Download MBBS Anatomy PPT 68 Pancreas Notes

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Pancreas- Brief History

Herophilus, Greek surgeon first described

pancreas.

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Wirsung discovered the pancreatic duct in 1642.
Pancreas as a secretory gland was investigated

by Graaf in 1671.

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R. Fitz established pancreatitis as a disease in

1889.

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Whipple performed the first pancreatico-

duodenectomy in 1935 and refined it in 1940.

Pancreas

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Pancreas

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Gland with both exocrine and endocrine functions
15-20 cm long, 2.5-3.8 cm broad, & 1.2-1.8 cm thick.
60-100 gram in weight
Location: retro-peritoneum*, 2nd lumbar vertebral

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level

Extends in an oblique, transverse position
Parts of pancreas: head, neck, body and tail

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LOCATION

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Head of Pancreas

Enlarged flattened right end of pancreas,

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situated with in the curve of the duodenum.

External features-
3 borders- sup.,inf. & rt.lat.
2 surfaces- ant. & post.

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1 process
RELATIONS-
Sup border ? overlapped by 1st part of duodenum

& is related to SPDA

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Inf. Border- 3rd part of duodenum & IPDA.
Rt. Lat. Border- 2nd part duodenum, terminal part of

bile duct & anastomosis between 2 pan.art.

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Two surfaces-
Ant. Suf- gastroduodenal a.
transverse colon
jejunum sep. frm it by peritoneum.

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Post. Suf- IVC, Terminal part of Renal veins
Rt. Crus of diaphragm & bile duct.

Uncinate proc.- Ant.- SMA
Post.- Aorta.

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Dr.

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HEAD OF THE PANCREAS & Its

Ravi

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relations.

Anterior

Relations

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Posterior

Relations

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Neck of Pancreas

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2.5 cm in length, constricted part bet. Head & Body.
2 surfaces ? Ant. & Post.

Ant. ? peritoneum covering post.wall of lesser sac &
pylorus

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Post.- termination of SMV and splenic vein

confluence to form portal vein

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Pancreas

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Body of Pancreas

Elongated, long structure Extends from neck to tail
Triangular on cross section
3 borders- ant.,sup., & inf.

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Tuber omentale

Relations-
Ant. Border- root of transeverse mesocolon
Sup. Border- coeliac trunk, hepatic a.(r) & splenic a(l)

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Inf. Border- sup. Mesent. Vessesls.

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Ant. Suf.- covered by peritoneum &
related to lesser sac & to stomach
Post. suf.- devoid of peritoneum
related to aorta, lt. adrenal gland,
lt. renal vessels and upper 1/3rd of lt. kidney,

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lt. crus of diaphragm & Splenic vein

Inf. suf.-covered by peritoneum &
related to DJ flexure, coils of jejunum & lt.
colic flexure

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Tail of Pancreas

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Narrow, lt. end of pancreas
Lies at the level of 12th thoracic vertebra
Ends within the splenic hilum
Lies in the lienorenal ligament

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Anteriorly, related to splenic flexure of colon
May be injured during splenectomy (fistula)

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Pancreatic Duct

Main duct (Wirsung) runs the entire length of

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pancreas

Joins CBD at the ampulla of Vater
2 ? 4 mm in diameter, 20 secondary branches
Ductal pressure is 15 ? 30 mm Hg (vs. 7 ? 17 in CBD)

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thus preventing damage to panc. duct

Lesser duct (Santorini) drains superior portion of head

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and empties separately into 2nd portion of duodenum

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Arterial Supply of Pancreas

Variety of major arterial sources (celiac, SMA and

splenic)

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Mainly pancreatic br. Of Splenic a.
Superior pancreaticoduodenal a.
Inferior pancreaticoduodenal a.

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Arterial Supply of Pancreas

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Venous Drainage of Pancreas

Follows arterial supply
Drain into- splenic, superior mesenteric
Ultimately, into portal vein

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Venous Drainage of Pancreas

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Lymphatic Drainage

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Lymphatics follows the arteries

Drain into pancreaticosplenic, coeliac & superior

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mesenteric group of lymph nodes.

28

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Innervation of Pancreas

Sympathetic fibers from the splanchnic nerves
Parasympathetic fibers from the vagus
Both give rise to intrapancreatic periacinar plexuses

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Parasympathetic fibers stimulate both exocrine and

endocrine secretion

Sympathetic fibers have a predominantly inhibitory

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effect