Spleen, Pancreas, Small Intestine Flashcards
Location of the spleen
Left hypochodriac region (LUQ)
under the cover of the left 9th-11th ribs in the midaxillary line
T/F spleen is usually palpable
False, it is not. In case of hypertrophy, do NOT palpate.
Position is assessed by?
percussion: dull area over 9th-11th ribs
abnormal: dull area over 9th to 10th
Fnxs of the spleen
Prenatal: hematopoietic organ
After birth: identifies. removes, and destroys expended RBCs and broken down platelets; recycles iron and globin
Largest lymphatic organ
spleen
What organ can self transfuse in times o fhemorrhagic stress
Spleen
From the hilum of the spleen to the greater curvature
Gastrosplenic ligament
Gastrosplenic ligament contains
short gastric and left gastroepiploic Ateries
from the front upper half of hte left kidney to the hilum of the spleen
splenorenal ligament
Visceral surfaces of the spleen
Gastric surface (above) Renal impression (R side of the spleen due to left kidney) Colic impression (down) Pancreatic (near hilum)
diagphragmatic surface of the spleen
convex and smooth
left leaf of the diaphragm
Arterial supply of the spleen
Splenic artery
Left and right gastroepiploic/gastroomental arteries
short gastric artery
Venous drainage of the spleen
Splenic vein
Lymphatic drainage of the spleen
Splenic hilum
Pancreaticosplenic LN
Innervation of the spleen
Nerves of the spleen from celiac nerve plexus (vasomotor) distributed around splenic artery
Location of the pancreas
Epigastric and left hypochondriac
An accessory digestive gland
Pancreas
Pancreas produces
pancreatic juices from acinar cells, glucagon and insulin from islets of Langerhans
Pancreas is a retroperitoneal organ that cross what vertebral bodies
L1-L2 (transpyloric plane)
What part of the pancreas is expanded and embraced by the C-shaped curve of the duodenum
Head of the pancreas
Pancreatic tumor can affect what? This presents as?
can obstruct the common bile duct
this presents as jaundice and chalk-colored stool, as well as referred pain
The pancreas is crossed anteriorly by the what?
Root of the transverse mesocolon
Part of the pancreas that extends medially to the left, posterior to eh superior mesenteric artery
Uncinate process
The head of the pancreas rests posteriorly on the
IVC, right renal artery and vein, left renal vein
Neck of the pancreas overlies what
Superior mesenteric vein
Body of the pancreas: peritoneum with or without?
Anterior: with peritoneum and forms part of stomach bed
Posterior: without peritoneum and in contact with ff.
SMV, left suprarenal gland, aorta and left kidney
Posterior part of body of pancreas in contact with?
SMV, left suprarenal gland, aorta and left kidney
Part of pancreas that is relatively mobile
tail
Pancreatic arterial supply
Pancreatic arteries+splenic arteries = arcades with pancreatic gastroduodenal atery and SMA
Arterial supply of head of pacreas
Ant and post pancreaticoduodenal arteries
T/F duodenum and the head of pancreas share for the most part the same vessels
True. This is why duodenum must be removed whent he head of the pancreas is resected.
Common blood supply of the head is through the?
Two arcades that lie in the anterior and posterior surface of the head of the pancreas
Arterial supply of the body and tail?
10 splenic artery branches
Dorsal, inferior, great pancreatic arteries
Venous drainage of the pancreas
pancreatic veins
mostly empty into splenic veins (joins)-> SMV and forms-> hepatic portal vein
Lymphatic system of pancreas
most terminate at the pancreaticosplenic LN
some: pyloric LN
Drain into SM LN or celiac LN via hepatic LN
Innervation of pancreas
from CNX and abdominopelvic splanchnic nerves
para and sympathetic fibers: fromc eliac plexus and SM plexus
Parasympathetic fiber fo pancreas
secretomotor but pancreatic secretion is primarily mediated by secretin and cholecystokinin
pancreatic secretion is primarily mediated by
secretin and cholecystokinin
main pancreatic duct
Duct of Wirsung
connects the duct of Wirsung and common bile duct
Ampulla of Vater
Minor pancreatic duct
Duct of Santorini (sometimes larger than main pancreatic duct)
Duct of Santorini drains what
anterosuperior part of head
Carcinoma in the head of pancreas causes
painless progressive jaundice and distention of GB
Small Intestine parts
deuodenum
jejunum 2/5 proximally
ileum 3/5 distally
shortest widest and most sessile part of the small intestine
duodenum
Does the duodenum have a mesentery?
No.
Duodenum has how many parts? Enumerate.
- Superior, Descending. Horizontal, Ascending
Most movable of all parts of the duodenum
1st part/superior, anteriorly covered by peritoneum but bare posteriorly
Part of duodenum from neck of gallbladder to the lower border of L3
2nd part/ descending
Part of duodenum that crossed by SMV, L3-L4
3rd part or horizontal
Part of duodenum that ascends to the upper border of L2
4th part or ascending
Ligament attached to the right crus of the diaphragm at the upper border of L2
Ligament of Treitz
after a barium meal, the superior part appears as a triangular homogenous shadow knows as
duodenal cap
circular folds in the SI
plicae circulares or valves of Keckring
Plicae circulares/valves of keckring permanent or not
permanent
Arterial supply of SI
1st part: supraduodenal, retroduodenal and duodenal branches from the R gastric, R gastroepiploic and gastroduodenal/pancreaticoduodenal arteries
2-4th: two arterial arcades
Venous Drainage SI
superior pancreaticoduodenal vein -> portal vein
inferior vein -> SMV
Lymphatics SI
upward: lymph vessels -> pancreaticoduodenal nodes -> gastroduodenal nodes -> celiac nodes
downward: lymph vessels -> pancreaticoduodenal nodes -> superior mesenteric nodes
Innervation SI
celiac and superior mesenteric plexuses
Differences between jejunum and ileum
check pic