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Radioanatomy of theRadioanatomy of theEndocrine GlandsEndocrine Glands
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What are endocrine glands?
Glands that produce hormones andsecrete them directly in the bloodstream
They do not have ducts
Pituitary
Thyroid
Parathyroid Adrenals
Pancreas
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Pituitary GlandPituitary Gland
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Pituitary GlandPituitary Gland
Master gland of the endocrine systemMaster gland of the endocrine system
Lies in the hypophyseal fossa (sellaLies in the hypophyseal fossa (sella
turcica)turcica)
Fossa is roofed by diaphragma sellaeFossa is roofed by diaphragma sellae
Stalk of the hypophysis cerebri piercesStalk of the hypophysis cerebri pierces
the diaphragma sellae and is attachedthe diaphragma sellae and is attached
above to the floor of the third ventricleabove to the floor of the third ventricle
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Pituitary GlandPituitary Gland
Gland is oval in shapeGland is oval in shape
Measures 8 mm (AP diameter) andMeasures 8 mm (AP diameter) and
12 mm (transversely)12 mm (transversely)
Weighs 500 mgWeighs 500 mg
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RelationsRelations
SuperiorlySuperiorly Diaphragma sellaeDiaphragma sellae
Optic chiasmaOptic chiasma
Tuber cineriumTuber cinerium
Infundibular recess of 3Infundibular recess of 3rdrd ventricleventricle InferiorlyInferiorly
Hypophyseal fossa and irregular venousHypophyseal fossa and irregular venouschannels between the two layers of durachannels between the two layers of dura
covering itcovering it Sphenoidal air sinusesSphenoidal air sinuses
On each sideOn each side
Cavernous sinus with its contentsCavernous sinus with its contents
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SubdivisionsSubdivisions
AdenohypophysisAdenohypophysis
Anterior lobeAnterior lobe
Intermediate lobeIntermediate lobe
Tuberal lobeTuberal lobe
NeurohypophysisNeurohypophysis
Posterior lobePosterior lobe
Infundibular stemInfundibular stem
Median eminence of the tuber cineriumMedian eminence of the tuber cinerium
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Blood SupplyBlood Supply
ArterialArterial
Branches of internal carotid arteryBranches of internal carotid artery
VeinsVeins Short veins emerge on the surface ofShort veins emerge on the surface ofthe gland and drain into thethe gland and drain into the
neighbouring venous sinusesneighbouring venous sinuses
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Radio-Imaging of PituitaryRadio-Imaging of Pituitary
GlandGland
Not visualized on Plain X-Ray of theNot visualized on Plain X-Ray of the
skull, except for the sella turcica andskull, except for the sella turcica and
clinoid processes housing theclinoid processes housing the
pituitary glandpituitary gland
Visualized onVisualized on
CT Scan of brainCT Scan of brain
MRI of brainMRI of brain
PET Scan of brainPET Scan of brain
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Radiograph of SkullRadiograph of Skull
Lateral view showsLateral view shows
the sella turcicathe sella turcica
Pituitary glandPituitary gland
resides on top of theresides on top of thesella turcicasella turcica
The anterior andThe anterior and
posterior clinoidposterior clinoid
processes define theprocesses define theanterior and posterioranterior and posterior
boundariesboundaries
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Radiograph of SkullRadiograph of Skull
Townes ViewTownes View
shows dorsumshows dorsum
sellae on top ofsellae on top of
which lies thewhich lies thepituitary glandpituitary gland
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A. Frontal LobeA. Frontal LobeB. Frontal Bone (SuperiorB. Frontal Bone (Superior
Surface of Orbital Part)Surface of Orbital Part)
C. Dorsum SellaeC. Dorsum Sellae
D. Basilar ArteryD. Basilar ArteryE. Temporal LobeE. Temporal Lobe
F. Mastoid Air CellsF. Mastoid Air Cells
G. Cerebellar HemisphereG. Cerebellar Hemisphere CT Scan of
Head
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MRI of Brain
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MRIofBrain
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MRI of Brain
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MRI of Brain
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PituitaryGland
