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Question 1

Is the pancreas retroperitoneal or intraperitoneal?

Answer 1

The pancreas is retroperitoneal except for the tail, which is intraperitoneal.

Question 2

Where does the tail of the pancreas pass, and what does it contact?

Answer 2

The tail passes in the splenicorenal (lienorenal) ligament and comes in contact with the hilum of the spleen.

Question 3

Where does the pancrease begin and where does it end?

Answer 3

The pancreas extends from the concavity of the duodenum to the hilum of the spleen.

Question 4

Which anatomical plane does the pancreas cross?

Answer 4

The pancreas crosses the transpyloric plane (L1).

Question 5

Where is the transpyloric plane located in relation to surface anatomy?

Answer 5

The transpyloric plane lies roughly a hand’s breadth beneath the xiphisternum or midway between the xiphisternum and the umbilicus.

Question 6

Which anatomical landmarks does the transpyloric plane intersect?

Answer 6

The plane cuts through the pylorus of the stomach, the tips of the ninth costal cartilages, and the lower border of the first lumbar vertebra.

Question 7

What are the parts of the pancreas?

Answer 7

The pancreas consists of the head, neck, body, and tail.

Question 8

How do the head and tail of the pancreas relate to the transpyloric plane?

Answer 8

The head lies below the transpyloric plane, while the tail lies above it.

Question 9

Where does the head of the pancreas lie?

Answer 9

The head of the pancreas lies within the concavity of the duodenum.

Question 10

What is the uncinate process, and where is it located?

Answer 10

The uncinate process is part of the head of the pancreas that extends to the left behind the superior mesenteric vessels.

Question 11

What structures are located anteriorly to the head of the pancreas?

Answer 11

The transverse colon and mesocolon.

Question 12

Which vessels cross in front of the uncinate process of the pancreas?

Answer 12

The superior mesenteric blood vessels (artery and vein).

Question 13

Where does the superior mesenteric artery run in relation to the superior mesenteric vein?

Answer 13

The artery runs to the left of the vein.

Question 14

What structures lie between the superior mesenteric artery and the aorta?

Answer 14

a) Left renal vein
b) Third part of the duodenum
c) Uncinate process of the pancreas

Question 15

What structures are located posteriorly to the head of the pancreas?

Answer 15

The common bile duct and the right renal vein.

Question 16

What is the neck of the pancreas?

Answer 16

It is the constricted portion between the head and the body, about 2 cm in length, and lies mostly behind the pylorus of the stomach.

Question 17

What is located behind the neck of the pancreas?

Answer 17

The portal vein is formed posterior to the neck by the union of the splenic and superior mesenteric veins.

Question 18

What is located anteriorly to the neck of the pancreas?

Answer 18

The pyloroduodenal junction.

Question 19

What is located posteriorly to the neck of the pancreas?

Answer 19

The beginning of the portal vein.

Question 20

What is the shape of the body of the pancreas in cross-section?

Answer 20

It is triangular.

Question 21

What direction does the body of the pancreas run?

Answer 21

It runs upward and to the left.

Question 22

What is located along the border of the body of the pancreas?

Answer 22

The splenic artery.

Question 23

What is located along the anterior border of the body of the pancreas?

Answer 23

The transverse mesocolon.

Question 24

What is located on the anterior surface of the body of the pancreas?

Answer 24

The lesser sac and the stomach.

Question 25

What structures are located posteriorly to the body of the pancreas?

Answer 25

- Aorta - Splenic vein - Inferior mesenteric vein - Left kidney and its vessels

Question 26

What are the arterial supplies of the pancreas?

Answer 26

- Splenic artery - Superior pancreaticoduodenal artery (anterior and posterior branches, branches of gastroduodenal) - Inferior pancreaticoduodenal artery (anterior and posterior branches, branch of superior mesenteric)

Question 27

Into which system do the veins of the pancreas drain?

Answer 27

The veins corresponding to the arteries of the pancreas drain into the portal system.

Question 28

Where are the lymph nodes of the pancreas located?

Answer 28

Along the arterial supply of the pancreas.

Question 29

Into which lymph nodes do the efferent vessels from the pancreas drain?

Answer 29

The celiac and superior mesenteric lymph nodes.

