Pancreas and spleen

Question 1

Two main functions of the glandular pancreas?

Answer 1

Endocrine:
Produces hormones to control blood sugar (insulin, glucagon)

Exocrine:
Produce enzymes to aid digestion (lipase, amylase)

Question 2

Head of pancreas

Answer 2

• in the concave part of the descending duodenum (2nd part)

- uncinate process wraps behind the SM vessels like a hook

Question 3

Neck

Answer 3

narrow area from head > body

lies anterior to the SM vessels

Question 4

Tail of pancreas

Answer 4

passes into lienorenal (splenorenal) ligament and is in contact with the hilus of the spleen

**( is intraperitoneal)

Question 5

Position and appearance of the splenic vessels

Answer 5

Splenic artery: anterior to pancreas, looks ‘tortuous’

Splenic vein: Runs through the pancreas

Question 6

Regions of the pancreas. where does the pancreas sit?

Answer 6

Head, neck, body, tail

sits beneath stomach

Question 7

What lies anterior and posterior to the pancreas

Answer 7

Anterior
- Stomach, transverse colon

Posterior
- splenic vein/artery, bile duct, portal vein, IVC/aorta, SMA, Lpsoas, Left kidney, spleen

Question 8

If present where does the accessory duct drain to?

Answer 8

through head of pancreas into duodenum

Question 9

Main pancreatic duct

Answer 9

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

Question 10

the three important sphincters are? What muscle forms these?

Answer 10

1) Sphincter of Oddi
2) Sphincter of Bile Duct
3) Sphincter of Pancreatic duct

smooth muscle

Question 11

ampulla of vater is also called…

Answer 11

Hepatopancreatic ampulla

Question 12

Why is the arterial etc supply pancreas so interesting?

Answer 12

Because its MIDWAY between foregut and midgut = DUAL SUPPLY

Question 13

How can you identify the Inferior pancreatoduodenal artery

Answer 13

comes off SMA, which is posterior to neck of pancreas

Question 14

Common hepatic&raquo_space;»

Answer 14

CH > gastroduodenal > superior pancreaticduodenal > anterior/posterior PD

Question 15

Splenic&raquo_space;»>

Answer 15

Splenic > dorsal & greater pancreatic

Question 16

Superior Mesenteric&raquo_space;»

Answer 16

SMA > inferior pancreaticduodenal > ant& post PD

Question 17

When does the proper hepatic artery form?

Answer 17

When gastroduodenal and the Right gastric has branched off

Question 18

Venous drainage of the pancreas

Answer 18

Will all flow back to the portal vein, through the splenic or SMV&raquo_space; to liver&raquo_space; to IVC

Question 19

Lymphatics of the pancreas

Answer 19

Dual lymphatic drainage
Coeliac nodes @T12
SM nodes @L1

Question 20

ANS of the pancreas

Answer 20

Coeliac and SM plexus
so Greater and lesser splanchnic
and vagus {X}

pain > epigastric region

Question 21

The spleen is

Answer 21

largest single mass of lymphoid tissue

• filters and recycles blood and supports IS
• NOT PART OF GUT
• sits between lienorenal and gastroplenic ligaments

Question 22

Lienorenal ligament carries

Answer 22

spleen to left kidney

carries splenic vessels and tail of pancreas

Question 23

Gastrosplenic ligament carries

Answer 23

spleen to stomach

carries short gastric (fundus) and gastro-epiploic vessels (left gastro-omental)

Question 24

Structures anterior to the spleen

Answer 24

tail of pancreas
stomach
left colic flexure

Question 25

structures posterior to the spleen

Answer 25

left kidney

ribs 9-11

Question 26

two surfaces of the spleen

Answer 26

• diaphragmatic (pressed up against the body wall/ diaphragm)
• visceral (in contact with anterior structures, eg: kidneys, stomach, colic flexure)

Question 27

Poles of the kidney and what they’re used for

Answer 27

upper and lower poles, for measuring

Question 28

Areas of the spleen

Answer 28

Gastric (sup), renal (inf), colic (ant)

Question 29

Art, Venous, lymph and ANS of spleen

Answer 29

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

Question 30

What lies on the Trans-pyloric plane (L1)?

Answer 30

• 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)

Question 31

Where does the transpyloric pane lie

Answer 31

midway between suprasternal notch and pubic symphysis @L1

Question 32

Rule of odd numbers,

1, 3, 5, 7, 9 11

Answer 32

1) spleens dimensions 1 x 3 x 5 inches (txlx5)
2) Spleens weight ~7 ounces (`200g)
3) spleen is found under ribs 9-11