DAU

3.  The pancreas is both an exocrine and an
endocrine gland
 Produces a secretion that hydrolyzes the
carbohydrates, proteins and fats
 The endocrine portion of the gland is islets of
langerhans produces insulin and glucagon
hormones
 These hormones play a key role in carbohydrate
metabolism

4.  15-25 cm long
 60-100 g
 Location: retro-
peritoneum, 2nd
lumbar
vertebral level
 Extends in an oblique,
transverse position

5.  It is an elongated structure
 Lies in the epigastrium and left upper quadrant
 It is soft and lobulated, situated on the
posterior abdominal wall behind the
peritoneum
 It is divided into head, neck, body and tail

6.  Includes uncinate process
 Flattened structure, 2 – 3 cm thick
 Attached to the 2nd
and 3rd
portions of duodenum on the
right
 Emerges into neck on the left
 Border b/w head and neck is
determined by GDA insertion
 SPDA and IPDA anastamose
between the duodenum and the
right lateral border

7.  2.5 cm in length
 Straddles SMV and PV
 Antero-superior surface
supports the pylorus
 Superior mesenteric
vessels emerge from the
inferior border
 Posteriorly, SMV and
splenic vein confluence to
form portal vein
 Posteriorly, mostly no
branches to pancreas

8.  Elongated, long structure
 Anterior surface, separated
from stomach by lesser sac
 Posterior surface, related to
aorta, lt. adrenal gland, lt.
renal vessels and upper
1/3rd
of lt. kidney
 Splenic vein runs
embedded in the post.
Surface
 Inferior surface is covered
by transverse mesocolon

9.  Narrow, short segment
 Lies at the level of the 12th
thoracic vertebra
 Ends within the splenic
hilum
 Lies in the splenophrenic
ligament
 Anteriorly, related to
splenic flexure of colon
 May be injured during
splenectomy (fistula)

10.  Anteriorly: Transverse colon and the
attachment of the transverse mesocolon, the
lesser sac and the stomach
 Posteriorly: Bile duct, the portal and splenic
veins, IVC, the aorta, the origin of superior
mesenteric artery, the left suprarenal gland, the
left kidney, and the hilum of the spleen

11.  The main duct of the
pancreas begins in the
tail
 Runs the length of the
gland, receiving
numerous tributaries
 Opens into the second
part of the duodenum
with the bile duct on the
major duodenal papilla

12.  Sometimes the main duct
drains separately into the
duodenum
 The accessory duct, if
present, drains the upper
part of the head
 Opens a little above the
main duct on the minor
duodenal papilla
 The accessory duct
frequently communicates
with the main duct

13.  Arteries: The superior and inferior
pancreaticoduodenal arteries
 Veins: The corresponding veins drain into the
portal vein

14.  Variety of major arterial sources (celiac, SMA
and splenic)
 Celiac  Common Hepatic Artery 
Gastroduodenal Artery  Superior
pancreaticoduodenal artery which divides into
anterior and posterior branches
 SMA  Inferior pancreaticoduodenal artery
which divides into anterior and posterior
branches

15.  Rich periacinar network that drain into 5 nodal
groups
 Superior nodes
 Anterior nodes
 Inferior nodes
 Posterior PD nodes
 Splenic nodes

16. Production of Pancreatic Hormones
by Three Cell Types
Alpha cells produce glucagon.
Beta cells produce insulin.
Delta cells produce somatostatin.

17.  Three cell types are
present, A (glucagon
secretion), B (Insulin
secretion) and D
(Somatostatin secretion)
 A and D cells are located
around the perimeter
while B cells are located in
the interior
 Venous return containing
insulin flows by the A
cells on its way out of the
islets

19. Figure 22-8: Metabolism is controlled by insulin and glucagon

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