Pancreas Flashcards
Shape of the pancreas
J-shaped
What does the exocrine part of the pancreas secrete?
Digestive pancreatic juice
What does the endocrine part of the pancreas secrete?
Hormones (e.g. insulin)
What is the vertebral location of the pancreas?
L1 and 2
Sections of the pancreas
Right to left:
Head
Neck
Body
Tail
Location of the pancreas head
Head is the enlarged flattened right end of the pancreas
Lies within the concavity of the duodenum
What are the borders of the pancreas head?
Superior
Inferior
Right lateral
What are the surfaces of the pancreas head?
Anterior
Posterior
What are the processes of the pancreas head?
Uncinate process
Relations of the superior border of the pancreas head
Overlapped by the first part of the duodenum
Related to the superior pancreaticoduodenal artery
Relations of the inferior border of the pancreas head
Related to the third part of the duodenum
Related to the inferior pancreaticoduodenal artery
Relations of the right lateral border of the pancreas head
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
What is the anterior surface of the pancreas head related to?
Superior to inferior:
First part of duodenum
Transverse colon
Jejunum (peritoneum separates the pancreas from jejunum)
What is the posterior surface of the pancreas head related to?
Inferior vena cava
Terminal parts of the renal veins
Right crus of the diaphragm
Bile duct
What is the uncinate process related to?
Anterior: Superior mesenteric vessels
Posterior: Aorta
What is the neck of the pancreas?
Slightly constricted part of the pancreas between its head and body
Direction of pancreas neck
Forwards, upwards and left
Surfaces of the pancreas neck
Anterior and posterior
Relations of the anterior surface of the pancreas neck
Peritoneum covering the posterior wall of the lesser sac
Pylorus
Relations of the posterior surface of the pancreas neck
Termination of the superior mesenteric vein
Beginning of the portal vein
What is the body of the pancreas?
Elongated segment of the pancreas from neck to tail
Direction of pancreas body
Passes towards the left with a slight upward and backward inclination
What are the external features of the pancreas body?
3 borders: Anterior, Superior and Inferior
Tuber omentale: part of body which projects above superior border
Relations of the anterior border of pancreas body
Root of transverse mesocolon
Relations of the superior border of pancreas body
Coeliac trunk over the tuber omentale
Hepatic artery to the right
Splenic artery to the left
Relations of the inferior border of pancreas body
Superior mesenteric vessels
Relations of the anterior surface of the pancreas body
Lesser sac
Stomach
Relations of the posterior surface of the pancreas body
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
Devoid of peritoneum
Relations of the inferior surface of the pancreas body
Duodenojejunal flexure
Coils of jejunum
Left colic flexure
Location of the pancreas tail
Left end of pancreas
Lies in the lienorenal ligament with the splenic vessels
Relations of the pancreas tail
Contacts with the lower part of the gastric surface of the spleen
Which ducts drain the exocrine pancreas?
Main and accessory ducts
What is the main pancreatic duct called?
Main pancreatic duct of Wirsung
Course of the main pancreatic duct
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 āVā 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
What is the accessory pancreatic duct called?
Accessory Pancreatic Duct of Santorini
Course of the accessory pancreatic duct of Santorini
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
Arterial supply of the pancreas
Mainly pancreatic branches of the splenic artery
The superior pancreaticoduodenal artery
The inferior pancreaticoduodenal artery
Venous drainage of the pancreas
Splenic, superior mesenteric and portal veins
Lymphatic drainage of the pancreas
Lymphatics follow the arteries and drain into the pancreaticosplenic, coeliac and superior mesenteric groups of lymph nodes
Nerve supply of the pancreas
The vagus (parasympathetic) and splanchnic (sympathetic) nerves supply the pancreas through the plexuses around its arteries
What are the manifestations of carcinomas at the pancreas head?
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
