lecture 10 - part 3

Question 1

Pancreas

Answer 1

Question 2

Question 3

Question 4

Pancreas surface anatomy

Answer 4

Right and left upper quadrants
Epigastrium, umbilical, left hypochondrium

Question 5

Pancreas divisions

Answer 5

Head: To the right of the SMA/V
Uncinate process: Inferior to head, posterior to the SMA
Neck: Anterior to the SMA/V
Body: To the left of the SMA/V
Tail: Splenic hilum

Question 6

Question 7

Position of pancreas

Answer 7

Retroperitoneal

Question 8

Main pancreatic duct

Answer 8

Pancreatic duct of wirsung
- found at the Body and tail of the pancreas

Question 9

Question 10

Accessory pancreatic duct

Answer 10

Uncinate process
Minor duodenal papilla

Question 11

Hepaticopancreatic ampulla (of Vater)

Answer 11

Major duodenal papilla
Sphincter of the bile duct
Sphincter of the pancreatic duct
Hepaticopancreatic sphincter (of Odi)

Question 12

Pancreas: Relationships
The head

Answer 12

Anterior: Transverse mesocolon
Posterior: IVC, right renal vessels, left renal vein, bile duct
Lateral, superior, inferior: Duodenum (D2/3)

Question 13

Pancreas: Relationships
The neck

Answer 13

Anterior: Pylorus
Posterior: SMA/V, portal vein

Question 14

Question 15

Pancreas: Arterial supply
Body and tail

Answer 15

Splenic artery
Gastroduodenal artery
Superior mesenteric artery

Question 16

Pancreas: Arterial supply
head

Answer 16

Superior and inferior pancreaticoduodenal arteries

Question 17

Question 18

Pancreas: Lymphatics

Answer 18

Pancreaticosplenic lymph nodes
Pyloric lymph nodes (head)
Superior mesenteric to hepatic to coeliac lymph nodes

Question 19

Pancreas: Lymphatics

Answer 19

Pancreaticosplenic lymph nodes
Pyloric lymph nodes (head)
Superior mesenteric to hepatic to coeliac lymph nodes

Question 20

Pancreas: innervation

Answer 20

Parasympathetic
Vagus nerve (CN X)
Motor

Sympathetic (T6-9)
Via superior mesenteric plexus

Question 21

Pancreatic Cancer

Answer 21

+ 4o years
Many types of pancreatic cancers, ductal adenocarcinoma most prevalent
Risk factors: smoking, obesity, diabetes etc.
Carcinoma of the head: Obstructs bile duct and ulcerates the duodenal mucosa
Carcinoma of the tail: Remains silent longer, usually large and advanced
Obstructing bile duct  jaundice, light coloured stool, abdominal pain, weightloss etc.