The Pancreas and Spleen Flashcards

1
Q

Where is the pancreas located?

A

Posterior to the stomach

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2
Q

Is the pancreas intraperitoneal or retroperitoneal?

A

Retroperitoneal

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3
Q

Where does the pancreas extend from?

A

From duodenum on the right across the posterior abdominal wall to the spleen on the left.

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4
Q

Which part of the pancreas is intraperitoneal?

A

The tail

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5
Q

What level is used to identify the pancreas?

A

L1

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6
Q

What is the pancreas divided into/

A
  • Head
  • Body
  • Neck
  • Tail
  • Uncinate process
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7
Q

Where does the head of the pancreas lie?

A

Within the curve of the duodenum

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8
Q

What vessels cross the head of the pancreas?

A

The superior mesenteric artery and vein.

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9
Q

Where does the uncinate process lie and wrap?

A

Lies adjacent to the ascending part of the duodenum and wraps behind the SMA and SMV

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10
Q

What does the tail of the pancreas extend into?

A

Extends into the Splenorenal ligament and abuts the spleen.

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11
Q

What are the three anterior branches of the aorta that supply the GI tract and related structures?

A
  • Coeliac Trunk
  • Superior Mesenteric Artery
  • Inferior Mesenteric Artery
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12
Q

What organs are supplied by the Coeliac trunk?

A
Ab. eosophagus
Stomach
Duodenum
Liver
Pancreas
Gall bladder
Spleen
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13
Q

What is supplied by the Superior Mesenteric Artery?

A
ACARDS
Duodenum
Small Intestine
Caecum
Appendix
Ascending colon
Right 2/3 of transverse colon
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14
Q

What is supplied by the inferior mesenteric artery?

A
LARDS
Left 1/3 of transverse colon
Descending colon
Sigmoid colon
Rectum
Anal canal
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15
Q

Where does the 20-25% of the livers blood supply come from?

A

From the hepatic branch of the coeliac artery.

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16
Q

Where does blood flow through in the liver before being returned to the heart by the Inferior vena cava.

A

liver sinusoids

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17
Q

What is the arterial supply of the body and tail of the pancreas?

A

The Splenic artery from celiac trunk

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18
Q

What is the arterial supply of the head of the pancreas?

A

Superior pancreatico-duodenal (common hepatic) and inferior Pancreatico-duodenal arteries (superior mesenteric)

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19
Q

Why is ischemia to the pancreas from vascular obstruction is uncommon?

A

Due to the dual supply

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20
Q

What is venous drainage of pancreas? x 2

A

Pancreatoduodenal veins (to SMV) and splenic vein to the portal vein

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21
Q

PG

A

15

22
Q

Lymph nodes of the pancreas

A

Superior/inferior pancreatic lymph nodes

23
Q

Where does the pancreatic duct begin?

A

In the tail of the pancreas

24
Q

What is the region that the pancreatic duct joins the bile duct?

A

Hepatopancreatic ampulla (of Vater)

25
Q

Where does the Hepatopancreatic ampulla open into?

A

The posterio-medial wall of part 2 of the duodenum at a point called the Major duodenal papilla.

26
Q

Where does the accessory pancreatic duct empty into duodenum? and what does it drain?

A

At the minor duodenal papilla. This drains the

head and ucinate process.

27
Q

What does the lower part of the head and uncinate process drain via?

A

Via an accessory pancreatic duct

28
Q

What do papillas in pancreas contain? and function

A

Sphincteric muscle which controls the flow from the ducts

29
Q

What does the hypertrophy of the head cause?

A

Portal or bile duct obstruction (eg Gall stone blocking ampulla of Vater)

30
Q

What does the hypertrophy of the head cause?

A

Portal or bile duct obstruction (eg Gall stone blocking ampulla of Vater)

31
Q

Pancreatitis types

A

Acute (serious) (Alcoholism, bile reflux) or chronic (Calcifications, Pseudocyst)

32
Q

What is annular pancreas?

A

Ring of pancreatic tissue blocks part 2 of duodenum. New born disease (1 in 13, 000) Blocks food to GIT. Not all cases show symptoms

33
Q

What does the type of adenocarcinoma of the pancreas depend on?

A

Location

34
Q

Are adenocarincomas of the pancreas usually endocrine or exocrine?

A

90% are exocrine

35
Q

What procedure is performed for tumours in tail and head of pancreas?

A

Radical distal pancreatectomy

36
Q

What will you need after pancreatectomy?

A

Lifelong insulin and enzyme replacement.

37
Q

Why is the spleen described with the pancreas?

A

As it drains into the portal venous system.

38
Q

Where does the spleen lie? (relation to diaphragm) and quadrant/region

A

Its lies below the diaphragm in the upper left Quadrant → left hypochondrium

39
Q

What ribs is the spleen found at?

A

Found underneath the 9th, 10th and 11th ribs on the left side.

40
Q

Attachments of the spleen by ligaments x 2

A

Strong attachments to the stomach and left kidney;

  • Gastrosplenic ligament
  • Splenorenal ligament
41
Q

What is the entry and exit point for splenic vessels

A

Splenic hilum
• Splenic artery -from celiac trunk
• Splenic vein – to portal vein

42
Q

What does lymphatic drainage of the spleen occur via?

A

Via retropancreatic nodes at hilum to coeliac nodes

43
Q

Innervation of the spleen

A

Coeliac plexus by sympathetic fibres

44
Q

What does the hileum of the spleen make contact with ?

A

With the tail of the pancreas

45
Q

Splenic artery branches

A
  • Pancreatic branches
  • Short gastric arteries
  • Left gastroepiploic artery
  • Posterior gastric
46
Q

What is the anterior border notch of the spleen a relic of?

A

Of the fusion of the several lobules from which the organ arises in the embryo.

47
Q

What is the red pulp of the spleen?

A

Sinusoids and vascular sinuses filled with blood

48
Q

Function of red pulp of spleen

A

Purifies blood and removes dead or old blood cells

49
Q

Composition of red pulp of spleen x 3

A
  1. A loose connective tissue network of reticulin fibres (collagen) and stellate fibroblasts;
  2. Capillaries.
  3. Numerous sinusoids with associated macrophages
50
Q

What is the white pulp of spleen?

A

Aggregates of lymphoid tissue adjacent to central arteries

51
Q

White pulp of spleen function

A

Produces white blood cells

52
Q

x 5 clinical conditions of the spleen

A
  • Enlarged Spleen (Splenomegaly)
  • Ruptured spleen
  • Sickle cell disease
  • Thrombocytopenia
  • Accessory spleen