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ANATOMY OF PANCREAS

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The document provides information on the anatomy and development of the pancreas. It discusses: - The pancreas is a retroperitoneal organ that extends from the duodenum to the spleen. It has a head, neck, body and tail. - It develops from ventral and dorsal pancreatic buds that fuse during development. The ventral bud forms parts of the head while the dorsal bud forms most of the pancreas. - The pancreas has both exocrine and endocrine functions. The exocrine pancreas produces enzymes for digestion while the endocrine pancreas contains islets of Langerhans that produce hormones like insulin and glucagon.

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ANATOMY OF PANCREAS
Introduction Developmental Anatomy Gross Anatomy Functional Anatomy Clinical Anatomy Recent Advances
Pancreas derived from the Greek pan, all, and kreas, flesh, probably referring to the organs homogenous appearance Herophilus, Greek surgeon first described pancreas. Wirsung discovered the pancreatic duct in 1642. Pancreas as a Secretory gland was investigated by Graaf in 1671. R. Fitz established pancreatitis as a disease in 1889. Whipple performed the first pancreatico- duodenectomy in 1935 and refined it in 1940.
The pancreas is the organ that we barely remember until we experience a disease associated with it. So, it is important to learn about this essential gland that is located behind the stomach and responsible for secreting juices that allow to digestion of the food.
It is one of accessory organ of digestion. It is an soft lobulated greyish pinkish gland It situated in the upper part of the posterior abdominal wall extending from duodenum on right side to spleen on the left side Lies behind the stomach separated from it by lesser sac Structurally it is an elongated compound and mixed gland, functionally it has exocrine and endocrine parts
ANATOMY OF PANCREAS
ANATOMY OF PANCREAS
Pancreas is an elongated, accessory digestive gland that lies retroperitoneally The pancreas lies more or less horizontally on the posterior abdominal wall It is occupies posterior part of epigastrium and left hypochondriac region It crosses the posterior abdomen wall obliquely from concavity of the duodenum, to the hilum of the spleen . The level of T12 to L3
Salmon pink in colour with a soft, lobulated surface. The Pancreas is J shaped (or) resembles a retort shaped flask. Length- 12-15 cm Breadth- 3- 4 cm Thickness- 1.5- 2 cm Weight- 80- 90 gms
The pancreas subdivided in to four parts 1. Head (with one process uncinate process 2. Neck 3. Body (with one process -tuber omentale) 4. Tail Body Neck
It the enlarged, disc shaped right end of the pancreas It lies in the concavity of the C-shaped curve of duodenum in front of the L2 vertebrate External feature the head presents the following features Three borders superior, inferior, and right lateral Two surfaces-anterior & posterior One process-Uncinate process (hook like process from the lower and left part of the head
Superior border- 1st part of duodenum, and superior pancreaticoduodenal artery, hepatic branch of coeliac trunk Inferior border- 3rd part of duodenum and inferior pacreaticoduodenal arteries Right lateral border- 2nd part of duodenum and anastomoses between superior and inferior pacreaticoduodenal arteries Uncinate process It projects to the left behind superior mesenteric vessels
Triangular Projection. Extends from inferior lateral end of the gland Anterior- superior mesenteric vessels Posterior - aorta Inferiorly - 3rdpart of duodenum Tumours do not cause obstruction of bile duct but compresses the 3rd part of Duodenum.
