Spleen

Question 1

Shape of spleen

Answer 1

Wedge-shaped organ

Question 2

Location of the spleen

Answer 2

Mainly in hypogastrium and partly in epigastrium

Question 3

Character of the spleen

Answer 3

Soft, highly vascular and dark purple in color

Question 4

Dimensions of the spleen

Answer 4

1 inch thick, 3 inches broad and 5 inches long

Question 5

Weight of spleen

Answer 5

7 ounces

Question 6

Vertebral level of spleen

Answer 6

9-11 rib

Question 7

Is the spleen palpable?

Answer 7

Not in normal physiology

Question 8

Axis of spleen

Answer 8

The spleen lies obliquely along the long axis of the 10th rib
Directed downwards, forwards and laterally, making an angle of about 45° with the horizontal plane

Question 9

What are the external features of spleen?

Answer 9

Two ends
Three borders
Two surfaces
Two angles and hilum

Question 10

What are the ends of the spleen?

Answer 10

Anterior/lateral end (downwards and forwards reaching midaxillary line)
Posterior/medial end (upwards, backwards and medially)

Question 11

Borders of the spleen

Answer 11

Superior border (notched near anterior end)
Inferior border (rounded)
Intermediate border (rounded and directed rightwards)

Question 12

Surfaces of the spleen

Answer 12

Diaphragmatic surface (convex and smooth)
Visceral surface (concave and irregular)

Question 13

Angles of the spleen

Answer 13

Anterobasal angle: Junction of superior border and lateral end. Most forward projecting part of the spleen
Posterobasal angle: Junction of inferior border with lateral end of spleen

Question 14

Location of spleen hilum

Answer 14

Between superior and intermediate borders
Pierced by branches and tributeries of splenic vessels

Question 15

What are the peritoneal relations of the spleen?

Answer 15

Gastrosplenic ligament
Lienorenal ligament
Phrenicocolic ligament

Question 16

Extent of the gastrosplenic ligament?

Answer 16

Extends from the hilum of the spleen to the greater curvature of the stomach

Question 17

What does the gastrosplenic ligament contain?

Answer 17

Short gastric vessels
Associated lymphatics
Sympathetic nerves

Question 18

What is the lienorenal ligament?

Answer 18

Extends from the hilum of the spleen to the anterior surface of the left kidney

Question 19

What does the lienorenal ligament contain?

Answer 19

Tail of the pancreas
Splenic vessels
Associated pancreaticosplenic lymph nodes, lymphatics and sympathetic nerves

Question 20

What is the phrenicocolic ligament?

Answer 20

Not attached to the spleen but supports its anterior end
Horizontal fold of peritoneum extending from the splenic flexure of colon to the diaphragm, opposite the 11th rib in the midaxillary line
It is also called sustentaculum lienis.

Question 21

Relations on visceral surface of spleen

Answer 21

Gastric impression
Renal impression
Colic impression
Pancreatic impression

Question 22

Gastric impression

Answer 22

Impression of fundus of stomach
Lies between superior and intermediate borders

Question 23

Renal impression

Answer 23

Impression of left kidney
Lies between inferior and intermediate borders

Question 24

Colic impression

Answer 24

Impression of splenic flexure and lower part related to phrenicocolic ligament
Occupies triangular area adjoining anterior end of spleen

Question 25

Pancreatic impression

Answer 25

Impression of tail of pancreas Lies between hilum and colic impression

Question 26

Diaphragmatic relations of spleen

Answer 26

Related to the diaphragm which separates the spleen from the costodiaphragmatic recess of pleura, lung and 9th, 10th and 11th ribs of the left side

Question 27

Arterial supply of spleen

Answer 27

Splenic artery

Question 28

Venous drainage of spleen

Answer 28

Splenic vein (formed at the hilum of the spleen)

Question 29

Course of splenic vein

Answer 29

Runs a straight course behind the pancreas Joins the superior mesenteric vein behind the neck of the pancreas to form the portal vein

Question 30

Lymphatic drainage of spleen

Answer 30

Splenic tissue proper has no lymphatics The connective tissue of the spleen capsule contain lymphatics including trabeculae and drain into the pancreaticosplenic lymph nodes situated along the splenic artery

Question 31

Nerve supply of spleen

Answer 31

Sympathetic fibers: Celiac plexus (vasomotor and supply smooth muscles of capsule)

Question 32

Functions of spleen

Answer 32

Phagocytosis Haemopoiesis Immune responses Storage of RBCs

Question 33

Where can an enlarged spleen be felt?

Answer 33

Under left costal margic during inspiration Projects into the right iliac fossa in the firection fo the axis of the tenth rib ## Footnote Spleen must be twice the normal size

Question 34

What is enlargement of the spleen called?

Answer 34

Splenomegaly

Question 35

What is a splenectomy?

Answer 35

Surgical removal of spleen ## Footnote Avoid damage to tail of pancreas which has Islets of Langerhans

Question 36

Intercostal space for splenic puncture

Answer 36

9th/10th intercostal space in midaxillary line using lumbar puncture needle ## Footnote Patient must hold breath during procedure