQ
duodenum/pancreas on transpyloric plane

Question 2

describe the gross structure of the duodenum

Answer 2

from pylorus to duodenojejunal junction
25cm lonh, C-shaped, around pancreas, vertebral level L1-3
mostly retroperitoneal
4 sections: superior, inferior, ascending, descending

Question 3

explain the gross structure of sections 1/2 of the duodenum

Answer 3

1st (superior):
- 5cm (2.5 intraperitoneal, 2.5 retro)
- pylorus -> superior duodenal flexure

2nd (descending):
- 8cm
- between superior/inferior duodenal flexures
- major/minor papillae

Question 4

describe the gross structure of sections 3/4 of the duodenum

Answer 4

3rd (inferior):
- 10cm
- inferior to pancreas
- coursing left

4th (ascending):
- 2.5cm
- to duodenojejunal flexure at L2
- suspensory muscle of duodenum

Question 5

describe the gross structure of the pancreas

Answer 5

retroperitoneal
15cm long
sits in C shape of duodenum
lies obliquely at L1/2
5 parts: head, neck, body, tail, uncinate process
general glandular appearance

Question 6

describe the ductal system of the pancreas

Answer 6

main pancreatic duct - meets bile duct at hepatopancreatic ampulla, major duodenal papilla
accessory pancreatic duct - connects with main duct (sometimes absent), minor papilla

Question 7

describe the gross structure of the spleen

Answer 7

largest lymphoid organ
thin capsule
diaphragmatic/visceral surfaces (separate areas/surfaces)
intraperitoneal
3 ligaments: gastrosplenic, splenorenal, phrenicosplenic

Question 8

describe what branches of the coeliac trunk supplies the duodenum, pancreas and spleen

Answer 8

splenic - spleen:
- dorsal pancreatic/pancreatic branches - pancreas neck/body/tail
gastroduodenal:
- ant/post superior pancreaticoduodenal - pancreas head/uncinate process/duodenum
small pancreatic branches - pancreas
retroduodenal branches/supraduodenal - proximal duodenum

Question 9

explain the SMA supply to the duodenum, pancreas and spleen

Answer 9

ant/post inferior pancreaticoduodenal - pancreas head/uncinate process, duodenum
first jejunal branch - distal duodenum
small pancreatic branches - pancreas

Question 10

explain the vebous drainage of the duodenum, pancreas and spleen

Answer 10

portal system (spleen)

splenic/SMA unite posterior to pancreas neck (HPV)

small brances follow patterns/names of arteries

ant/sup PDV - SMV
post/sup PDV - HPV
ant/post inf PDV - SMV

Question 11

describe the lymphatic drainage of the duodenum, spleen and pancreas

Answer 11

small vessels (interlobular septum) -> large vessels -> lymph nodes -> sistena hilae? -> thoracic duct ->

Question 12

describe the nerve supply of the duodenum, spleen and pancreas

Answer 12

parasymp - vagal trunks
symp - greater/lesser splanchnic (T5-12)

Question 13

describe some clinical significances of the duodenum, pancreas and spleen

Answer 13

duodenum - ulcers, paraduodenal hernias, gallstones
pancreas - gallstones (pancreatitis), rupture (digestion of surrounding tissue)
spleen - splenomegaly, rupture

Question 14

describe the nerve supply to the spleen, duodenum and pancreas

Answer 14

parasymp - vagal trunks
symp - greater/lesser splanchnic (T5-12)

follows blood supply