Anatomy, Histology, & Embryology of the Pancreas

*Pancreas is secondary retroperitoneal, with the exception of the tail, the foregut.
Anatomy of Pancreas
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Location: Within the curve of the duodenum, located in the epigastric and left hypochondriac regions
Surface Projection: Surface projection of is different depending on the part of it, and will be entailed
later.
Topography: touches the doudenum, the spleen, the left kidney, the lower border of the stomach.
Function: releases secretions in an exocrine fashion, namely pancreatic juice, which it then secretes
into the duodenum through the major duodenal papilla, or papilla of Vater. This major pancreatic
duct is also called the duct of Wirsung. Endocrine secretions include glucagon and insulin into the
blood.

Parts:
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Head located between L1-2 in curve of the duodenum, to the descending and horizontal parts
of it. develops mainly from the ventral pancreatic bud, except the upper part, which is from the
dorsal pancreatic bud. Is located right to the sup mesenteric a/v.SP = head of pancreas is
anterior loc to IVC, right renal a/v, left renal v Uncinate process- at lower head behind sup
mesenteric a/v
Neck - short, 1-2cm, sup mesenteric a/v go behind the neck, @ notch below neck, called
pancreatic notch. Ant surface of neck covered with peritoneum, and moves along with
movements of pylorus of stomach. Sup mesenteric v and splenic v combine behind the neck of
pancreas, to form portal v.
Body loc @ L1-2, in front of vert column, posterior to lesser sac Has 3 surfaces:

Tail loc. at left costal arch, 2-3 fingers lat to T12, runs to hilum of spleen.

Ant covered by peritoneum, and indirectly contacts post stomach, lies in floor of lesser
sac, helps form gastric bed >
Post - contact with aorta, sup mesenteric a/v, L kidney & renal vessels, and L suprarenal
gland, Splenic a runs in tortous path superior to it, and has groove for splenic v.
Inf - touches 3rd and 4th part of duod Omental tuberosity in sup surface of body
below celiac trunk, contact with visceral surface of liver. (T12-L1 midline)

Can be retroperitoneal or intraperitoneal.

If shorter, than usually retroperitoneal, like the rest of pancreas. Then a small peritoneal
ligament = pancreaticolineal lig extends from tip of tail > hilum of spleem. Splenic a/v
enter spleen through this ligament.
If longer, intraperitoneal, and splenic a/v can go directly to spleen.

Ducts:

Main pancreatic duct = Duct of Wirsung, duct of ventral pancreatic bud, begins in tail
and runs along entire pancreas, till head, where it turns inf and runs with common bile
duct. Opens at major duodenal duct Ampulla of Vater, which is gaurded by sphincter
of Oddi, after joining bile duct.
Accessory pancreatic duct = Santorinis duct can open into main or minor duodenal
papilla, sometimes both. minor duodenal papilla located 2cm above major one, Begins
in lower portion of the head, and drains small portion of head and body.
Clinical NOTE - Bile ducts is embedded into a groove on the post/sup side of the head. If
tumors are located within the head, this can block bile flow into the duodenum,
resulting in jaundice.
Blood Supply: B/c develops from FOREGUT supplied by branches of celiac trunk.

Splenic a supplies derivatives of dorsal pancreatic bud > neck, body, tail of pancreas
located on shallow groove on sup/post side of pancreas. 10 branches, that can form
arterial arcades (networks) with branches from gastroduodenal a and sup mesenteric a
Sup pancreaticoduodenal a (gastroduodenal a) & Inf pancreaticoduodenal a (sup
mesenteric a ) splits into ant/post branches to supply the head of the pancreas
Most veins empty into splenic v, which is embedded into the back of the pancreas itself

Lymph Drainage

lymph vessels follow the arteries and drain into pancreatiosplenic nodes that lie along
splenic arteries. The ones by the head go to pyloric lymph nodes, as well.
These two sets of nodes drain into celiac, hepatic, and sup mesenteric lymph nodes

Innervation
PNS (Para Sympethatic Nervous System) (+) digestion, secretion, vasodilation.

