A4-A5 Pancreas, Liver & Kidney

Parts of Pancreas

Location of relative to peritoneum: retroperitoneal - Located behind the peritoneum.

Location relative to organs: Behind the stomach, between the duodenum and spleen.

Functions:

Exocrine (digestion): Secretes pancreatic juice (enzymes).

Endocrine (hormones): Secretes glucagon and insulin.

• Head: wide part; attached to duodenum; uncinate process is a projection from the inferior part of the head

• Neck: short; lies over superior mesenteric arteries & veins

• Body: continues from the neck and is on the left side of the SMA and SMV

• Tail: near hilum of spleen and the left colic flexure

• Duct: goes from the tail to head, then turns inferiorly and connects to the bile

Surfaces of liver

Diaphragmatic surface: Anterio-superior, and curved posteriorly; covered with peritoneum except the bare area

• Coronary ligament: Has anterior and posterior layers that surround the bare area.

Base: broad part

Apex: pointy part

• Visceral surface: postero-inferior; relatively flat; concave.

Related areas:

Gastric area: Related to the stomach.

Duodenal area: Related to the duodenum.

Renal area: Related to the right kidney.

Colic area: Related to the colon.

Lobes of the liver:

• Right lobe: Larger lobe.

• Left lobe: Smaller lobe.

• Caudate lobe: Located on the visceral surface.

• Quadrate lobe: Located on the visceral surface.

Ligaments of liver

• Falciform: attaches the liver to anterior wall and divides right & left lobes

• Round: also known as ligamentum teres; connects from liver to umbilicus (remnant of umbilical vein)

(It’s called remnant bc it was a leftover blood vessel used before birth)

Portal triad

• Portal hepatis/triad: transverse fissure on the visceral surface of the liver containing:

- Portal vein: Carries nutrient-rich blood from the digestive organs to the liver

-Hepatic artery: supplies oxygenated blood to the liver

-Bile duct: Carries bile toward the gallbladder and small intestine

Gallbladder

• Gallbladder sits on the the visceral surface of the liver where there’s a dent (gallbladder fossa)

• Main function: Stores bile

• 3 Parts of the Gallbladder: Fundus: the wide end, Body, Neck: narrow and tapered; joins the cystic duct

Right/Left hepatic duct Carries bile from the right/left side of the liver.

Common hepatic duct: joins left & right duct together

Cystic duct Allows bile to move into and out of the gallbladder.

Common bile duct Carries bile toward the duodenum.

Pancreatic ducts: carry pancreatic juice (enzymes) to duodenum

Parts of kidney

Renal cortex: Blood is filtered in nephrons and enters the tubules to become urine

Renal medulla: Urine is concentrated by moving some water back into blood

Renal Pyramids: Urine goes to the renal pyramids

Renal papilla: Urine drains out of these tips

Minor calyx: Collects the urine from renal papilla

Major calyx: Collects urine from the minor calyces.

Renal pelvis: Collects urine from the major calyces to ureter

Ureter: Carries urine to the bladder

Renal fibrous capsule: Tough, thin outer covering that protects the kidney

Renal columns: Contains blood vessels and separate the pyramids.

Renal vein and artery / blood supply

Abdominal aorta: Supplies blood to the right and left renal arteries.

Renal arteries: Carry blood to the kidneys to be filtered.

Renal veins: Carry filtered blood away from the right and left kidneys.

IVC: Receives blood from the renal veins and carries it back toward the heart.

Arterial supply of GI tract

celiac artery Blood supply

The celiac artery branches off the abdominal aorta and supplies the: Stomach, Duodenum, Pancreas, Spleen, Liver

The celiac artery branches into three arteries:

• Left gastric artery

• Splenic artery

• Common hepatic artery

Common Hepatic Artery

Pathway 1: Gastroduodenal artery

Right gastro-omental artery → supplies the greater curvature of the stomach.

Superior pancreaticoduodenal artery → supplies the pancreas and duodenum.

Duodenal Branch - supplies the duodenum

Pathway 2: Hepatic artery proper

Right gastric artery → supplies the lesser curvature of the stomach.

Right hepatic artery → supplies the right part of the liver.

Left hepatic artery → supplies the left part of the liver.

Left Gastric Artery

Supplies: Lesser curvature of the stomach and lower esophagus

Splenic Artery

Splenic Artery: Supplies the spleen

3 Things the splenic artery branches to:

Short gastric arteries: Supply the upper part of the stomach.

Left gastro-omental artery: Supplies the greater curvature of the stomach.

Pancreatic branches: Supply the pancreas.

SUPERIOR MESENTERIC A

Supplies:

-Duodenum

-Pancreas

-Small intestine

-Cecum

-Appendix

-Ascending colon

-Transverse colon

Superior Mesenteric Artery

Branches to:

Inferior pancreaticoduodenal artery → supplies the pancreas and duodenum.

1. Jejunal / ileal arteries

Supply the jejunum and ileum, the middle and final parts of the small intestine.

2. Ileocolic artery

Supplies the ileum and cecum, and contributes to the blood supply of the ascending colon.

3. Appendicular artery

Supplies the appendix.

4. Right colic artery

Supplies the ascending colon.

5. Middle colic artery

Supplies the transverse colon.

Inferior Mesenteric Artery

1. Left colic artery

Supplies the descending colon and part of the transverse colon.

2. Sigmoid arteries

Supply the sigmoid colon.

3. Superior rectal artery

Supplies the upper rectum.

Nutcracker syndrome

Left renal vein is squeezed against abdominal aorta by SMA

Blood flow in typical & portal circulatory pathways

First capillary beds: Located in the digestive organs (small intestine absorb food & turn it into blood)

Hepatic portal vein: Carries blood to the liver.

Hepatic sinusoids: The hepatic portal vein branches in the liver, forming sinusoids to adjust nutrient levels and blood is detoxified.

Hepatic veins: Drain blood from the liver into the IVC.

Venous drainage from GI tract

Superior mesenteric vein (SMV): carries blood away from small & large intestine

Splenic vein: carries blood away from the spleen and also receives blood from parts of the digestive system, including the pancreas.

Inferior mesenteric vein (IMV): drains blood from descending and sigmoid colon.

Portal vein: carries blood from digestive organs toward the liver.

Hepatic veins: carry blood away from the liver into the inferior vena cava.

Inferior vena cava (IVC): carries blood from the lower body back toward the heart.