Exocrine Pancreas Anatomy Flashcards
What are the 4 sections of the pancreas?
The head, neck, body, and tail.
What is the anatomical location of the head?
Lies to the right of midline within the C loop of the duodenum, immediately anterior to
the vena cava at the confluence of the renal veins.
What is the anatomical location of the uncinate process?
Extends from the head of the pancreas behind the superior mesenteric vein
(SMV) and terminates adjacent to the superior mesenteric artery (SMA).
What vein is just beneath the neck?
The SMV
What is the anatomical location of the body and tail?
Extend across the midline, anterior to Gerota fascia
terminating within the splenic hilum.
Arterial supply to the head and uncinate
Supplied by the pancreaticoduodenal arteries (anterior and
posterior), which arise from the hepatic artery through the gastroduodenal artery (GDA) superiorly
and the SMA inferiorly.
Arterial supply to the body and tail
The dorsal pancreatic artery arises from the splenic artery and courses posterior to the body of the gland to become the inferior pancreatic artery.
The inferior pancreatic artery then runs along the inferior border of the pancreas, terminating at
its tail.
What gives rise to the dorsal and ventral buds?
Primitive duodenal endoderm
The dorsal bud
Develops into the superior head, neck, body, and tail
maintains communication with the biliary tree
The ventral bud
The ventral bud will become the inferior part of the head and uncinate process
Initiation of pancreas bud formation and differentiation of the ventral bud from the hepatic-biliary
fates is dependent on___?
PDX1 and PTF1
notch signaling is vital for___?
Exocrine differentiation.
Pancreas Divisum
Failure of the dorsal and ventral ducts to fuse
implicated in the development of relapsing acute or chronic pancreatitis
10% of the population is affected by pancreas divisum, only rarely do affected individuals
develop pancreatitis.
The major papilla is with which bud?
Ventral
The minor papilla is with which bud?
Dorsal
Annular Pancreas
aberrant migration of the ventral pancreas bud
circumferential or near-circumferential pancreas tissue surrounding the second portion of the
duodenum.
symptoms of obstruction
surgical bypass through duodenojejunostomy
Pancreatic secretory trypsin inhibitor that when mutated leads to chronic pancreatitis?
SPINK1
The cephalic phase
The pancreas is stimulated by the vagus nerve in response to the sight, smell, or taste of food.
mediated by the release of acetylcholine at the terminal endings of postganglionic fibers.
This phase accounts for 20% to 25% of the daily secretion of pancreatic juice.
The gastric phase.
Mediated by vagovagal reflexes triggered by gastric distention after the ingestion of food.
accounts for 10% of the pancreatic juice produced daily
The intestinal phase
Accounts for 65% to 70% of the total secretion of pancreatic juice.
Secretin
Acidification of the duodenal lumen induces the release of secretin by S cells.
is the most important mediator of the secretion of water, bicarbonate, and other electrolytes into
the duodenum.
CCK
Presence of lipid, protein, and carbohydrates inside the duodenum induces the secretion of
CCK-releasing factor
induce release of CCK by I cells present in the duodenal mucosa.
CCK
induces the release of pancreatic enzymes by acinar cells.
induces local duodenal vagovagal reflexes
cause the release of acetylcholine, vasoactive intestinal peptide, and gastrin-releasing peptide
induces the relaxation of the sphincter of Oddi.