Anterior surface: Upper part non peritoneal part , Transverse colon, 1st part of the duodenum Lower part-peritoneal part Transverse mesocolon Coils of jejunum Posterior surface: non perioneal Inferior venacava Terminal parts of renal veins Right crus of diaphragm In upper lateral part -Common bile duct
Inferior venacava Right crus of diaphragm Common bile duct
It is slightly constricted part of the gland which connects the head with the body It is about 2.5 cm long and is directed forward, upwards and to left upper part of anterior aspect of head It has two surface Anterior & Posterior Surface
Anterior surface The peritoneum of the lesser sac and pyloric end of the stomach Posterior surface(np) Shallow groove -Terminal part of superior mesenteric vein in the lower part and trunk of portal vein in the upper part joined to splenic vein. Upper border- 1st part of the duodenum, lower border Root of transverse mesocolon
It is largest part of the gland extending left side of neck to tail Extends from front of the Aorta to Left Kidney Triangular in cross section It passes towards to the left with slight upward and backward inclination It lies at the level of L1. 3 Surfaces: Anterior, Posterior ,Inferior 3 Borders: Superior, Anterior and Inferior
Anterior surface: Concave forward and upwards Covered by peritoneum of lesser sac Its related to Posterio-Inferior surface of stomach separate from lesser sac Inferior surface: Duodeno - jejunal flexure A Coils of Jejunum Left colic flexure A
Posterior surface It is a non-peritoneal part A) Abdominal aorta & origin of the SMA B) Left kidney C) Left crus of diaphragm D) Left suprarenal gland E) Left renal vein F) Splenic vein
Left suprarenal gland Left Kidney Left renal vessels & renal pelvis Left crus of diaphragm Abdominal aorta POSTERIOR Left Colic flexure Coils of jejunum Duodeno jejunal flexure Inferior surface
Borders: Superior border: It is close to the right end. It presents a conical projection known as tuber omantale Tuber omentale is related to coeliac trunk, splenic artery and common hepatic artery
Anterior border: Two layers of transverse mesocolon diverge from each other Inferior border: At its right end it is related to superior mesenteric vessels.
TAIL: This is the left end of the gland, variable in size. It passes between the layers of the lienorenal ligament and reaches the spleen with the splenic vessels. Islets of Langerhans are most numerous in the tail
Exocrine pancreas drained by two ducts a) Main pancreatic duct b) Accessory pancreatic duct
ANATOMY OF PANCREAS
ANATOMY OF PANCREAS
Head and neck: Branches from superior and inferior pancreatico duodenal arteries Body and tail: Pancreatic Branches from splenic artery Splenic artery Superior pancreaticoduodenal artery Inferior pancreaticoduodenal artery
ANATOMY OF PANCREAS
Venous drainage: Body and tail-Splenic vein Uncinate process and lower part of head- Superior mesenteric vein Upper part of head and neck- portal vein
31 Inf.pan.duo.vein Sup. Mesentric-vein Splenic Vein Portal Vein
Head and neck - drain in to ventral and dorsal group of pancreatico duodenal lymph nodes Body and tail-drain in to pancraetico splenic lymph nodes Efferent vessels of these nodes terminate into coeliac and superior mesenteric group of pre- aortic lymph node
Sympathetic nerves are derived from coelic and superior mesenteric plexus around its arteries Parasympathetic nerves are derived from both vagus nerves Sympathetic nerves are vasomotor, parasympathetic nerves control the pancreatic secretion . (Exocrine pancreatic secretion are controlled by nerves and enzymes like Secretin and pancreozymin)
Its Covered with a very thin layer of loose connective tissue Thin septa arising from capsule and divide the gland into many lobules. Inter lobular connective tissue contains large ducts, blood vessels and nerve fibers. Interlobular- surrounds the acini & Islets Most of the substance of lobules is made of exocrine pancreas with scattered endocrine islets.
It is the serous gland. The exocrine part of the pancreas is made up of acinar cell, intralobular and interlobular ducts. Acini are typical serous acini.
They are small rounded cluster of pyramidal cells with a very small lumen. Each cell has a rounded basal nucleus. Supranuclear portion contains secretory granules.
Centroacinar cells. These are the initial segments of cuboidal cells of intercalated ducts invaginated into the acinus.
The cuboidal cells of intercalated ducts are later replaced by taller cuboidal and eventually columnar cells more distally. The intralobularducts drain into larger interlobular ducts lined by columnar epithelium and goblet cells.
The endocrine part of pancreas consists of islets or insulae of Langerhans, composed of spheroidal or ellipsoidal cluster of cells. The human pancreas may contain more than a million islets usually most in the tail. The cells of islets are polyhedral in shape and are pervaded by fenestrated capillaries and a rich autonomic innervation.
There are 3 types of cells, designated A, B, and D. A cells - secretes glucagon B cells - secrete insulin D cells - secrete somatostatin,
DEVELOPMENT OF PANCREAS
The pancreas develops from 2 buds arising from the endoderm of the caudal part of foregut : A ventral pancreatic bud : which develops from the proximal end of hepatic diverticulum (forms the liver & gall bladder). A dorsal pancreatic bud : which develops from dorsal wall of duodenum slightly cranial to the ventral bud. Most of pancreas is derived from the dorsal pancreatic bud.
