Anatomy #3.5- Pancreas+Spleen/Stomach+Urinary

Transverse section at pancreas level

Pancreas

• The pancreas is a long narrow retroperitoneal organ that lies posterior to the stomach

• Extending from the concavity of the duodenum to the hilum of the spleen 

• Found in a horizontal-oblique line

• Lies in epigastric and left hypochondriac

• It is approximately 12cm long and 2cm thick

Five parts of pancreas

• Ucinate process

• Head

• Neck

• Body

• Tail

Head

• Thickest part of the gland

• Two vessels can be commonly seen running through the head

  • Common bile duct in the right posterior aspect

  • Gastroduodenal artery in the anterior aspect

• Lies approximately level L2-L3

• Head is anterior to the IVC and renal veins

• A transverse section through the head of the pancreas typically intersects the second part of the duodenum that is at the left margin of the head

Uncinate Process

• Medial and posterior extension of the head of the pancreas that hooks towards the back of the abdomen

• It may hook around two very important blood vessels

  • Superior mesenteric artery

  • Superior mesenteric vein

• Lying between the superior mesenteric vein and IVC

• The uncinate process is posterior to the superior mesenteric vessels

Neck

• The neck, the constricted portion of the gland is located between the pancreatic head and body

• Located just posterior to the neck is the portal splenic confluence where the portal vein is formed by the merging of the superior mesenteric and splenic veins

Body

• The body is the largest and most anterior portion of the pancreas, extending transversly to the left, anterior to the aorta, and superior mesenteric atery

• The splenic vein runs along the posterior surface of the body on its route to the portal splenic confluence

• The body tapers superiorly and posteriorly into the pancreatic tail

• The body lies posterior to the stomach

Tail

• The tail extends into the left anterior to the left kidney to end at the splenic hilum

• Splenic artery forms the superior border

• Splenic vein forms the posterior border

• The stomach forms the superoanterior border

• The most superior portion of the pancreas is the tail near the spleen

anterior view of pancreas

Transverse view of pancreas with important vessels

Vascular landmarks

Fucntions of the pancreas

• Exocrine function- acini cells produce digestive enzymes for digestion secreted via the pancreatic duct

• Endocrine function- islets of langerhands cells produce insulin and glucagon, the control blood levels of nutrients

• It delivers its endocrine hormones into the draining venous syste and its enzymes into the small intestines

• The endocrine hormones help control plasma glucose concentration

• Pancreatic digestive enzymes include amylase for the digestion of starch, lipase for the digestion of lipids, peptidases for protein digestion, and sodium bicarbonate to neutralize gastric acid

Pancreatic duct

• Wirsung’s duct- the main pancreatic duct, extending the entire length of the gland

• Santorini’s duct- secondary duct, enters duodenum at minor papilla

Wirsung’s duct

• the main pancreatic duct, extending the entire length of the gland

• Enters the medial second part of the duodenum with the common bile duct at vater’s ampulla (major duodenal papilla)

  

Santorini’s duct

• secondary duct

• Enters the duodenum at the minor papilla approximately 2cm proximal to Vater’s ampulla