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Pituitary Gland
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NormalOpticChiasm
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PituitaryAdenoma
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Opticnerves
PituitaryAdenom
a
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Thyroid GlandThyroid Gland
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Endocrine Gland
regulates basalmetabolic rate
stimulatessomatic and psychicgrowth
plays importantrole in calciummetabolism
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Ultrasound of Thyroid Gland
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Thyroid GlandThyroid Gland
Two lobes joined by theTwo lobes joined by theisthmusisthmus
Lies against the C5,C6, C7Lies against the C5,C6, C7and T1 vertebrae claspingand T1 vertebrae claspingthe upper part of tracheathe upper part of trachea
Each lobe extends fromEach lobe extends fromthe middle of the thyroidthe middle of the thyroidcartilage to the 4cartilage to the 4thth or 5or 5thth tracheal ringtracheal ring
Isthmus extends from 2Isthmus extends from 2ndnd
to 3to 3rdrd tracheal ringstracheal rings
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Thyroid GlandThyroid Gland
Lobes measure about 5 cm x 2.5 cmLobes measure about 5 cm x 2.5 cm
x 2.5 cmx 2.5 cm
Isthmus measures about 1.2 cm xIsthmus measures about 1.2 cm x
1.2 cm1.2 cm
Larger in females than in malesLarger in females than in males
Increases in size during menstruationIncreases in size during menstruation
and pregnancyand pregnancy
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CapsulesCapsules
True peripheral condensation ofTrue peripheral condensation ofconnective tissue of the glandconnective tissue of the gland
False derived from pretrachealFalse derived from pretracheal
layers of deep cervical fascialayers of deep cervical fascia False capsule forms the suspensoryFalse capsule forms the suspensory
ligament of Berry which connects theligament of Berry which connects the
lobe to the cricoid cartilagelobe to the cricoid cartilage A dense capillary plexus is presentA dense capillary plexus is present
deep to the true capsuledeep to the true capsule
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RelationsRelations
Lobes are conical in shape and haveLobes are conical in shape and have
ApexApex
BaseBase
Three surfaces lateral, medial andThree surfaces lateral, medial and
posterolateralposterolateral
Two borders anterior and posteriorTwo borders anterior and posterior
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RelationsRelations
Lateral surfacesLateral surfaces
ConvexConvex
Covered by sternothyhyoid,Covered by sternothyhyoid,
sternohyoid, superior belly of omohyoidsternohyoid, superior belly of omohyoidand anterior border of sternomastoidand anterior border of sternomastoid
musclesmuscles
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RelationsRelations
Medial surfaceMedial surface
Two tubes trachea and esophagusTwo tubes trachea and esophagus
Two muscles inferior constrictor andTwo muscles inferior constrictor and
cricothyroidcricothyroid
Two nerves extrenal laryngeal andTwo nerves extrenal laryngeal and
recurrent laryngealrecurrent laryngeal
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RelationsRelations
Posterolateral surfacePosterolateral surface
Carotid sheathCarotid sheath
Overlaps common carotid arteryOverlaps common carotid artery
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RelationsRelations
Anterior borderAnterior border
ThinThin
Anterior branch of superior thyroid arteryAnterior branch of superior thyroid artery
Posterior borderPosterior border ThickThick
Inferior thyroid arteryInferior thyroid artery
Anastomosis between superior and inferiorAnastomosis between superior and inferior
thyroid arterythyroid artery
Parathyroid glandParathyroid gland
Thoracic duct (left side)Thoracic duct (left side)
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RelationsRelations
ApexApex
Directed upwardsDirected upwards
BaseBase
At the level of 4At the level of 4 thth or 5or 5thth tracheal ringtracheal ring
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RelationsRelations
IsthmusIsthmus
Connects the lower parts of the lobesConnects the lower parts of the lobes
Two surfaces Two surfaces Anterior and posterior surfacesAnterior and posterior surfaces
Two bordersTwo borders Superior and inferior bordersSuperior and inferior borders
