Pancreas

Question 1

Shape of the pancreas

Answer 1

J-shaped

Question 2

What does the exocrine part of the pancreas secrete?

Answer 2

Digestive pancreatic juice

Question 3

What does the endocrine part of the pancreas secrete?

Answer 3

Hormones (e.g. insulin)

Question 4

What is the vertebral location of the pancreas?

Answer 4

L1 and 2

Question 5

Sections of the pancreas

Answer 5

Right to left:
Head
Neck
Body
Tail

Question 6

Location of the pancreas head

Answer 6

Head is the enlarged flattened right end of the pancreas
Lies within the concavity of the duodenum

Question 7

What are the borders of the pancreas head?

Answer 7

Superior
Inferior
Right lateral

Question 8

What are the surfaces of the pancreas head?

Answer 8

Anterior
Posterior

Question 9

What are the processes of the pancreas head?

Answer 9

Uncinate process

Question 10

Relations of the superior border of the pancreas head

Answer 10

Overlapped by the first part of the duodenum
Related to the superior pancreaticoduodenal artery

Question 11

Relations of the inferior border of the pancreas head

Answer 11

Related to the third part of the duodenum
Related to the inferior pancreaticoduodenal artery

Question 12

Relations of the right lateral border of the pancreas head

Answer 12

Related to the second part of the duodenum
Related to the terminal part of the bile duct
Related to the anastomosis between the two pancreaticoduodenal arteries

Question 13

What is the anterior surface of the pancreas head related to?

Answer 13

Superior to inferior:
First part of duodenum
Transverse colon
Jejunum (peritoneum separates the pancreas from jejunum)

Question 14

What is the posterior surface of the pancreas head related to?

Answer 14

Inferior vena cava
Terminal parts of the renal veins
Right crus of the diaphragm
Bile duct

Question 15

What is the uncinate process related to?

Answer 15

Anterior: Superior mesenteric vessels
Posterior: Aorta

Question 16

What is the neck of the pancreas?

Answer 16

Slightly constricted part of the pancreas between its head and body

Question 17

Direction of pancreas neck

Answer 17

Forwards, upwards and left

Question 18

Surfaces of the pancreas neck

Answer 18

Anterior and posterior

Question 19

Relations of the anterior surface of the pancreas neck

Answer 19

Peritoneum covering the posterior wall of the lesser sac
Pylorus

Question 20

Relations of the posterior surface of the pancreas neck

Answer 20

Termination of the superior mesenteric vein
Beginning of the portal vein

Question 21

What is the body of the pancreas?

Answer 21

Elongated segment of the pancreas from neck to tail

Question 22

Direction of pancreas body

Answer 22

Passes towards the left with a slight upward and backward inclination

Question 23

What are the external features of the pancreas body?

Answer 23

3 borders: Anterior, Superior and Inferior
Tuber omentale: part of body which projects above superior border

Question 24

Relations of the anterior border of pancreas body

Answer 24

Root of transverse mesocolon

Question 25

Relations of the superior border of pancreas body

Answer 25

Coeliac trunk over the tuber omentale Hepatic artery to the right Splenic artery to the left

Question 26

Relations of the inferior border of pancreas body

Answer 26

Superior mesenteric vessels

Question 27

Relations of the anterior surface of the pancreas body

Answer 27

Lesser sac Stomach

Question 28

Relations of the posterior surface of the pancreas body

Answer 28

The aorta with the origin of the superior mesenteric artery Left crus of the diaphragm Left suprarenal gland Left kidney Left renal vessels Splenic vein ## Footnote Devoid of peritoneum

Question 29

Relations of the inferior surface of the pancreas body

Answer 29

Duodenojejunal flexure Coils of jejunum Left colic flexure

Question 30

Location of the pancreas tail

Answer 30

Left end of pancreas Lies in the lienorenal ligament with the splenic vessels

Question 31

Relations of the pancreas tail

Answer 31

Contacts with the lower part of the gastric surface of the spleen

Question 32

Which ducts drain the exocrine pancreas?

Answer 32

Main and accessory ducts

Question 33

What is the main pancreatic duct called?

Answer 33

Main pancreatic duct of Wirsung

Question 34

Course of the main pancreatic duct

Answer 34

Begins at the tail Runs towards the right through the body of the pancreas Bends at the neck to run downwards Backwards and to the right in the head Receives many small tributaries which join it at acute angles to its long axis showing a ‘V’ shape pattern (Herring bone pattern) The pancreatic duct and the bile duct enter the wall of the second part of the duodenum, and join to form the Hepatopancreatic Ampulla of Vater which opens by a narrow mouth on the summit of the major duodenal papilla, 8 to 10 cm distal to the pylorus

Question 35

What is the accessory pancreatic duct called?

Answer 35

Accessory Pancreatic Duct of Santorini

Question 36

Course of the accessory pancreatic duct of Santorini

Answer 36

Begins in the lower part of the head Crosses the front of the main duct with which it communicates and opens into the duodenum at the minor duodenal papilla The papilla of accessory pancreatic duct is situated 6 to 8 cm distal to the pylorus The opening of the accessory duct lies cranial and ventral to that of the main duct

Question 37

Arterial supply of the pancreas

Answer 37

Mainly pancreatic branches of the splenic artery The superior pancreaticoduodenal artery The inferior pancreaticoduodenal artery

Question 38

Venous drainage of the pancreas

Answer 38

Splenic, superior mesenteric and portal veins

Question 39

Lymphatic drainage of the pancreas

Answer 39

Lymphatics follow the arteries and drain into the pancreaticosplenic, coeliac and superior mesenteric groups of lymph nodes

Question 40

Nerve supply of the pancreas

Answer 40

The vagus (parasympathetic) and splanchnic (sympathetic) nerves supply the pancreas through the plexuses around its arteries

Question 41

What are the manifestations of carcinomas at the pancreas head?

Answer 41

Pressure over the posteriorly placed bile duct leads to persistent obstructive jaundice Presses portal vein, causing ascites; or may involve the stomach, causing pyloric obstruction