Download MBBS Pancreas and Portalvin Lecture PPT

Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Latest Pancreas and Portalvin Lecture PPT


PANCREAS



Pancreas ?all flesh

(pan=all and kreas=flesh)

Introduction...

? Soft, lobulated

elongated gland

with both exocrine

and endocrine

functions

? Exocrine ?

pancreatic

juice

? Endocrine-insulin,

Glucogan


Location...

? epigastric & left

hypochondriac

regions.

? behind the

stomach

and lesser sac

? Transversely across

the posterior

abdominal wall at

the level of L1 -

L3


Size and shape..

? J shaped or

retort shaped.

? Length-15-20 cm

? Thickness-

1.2-1.8 cm

? Breadth-2.5 -3.8

cm

? Wt- around 90

gm


PARTS


HEAD

Enlarged part C

shaped, lying within

the concavity of

duodenum, consist of

? 3 borders-superior

,inferior & right lateral

? 2 surfaces-anterior &

Posterior

? uncinate process


HEAD...

? Superior border-

-1st part of duodenum

-Sup. PancreaticodudenalA.

? Inferior border-

-3rd part of duodenum

-Inf. pancreaticodudenal A.

? Rt. lateral border-

-2nd part of duodenum

-Terminal part of bile duct

-Anastomosis betn 2

arteries.


HEAD...

Anterior surface

? 1st part of

duodenum.

? Transverse

colon

? Jejunum

separated by

peritotneum.


HEAD...

Posterior

surface:

? IVC

? Right Renal

veins

? Right crus of

diaphragm

? Bile duct


UNCINATE PROCESS

Triangular projection

which arises from

lower and left part of

the body.

Relations:

? Anterior:

-Superior mesenteric

vessels.

? Posterior

-Aorta

? Above

-Left renal vein


NECK

Relations:

Upper border:

. First part of

Duodenum

Anterior surface

? Peritoneum

covering lesser sac

? Pylorus


NECK..

Posterior surface

is related to

? superior

mesenteric vein

? portal vein


BODY

? Elongated part.

? Extends from neck to

the tail.

? Passes toward the

left with slight upward

and backward

inclination
BODY...

Triangular in cross

section

? 3 borders-

-Anterior

-superior

-Inferior

? Tuber omentale -

small projection

on superior border

little to the left of

the neck


BODY...

Relations...

Borders:

? Anteriorly attach to

root of the tranverse

mesocolon .

? Superior related to

coeliac trunk,

hepatic artery &

splenic artery

? Inferior is related

to

superior mesenteric

artery.


BODY..

Relations...

Surfaces:

? Anterior is convex

covered by the

peritoneum related to

the lesser sac &

stomach.

? Inferior surface covered

by the peritoneum

related the DJ flexure

coils of jejunum & Lt.

colic flexure.


BODY..

? Posterior surface

-Aorta

-Left crus of the

diaphragm

-Left kidney

-Left Suprarenal

gland

-Left renal vessels

-Splenic vein
TAIL

? Left end of the

pancreas

? Lies in the

lienorenal

ligament ,together

with the splenic

vessels

? Related to the

lower part of the

spleen (gastric

surface.


DUCT SYSTEM

Exocrine part

of pancreas is

drained by the

2 ducts

? Main

? Accessory.


Main pancreatic duct of Wirsung

? Lies near posterior

surface ,3 mm in

diam.white in colour

? Begins at the tail, runs

throughout the body

,bends at the neck to

run downwards

backwards in the

head.

? Herring bone pattern


Herring bone pattern


Main pancreatic duct of Wirsung

? In the head of the

pancreas, it is related to

the bile duct(on rt. side)

? Two ducts open in the

wall of the 2nd part of

the duodenum and join

to form

hepatopancreatic

ampulla of vater which

open as major duodenal

papilla,8-10 cm distal to

pylorus.


Accessory duct of Santorini

? Begins in the lower

part of head, crosses

the main duct with

which it communicates

? Opens as minor

duodenal papilla in

the 2nd part of

duodenum (6-8 cm

distal to pylorus)


Arterial supply...

-Splenic A.

-Superior

pancreaticoduodenal

artery

(from coeliac trunk)

-Inferior

pancreaticoduodenal

A.(from

superior mesenteric


Venous drainage

-Splenic vein

-Superior

mesenteric

Vein

-Portal vein


Nerve Supply

? Parasympathetic by

the vagus nerve

controlling secretion .

? Sympathetic from

coeliac & superior

mesenteric plx.

? Secretion is also

controlled by

hormone

secretinpancreozymine


DEVELOPMENT

The pancreas develops in

two parts, both of

which arise from the

endoderm of the

primitive duodenum.

The ventral bud develops

more caudally as a

diverticulum.


DEVELOPMENT
DEVELOPMENT

The dorsal bud is the first to

appear, as a diverticulum from the

dorsal wall of the duodenum. This

eventually forms the whole of the

neck, body and tail of the gland,

together with part of the head.
Between the fourth and eighth

week, the ventral bud rotates

posteriorly in a clockwise fashion to

fuse with the dorsal bud.
DEVELOPMENTAL ANOMALIES

PANCREATIC DIVISUM

Most common congenital anomaly

Results from failure of dorsal and ventral

ducts to fuse

Detected in 5% to 10% of population in

autopsy studies

ANNULAR PANCREAS

Rare congenital anomaly

Ring of pancreatic tissue surrounds the

duodenum

May be partial or complete

1 in every 12 000 to 15 000 live births
DEVELOPMENTAL ANOMALIES

ECTOPIC PANCREAS

Described as pancreatic tissue that lacks anatomic or

vascular continuity with the normal pancreas.

Usually asymptomatic and occurs as incidental

finding.

AGENESIS AND HYPOPLASIA

Total agenesis is extremely rare and incompatible

with life.

Hypoplasia result from absence of ventral or dorsal

pancreatic bud.
DEVELOPMENTAL ANOMALIES

ACCESSORY PANCREATIC LOBE

Extremely rare anomaly

Accessory lobe of pancreatic tissue originating from

main pancreatic gland.

May contain an aberrant duct

ANSA PANCREATICA

Rare anatomical variation.

Communication between main pancreatic and

accessory pancreatic duct.

Predisposing factor in patients with idiopathic acute

pancreatitis.
CLINICAL CORRELATION

1. Carcinoma of the head of pancreas
2. Acute Pancreatitis
PORTAL VEIN




Hepatic Portal Vein

? Origin & end in capillaries /

venous

sinusoids

? Size: 8cm X 1 cm

? Drains

? Abdominal part of alimentary

tract (except lower part of anal

canal)

? Spleen & Pancreas

? Conveys absorbed products of

digested food to liver

? Devoid of valves

? Reservoir of blood : 1200 ml /

min


Formation

? Union of Sup mesenteric & Splenic vein

? Between neck of Pancreas & IVC at level L2

This post was last modified on 30 November 2021