Spleen and pancreas Flashcards
Which tissue type is the spleen derived from?
Mesoderm
What sort of injury can damage spleen?
Rib fractue, difficult to repair so common to have it removed
What can happen to the spleen in portal hypertension?
Splenomegaly, due to backing up of pressure along splenic vein. Spleen is soft and so tissue can expand easily
Which part of the spleen is most easy to palpate and when?
Splenic notch when spleen is enlarged
What is significant about the splenic artery?
Tortuous so can stretch and move with other organs around it
Has no anastamoses, so no back up supply if damaged
What are the 5 anatomical parts of the pancreas?
Tail Body Neck Head Uncinate process
What are the 3 main arteries that supply the pancreas and where do they originate?
Splenic artery - Coeliac trunk
Super pancreaticoduodenal - coeliac trunk
Inferior pancreaticoduodenal - SMA
Where does the pancreas sit?
Secondarily retroperitoneal In C of duodenum Behind stomach and lesser sac Neck sits on transpyloric plane L1 Tail sits near splenic hilum In epigastrium and extends to right hypochondrium
Why is a pancreatectomy a particularly difficult procedure?
Multiple blood supplies
Retroperitoneal
What guards the entrance to the major duodenal papilla?
Hepatopancreatic sphincter
Where does the neck of the pancreas sit?
Transpyloric plane L1
Where does pancreatitis pain refer to?
Back
Epigastric
Fluid accumulation in lesser sac
Which bud of the developing pancreas rotates to its adult position?
Ventral bud rotates 90 degrees clockwise
What is an annular pancreas?
Ring of pancreatic tissue surrounding duodenum which can cause blockage
What is the visceral afferent responsible for pancreatitis pain?
Greater splanchnic nerve T5-9
Where would fluid collect in pancreatitis?
Lesser sac, posterior to stomach
Why might pancreatic cancer cause jaundice?
Blocked bile duct
What are the relations of the spleen?
Stomach Colon Pancreas Kidney Diaphragm Ribs 9-12 Costodiaphragmatic recess
What is the lymph drainage of the spleen?
Coeliac nodes
Where should an examination of the spleen start?
Right iliac fossa
If enlarged, won’t feel splenic notch unless start down here
What would be a test for acute pancreatitis?
Amylase (lipase)
What are secretions of the exocrine pancreas?
Alkali - isotonic solution rich in HCO3 Digestive enzymes - Trypsin (endopeptidase), Chymotrypsin (endopeptidase), Carboxypeptidase (ectopeptidase), Pancreatic amylase (breaks down starches), Lipases (break down fats) Other enzymes (phospholipase, cholesterol esterase, ribonuclease)
Which cells of the exocrine pancreas secrete enzymes?
Acinar cells
Which exocrine pancreas cells secrete alkali?
Duct cells
What converts Trypsinogen to trypsin?
Membrane bound enterokinase on epithelial cells
Describe the mechanism of pancreatic HCO3 secretion
Carbonic anhydrase converts H2O and CO2 into HCO3 and H+
HCO3 is antiported with Cl into duct lumen
H is antiported with Na out into blood
What controls enzymatic secretion from the exocrine pancreas?
CCK and ACh
What controls bicarbonate secretion in the exocrine pancreas?
Stimulated by secretin and potentiated by CCK and ACh (vagal tone)
Where does the spleen sit in the abdominal cavity?
Left posterolateral abdominal wall, related to ribs 9-12
