Part 7: Pancreas

Question 1

Pancreas is a composite gland of what?

Answer 1

Endocrine and exocrine

Question 2

What is the shape and length of pancreas?

Answer 2

Thick walking stick shape, approx 15cm long

Question 3

Where does the pancreas lie?

Answer 3

Immediately behind peritoneum in posterior abdominal wall. Lies at L2, anterior to L renal vien, aorta, IVC, L diaphragm and L psoas muscle

Question 4

Is the pancreas in supra or infra colic compartment?

Answer 4

Both - transverse mesocolon attaches to anterior pancreas - therefore most is supracolic but some lies below attachment in infracolic

Question 5

What are the parts of the pancreas?

Answer 5

Head - broadest part, moulded into C-shape of duodenum
Neck - narrow band in front of SMV and PV, SMV passes between neck and uncinate process
Body - passes R to L, sloping up
Tail - Passes through 2 layers of lienorenal ligament to hilum of spleen

Question 6

What is the blood supply of the pancreas?

Answer 6

Head: Superior and inferior pancreaticoduodenal arteries and
Neck, body and tail: splenic artery - largest branch is arteria pancreatica magna

Question 7

What is the venous drainage of the pancreas?

Answer 7

Numerous small veins to splenic vein and superior pancreaticoduodenal to portal vein and inferior pancreaticoduodenal vein to SMV

Question 8

What is the nerve supply of the pancreas?

Answer 8

Parasympathetic - posterior vagal trunk and coeliac plexus
Sympathetic - splanchnic nerves (T6-10) and coeliac plexus. Pain fibres associated with sympathetic fibres and pain may therefore be referred to T6-10 dermatomes

Question 9

What is the structure of the pancreas?

Answer 9

Lobulated gland of serous acini (exocrine) similar to salivary glands.
Pale-staining islets (of Langerhans) are scattered throughout acini give endocrine function

Question 10

What are the types of islets of Langerhans and what do they secrete?

Answer 10

alpha - glucagon
beta - insulin
delta - somatostatin

Question 11

What is the name of the pancreatic duct and accessory duct?

Answer 11

Pancreatic duct - of Wirsung

Accessory duct - of Santorini (drains uncinate process)

Question 12

Why does the pancreas have 2 ducts?

Answer 12

Develops as 2 buds - dorsal and ventral each with a duct. Duodunum rotates so that ventral bud sits alongside dorsal. The glands fuse to form the pancreas but maintain their own ducts (although ductal systems anastomose distally). Differential growth causes the accessory duct(dorsal bud) to insert into duodenum more proximally.

Question 13

What is the lymph drainage of the pancreas?

Answer 13

Follows course of arteries, neck, body and tail into retropancreatic nodes and head into upper coeliac group