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Phase 1 - Anatomy > Anatomy - Pancreas and duodenum > Flashcards

Anatomy - Pancreas and duodenum Flashcards

1
Q

Name the 2 branches of the Gastroduodenal artery.

A
  1. Right gastroepiploic artery (supplies greater curvature of the stomach). 2. Superior pancreaticoduodenal artery (supplies head of pancreas).
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2
Q

Name the 3 branches of the proper hepatic artery?

A
  1. Right hepatic artery. 2. Left hepatic artery. 3. Right gastric artery.
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3
Q

What does the right gastric artery supply?

A

The lesser curvature of the stomach.

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4
Q

What is a branch of the right hepatic artery?

A

The cystic artery (supplies the gall bladder).

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5
Q

Name the 4 divisions of the Duodenum.

A
  1. Superior. 2. Descending. 3. Inferior. 4. Ascending.
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6
Q

Where in the duodenum are ulcers most likely? And which artery would they affect?

A

Most likely in the superior duodenum (1st part). If the ulcers erode through the posterior wall they may effect the gastroduodenal artery and cause haemorrhage.

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7
Q

What does the descending portion of the Duodenum lie posteriorly and anteriorly to?

A

Posteriorly to transverse colon. Anteriorly to the right kidney.

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8
Q

What vessels lie anteriorly to the inferior part of the duodenum? (3rd part)

A

The superior mesenteric artery and vein.

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9
Q

Is the duodenum retroperitoneal or intraperitoneal?

A

The duodenal cap is intraperitoneal but the rest of the duodenum is retroperitoneal.

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10
Q

Is the pancreas retroperitoneal or intraperitoneal?

A

The tail is intraperitoneal but the rest of the pancreas is retroperitoneal.

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11
Q

Name the 5 parts of the Pancreas.

A
  1. The head. 2. The uncinate process. 3. The neck. 4. The body. 5. The tail.
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12
Q

What does the tail of the pancreas lie in close proximity to?

A

The hilum of the spleen.

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13
Q

Why can diseases of the pancreas spread to adjacent tissues?

A

Because it isn’t contained within a capsule.

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14
Q

What is the blood supply to the head of the pancreas?

A

The superior and inferior pancraticoduodenal arteries.

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15
Q

What is the superior pancraticoduodenal artery a branch of?

A

The gastroduodenal artery.

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16
Q

What is the inferior pancraticoduodenal artery a branch of?

A

The SMA.

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17
Q

What is the blood supply to the rest of the pancreas?

A

Pancreatic branches of the splenic artery.

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18
Q

What is the venous drainage of the pancreas?

A

The head drains into the SMV (drains into hepatic portal vein). the pancreatic veins drain the rest of the pancreas (these drain into the splenic vein).

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19
Q

What is the function of the spleen?

A

In an adult it functions mainly as a blood filter, removing old RBC’s from circulation.

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20
Q

Is the spleen intraperitoneal or retroperitoneal?

A

Intraperitoneal.

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21
Q

What ligaments of the greater omentum connect the spleen to the stomach and kidney?

A

Gastrosplenic and Splenorenal.

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22
Q

How far away is the major duodenal papilla from the pylorus of the stomach?

A

5cm.

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23
Q

What is the embryological significance of the major duodenal papilla?

A

It marks the junction between the foregut and the midgut.

24
Q

What is the importance of the plicae circularis?

A

They increase the intestinal SA available for absorption.

25
Q

What vertebral level is the pancreas? What transverse plane is this?

A
  • L2
  • Transpyloric plane
26
Q

Describe the pancreas in terms of it’s position to the abdominal peritoneum?

A

all, except for the tail it is a retroperitoneal organ

27
Q

Describe the pancreas’ anatomical relation to the stomach?

A

Separated from the pancreas by the lesser sac, the stomach and pylorus lie anterior and to the pancreas

28
Q

Describe the pancreas’ anatomical relation to the duodenum?

A
  • The “C” shaped duodenum curves around and outlines the head of the pancreas.
  • The first part of the duodenum lies anteriorly
  • The second part of the duodenum including the ampulla of Vater lies laterally to the right of the pancreatic head
29
Q

Describe the pancreas’ anatomical relation to the transverse mesocolon?

A

attaches to the anterior surface of the pancreas

30
Q

Describe the pancreas’ anatomical relation to the common bile duct?

A

Descends behind the head of the pancreas before opening into the second part of the duodenum alongside the major pancreatic duct through the major duodenal papilla

31
Q

Describe the pancreas’ anatomical relation to the spleen?

A
  • located posteriorly and laterally.
  • The lienorenal ligament is formed from the peritoneum and connects the spleen to the tail of the pancreas.
32
Q

Which major vessels pass posteriorly to the head of the pancreas?

