Pancreas

The pancreas has two functions:
  1. digestive - produces digestive enzymes
  2. hormonal - islets of Langerhans produce insulin needed to control blood sugar levels
Parts and relations
  1. Head
    • lies within the curve of the duodenum
    • uncinate process is a prolongation of the head. The superior mesenteric artery and vein crosses this process.
  2. uncinate process
    • the part of the head that wraps behind the superior mesenteric artery and vein and comes to lie adjacent to the ascending part of the duodenum.
  3. Neck
    • a constricted portion to the left of the head. It abuts the pylorus above and the beginning of the portal vein behind.
  4. Body
    • anterior surface separated from the stomach by the omental bursa
    • posteriorly related to the aorta, splenic vein, left kidney and renal vessels, left suprarenal, origin of superior mesenteric artery and crura of diaphragm.
  5. Tail
    • extends into the lienorenal ligament and abuts the spleen.

Dorsal Aspect of the Pancreas and its Ducts

When the pancreas and duodenum are flipped over and the pancreas dissected, you will be able to identify the ducts of the pancreatic system. In order to see the complete system, you must open the descending part of the duodenum.



Identify the following:
  • major pancreatic duct of Wirsung
  • accessory pancreatic duct of Santorini
  • common bile duct
  • major duodenal papilla
  • minor duodenal papilla
Note that the major pancreatic duct merges with the common bile duct to form a swelling in the duodenal wall called the ampulla (of Vater). The muscular wall of the ampulla may be thickened, forming the sphincter of Oddi. This ampulla then empties into the descending part of the duodenum at the major duodenal papilla. There may not be an accessory pancreatic duct but if there is, its opening is located a couple of centimeters above the major papilla at the minor duodenal papilla.

Blood Supply of Pancreas

    Arteries
  • small branches from the splenic
  • superior pancreaticoduodenal - from the gastroduodenal
  • inferior pancreaticoduodenal - from the superior mesenteric
    Veins
  • splenic vein to portal vein
  • superior mesenteric vein which then becomes the portal vein
Clinical Considerations



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