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Anterior surface covered byAnterior surface covered by
Sternothyroid and sternohyoid musclesSternothyroid and sternohyoid muscles
(R&L)(R&L) Anterior jugular veinsAnterior jugular veins
Fascia and skinFascia and skin
Posterior surface related toPosterior surface related to 22ndnd and 3and 3rdrd tracheal ringstracheal rings
Isthmus
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IsthmusIsthmus
Upper borderUpper border
Anastomosis between Right and LeftAnastomosis between Right and Left
Superior Thyroid ArteriesSuperior Thyroid Arteries Lower borderLower border
Inferior thyroid veins leave the gland atInferior thyroid veins leave the gland at
this borderthis border
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Blood SupplyBlood Supply
ArterialArterial
Superior thyroid artery branch ofSuperior thyroid artery branch of
external carotid arteryexternal carotid artery
Inferior thyroid artery branch ofInferior thyroid artery branch ofthyrocervical trunkthyrocervical trunk
VeinousVeinous
Superior thyroid veinSuperior thyroid vein Inferior thyroid veinInferior thyroid vein
R di I i f Th idR di I i f Th id
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Radio-Imaging of ThyroidRadio-Imaging of Thyroid
GlandGland Not visualized on Plain X-Ray unlessNot visualized on Plain X-Ray unless
calcifiedcalcified
Visualized onVisualized on
UltrasoundUltrasound
CT scanCT scan
MRIMRI
Nuclear Medicine studyNuclear Medicine study
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Coned apical radiograph of the upperthorax shows curvilinear calcificationin a thyroid adenoma, at the root of
the neck, on the right side
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CarotidArtery
Trachea
Thyroid Gland
IsthmusStenohyoid andsternothyroid
muscles
Transverse Section of the Right Lobe of Thyroid
Gland
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Sagittal Sectionof the ThyroidGland
Transversesection of ThyroidGland
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Isthmus
Right LobeLeft Lobe
Trachea
Transver
seSectionof the
Thyroid
Gland
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CT Scan of Thyroid GlandCT Scan of Thyroid Gland
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Thyroid Scanning NuclearMedicine
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Parathyroid GlandParathyroid Gland
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Parathyroid GlandParathyroid Gland
Two pairsTwo pairs
SuperiorSuperior
InferiorInferior
Lie on the posterior border of the thyroidLie on the posterior border of the thyroidgland within the thyroid capsulegland within the thyroid capsule
Oval or lentiform in shapeOval or lentiform in shape
Measure about 6 x 4 x 2 mmMeasure about 6 x 4 x 2 mm Weighs 50 mgWeighs 50 mg
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Parathyroid GlandParathyroid Gland
Anastomotic artery between superiorAnastomotic artery between superior
and inferior thyroid artery is a goodand inferior thyroid artery is a good
marker because they lie close to itmarker because they lie close to it
Superior parathyroid glands are moreSuperior parathyroid glands are moreconsistent in location near theconsistent in location near the
middle of the posterior border of themiddle of the posterior border of the
thyroid lobethyroid lobe
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Blood SupplyBlood Supply
ArterialArterial
Inferior thyroid arteryInferior thyroid artery
Anastomosis between superior andAnastomosis between superior and
inferior thyroid arteriesinferior thyroid arteries
VeinousVeinous
Thyroid veinsThyroid veins
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Radio-ImagingRadio-Imaging
Not visualized on normal studiesNot visualized on normal studies
Seen mostly when there is adenomaSeen mostly when there is adenoma
Sometimes may be ectopic inSometimes may be ectopic in
locationlocation
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Transverse and longitudinal viewsof the left parathyroid gland
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Immediatescan Delayed scans
Nonspecific accumulation ofradioactivity in the region of the
parathyroids
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A 1.3 x 1.0 cm. nodule, relativelyhyperintense is seen posterior to the left lobeof the thyroid gland and lateral to theesophagus.