From CN X, carries pre ggl fibers to submucosal and myenteric plexus within
walls of organs, with short post ggl PNS fibers.
Go to parenchyme (acinar cells and islets of Langerhans)
Inc Insulin secretion, Inc glucagon secretion

SNS (Sympathetic Nervous System) (-) digestion, secretion, vasoconstriction

SNS > (T5-T9) from thoracic splanchnic n > aortic hiatus > celiac ggl plexus
around the celiac trunk > post ggl fibers run with branches of celiac trunk.
Go to pancreatic glands and parenchyme (pancreatic acinar cells and islets of
Langerhans)
dec insulin secretion, inc glucagon secretion
Peritoneal ligaments:
Peritoneal ligaments: none ,except for the tail sometimes, which can be located within the
pancreaticolienal ligament.

Histology Pancreas slide

Structures to Identify:

Intercalated duct
Intralobular duct
a/v/capillaries
Islets of Langerhans
Secretory acinus
A,B,D, cells
CT septa lobules

General Information

Digestive gland with head, neck, body ,

tail regions
Mixed gland with endocrine and
exocrine functions

Exocrine:

Tubuloacinar
glands
manily
composed of serous secretory units
Secretions proteolytic enzymes
Proteolytic
Endo-peptidases:
trypsinogen, chemotrypsinogen
Exopeptidases:
procarboxypeptidases,
proaminopeptidases,
alpha
amylases,
lipases
nucleolytic
enzymes
Has hormonal/ neural control
regulation: Secretin inc. fluid
secretion, CCK pro enzyme
secretion Chyme of stomach and
duodenum
stimulate
enteroendocrine cells to secrete CCk
and Secretin causes pancreas to
secrete
Forms most of pancreas, has tightly
packed serous acini circular gland,
small circular lumen, darkly stained.
zymogen cells arranged in lobule
fashion
Lobules
seperated
by
thin
intralobular, and interlobular CT
septa have blood vessels,
interlobular
ducts,
pacinian
corpsucles
Pacinian corpsucle - concentric
circles, lighter than surrounding
acini, is a sensory receptor

Endocrine:

Islets of Langerhans (Pancreatic Islets) highly vascularized epitheloid tissue

alpha, beta, delta, cells in periphery, beta cells also in center.
light staining, globular, with thin CT capsule surrounding it.
Pyramid shaped cells facing central lumen,
Secretions go to large vacular network of capillaries just outside the islets,
Excretes into intercalated duct, lined by low cuboidal epithelium

Alpha cells glucagon inc amount of glucose in blood

Beta cells insulin dec amount of glucose in blood
Delta cells -Somatostatin inhibits the other two
Duct flow:
Within the islets, flow into pale staining centro acinar cells within lumen intercalated (same as
intralobular) ducts interlobular ducts (simple cuboidal epith) in interlobular CT septa
larger ducts (also interlobular, but with stratified columnar epith)

Embryology Development of Pancreas

Endodermal lining of forgut forms two outgrowths, ventral pancreatic bud and dorsal pancreatic
bud
Within both buds, endodermal tubules surr. by mesoderm > branch to from acinar cells and
ducts (exocrine part).
Clumps of cells within exocrine part form, and become the future islets (endocrine part)
Remember how the duodenum rotates 90 degrees clockwise? Because of this, the ventral bud
(ant) rotates also dorsally (post) and fuses with the dorsal bud already there to form adult
pancreas
Ventral bud = uncinate process and lower part of head of pancreas
Dorsal bud = rest of pancreas
Main pancreatic duct (of Wirsung) = formed by distal dorsal bud and all of ventral bud
Acc pancreatic duct (of Santorini) = prox part of dorsal bud
Endoderm origin = acinar cells, islet cells, simple columnar and cuboidal lined parts of duct
system
Visceral mesoderm = CT surrounding them, and a/v/capillaries

Source: http://anatomytopics.wordpress.com/2008/12/23/23-anatomy-histology-embryology-ofthe-pancreas/