أسئلة الثالثة أناتومي ثانية Pancreas & Suprarenal (قبل التعديل)

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Questions and Answers

What is the positional relationship between the uncinate process of the pancreas, the aorta, and the superior mesenteric artery (SMA)?

  • The uncinate process is medial to the aorta and lateral to the SMA.
  • The uncinate process is posterior to the aorta and anterior to the SMA. (correct)
  • The uncinate process is anterior to the aorta and posterior to the SMA.
  • The uncinate process is lateral to the aorta and medial to the SMA.

Which of the following structures is directly posterior to the neck of the pancreas?

  • Pyloro-duodenal junction
  • Beginning of the portal vein (correct)
  • Inferior vena cava
  • Common bile duct

A surgeon is operating in the lesser sac. Which surface of the pancreas would they most likely encounter?

  • Superior surface
  • Anterior surface (correct)
  • Posterior surface
  • Inferior surface

During an exploratory laparotomy, which of the following structures is found to be directly related to the posterior surface of the pancreas and is not covered by peritoneum?

<p>Left kidney (A)</p> Signup and view all the answers

A CT scan reveals a mass located near the head of the pancreas. Which structure is most likely to be anteriorly related to this mass?

<p>Transverse colon (D)</p> Signup and view all the answers

The anterior border of the pancreas is attached to which structure?

<p>Transverse mesocolon (B)</p> Signup and view all the answers

Where does the main pancreatic duct typically unite before emptying its contents?

<p>Common bile duct (B)</p> Signup and view all the answers

Which artery does NOT directly contribute to the arterial supply of the pancreas?

<p>Inferior phrenic artery (D)</p> Signup and view all the answers

Most of the lymphatic drainage from the pancreas flows into which lymph nodes?

<p>Coeliac lymph nodes (B)</p> Signup and view all the answers

What is the sympathetic nerve supply to the pancreas derived from?

<p>Coeliac and superior mesenteric plexus (C)</p> Signup and view all the answers

The right suprarenal gland drains directly into which vein?

<p>Inferior vena cava (D)</p> Signup and view all the answers

Which artery does NOT supply the suprarenal gland?

<p>Gastroduodenal artery (B)</p> Signup and view all the answers

From which embryonic germ layer does the suprarenal medulla originate?

<p>Ectoderm (D)</p> Signup and view all the answers

If a surgeon is performing a procedure involving the structures directly posterior to the neck of the pancreas, which vessel is most at risk of injury?

<p>Portal vein (A)</p> Signup and view all the answers

Upon entering the lesser sac during surgery, which surface of the pancreas would the surgeon visualize first?

<p>Anterior surface of the body (A)</p> Signup and view all the answers

A surgeon needs to access the posterior surface of the pancreas without disrupting any peritoneal attachments. Which approach would allow for this?

<p>Directly through the retroperitoneum, lateral to the left kidney (A)</p> Signup and view all the answers

A mass located near the head of the pancreas is compressing a major vessel. If the mass is anterior to the vessel, which of the following is most likely affected?

<p>Superior mesenteric artery (B)</p> Signup and view all the answers

Which anatomical relationship explains the potential for pancreatic cancer in the body to cause splenic vein thrombosis?

<p>The splenic vein is posterior to the pancreas and embedded in its substance. (C)</p> Signup and view all the answers

If a surgeon identifies the omental tuberosity during a pancreatic exploration, which major vessel is most immediately adjacent to the pancreas in this region?

<p>Splenic artery (B)</p> Signup and view all the answers

Damage to which structure would most likely impair both bile and pancreatic juice secretion into the duodenum?

<p>Sphincter of Oddi (D)</p> Signup and view all the answers

A pancreatic lesion obstructing the accessory pancreatic duct would most likely directly affect the drainage from which part of the pancreas?

<p>Head of pancreas (B)</p> Signup and view all the answers

During a surgical procedure involving the pancreas, an anatomical landmark must be identified to avoid injury to a major blood vessel. Which landmark corresponds most closely to the location of the superior mesenteric artery?

<p>Posterior surface of the neck of the pancreas (C)</p> Signup and view all the answers

A patient presents with a tumor compressing the portal vein. Which of the following lymphatic drainage pathways from the pancreas would most likely be affected?

<p>Drainage into the superior mesenteric lymph nodes (A)</p> Signup and view all the answers

Which of the following best describes the venous drainage pattern of the left suprarenal gland compared to the right suprarenal gland?

<p>The left suprarenal vein drains into the left renal vein, while the right drains directly into the inferior vena cava. (B)</p> Signup and view all the answers

A genetic mutation affecting the migration of neural crest cells during embryonic development would most directly impact the formation of which part of the suprarenal gland?

<p>Suprarenal medulla (A)</p> Signup and view all the answers

Surgical access to the posterior surface of the pancreas requires careful consideration of its relationship to other retroperitoneal structures. Which of the following structures is in direct contact with the posterior surface of the pancreas?

<p>Left kidney (A)</p> Signup and view all the answers

Flashcards

Pancreas Head Relationships

Anteriorly related to the transverse colon and small intestine. Posteriorly related to the common bile duct (CBD) and inferior vena cava.

Uncinate Process Position

Lies between the aorta (posteriorly) and the superior mesenteric artery (SMA) anteriorly.

