Pancreas and spleen Flashcards
Two main functions of the glandular pancreas?
Endocrine:
Produces hormones to control blood sugar (insulin, glucagon)
Exocrine:
Produce enzymes to aid digestion (lipase, amylase)
Head of pancreas
- in the concave part of the descending duodenum (2nd part)
- uncinate process wraps behind the SM vessels like a hook
Neck
narrow area from head > body
lies anterior to the SM vessels
Tail of pancreas
passes into lienorenal (splenorenal) ligament and is in contact with the hilus of the spleen
**( is intraperitoneal)
Position and appearance of the splenic vessels
Splenic artery: anterior to pancreas, looks ‘tortuous’
Splenic vein: Runs through the pancreas
Regions of the pancreas. where does the pancreas sit?
Head, neck, body, tail
sits beneath stomach
What lies anterior and posterior to the pancreas
Anterior
- Stomach, transverse colon
Posterior
- splenic vein/artery, bile duct, portal vein, IVC/aorta, SMA, Lpsoas, Left kidney, spleen
If present where does the accessory duct drain to?
through head of pancreas into duodenum
Main pancreatic duct
From tail to ampulla of vater
is joined by bile duct
-Enters duodenum via the sphinter of Oddi/ major duodenal papilla
Here pancreatic juice/bile is released
An accessory duct MAY be present, which drains into upper part of head > minor duodenal papilla
the three important sphincters are? What muscle forms these?
1) Sphincter of Oddi
2) Sphincter of Bile Duct
3) Sphincter of Pancreatic duct
smooth muscle
ampulla of vater is also called…
Hepatopancreatic ampulla
Why is the arterial etc supply pancreas so interesting?
Because its MIDWAY between foregut and midgut = DUAL SUPPLY
How can you identify the Inferior pancreatoduodenal artery
comes off SMA, which is posterior to neck of pancreas
Common hepatic»_space;»
CH > gastroduodenal > superior pancreaticduodenal > anterior/posterior PD
Splenic»_space;»>
Splenic > dorsal & greater pancreatic
Superior Mesenteric»_space;»
SMA > inferior pancreaticduodenal > ant& post PD
When does the proper hepatic artery form?
When gastroduodenal and the Right gastric has branched off
Venous drainage of the pancreas
Will all flow back to the portal vein, through the splenic or SMV»_space; to liver»_space; to IVC
Lymphatics of the pancreas
Dual lymphatic drainage
Coeliac nodes @T12
SM nodes @L1
ANS of the pancreas
Coeliac and SM plexus
so Greater and lesser splanchnic
and vagus {X}
pain > epigastric region
The spleen is
largest single mass of lymphoid tissue
- filters and recycles blood and supports IS
- NOT PART OF GUT
- sits between lienorenal and gastroplenic ligaments
Lienorenal ligament carries
spleen to left kidney
carries splenic vessels and tail of pancreas
Gastrosplenic ligament carries
spleen to stomach
carries short gastric (fundus) and gastro-epiploic vessels (left gastro-omental)
Structures anterior to the spleen
tail of pancreas
stomach
left colic flexure
structures posterior to the spleen
left kidney
ribs 9-11
two surfaces of the spleen
- diaphragmatic (pressed up against the body wall/ diaphragm)
- visceral (in contact with anterior structures, eg: kidneys, stomach, colic flexure)
Poles of the kidney and what they’re used for
upper and lower poles, for measuring
Areas of the spleen
Gastric (sup), renal (inf), colic (ant)
Art, Venous, lymph and ANS of spleen
Art: splenic artery (from Coeliac trunk)
Venous: splenic vein ( into portal vein)
Lymphatics: coeliac nodes @ T12
ANS: coeliac nodes @T12 (PS- vagus, S- greater splanchnic)
pain to epigastric region
What lies on the Trans-pyloric plane (L1)?
- pyloric region of stomach
- 1st part of duodenum
- GB fundus
- hila of kidneys
- hilus of spleen
- neck of pancreas
- SMA origin
- PV origin
- tip of 9th costal cartilage
- end of spinal cord (filum terminale)
Where does the transpyloric pane lie
midway between suprasternal notch and pubic symphysis @L1
Rule of odd numbers,
1, 3, 5, 7, 9 11
1) spleens dimensions 1 x 3 x 5 inches (txlx5)
2) Spleens weight ~7 ounces (`200g)
3) spleen is found under ribs 9-11