Question 30

What is the sympathetic nerve supply of the pancreas?

Answer 30

T5–T9 spinal nerves.

Question 31

What is the parasympathetic nerve supply of the pancreas?

Answer 31

The vagus nerve.

Question 32

What is the main pancreatic duct, and where does it begin?

Answer 32

The main pancreatic duct (Duct of Wirsung) begins in the tail of the pancreas and runs the entire length of the gland, receiving numerous tributaries.

Question 33

Where does the main pancreatic duct open into the duodenum?

Answer 33

It joins the common bile duct to form the hepatopancreatic ampulla of Vater, opening into the major duodenal papilla in the middle of the second part of the duodenum.

Question 34

What surrounds the opening of the main pancreatic duct in the duodenum?

Answer 34

The opening is surrounded by the Sphincter of Oddi.

Question 35

How does the main pancreatic duct rarely drain?

Answer 35

Rarely, the main pancreatic duct drains separately into the duodenum.

Question 36

What is the accessory pancreatic duct, and what does it drain?

Answer 36

The accessory pancreatic duct (Duct of Santorini) drains the upper part of the pancreatic head.

Question 37

Where does the accessory pancreatic duct open into the duodenum?

Answer 37

It opens into the minor duodenal papilla, a short distance above the opening of the main duct.

Question 38

Does the accessory pancreatic duct communicate with the main duct?

Answer 38

Yes, the accessory pancreatic duct frequently communicates with the main pancreatic duct.

Question 39

What is the length of the small intestine?

Answer 39

The small intestine is 6-7 m (20-22 feet) long.

Question 40

Into which three portions is the small intestine divided?

Answer 40

The small intestine is divided into the duodenum, jejunum, and ileum.

Question 41

How long is the duodenum?

Answer 41

The duodenum is 10 inches long.

Question 42

Which part of the duodenum is not retroperitoneal?

Answer 42

The first inch of the duodenum is not retroperitoneal.

Question 43

How is the duodenum structured in terms of its parts?

Answer 43

The duodenum is divided into four parts, each coursing in different directions.

Question 44

What overall shape does the duodenum form, and what fills its concavity?

Answer 44

The duodenum forms the shape of the letter 'C,' with the concavity filled by the head of the pancreas.

Question 45

At what vertebral level is the first part of the duodenum located?

Answer 45

The first part of the duodenum is at the level of L1.

Question 46

What structure is attached to the first inch of the duodenum?

Answer 46

The hepatoduodenal ligament

Question 47

What structures are contained within the hepatoduodenal ligament?

Answer 47

The hepatoduodenal ligament contains the hepatic artery proper, common bile duct, and portal vein.

Question 48

What lies anterior to the first part of the duodenum?

Answer 48

Anterior to the first part of the duodenum are: 1 The quadrate lobe of the liver 2 The neck of the gallbladder

Question 49

What lies posterior to the first part of the duodenum?

Answer 49

Posterior to the first part of the duodenum are: 1. The lesser sac (first inch only) 2. The gastroduodenal artery 3. The bile duct 4. The portal vein 5. The inferior vena cava

Question 50

What lies superior to the first part of the duodenum?

Answer 50

Superior to the first part of the duodenum is the epiploic foramen.

Question 51

What lies inferior to the first part of the duodenum?

Answer 51

Inferior to the first part of the duodenum is the pancreas.

Question 52

What is the duodenal cap (ampulla)?

Answer 52

The duodenal cap or ampulla is the very first part of the duodenum, which is slightly dilated, intraperitoneal, and about 1 inch long.

Question 53

Why is the duodenal cap a common site for ulcers?

Answer 53

The duodenal cap is the most common site of duodenal ulcers because it is where acidic chyme meets the duodenal mucosa before mixing with the alkaline secretions of the duodenum.

Question 54

What is unique about the mucous membrane of the first inch of the duodenum?

Answer 54

The mucous membrane of the first inch of the duodenum is smooth, unlike the rest of the duodenum, which has circular folds called plicae circulares.

Question 55

What happens to the second inch of the first part of the duodenum?

Answer 55

The second inch of the first part of the duodenum 'disappears' behind the peritoneum, becoming retroperitoneal.