Spleen Flashcards
Shape of spleen
Wedge-shaped organ
Location of the spleen
Mainly in hypogastrium and partly in epigastrium
Character of the spleen
Soft, highly vascular and dark purple in color
Dimensions of the spleen
1 inch thick, 3 inches broad and 5 inches long
Weight of spleen
7 ounces
Vertebral level of spleen
9-11 rib
Is the spleen palpable?
Not in normal physiology
Axis of spleen
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
What are the external features of spleen?
Two ends
Three borders
Two surfaces
Two angles and hilum
What are the ends of the spleen?
Anterior/lateral end (downwards and forwards reaching midaxillary line)
Posterior/medial end (upwards, backwards and medially)
Borders of the spleen
Superior border (notched near anterior end)
Inferior border (rounded)
Intermediate border (rounded and directed rightwards)
Surfaces of the spleen
Diaphragmatic surface (convex and smooth)
Visceral surface (concave and irregular)
Angles of the spleen
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
Location of spleen hilum
Between superior and intermediate borders
Pierced by branches and tributeries of splenic vessels
What are the peritoneal relations of the spleen?
Gastrosplenic ligament
Lienorenal ligament
Phrenicocolic ligament
Extent of the gastrosplenic ligament?
Extends from the hilum of the spleen to the greater curvature of the stomach
What does the gastrosplenic ligament contain?
Short gastric vessels
Associated lymphatics
Sympathetic nerves
What is the lienorenal ligament?
Extends from the hilum of the spleen to the anterior surface of the left kidney
What does the lienorenal ligament contain?
Tail of the pancreas
Splenic vessels
Associated pancreaticosplenic lymph nodes, lymphatics and sympathetic nerves
What is the phrenicocolic ligament?
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.
Relations on visceral surface of spleen
Gastric impression
Renal impression
Colic impression
Pancreatic impression
Gastric impression
Impression of fundus of stomach
Lies between superior and intermediate borders
Renal impression
Impression of left kidney
Lies between inferior and intermediate borders
Colic impression
Impression of splenic flexure and lower part related to phrenicocolic ligament
Occupies triangular area adjoining anterior end of spleen
Pancreatic impression
Impression of tail of pancreas
Lies between hilum and colic impression
Diaphragmatic relations of spleen
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
Arterial supply of spleen
Splenic artery
Venous drainage of spleen
Splenic vein (formed at the hilum of the spleen)
Course of splenic vein
Runs a straight course behind the pancreas
Joins the superior mesenteric vein behind the neck of the pancreas to form the portal vein
Lymphatic drainage of spleen
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
Nerve supply of spleen
Sympathetic fibers: Celiac plexus (vasomotor and supply smooth muscles of capsule)
Functions of spleen
Phagocytosis
Haemopoiesis
Immune responses
Storage of RBCs
Where can an enlarged spleen be felt?
Under left costal margic during inspiration
Projects into the right iliac fossa in the firection fo the axis of the tenth rib
Spleen must be twice the normal size
What is enlargement of the spleen called?
Splenomegaly
What is a splenectomy?
Surgical removal of spleen
Avoid damage to tail of pancreas which has Islets of Langerhans
Intercostal space for splenic puncture
9th/10th intercostal space in midaxillary line using lumbar puncture needle
Patient must hold breath during procedure