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Injection of radioactiveInjection of radioactive
material shows rapidmaterial shows rapid
uptake by the thyroiduptake by the thyroid
glandgland
Delayed imageshows a retention of
the radioactivematerial at theinferior pole of theleft thyroid arath roid
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Adrenal GlandsAdrenal Glands
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Adrenal GlandsAdrenal Glands
A pair of glandsA pair of glands
Lie in the epigastium at the upperLie in the epigastium at the upper
pole of the kidneyspole of the kidneys
In front of the crus of diaphragmIn front of the crus of diaphragm
Opposite the vertebral end of the 11Opposite the vertebral end of the 11ththintercostal space and 12intercostal space and 12thth ribrib
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Adrenal GlandsAdrenal Glands
Right adrenal gland is triangular orRight adrenal gland is triangular or
pyramidal in shapepyramidal in shape
Left adrenal gland is semilunarLeft adrenal gland is semilunar
Measures about 50 mm in height, 30 mmMeasures about 50 mm in height, 30 mmin breadth and 10 mm in thicknessin breadth and 10 mm in thickness
1/31/3rdrd the size of kidneys in children andthe size of kidneys in children and
1/301/30thth
the size in adultsthe size in adults Weighs 5 gWeighs 5 g
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Right Adrenal GlandRight Adrenal Gland
An apexAn apex
A baseA base
Two surfaces anterior and posteriorTwo surfaces anterior and posteriorThree borders anterior, medial andThree borders anterior, medial and
laterallateral
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RelationsRelations
Anterior surface devoid of peritoneumAnterior surface devoid of peritoneumexcept a small part belowexcept a small part below Inferior vena cava mediallyInferior vena cava medially Liver laterally andLiver laterally and Occasionally duodenum inferiorlyOccasionally duodenum inferiorly
Posterior surfacePosterior surface Crus of diaphragmCrus of diaphragm
Anterior borderAnterior border Hilum where veins emerge below the apexHilum where veins emerge below the apex
Medial borderMedial border Right celiac ganglionRight celiac ganglion Right inferior phrenic arteryRight inferior phrenic artery
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Left Adrenal GlandLeft Adrenal Gland
Two ends Two ends Upper narrow endUpper narrow end
Lower rounded endLower rounded end
Two bordersTwo borders Medial convexMedial convex
Lateral concaveLateral concave
Two surfacesTwo surfaces AnteriorAnterior PosteriorPosterior
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RelationsRelations
Anterior surface Anterior surface cardiac end of stomachcardiac end of stomach
Splenic arterySplenic artery
PancreasPancreas
Posterior surfacePosterior surface Kidney laterallyKidney laterally
Left crus of diaphragm mediallyLeft crus of diaphragm medially
Medial borderMedial border Left celiac ganglionLeft celiac ganglion Left inferior phrenic arteryLeft inferior phrenic artery
Left gastric arteryLeft gastric artery
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Blood SupplyBlood Supply
ArterialArterial
Superior adrenal artery branch ofSuperior adrenal artery branch of
inferior phrenic arteryinferior phrenic artery
Middle adrenal artery branch ofMiddle adrenal artery branch ofabdominal aortaabdominal aorta
Inferior adrenal artery branch of renalInferior adrenal artery branch of renal
arteryartery
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Blood SupplyBlood Supply
VeinousVeinous
Each gland drained by one veinEach gland drained by one vein
Right adrenal vein drains into inferiorRight adrenal vein drains into inferior
vena cavavena cava Left adrenal vein drains into left renalLeft adrenal vein drains into left renal
veinvein
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Radio-ImagingRadio-Imaging
Not seen on plain X-Ray unlessNot seen on plain X-Ray unless
calcifications are presentcalcifications are present
Visualized byVisualized by
CT ScanCT Scan
MRIMRI
Ultrasonography seen better inUltrasonography seen better in
children than in adultschildren than in adults