Pancreas Neck Relationships

Anteriorly related to the pyloro-duodenal junction. Posteriorly related to the beginning of the portal vein.

Pancreas Body - Anterior Surface

Part of the stomach bed and covered by the lesser sac.

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Pancreas Body - Inferior Surface

Related to the small intestine and covered by the greater sac.

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Anterior border of pancreas

Attaches to transverse mesocolon.

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Main Pancreatic Duct

Unites with CBD to form ampulla of vater, opening into the 2nd part of the duodenum.

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Accessory Pancreatic Duct

Opens on the minor duodenal papillae in the 2nd part of the duodenum.

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Pancreas Arterial Supply

Primarily supplied by the splenic artery.

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Pancreaticoduodenal Arteries

Head of pancreas supplied by superior pancreatico-duodenal (from gastroduodenal) and inferior pancreatico-duodenal (from superior mesenteric).

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Pancreas Venous Drainage

Drains into the portal vein.

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Suprarenal Gland Site

At the upper end of the kidney.

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Suprarenal Vein Drainage

Right side drains directly into the inferior vena cava. Left side drains into the left renal vein.

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Pancreas Body - Posterior Surface

A surface of the pancreas body not covered with peritoneum and related to several structures.

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Structures Posterior to Pancreas

Structures related to the posterior surface of the pancreas body.

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Aorta Relation to Pancreas

Lies posterior to the pancreas body.

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Superior Border of Pancreas

Related to the splenic artery and marked by the omental tuberosity.

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Tail of Pancreas

Passes within the lieno-renal ligament, along with the splenic vessels.

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Pancreas Parasympathetic Nerve Supply

From the vagus nerve.

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Suprarenal Gland Shape

Right side is pyramidal, left side is semilunar (crescent-shaped).

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Suprarenal Gland Cover

Covered by renal fascia and perinephric fat.

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Suprarenal Arterial Supply

Superior Supra-renal (from inferior phrenic artery), Middle Supra-renal (from abdominal aorta), Inferior Supra-renal (from renal artery).

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Suprarenal Gland Development

Cortex: mesoderm. Medulla: ectoderm (neural crest cells).

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Study Notes

Pancreas Parts

  • The pancreas head relates anteriorly to the transverse colon and small intestine.
  • The pancreas head relates posteriorly to the common bile duct (CBD) and inferior vena cava.
  • The uncinate process lies between the aorta (posteriorly) and the superior mesenteric artery (SMA) anteriorly.
  • The pancreas neck relates anteriorly to the pyloro-duodenal junction.
  • The pancreas neck relates posteriorly to the beginning of the portal vein.
  • The pancreas body has three surfaces and three borders.
  • The anterior surface is part of the stomach bed and is covered by the lesser sac.
  • The inferior surface relates to the small intestine and is covered by the greater sac.
  • The posterior surface is not covered with peritoneum and relates to the aorta, splenic vein, left kidney, left psoas major, superior mesenteric artery, left renal vein, left suprarenal gland, and left crus diaphragm.
  • The anterior border attaches to the transverse mesocolon.
  • The superior border relates to the splenic artery and is marked by the presence of omental tuberosity.
  • The posterior border has the same relation as the posterior surface.
  • The pancreas tail passes in the lieno-renal ligament with splenic vessels.

Pancreatic Ducts

  • The main pancreatic duct unites with the common bile duct to form the ampulla of Vater, which opens on the major duodenal papillae in the second part of the duodenum.
  • The accessory pancreatic duct opens on the minor duodenal papillae in the second part of the duodenum.

Pancreas Blood Supply

  • Arterial supply mainly comes from the splenic artery.
  • The head of the pancreas is supplied by the superior pancreatico-duodenal artery from the gastroduodenal artery and the inferior pancreatico-duodenal artery from the superior mesenteric artery.
  • Venous drainage drains into the portal vein.
  • Lymph drainage primarily drains into the celiac lymph nodes, with a few parts draining into the superior mesenteric lymph nodes.
  • Parasympathetic nerve supply comes from the vagus nerve.
  • Sympathetic nerve supply comes from the celiac and superior mesenteric plexus.

Supra-Renal Gland Information

  • The supra-renal gland is located at the upper end of the kidney.
  • The right supra-renal gland has a pyramidal shape.
  • The left supra-renal gland has a semilunar shape.
  • Supra-renal glands are covered by renal fascia and perinephric fat.
  • Peritoneal cover is retro-peritoneal.
  • The right hilum is directed upward and does not reach the renal hilum.
  • The left hilum is directed downward and reaches the renal hilum.

Supra-Renal Gland Blood Supply

  • Arterial supply includes the superior supra-renal artery from the inferior phrenic artery, the middle supra-renal artery from the abdominal aorta, and the inferior supra-renal artery from the renal artery.
  • Venous drainage from the right side ends in the inferior vena cava.
  • Venous drainage from the left side ends in the left renal vein.

Supra-Renal Gland Development

  • The supra-renal cortex is of mesodermal origin.
  • The supra-renal cortex differentiates into three layers: the zona glomerulosa, the zona fasciculata, and the zona reticularis.
  • The supra-renal medulla is ectodermal in origin.
  • The supra-renal medulla originates from chromaffin cells, also known as neural crest cells.

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