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Questions and Answers
What is the approximate length of the pancreas?
Where is the pancreas located?
Which region does the greater part of the pancreas lie in?
What is the shape of the pancreas?
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Which vertebrae level is opposite to the hilum of spleen where the pancreas is located?
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What percentage of the pancreatic mass comprises digestive enzymes secretion?
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What are the functions of exocrine pancreas?
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Where does the greater part of the pancreas lie?
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What is the weight range of a normal pancreas?
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What is another term used to describe the shape of the pancreas?
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Where do the right and left hepatic ducts unite?
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What hormone triggers the contraction of the gallbladder to release bile?
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Which vessel supplies blood to the gallbladder?
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What is the approximate length of the common bile duct?
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Where does the cystic duct connect to form the bile duct?
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What does the cystic vein drain into?
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What is the function of the spiral fold in the cystic duct?
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Where is the gallbladder located in relation to the liver?
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What structures join to form the common bile duct?
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Where does bile pass after a fatty meal?
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Which artery supplies the head and neck of the pancreas?
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What is the function of somatostatin produced by the pancreas?
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What is the main cause of acute pancreatitis?
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Where does the Main Duct (of Wirsung) join another duct before opening into the duodenum?
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Which part of the pancreas is related to the gastroduodenal artery and transverse colon?
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Where is the uncinate process of the pancreas located?
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What is the approximate weight of the pancreas?
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Where is the greater part of the pancreas located?
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What is the shape of the pancreas?
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Which artery supplies the head and neck of the pancreas?
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What is the approximate percentage of pancreatic mass that the Main Duct (of Wirsung) comprises?
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Where does the uncinate process of the pancreas extend to?
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What is the function of the spiral fold in the cystic duct?
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Where does the cystic vein drain?
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What triggers the contraction of the gallbladder to release bile?
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Which vessel supplies blood to the gallbladder?
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Study Notes
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The pancreas is an endocrine and exocrine gland that produces hormones like insulin, glucagon, and somatostatin, controlling energy metabolism and storage. It comprises 1-2% of pancreatic mass and has two major ducts: the Main Duct (of Wirsung) and the Accessory Duct (of Santorini).
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The Main Duct begins at the pancreas tail and runs the entire length of the pancreas, draining the entire gland except the upper portion of the head. It joins the common bile duct and together they open into a small hepatopancreatic ampulla (Ampulla of Vater) in the 2nd part of the duodenum.
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The Head of the pancreas is the site of carcinoma and acute pancreatitis. Acute pancreatitis is a serious condition caused by obstruction of the pancreatic duct, alcohol ingestion, viral infections, or trauma, resulting in the leakage of activated enzymes and autodigestion of the gland. It presents with severe epigastric pain, fever, nausea, and vomiting.
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The pancreas has several parts: the Head, Neck with Uncinate process, Body with Tuber omentale, and Tail. The Head is related to the 2nd and 3rd portions of the duodenum on the right and continues with the neck on the left. Its anterior surface is related to the gastroduodenal artery, transverse colon, root of the transverse mesocolon, and jejunum. Its posterior surface is related to the inferior vena cava, left renal vein, bile duct, and right crus of diaphragm. The uncinate process is a part extending to the left behind the superior mesenteric vessels and is related to them both anteriorly and posteriorly.
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The pancreas is situated in front of the vertebral column at or just below the transpyloric plane, and contains the largest number of islets of Langerhans. It is related to the splenic vein, which is a tributary of the portal vein, and is involved in the production, storage, and transportation of bile.
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The pancreas has various relations and is supplied by the superior mesenteric artery and the splenic artery, both of which drain into the splenic vein. The splenic artery has several branches that drain the head and neck, and the body and tail of the pancreas are drained by the splenic vein. The splenic vein ultimately drains into the portal vein.
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The pancreas is innervated by the sympathetic and parasympathetic nervous systems, and receives arterial supply from the superior mesenteric artery and the splenic artery. It is related to the biliary system, which consists of the bile ducts, liver, and gallbladder, and is involved in the production, storage, and transportation of bile. Bile is constantly secreted by the liver and stored and concentrated in the gallbladder until it is delivered to the duodenum. The bile duct consists of several portions, including bile canaliculi, which are the smallest tributaries of the bile ducts, and the ampulla of Vater, which is the opening of the bile duct and the main pancreatic duct into the duodenum.
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Interlobular ducts join each other to form the right and left hepatic ducts at the porta hepatis.
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Right hepatic duct drains the right lobe of the liver, while the left hepatic duct drains the left lobe, the caudate lobe, and the quadrate lobe.
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Right and left hepatic ducts unite to form the common hepatic duct, which is approximately 1.5 inches (4 cm) long.
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Common hepatic duct descends within the free margin of the lesser omentum and is joined by the cystic duct from the gallbladder to form the bile duct.
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Cystic duct, about 1.5 inches (3.8 cm) long and S-shaped, connects the neck of the gallbladder to the common hepatic duct. It contains a spiral fold, also known as the "spiral valve," to keep the lumen open.
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Common bile duct, about 3 inches (8 cm) long, begins in the right free margin of the lesser omentum and becomes the common bile duct when it unites with the main pancreatic duct. It pierces the medial wall of the second part of the duodenum and opens into the duodenum through the hepatopancreatic ampulla (ampulla of Vater).
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Bile passes from the common hepatic duct to the cystic duct and into the gallbladder for storage. After a fatty meal, it moves from the gallbladder to the cystic duct and passes into the common bile duct.
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Gallbladder is a pear-shaped sac lying on the undersurface of the liver with a capacity of 30 to 50 ml. It stores and concentrates bile and secrets mucus and cholesterol.
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The gallbladder is located in contact with the anterior abdominal wall and the visceral surface of the liver.
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The blood supply for the gallbladder is the cystic artery, a branch of the right hepatic artery.
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The cystic vein drains the gallbladder directly into the portal vein, while the lymph drains into a cystic lymph node near the neck of the gallbladder and passes to the hepatic nodes along the course of the hepatic artery.
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The gallbladder contracts in response to the hormone cholecystokinin (CCK), which is produced by the mucous membrane of the cystic duct and duodenum on the arrival of fatty food.
Key facts:
- Interlobular ducts join to form the right and left hepatic ducts
- Right hepatic duct drains the right lobe, left hepatic duct drains the left lobe, and they unite to form the common hepatic duct
- The common bile duct and the main pancreatic duct join to form the common bile duct, which opens into the duodenum
- The gallbladder stores and concentrates bile and contracts in response to the hormone cholecystokinin (CCK) to release bile into the common bile duct
- The gallbladder receives blood supply from the cystic artery and drains into the cystic vein, which empties into the portal vein.
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Description
Test your knowledge on the topographical anatomy, surface anatomy, parts, relations, and peritoneal reflection of the pancreas and gallbladder. Explore the blood supply, nerve supply, lymphatic drainage, and course of common hepatic, cystic, and common bile duct.