When the duodenum rotates to the right and becomes C- shaped, the ventral pancreatic bud moves dorsally to lie below and behind the dorsal bud. Later the 2 buds fused together and lying in the dorsal mesentery.
The ventral bud forms : Uncinate process. Inferior part of head of pancreas. The dorsal pancreatic bud forms : Upper part of of head. Neck. Body & Tail of pancreas.
The main pancreatic duct is formed from : The duct of the ventral bud. The distal part of duct of dorsal bud. The accessory pancreatic duct is derived from : Proximal part of duct of dorsal bud. The parenchyma of pancreas is derived from the endoderm of pancreatic buds. Pancreatic islets develops from parenchymatous pancreatic tissue. Insulin secretion begins at 5th month of pregnancy.
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ANATOMY OF PANCREAS
Digestive Endocrine Pancreatic juice
ANATOMY OF PANCREAS
Annular pancreas A rare condition where a abnormal ring of pancreatic tissue that forms a circle around the duodenum causing partial or complete obstruction of the duodenum and block or impair the flow of food to the rest of the intestines. Annular pancreas, a ring of pancreas caused by a failure of the embryologic ventral pancreatic bud to migrate to the right of the duodenum
Symptoms from annula pancreas are nausea, vomiting, feeling of fullness after and feeding problem in newborns
Ectopic pancreas It is the detatched portion of Pancreatic tissue usually uncinate process situated outside the normal pancreas. Ectopic pancreatic tissue can be found in the Stomach, Duodenum, Jejunum, Ileum and Meckle's diverticulum Typical picture of accessory pancreas
ANATOMY OF PANCREAS
Accessory pancreas situated in the greater curvature of the pyloric antrum Accessory pancreatic tissue in duodenum
CANCER OF PANCREAS 95% of all cancer tumors start in the head of the pancreas where the digestive juices are made. 5% of the cancer tumors start in the tail where hormones such as insulin are made
Obstruction to bile duct Leading to- Obstructive jaundice Portal vein-Ascitis Pyrlorus Of stomach (Pyloric obstruction)
ANATOMY OF PANCREAS
The diseased pancreas can cause a LOT of trouble Diabetes: In the United States, 25.8 million adults and children (8.3% of population) have diabetes Systemic disease Pancreatic cancer 4th most common cause of cancer-related death, extremely poor prognosis Pancreatitis is an emergency situation

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ANATOMY OF PANCREAS

  • 2. Introduction Developmental Anatomy Gross Anatomy Functional Anatomy Clinical Anatomy Recent Advances
  • 3. Pancreas derived from the Greek pan, all, and kreas, flesh, probably referring to the organs homogenous appearance Herophilus, Greek surgeon first described pancreas. Wirsung discovered the pancreatic duct in 1642. Pancreas as a Secretory gland was investigated by Graaf in 1671. R. Fitz established pancreatitis as a disease in 1889. Whipple performed the first pancreatico- duodenectomy in 1935 and refined it in 1940.
  • 4. The pancreas is the organ that we barely remember until we experience a disease associated with it. So, it is important to learn about this essential gland that is located behind the stomach and responsible for secreting juices that allow to digestion of the food.
  • 5. It is one of accessory organ of digestion. It is an soft lobulated greyish pinkish gland It situated in the upper part of the posterior abdominal wall extending from duodenum on right side to spleen on the left side Lies behind the stomach separated from it by lesser sac Structurally it is an elongated compound and mixed gland, functionally it has exocrine and endocrine parts
  • 8. Pancreas is an elongated, accessory digestive gland that lies retroperitoneally The pancreas lies more or less horizontally on the posterior abdominal wall It is occupies posterior part of epigastrium and left hypochondriac region It crosses the posterior abdomen wall obliquely from concavity of the duodenum, to the hilum of the spleen . The level of T12 to L3
  • 9. Salmon pink in colour with a soft, lobulated surface. The Pancreas is J shaped (or) resembles a retort shaped flask. Length- 12-15 cm Breadth- 3- 4 cm Thickness- 1.5- 2 cm Weight- 80- 90 gms
  • 10. The pancreas subdivided in to four parts 1. Head (with one process uncinate process 2. Neck 3. Body (with one process -tuber omentale) 4. Tail Body Neck
  • 11. It the enlarged, disc shaped right end of the pancreas It lies in the concavity of the C-shaped curve of duodenum in front of the L2 vertebrate External feature the head presents the following features Three borders superior, inferior, and right lateral Two surfaces-anterior & posterior One process-Uncinate process (hook like process from the lower and left part of the head
  • 12. Superior border- 1st part of duodenum, and superior pancreaticoduodenal artery, hepatic branch of coeliac trunk Inferior border- 3rd part of duodenum and inferior pacreaticoduodenal arteries Right lateral border- 2nd part of duodenum and anastomoses between superior and inferior pacreaticoduodenal arteries Uncinate process It projects to the left behind superior mesenteric vessels
  • 13. Triangular Projection. Extends from inferior lateral end of the gland Anterior- superior mesenteric vessels Posterior - aorta Inferiorly - 3rdpart of duodenum Tumours do not cause obstruction of bile duct but compresses the 3rd part of Duodenum.
