L9 Pancreas and Spleen

Question 1

Location of the Pancreas?

Answer 1

Retroperitoneal

From curve of duodenum L2 L3 to
splenic hilum (crosses the transpyloric plane)

Question 2

Regions of the Pancreas?

Answer 2

Question 3

Pancreatic Development?

Answer 3

Pancreas = diverticula of duodenum (week 4)

Rotation of duodenum brings ventral bud (with bile duct) posteriorly

Ventral bud gives rise to:
lower head
uncinate process
main pancreatic duct

Dorsal bud gives rise to:
rest of pancreas
accessory duct

Question 4

Structures Anterior to head of the Pancreas?

Answer 4

pylorus
gastroduodenal artery
pancreatico duodenal
arteries

Question 5

Structures Posterior to head of the Pancreas

Answer 5

Bile duct
IVC
renal veins

Question 6

Structures anterior to Neck of the Pancreas?

Answer 6

pylorus
gastroduodenal artery

Question 7

Structures posterior to Neck of the pancreas?

Answer 7

Superior Mesenteric Artery/Vein
Origin of Portal Vein
Aorta

Question 8

What is superior mesenteric artery syndrome?

Answer 8

Duodenum is compressed between two arteries (the aorta and the superior mesenteric artery) causing partial or complete blockage of the duodenum

Question 9

Structures posterior to Body of Pancreas?

Answer 9

Splenic vein
Left kidney, vessels and suprarenal gland
Inferior Mesenteric Vein

Question 10

Structures posterior to TAIL of Pancreas?

Answer 10

INTRAPERITONEAL!!

Left kidney
Splenic flexure
Splenic hilum

Question 11

What do the main pancreatic duct (of
Wirsung ) and the common bile duct unite to form?

Answer 11

Form the hepatopancreatic ampulla (of Vater) => projects as the
major duodenal
papilla entering D2 (descending duodenum)

A little higher the accessory pancreatic duct (of Santorini in continuity with the main duct) enters at the minor duodenal papilla.

Question 12

Arterial Supply of Pancreas?

Answer 12

–Splenic artery
–Superior + inferior
pancreaticoduodenal
arteries

Question 13

Venous Drainage of Pancreas?

Answer 13

–Splenic vein from body
and tail
–Pancreaticoduodenal
veins drain to superior
mesenteric vein

Question 14

Innervation of Pancreas?

Answer 14

splanchnic nerves and
vagi via coeliac plexus

Question 15

Answer 15

1. Gallbladder
2. Right/Left Hepatic Ducts
3. Cystic Ducts
4. Common Hepatic Duct
5. Bile Duct
6. Accessory Pancreatic Duct
7. Main Pancreatic Duct
8. Descending Duodenum (D2)
9. major duodenal
   papilla

Question 16

What does a Pancreaticoduodenectomy entail, what is it also known as?

Answer 16

Whipple’s Procedure involves removing the head of the pancreas, duodenum, the gallbladder and the bile duct

used to treat tumors and other disorders of the pancreas, intestine and bile duct.

Question 17

Functions of the Spleen?

Answer 17

Immunological
responses to blood
borne antigen

Erythrocyte and
platelet turnover

Iron and haemoglobin
recycling

Haemopoesis
(Foetal and in disease)

Question 18

Location of Spleen?

Answer 18

Located in Left Hypochondrium (9-11th ribs)

Question 19

Relationships of the Spleen?

Answer 19

Posterior: Left Diaphragm
Medial: Left Kidney
Anteriorly: Stomach
Inferiorly: Left Colic Flexure

Question 20

Intraperitoneal Attachments of the Spleen?

Answer 20

Gastrosplenic ligament: To fundus of stomach

Splenorenal ligament: Lateral boundary of lesser sac

Question 21

Arterial Supply of the Spleen?

Answer 21

Splenic Artery (Branched from Celiac trunk)

Question 22

Venous Draingage of Spleen?

Answer 22

Splenic vein to portal vein

Question 23

Innervation of the Spleen?

Answer 23

Coeliac Plexus