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Imaging of Adrenal GlandsImaging of Adrenal Glands
Located in the perirenal space near the upper pole ofeach kidney
They may be shaped like the letters H, L, Y, T, or V
They are less than 4 cm in length and less than 1.0 cm
in thickness
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CT ScanCT Scan
They may be shaped like the letters H, L, Y, T, or V
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Crus of diaphragm
IVC
Pancreas
Spleen
andSplenic
Vessels
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Ultrasound of adrenalUltrasound of adrenalmassmass
Oblique sagittal imageOblique sagittal image
of the abdomenof the abdomen
demonstrates andemonstrates an
isoechoic mass of theisoechoic mass of the
left adrenal gland thatleft adrenal gland that
is anterolateral to theis anterolateral to the
aorta and medial toaorta and medial to
the left kidneythe left kidney
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Right
AdrenalAdenoma
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PancreasPancreas
PP
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PancreasPancreas
Exocrine glandExocrine gland Secretes digestive enzymesSecretes digestive enzymes
Endocrine glandEndocrine gland
Secretes hormones like insulinSecretes hormones like insulin
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The pancreas is 12-15 cm long and isThe pancreas is 12-15 cm long and islocated in the epigastriumlocated in the epigastrium
Parts of the pancreas:Parts of the pancreas: HeadHead Uncinate processUncinate process NeckNeck
BodyBodyTailTail
The head and body lie outside theThe head and body lie outside theperitoneumperitoneum
The head of the pancreas is surrounded byThe head of the pancreas is surrounded bythe duodenum as it makes a C-loopthe duodenum as it makes a C-looparound the pancreasaround the pancreas
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The common bile duct traversesThe common bile duct traversesthrough the head of the pancreas andthrough the head of the pancreas and
joins with the pancreatic duct at thejoins with the pancreatic duct at theampulla of Vater to empty bile into theampulla of Vater to empty bile into the
second or descending part of thesecond or descending part of theduodenumduodenum Both the pancreatic ducts of SantoriniBoth the pancreatic ducts of Santorini
and Wirsung drain the exocrineand Wirsung drain the exocrine
pancreaspancreas
Relationship to SurroundingRelationship to SurroundingSt tSt t
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StructuresStructures
HeadHead PosteriorPosterior
Superior Mesenteric VeinSuperior Mesenteric Vein Splenic veinSplenic vein
Inferior Vena CavaInferior Vena CavaTerminal portion of renal veinTerminal portion of renal vein Right crus of diaphragmRight crus of diaphragm
AnteriorAnterior
Transverse colonTransverse colon LateralLateral
Bile ductBile duct
Relationship to SurroundingRelationship to Surrounding
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Relationship to Surroundingp g
StructuresStructures
NeckNeckAnteriorAnterior
PylorusPylorus
Omental bursaOmental bursaPosteriorPosterior
SMVSMVBeginning of portal veinBeginning of portal vein
Relationship to SurroundingRelationship to Surrounding
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Relationship to Surroundingp g
StructuresStructures
BodyBody AnteriorAnterior
Stomach separated by omental bursaStomach separated by omental bursa PosteriorPosterior
Aorta and SMAAorta and SMA Left crus of diaphragmLeft crus of diaphragm Left kidney and adrenal glandLeft kidney and adrenal gland Left renal vein and splenic veinLeft renal vein and splenic vein
InferiorInferiorTransverse mesocolon and splenicTransverse mesocolon and splenic
flexureflexure Duodeno-jejunal junctionDuodeno-jejunal junction
Relationship to SurroundingRelationship to Surrounding
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p gp g
StructuresStructuresTailTail
The tail of the pancreas lies in theThe tail of the pancreas lies in thesplenorenal ligament and enters thesplenorenal ligament and enters thehilum of the spleen with splenichilum of the spleen with splenic
vesselsvessels
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Have a Good DayHave a Good Day