  • 14. Anterior surface: Upper part non peritoneal part , Transverse colon, 1st part of the duodenum Lower part-peritoneal part Transverse mesocolon Coils of jejunum Posterior surface: non perioneal Inferior venacava Terminal parts of renal veins Right crus of diaphragm In upper lateral part -Common bile duct
  • 15. Inferior venacava Right crus of diaphragm Common bile duct
  • 16. It is slightly constricted part of the gland which connects the head with the body It is about 2.5 cm long and is directed forward, upwards and to left upper part of anterior aspect of head It has two surface Anterior & Posterior Surface
  • 17. Anterior surface The peritoneum of the lesser sac and pyloric end of the stomach Posterior surface(np) Shallow groove -Terminal part of superior mesenteric vein in the lower part and trunk of portal vein in the upper part joined to splenic vein. Upper border- 1st part of the duodenum, lower border Root of transverse mesocolon
  • 18. It is largest part of the gland extending left side of neck to tail Extends from front of the Aorta to Left Kidney Triangular in cross section It passes towards to the left with slight upward and backward inclination It lies at the level of L1. 3 Surfaces: Anterior, Posterior ,Inferior 3 Borders: Superior, Anterior and Inferior
  • 19. Anterior surface: Concave forward and upwards Covered by peritoneum of lesser sac Its related to Posterio-Inferior surface of stomach separate from lesser sac Inferior surface: Duodeno - jejunal flexure A Coils of Jejunum Left colic flexure A
  • 20. Posterior surface It is a non-peritoneal part A) Abdominal aorta & origin of the SMA B) Left kidney C) Left crus of diaphragm D) Left suprarenal gland E) Left renal vein F) Splenic vein
  • 21. Left suprarenal gland Left Kidney Left renal vessels & renal pelvis Left crus of diaphragm Abdominal aorta POSTERIOR Left Colic flexure Coils of jejunum Duodeno jejunal flexure Inferior surface
  • 22. Borders: Superior border: It is close to the right end. It presents a conical projection known as tuber omantale Tuber omentale is related to coeliac trunk, splenic artery and common hepatic artery
  • 23. Anterior border: Two layers of transverse mesocolon diverge from each other Inferior border: At its right end it is related to superior mesenteric vessels.
  • 24. TAIL: This is the left end of the gland, variable in size. It passes between the layers of the lienorenal ligament and reaches the spleen with the splenic vessels. Islets of Langerhans are most numerous in the tail
  • 25. Exocrine pancreas drained by two ducts a) Main pancreatic duct b) Accessory pancreatic duct
  • 28. Head and neck: Branches from superior and inferior pancreatico duodenal arteries Body and tail: Pancreatic Branches from splenic artery Splenic artery Superior pancreaticoduodenal artery Inferior pancreaticoduodenal artery
  • 30. Venous drainage: Body and tail-Splenic vein Uncinate process and lower part of head- Superior mesenteric vein Upper part of head and neck- portal vein
  • 32. Head and neck - drain in to ventral and dorsal group of pancreatico duodenal lymph nodes Body and tail-drain in to pancraetico splenic lymph nodes Efferent vessels of these nodes terminate into coeliac and superior mesenteric group of pre- aortic lymph node
  • 33. Sympathetic nerves are derived from coelic and superior mesenteric plexus around its arteries Parasympathetic nerves are derived from both vagus nerves Sympathetic nerves are vasomotor, parasympathetic nerves control the pancreatic secretion . (Exocrine pancreatic secretion are controlled by nerves and enzymes like Secretin and pancreozymin)
  • 34. Its Covered with a very thin layer of loose connective tissue Thin septa arising from capsule and divide the gland into many lobules. Inter lobular connective tissue contains large ducts, blood vessels and nerve fibers. Interlobular- surrounds the acini & Islets Most of the substance of lobules is made of exocrine pancreas with scattered endocrine islets.