A
  • aorta
  • inferior vena cava
33
Q

Describe the anatomical positioning of the superior mesenteric artery in relation to the pancreas?

A
  • posterior to the neck
  • anterior to the uncinate process
34
Q

Describe the anatomical positioning of the superior mesenteric and splenic veins in relation to the pancreas? What do they unite to form?

A
  • both posterior to the neck
  • form the hepatic portal vein
35
Q

What artery transverses the superior border of the pancreas?

A
  • splenic artery (from celiac trunk to spleen)
36
Q

Describe the head of the pancreas?

A
  • the widest part of the pancreas
  • lies within the C-shaped curve created by the duodenum
    • connected to it by connective tissue.
37
Q

Describe the uncinate process?

A
  • a projection arising from the lower part of the head
  • extends medially to lie beneath the body of the pancreas
  • posterior to the superior mesenteric vessels.
38
Q

Describe the neck of the pancreas?

A
  • located between the head and the body of the pancreas
  • It overlies the superior mesenteric vessels which form a groove in its posterior aspect.
39
Q

Describe the body of the pancreas?

A

centrally located, crossing the midline of the human body to lie behind the stomach and to the left of the superior mesenteric vessels

40
Q

Describe the tail of the pancreas?

A
  • The left end of the pancreas that lies within close proximity to the hilum of the spleen.
  • It is contained within the splenorenal ligament with the splenic vessels.
  • Only part of the pancreas that is intraperitoneal.
41
Q

Describe the duct system of the pancreas?

A
  • acini are collected by intercalated ducts
  • intercalated ducts unite to form intralobular ducts
  • intralobular ducts then drain into the main pancreatic duct
  • The pancreatic duct runs the length of the pancreas
  • unites with the common bile duct, forming the hepatopancreatic ampulla of Vater
  • Opens into the duodenum via the major duodenal papilla.
42
Q

What controls secretions into the duodenum?

A
  • sphincter of Oddi
  • Surround the ampulla of Vater, acting as a valve
43
Q

Describe arterial supply to the pancreas?

A
  • Pancreatic branches of the splenic artery
  • the head is additionally supplied by the superior and inferior pancreaticoduodenal arteries
    • superior: branches of the gastroduodenal (from coeliac trunk)
    • inferior: branches of the superior mesenteric arteries
44
Q

Describe venous drainage of the pancreas?

A
  • Pancreatic head: Into the superior mesenteric branches of the hepatic portal vein.
  • Rest: the splenic vein into the hepatic portal vein
45
Q

How is lymphatics drained from the pancreas?

A
  • Lymphatic vessels follow the arterial supply.
  • Empty into the pancreaticosplenal nodes and the pyloric nodes,
  • Drain into the superior mesenteric and coeliac lymph nodes.
46
Q

Describe an ERCP?

A
  • endoscopic retrograde cholecystopancreatogram
  • an endoscope is passed through the mouth, oesophagus and stomach into the duodenum
  • a fine tube is passed through the duodenal papilla
  • x-ray visible chemical is injected to visualise the ducts
47
Q

Briefly describe pancreatitis?

A
  • gall stone can be too large to pass through the sphincter of Oddi
  • blocking either or both ducts
  • the patient becomes jaundice and can progress to live failure
  • blockage of the pancreatic duct causes high pressure in the ducts and digestive enzymes leak out of the ducts and start digesting the pancreas
  • carcinoma of the pancreatic head can cause similar issues as it can invade the duct system
  • can also obstruct hepatic portal drainage
48
Q

Briefly describe a pseudocyst relevant to pancreatitis?

A
  • after surviving pancreatitis fluid may leak into the lesser sac
  • this compresses the stomach from behind causing difficultly eating
49
Q

Can the spleen be palpated during abdominal examination?

A

Normally no, it needs to be considerably enlarged or displaced by a large mass to be palpable.

50
Q

What structures might a tumour of the head of the pancreas involve?

A

The hepatic portal vein, bile duct or pancreatic duct.

51
Q

What structures join to form the common bile duct and what is its course?

A
  • The common hepatic and cystic duct
  • The common bile duct runs in the free edge of the lesser omentum and behind the first part of the duodenum, onto the posterior of the pancreas
  • enters the pancreas to run alongside the pancreatic duct
  • opens into the duodenum.
52
Q

Where is the sphincter of Oddi located?

A

On the medial wall of the duodenum between the second and third parts.

53
Q

Which artery lies behind the first part of the duodenum?

A

Gastroduodenal artery

54
Q

What lies between the pancreas and the stomach?

A

the lesser sac

55
Q

How many pancreatic ducts are there? What is the embryological significance?

A
  • 2
  • one from the ventral pancreatic bud
  • one from the dorsal pancreatic bud.
56
Q
A
57
Q
A

Phase 1 - Anatomy (29 decks)

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