Pancreas Anatomy PDF

PANCREAS ❖ Largest of the digestive glands ❖ Epigastric region-left ❖ 12-15cm hypocondriac region ❖ Retroperitoneal ❖ Between duodenum and spleen ❖ Firm, lobulated smooth surface ❖ Behind stomach ❖ Extends across the posterior ❖ Both...

PANCREAS ❖ Largest of the digestive glands ❖ Epigastric region-left ❖ 12-15cm hypocondriac region ❖ Retroperitoneal ❖ Between duodenum and spleen ❖ Firm, lobulated smooth surface ❖ Behind stomach ❖ Extends across the posterior ❖ Both endocrine and exocrine abdominal wall functions Parts of Pancreas ❖ Head ❖ Neck ❖ Body ❖ Tail ❖ Uncinate process  Head ❖ Lies to the right of the midline, anterior and to the right side of the vertebral column within duodenal curve ❖ Upper border is overlapped by superior part of duodenum ❖ Uncinate process; ❖Upward projection from head posterior to sup mesenteric vessels anterior to aorta  Head ❖ Anterior to head; ✓ Gastroduodenal artery ✓ Jejunum ✓ Transvers colon Head ❖ Posterior to head; ✓ Right crus of diafragma ✓ IVC ✓ Renal vein ✓ Common bile duct Neck ❖ 2cm ❖ Between head and body ❖ Posterior to neck; ✓ Superior mesenteric vein ✓ Portal vein (beginning)  Body ❖ Seperated from stomach by omental bursa ❖ It is slightly triangular in crosssection ❖ 3 surfaces; Anterosuperior Posterior Anteroinferior ❖ 3 borders; Anterior Superior Inferior ❖ Anterosuperior surface; covered by peritoneum ❖ Posterior surface; is anterior to SMA, aorta, renal vessels, left suprarenal gland, left kidney ❖ Anteroinferior surface; is superior to duodenojejunal junction and coils of jejunum ❖ Superior border; Omental tuberosity Coeliac trunk, splenic artery, common hepatic artery ❖ Inferior border; Separates posterior from anteroinferior surfaces At the medial end of the inferior border, adjacent to the neck of the pancreas, the superior mesenteric vessels emerge from behind the gland More laterally, IMV runs under the border to join the splenic vein on the posterior surface ❖ Anterior border; Separates anterosuperior from anteroinferior surfaces Along this border two layers of transverse mesocolon diverge, one passing up over ant surface, the other over inf surface  Tail ❖ Splenorenal ligament; ✓ Tail of pancreas ✓ Splenic artery ✓ Splenic vein Uncinate process ❖ Extends from the inferior lateral end of the head of the gland ❖ Embryologically separate from the rest of the gland ❖ Lies posterior to the superior mesenteric vessels ❖ Posteriorly lies in front of the aorta ❖ Inferiorly lies on the upper surface of the third part of the duodenum  Pancreatic Ducts The exocrine pancreatic tissue drains into multiple small lobular ducts The arrangement of the main ducts draining the pancreas is subject to some variation but the commonest arrangement is a single main and a single accessory duct ❖ Main pancreatic duct (of Wirsung); ✓ Hepatopancreatic ampulla (ampulla of Vater) ✓ Major duodenal papilla ❖ Accessory pancreatic duct; ✓ Minor duodenal papilla ✓ Drains uncinate process ✓ Upper part of head Sphincters ✓ Sphincter of pancreatic duct ✓ Sphincter of bile duct ✓ Hepatopancreatic sphincter (sphincter of Oddi; sphincter of ampulla) ✓ Smooth muscle sphincters ✓ Control flow of bile and pancreatic juice into duodenum Arteries ✓ Splenic a. ✓ Gastroduodenal a. ✓ Superior pancreaticoduodenal a. ✓ Inferior pancreaticoduodenal a.  Veins ✓ Portal v. ✓ Splenic v. ✓ Superior mesenteric v. Lymphatics ✓ Pancreoticosplenic LN ✓ Pyloric LN ✓ Celiac LN ✓ Superior mesenteric LN Nerves ✓ Vagus n. ✓ Thorasic splanchnic nn.