ANATOMY- The Pancreas

Question 1

What is the Surface Anatomy of the Pancreas?

Answer 1

Lies in the TRANSPYLORIC PLANE

Question 2

What spinal level is the TRANSPYLORIC PLANE?

Answer 2

L1

Question 3

TRANSPYLORIC PLANE

Answer 3

Question 4

What are the ANTERIOR Relations of the Pancreas?

Answer 4

Lesser Sac
Stomach

Question 5

Where are PSEUDOCYSTS typically found?

Answer 5

Lesser sac

Question 6

What is a CYSTGASTROSTOMY?

Answer 6

Drainage of Pseudocyst from the lesser sac into the stomach

Question 7

What are the POSTERIOR relations of the Pancreas?

Answer 7

Left Kidney
IVC
Superior Mesenteric Vessels
Portal Vein
Aorta
CBD

Question 8

Where is the HEPATIC PORTAL VEIN FORMED?

Answer 8

POSTERIOR to the NECK OF THE PANCREAS

Question 9

What Vessels form the HEPATIC PORTAL VEIN?

Answer 9

Superior Mesenteric Vein
Splenic Vein

Question 10

What is the ARTERIAL Blood supply of the Pancreas?

Answer 10

SPLENIC ARTERY
PANCREATICODUODENAL ARTERY

Question 11

Where does the SPLENIC ARTERY COME FROM?

Answer 11

COELIAC PLEXUS
ABDOMINAL AORTA

Question 12

Where does the PANCREATICODUODENAL ARTERY COME FROM?

Answer 12

GASTRODUODENAL ARTERY

Question 13

Where does the GASTRODUODENAL ARTERY come from?

Answer 13

COMMON HEPATIC ARTERY

Question 14

Is the Pancreas an INTRAPERITONEAL or RETROPERITONEAL organ?

Answer 14

RETROPERITONEAL ORGAN

Question 15

Where does the PANCREATIC DUCT drain?

Answer 15

Second Part of the Duodenum

MAJOR DUODENAL PAPILLA

Question 16

What structure surrounds the Pancreatic Duct?

Answer 16

SPHINCTER OF ODDI

Question 17

What Structure does the Pancreatic Duct Join before it enters the Ampulla of Vater?

Answer 17

COMMON BILE DUCT

Question 18

AMPULLA OF VATER

Answer 18

Question 19

What causes the RELAXATION of the Sphincter of oddi?

Answer 19

Cholecystokinin

Question 20

Where is cholecystokinin released?

Answer 20

Released from I-Cells in the DUODENUM

Question 21

What is the FUNCTION of CCK?

Answer 21

1) Stimulates the Pancreas to produce digestive enzymes

2) Contraction of the Gallbladder

3) Relaxation of the Sphincter of Oddi

4) Suppression of Hunger

Question 22

What stimulates the release of CCK?

Answer 22

• The presence of food rich in FAT and PROTEIN in the Small bowel

Question 23

What stops the Release of CCK?

Answer 23

SOMATOSTATIN

Question 24

What is the ACCESSORY DUCT OF SANTORINI?

Answer 24

• Additional Pancreatic Duct
  -May open into the Duodenum via the MINOR DUODENAL PAPILLA

Question 25

MINOR DUODENAL PAPILLA

Answer 25

Question 26

What is an ANNULAR PANCREAS?

Answer 26

- Abnormal embryological development of the pancreas -Results in a ring of pancreatic tissue, which surrounds the Duodenum -May cause Bowel Obstruction

Question 27

Describe the Embryology of the Pancreas?

Answer 27

- Develops from the FOREGUT - Formed from the Dorsal and Ventral Pancreatic Bud, which fuse together

Question 28

What is Pancreatic Divisum?

Answer 28

- Failure of the Dorsal and Ventral Pancreatic buds to fuse -Results in the Majority of the Pancreas being drained by the ACCESSORY PANCREATIC DUCT

Question 29

Histologically what are the TWO main parts of the Pancreas? Which forms the majority of the gland?

Answer 29

EXOCRINE PANCREAS- Secretions Drain into Ducts ENDOCRINE PANCREAS- Islets of langerhans, producing hormones EXOCRINE PANCREAS forms the bulk of the gland

Question 30

What does the EXOCRINE Pancreas produce?

Answer 30

- Enzyme Rich ALKALINE Fluid -PROENZYMES

Question 31

Why does the Pancreas produce Proenzymes?

Answer 31

Prevents auto digestion of the Pancreas

Question 32

What type of Proenzymes does the Pancreas Produce?

Answer 32

PROTRYPSIN PROCHYMOTRYPSIN

Question 33

What activates pancreatic proenzymes?

Answer 33

ENTEROKINASE secreted by the Duodenal mucosa

Question 34

What FACTORS Increase PANCREATIC SECRETION? Where are they Produced?

Answer 34

1) CCK- I Cells of the Duodenum 2) GASTRIN- G-cells of the STOMACH 3) SECRETIN- S-cells of the Duodenum

Question 35

Describe the HISTOLOGY of the EXOCRINE PANCREAS

Answer 35

- Secretory Acini, which drain into Pancreatic Duct

Question 36

EXOCRINE PANCREAS

Answer 36

Question 37

Describe the HISTOLOGY of the ENDOCRINE PANCREAS

Answer 37

ISLETS OF LANGERHANS composed of the following cells: Alpha cells- Glucagon (25% of Cells) Beta Cells- Insulin (60% of Cells) Delta Cells- Somatostatin

Question 38

ENDOCRINE PANCREAS

Answer 38

Question 39

Describe the Production of the INSULIN?

Answer 39

- Produced as PREPROINSULIN in the Rough Endoplasmic Reticulum - PREPROINSULIN is Cleaved to PROINSULIN in the Golgi apparatus - PROINSULIN is Cleaved to INSULIN and packaged into Secretory granules