Pancreatic disease
Pancreatic disease
Anatomy and Physiology
Anatomy and Physiology
FORECUEmbryologyECHEASIOMAVEWThepancreasarisesinthe4thweekoffetal lifeCOMMONMIEYOLKSAMESENTERIO(CURAWACVEINPORERLAS.Dorsalandventralpancreaticbuds1.BUDFORMATIONVENTRA.Onlythecaudal portionofthe head and the uncinateprocessarederivedfromthe ventral pancreasVENTRALPANCREASHASNOTYETTAKENPLACEPANCREASANDUNIONOFDUCTSD1 Klein SD, Affronti JP. Pancreas divisum, an evidence-based review. part I, pathophysiology.Gastrointest Endosc. 2004;60(3):419-425, doi:10.1016/s0016-5107(04)01815-22]llustrationsfromTheNetterCollection,Volume3.Part3.lustionsbyFrankHNetterMD
Embryology • The pancreas arises in the 4th week of fetal life • Dorsal and ventral pancreatic buds • Only the caudal portion of the head and the uncinate process are derived from the ventral pancreas [1] Klein SD, Affronti JP. Pancreas divisum, an evidence-based review: part I, pathophysiology. Gastrointest Endosc. 2004;60(3):419-425. doi:10.1016/s0016-5107(04)01815-2 [2] Illustrations from The Netter Collection, Volume 3, Part 3. Illustrations by Frank H. Netter, MD
AnatomyLieswithintheretroperitoneum intheupperabdomen·Be divided into 4 portionshead, neck, bodyandtailThehead of the pancreasis intimatelyadherentto the medial portion of theduodenum and liesin front of the inferiorvena cava and superiormesentericvessels.The stomachand the firstportion of the duodenum lie partly in front of thepancreas. The common bile duct passes througha posterior groove in the head of the pancreasadjacent to the duodenum.atomy,Frank H,Netter,MD
Anatomy • Lies within the retroperitoneum in the upper abdomen • Be divided into 4 portions—head, neck, body, and tail • The head of the pancreas is intimately adherent to the medial portion of the duodenum and lies in front of the inferior vena cava and superior mesenteric vessels. The stomach and the first portion of the duodenum lie partly in front of the pancreas. The common bile duct passes through a posterior groove in the head of the pancreas adjacent to the duodenum. [3] Atlas of human anatomy, Frank H. Netter, MD
CelactrurProper hepatic ariern hepatic arterySplenic arternyodenalarter(partalyinphanompostoroesuoetiopancreaticoduodenal artery(Common)bile duclRieht gast(sastroepiplocartery(phantomtcut)Great pancreatic artAnterior superiopancreaticoduodenal arterynierio(ohantom)oanAnastomotic branchDoesoPosleriorinfericpancreaticoduodenalartererior inferiorpancreaticdhsodenalartervinhanhovmiPosterior viewThebloodsupplyofthepancreasisderivedfrombranchesoftheceliacandsuperiormesenteric.Thesuperiorpancreaticoduodenal arteryarisesfrom the gastroduodenalartery,andeventuallymeets the inferiorpancreaticoduodenalartery,abranchofthesuperiormesentericartery,toformanarcade.Thesplenicarteryprovides tributariesthat supplythebodyandtail of thepancreas.Themainbranches aretermedthedorsalpancreatic,pancreaticamagna,and caudalpancreaticarteries.Thevenoussupplyoftheglandparallelsthearterial supply.Lymphaticdrainageis intotheperipancreaticnodeslocatedalongthe veins.Theinnervationofthepancreasisderivedfromthevagalandsplanchnicnerves.Thevisceralafferentfibersfromthepancreasalsotravelinthevagalandsplanchnicnerves,butthosethatmediatepainareconfinedtothelatter
• The blood supply of the pancreas is derived from branches of the celiac and superior mesenteric. The superior pancreaticoduodenal artery arises from the gastroduodenal artery, and eventually meets the inferior pancreaticoduodenal artery, a branch of the superior mesenteric artery, to form an arcade. The splenic artery provides tributaries that supply the body and tail of the pancreas. The main branches are termed the dorsal pancreatic, pancreatica magna, and caudal pancreatic arteries. The venous supply of the gland parallels the arterial supply. Lymphatic drainage is into the peripancreatic nodes located along the veins. • The innervation of the pancreas is derived from the vagal and splanchnic nerves. The visceral afferent fibers from the pancreas also travel in the vagal and splanchnic nerves, but those that mediate pain are confined to the latter