SDL - Duodenum, Pancreas, Spleen Flashcards
Describe 1st part of duodenum
Ascends, the first part is intraperitoneal (hepatoduodenal ligament)
L1
Describe 2nd part of duodenum
Descends to right part of lumbar vertebra down to L3
Describe 3rd part of duodenum
Horizontal across to the left, going over the IVC, aorta and L3 vertebral body
Describe 4th part of duodenum
Superiorly, to the left of the aorta, up to the pancreas.the joins jejunum at duodenaljejunal junction. Here it is supported by a thin slip of muscle – suspensory muscle of diaphragm. A piece of peritoneum (ligament of treitz) causes duodenum to ascend. When this muscle contracts the flexure widens allowing food to enter the jejunum
Describe the difference between duodenum and jejunum
Duodenum is retroperitoneal (except first part)
Jejunum has mesentery
Where is the uncinate process? Describe its relation to important vessels
Extension of head of pancreas
Lower part of head is prolonged to the left, behind the SMA and SMV and in front of the aorta
What vein is formed behind the neck of the pancreas?
Hepatic portal vein
What is the tail of the pancreas invested in?
The splenorenal / lienorenal ligament
What is the exocrine component of the pancreas responsible for?
The secretion of various digestive enzymes
These are collected into a series of ducts which, in turn, open into a principal pancreatic duct
Where does the major pancreatic duct join the common bile duct?
At the hepatopancreatic ampulla (of Vater). this empties into the duodenum at the major duodenal papilla.
What is the hepatopancreatic ampulla (of Vater) controlled by?
Sphincter of Oddi
What does the accessory pancreatic duct drain?
The uncinate process
Where does the accessory pancreatic duct empty into?
Duodenum at minor duodenal papilla
The major duodenal papilla marks the boundary between which two subdivisions of the gut?
Foregut and midgut
What are the important relations of the pancreas?
Tail = spleen
Body = origin of transverse mesocolon
Neck = formation HPV posteriorly
Head = within concavity of duodenum
Uncinated process = SMV and SMA anteriorly
What effects might you expect from a carcinoma of the head of the pancreas?
Why is this condition often inoperable?
Jaundice
Location within abdomen and its vascular relations. Also has considerable lymph associated.
Where does the spleen lie?
It lies beneath the costal margin, in the left hypochondrium.
What ribs is the spleen related to?
Ribs 9-11
Where does the hilum of the spleen lie?
The hilum of the spleen lies at the level of L1 vertebra ie. in the transpyloric plane.
What is the transpyloric plane?
An imaginary axial plane located midway between the jugular notch and superior border of pubic symphysis, at approximately the level of L1 vertebral body.
What are the important relations of the spleen?
Laterally = ribs
Medially = lesser sac, stomach, pancreas
Superiorly, anteriorly and posteriorly = diaphragm
Inferiorly = splenic flexure
