Image Caption : Importance of Pancreas : The pancreas is really two organs in one: a digestive organ that secretes enzymes that help break down nutrients into forms the body can readily absorb; and endocrine gland that produces the hormones that govern the digestion of sugar. The dramatic upsurge in the incidence of diabetes has put the organ in the spotlight.
Levels of insulin and glucose in the blood must be maintained in careful balance. Chronic conditions of too much or too little glucose in the bloodstream can damage to the heart, kidneys, eyes, nerves, and blood vessels; acute disruptions of the insulin/glucose balance can be life-threatening.
PANCREAS—ISLETS OF LANGERHANS
The pancreas is a long, soft organ that lies transversely along the posterior abdominal wall, posterior to the stomach, and extends from the region of the duodenum to the spleen. This gland has an exocrine portion that secretes digestive enzymes that are carried through a duct to the duodenum. The endocrine portion consists of the pancreatic islets, which secrete glucagons and insulin.
Alpha cells in the pancreatic islets secrete the hormone glucagons in response to a low concentration of glucose in the blood. Beta cells in the pancreatic islets secrete the hormone insulin in response to a high concentration of glucose in the blood.
The soft, oblong, glandular pancreas lies transversely in the retroperitoneum behind the stomach. Its head is nestled into the "c-shaped" curvature of the duodenum with the body extending to the left about 15.2 cm (6 in) and ending as a tapering tail in the hilum of the spleen. It is a curious mix of exocrine (secreting digestive enzymes) and endocrine (releasing hormones into the blood) functions (Figure).
The pancreas has a head, a body, and a tail. It delivers pancreatic juice to the duodenum through the pancreatic duct.
The exocrine part of the pancreas arises as little grape-like cell clusters, each called an acinus (plural = acini), located at the terminal ends of pancreatic ducts. These acinar cells secrete enzyme-rich pancreatic juice into tiny merging ducts that form two dominant ducts. The larger duct fuses with the common bile duct (carrying bile from the liver and gallbladder) just before entering the duodenum via a common opening (the hepatopancreatic ampulla). The smooth muscle sphincter of the hepatopancreatic ampulla controls the release of pancreatic juice and bile into the small intestine. The second and smaller pancreatic duct, the accessory duct (duct of Santorini), runs from the pancreas directly into the duodenum, approximately 1 inch above the hepatopancreatic ampulla. When present, it is a persistent remnant of pancreatic development.
Scattered through the sea of exocrine acini are small islands of endocrine cells, the islets of Langerhans. These vital cells produce the hormones pancreatic polypeptide, insulin, glucagon, and somatostatin.
The pancreas produces over a liter of pancreatic juice each day. Unlike bile, it is clear and composed mostly of water along with some salts, sodium bicarbonate, and several digestive enzymes. Sodium bicarbonate is responsible for the slight alkalinity of pancreatic juice (pH 7.1 to 8.2), which serves to buffer the acidic gastric juice in chyme, inactivate pepsin from the stomach, and create an optimal environment for the activity of pH-sensitive digestive enzymes in the small intestine. Pancreatic enzymes are active in the digestion of sugars, proteins, and fats.
The pancreas produces protein-digesting enzymes in their inactive forms. These enzymes are activated in the duodenum. If produced in an active form, they would digest the pancreas (which is exactly what occurs in the disease, pancreatitis). The intestinal brush border enzyme enteropeptidase stimulates the activation of trypsin from trypsinogen of the pancreas, which in turn changes the pancreatic enzymes procarboxypeptidase and chymotrypsinogen into their active forms, carboxypeptidase and chymotrypsin.
The enzymes that digest starch (amylase), fat (lipase), and nucleic acids (nuclease) are secreted in their active forms, since they do not attack the pancreas as do the protein-digesting enzymes.
Regulation of pancreatic secretion is the job of hormones and the parasympathetic nervous system. The entry of acidic chyme into the duodenum stimulates the release of secretin, which in turn causes the duct cells to release bicarbonate-rich pancreatic juice. The presence of proteins and fats in the duodenum stimulates the secretion of CCK, which then stimulates the acini to secrete enzyme-rich pancreatic juice and enhances the activity of secretin. Parasympathetic regulation occurs mainly during the cephalic and gastric phases of gastric secretion, when vagal stimulation prompts the secretion of pancreatic juice.
Usually, the pancreas secretes just enough bicarbonate to counterbalance the amount of HCl produced in the stomach. Hydrogen ions enter the blood when bicarbonate is secreted by the pancreas. Thus, the acidic blood draining from the pancreas neutralizes the alkaline blood draining from the stomach, maintaining the pH of the venous blood that flows to the liver.
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ANATOMY OF THE PANCREAS & DUODENUM
The pancreas has three main sections:
- Head: area of pancreas to right of left border of superior mesenteric vein.
- Body: area of pancreas between left border of superior mesenteric vein and left border of aorta.
- Tail: area of pancreas between left border of aorta and hilum of spleen.
The most common site of primaries is the head of the pancreas. The pancreas has two functional components: endocrine, to produce insulin and other hormones, and exocrine, to produce pancreatic juices for digestion. The pancreas is in direct contact with the stomach, duodenum, spleen, and major vessels of the abdomen.
- Head of pancreas
- Uncinate process
- Pancreatic notch
- Body of pancreas
- Anterior surface
- Inferior surface
- Superior margin
- Anterior margin
- Inferior margin
- Omental tuber
- Tail of pancreas
- Duct of Wirsung: pancreatic duct opening into duodenum.
- Insulin: hormone produced by the pancreas that regulates carbohydrate metabolism.
National Cancer Institute / NIH
The pancreas /ˈpæŋkriəs/ is a glandular organ in the digestive system and endocrine system of vertebrates. In humans, it is located in the abdominal cavity behind the stomach. It is an endocrine gland producing several important hormones, including insulin, glucagon, somatostatin, and pancreatic polypeptide which circulate in the blood. The pancreas is also a digestive organ, secreting pancreatic juice containing digestive enzymes that assist digestion and absorption of nutrients in the small intestine. These enzymes help to further break down the carbohydrates, proteins, and lipids in the chyme. The pancreas is also known as mixed gland.
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