Pancreas (Dave's notes) Flashcards

1
Q

What is the role of the pancreas?

A

The pancreas is a composite gland of exocrine function to the duodenum and endocrine (islets of langerhans) function

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2
Q

What is the size and shape of the pancreas

A

The pancreas is shaped like a thick walking stick, with a length of approximately 15cm firm and finely lobulated.

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3
Q

What are the parts of the spleen?

A

Head, neck, body, tail

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4
Q

Describe the head of and relations of the head of the pancreas

A

The head is the broadest part of the pancreas, moulded into a c-shaped duodenal concavity. Lies on the IVC and R and L renal veins (L2). The uncinate process is prolonged and wedge shaped, an dlies behind the SMA and SMV

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5
Q

What is attached to the anterior surface of the pancreas?

A

The tansverse colon (or mesentary thereof??). The pancreas lies immediately behind the periotoneum in the posterior abdominal wall

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6
Q

Describe the neck of and relations of the neck of the pancreas

A

The neck of the pancreas is a narrow band intrond of the SMV and portal vein. The SMV passes between the neck and the uncinate process

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7
Q

What are the relations of the body of the pancreas?

A

The body passes from the neck of the pancreas to the left, sloping up across the left renal vein, aorta (coeliac trunk origin), L) crus, L) psoas, and lower pole of the left suprarenal cland, and the hilum of the left kidney. The coeliac trunk and then splenic artery passes along the upper border (??). The SMA originates at the lower border. The splenic vein lies closely apposed to the posterior surface

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8
Q

What are the relations of the tail of the pancreas?

A

The tail of the pancreas passes from the anterior surface of the left kidney, through the two layers of the lienorenal ligament to the hilum of the spleen

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9
Q

What is the course of the pancreatic duct?

A

The pancreatic duct passes from tail to head to enter D2, 2cm downstream from the accessory duct draining the uncinate process

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10
Q

What is the blood supply of the pancreas?

A

The blood supply of the pancreas is primarily from the splenic artery. The superior and inferior pancreaticoduodenal arteries supply the head.

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11
Q

What is the venous drainage of the pancreas?

A

The venous drainage of the pancreas is by the splenic vein and the superior pancreaticoduodenal vein, into the portal vein, and the inferior pancreaticoduodenal vain, into the SMV.

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12
Q

What is the lymphatic drainage of the pancreas?

A

The lymphatic drainage of the pancreas mirrors the arterial supply

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13
Q

What is the nerve supply of the pancreas?

A

Parasympathetic and sympathetic

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14
Q

Describe the parasympathetic supply of the pancreas

A

The parasympathetic supply of the pancreas stimulates. It is supplied by a posterior vagal trunk from the coeliac plexus.

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15
Q

Describe the sympathetic supply of the pancreas

A

The sympathetic supply of the pancreas has a vasoconstrictor effect. From T6-10, travelling via splanchnic nerves which also carry fibres for pain.

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16
Q

What is the main driver for pancreatic function?

A

Hormonal

17
Q

The pancreas is a ……… gland of ……. ……… with ……… function. Its cells are similar to those of the ……….. glands.

A

The pancreas is a lobulated gland of serous acini with exocrine function. Its cells are similar to those of the salivery glands.

18
Q

What hormones affect the pancreas and how?

A

The pancreas responds to secretin and CCK, by secreting trypsin, lipase et al

19
Q

Describe the development of the pancreas

A

The pancreas develops as two separate buds as outgrowths. The ventral (from the ventral mesogastrium) is common with the outgrowth of the bile duct and becomes the main pancreatic duct. The dorwal (dorsal mesogastrium) grows indepently and becomes accessory. The duodenum rotates and the two ducts are brought together

20
Q

What manouvre is used to mobilise the pancreatic head?

A

Kocher’s manouvre

21
Q

How may pseudocysts be drained?

A

Intragastrically