  • 35. It is the serous gland. The exocrine part of the pancreas is made up of acinar cell, intralobular and interlobular ducts. Acini are typical serous acini.
  • 36. They are small rounded cluster of pyramidal cells with a very small lumen. Each cell has a rounded basal nucleus. Supranuclear portion contains secretory granules.
  • 37. Centroacinar cells. These are the initial segments of cuboidal cells of intercalated ducts invaginated into the acinus.
  • 38. The cuboidal cells of intercalated ducts are later replaced by taller cuboidal and eventually columnar cells more distally. The intralobularducts drain into larger interlobular ducts lined by columnar epithelium and goblet cells.
  • 39. The endocrine part of pancreas consists of islets or insulae of Langerhans, composed of spheroidal or ellipsoidal cluster of cells. The human pancreas may contain more than a million islets usually most in the tail. The cells of islets are polyhedral in shape and are pervaded by fenestrated capillaries and a rich autonomic innervation.
  • 40. There are 3 types of cells, designated A, B, and D. A cells - secretes glucagon B cells - secrete insulin D cells - secrete somatostatin,
  • 42. The pancreas develops from 2 buds arising from the endoderm of the caudal part of foregut : A ventral pancreatic bud : which develops from the proximal end of hepatic diverticulum (forms the liver & gall bladder). A dorsal pancreatic bud : which develops from dorsal wall of duodenum slightly cranial to the ventral bud. Most of pancreas is derived from the dorsal pancreatic bud.
  • 43. When the duodenum rotates to the right and becomes C- shaped, the ventral pancreatic bud moves dorsally to lie below and behind the dorsal bud. Later the 2 buds fused together and lying in the dorsal mesentery.
  • 44. The ventral bud forms : Uncinate process. Inferior part of head of pancreas. The dorsal pancreatic bud forms : Upper part of of head. Neck. Body & Tail of pancreas.
  • 45. The main pancreatic duct is formed from : The duct of the ventral bud. The distal part of duct of dorsal bud. The accessory pancreatic duct is derived from : Proximal part of duct of dorsal bud. The parenchyma of pancreas is derived from the endoderm of pancreatic buds. Pancreatic islets develops from parenchymatous pancreatic tissue. Insulin secretion begins at 5th month of pregnancy.
  • 46. 46
  • 48. Digestive Endocrine Pancreatic juice
  • 50. Annular pancreas A rare condition where a abnormal ring of pancreatic tissue that forms a circle around the duodenum causing partial or complete obstruction of the duodenum and block or impair the flow of food to the rest of the intestines. Annular pancreas, a ring of pancreas caused by a failure of the embryologic ventral pancreatic bud to migrate to the right of the duodenum
  • 51. Symptoms from annula pancreas are nausea, vomiting, feeling of fullness after and feeding problem in newborns
  • 52. Ectopic pancreas It is the detatched portion of Pancreatic tissue usually uncinate process situated outside the normal pancreas. Ectopic pancreatic tissue can be found in the Stomach, Duodenum, Jejunum, Ileum and Meckle's diverticulum Typical picture of accessory pancreas
  • 54. Accessory pancreas situated in the greater curvature of the pyloric antrum Accessory pancreatic tissue in duodenum
  • 55. CANCER OF PANCREAS 95% of all cancer tumors start in the head of the pancreas where the digestive juices are made. 5% of the cancer tumors start in the tail where hormones such as insulin are made
  • 56. Obstruction to bile duct Leading to- Obstructive jaundice Portal vein-Ascitis Pyrlorus Of stomach (Pyloric obstruction)
  • 58. The diseased pancreas can cause a LOT of trouble Diabetes: In the United States, 25.8 million adults and children (8.3% of population) have diabetes Systemic disease Pancreatic cancer 4th most common cause of cancer-related death, extremely poor prognosis Pancreatitis is an emergency situation