医学大全胰腺疾病.pptx

Pancreas胰腺疾病 牛牛文库文档分享Anatomy The pancreas lies within the retroperitoneum in the upper abdomen, lying in front of the second lumber vertebra and ending in the splenic hilum. The gland can be divided into four portions-head, neck, body, and tail. uncinate process 牛牛文库文档分享AnatomyThe main pancreatic duct (the duct of Wirsung, 2~3 mm in diameter) courses along the gland from the tail to the head and joins the common bile duct just before entering the duodenum at the ampulla of Vater (85%). The accessory pancreatic duct (the duct of Santorini) enters the duodenum 2~2.5 cm proximal to the Vater. 牛牛文库文档分享Santoriniuncinate process ampulla of V 牛牛文库文档分享the duct of WirsungAnatomy Blood supplyThe superior pancreaticoduodenal artery arises from the gastroduedenal artery, runs parallel to the duodenum, 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. pancreatic magna A 牛牛文库文档分享superior pancreaticoduodenal arterydorsal pancreatic Asplenic arterypancreatic magna Aarcadesuperior mesenteric arterysuperior mesenteric Vinferior pancreaticoduodenal 牛牛文库文档分享 牛牛文库文档分享Physiology Exocrine FunctionThe external secretion consists of a clear, alkaline (pH 7.0~8.3) solution of 750~1000 ml/d containing digestive enzymes. Secretion is stimulated by the hormones secretin and cholecystokinin (CCK) and by parasympathetic vagal discharge. Secretin and CCK are synthesized, store, and released from duodenal mucosal cells in response to specific stimuli. Acid in the lumen of the duodenum causes the release of secretin, and luminal digestion products of fat and protein cause the release of CCK. 牛牛文库文档分享PhysiologyExocrine Function enzymes synthesized, stored (as zymogen granules), and released by the acinar cells of the gland, in response to CCK and vagal stinulation. Pancreatic enzymes are proteolytic, lipolytic, and emylolytic. Lipase and