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Structure of the pancreas

Learning outcomes
1. Describe the location, parts and the duct system of the pancreas

2. Describe its important anatomical relations.
3. Describe its arterial supply and venous drainage 4. Describe the microscopic arrangement of its exocrine and endocrine secretary units

body& tail . neck.Pancreas • Mixed exocrine endocrine gland • lies transversely in the posterior abdominal wall ( L1 & L2 level) • Retroperitoneal • Divided in to head.

• Neck is very short. Portal vein is formed behind the neck. IVC & bile duct lie behind head. • Body lies in front of the aorta.relations • Head lies in the C – shaped concavity of the duodenum. • Tail lies in front of the left kidney & is related to .Pancreas . left renal artery & left suprarenal gland.

It opens to minor duodenal papilla . • Occasionally both ducts open separately Accessory duct when present communicate with the main duct. • Joins with the bile duct to form the hepatopancreatic ampulla ( of Vater) • Opens into the descending part of duodenum at major duodenal papilla.Pancreas – duct system • Main pancreatic duct extends from tail towards the head.

Pancreas – duct system Smooth muscle sphincters control flow of bile and pancreatic fluid into duodenum. • Hepatopancreatic sphincter ( of Oddi) • Pancreatic duct sphincter • Bile duct sphincter .

Pancreas – Arterial supply 1. • inferior pancreatico – duodenal artery . From superior mesenteric A. From the coelic artery • branches of the splenic artery • Common hepatic artery superior pancreaticoduodenal artery ( branch of gastroduodenal artery) 2.

Pancreas – Venous drainage Veins accompany the arteries and drain to • splenic vein • superior mesenteric vein Join to form the portal vein .

Exocrine Pancreas • Arranged as acini • Intercalated ducts penetrate the acini • Basement membrane around the acini • Acinar cells have zymogen granules • secrets proteases. lipase and amylases Pancreatic acini islets of Langerhans .

Endocrine Pancreas • Rounded cluster of cells arranged as islets • More than million of islets • More abundant in the tail region • Islet cells arranged as cords & clumps • In between capillaries .

5% • F cells less than 5% - .20% • B cells ( beta cells) .Endocrine Pancreas Four types of islet cells • A cells ( alpha cells) .70% • D cells ( delta cells ) .

lypolysis & gluconeogenesis • B cells .Endocrine Pancreas • A cells – Glucagon increases blood glucose by glycogenolysis .Insulin reduces blood glucose • D cells – Somatostatin - inhibits the release of other islet cell hormones • F cells – pancreatic polypeptides – controls gastric secretions Tumors can arise from islet cells B cell tumors being the commonest ( insulinoma) Reduce insulin leads to diabetes mellitus .