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MD3002 > Spleen and Portal Venous System > Flashcards

Spleen and Portal Venous System Flashcards

1
Q

Where does the spleen lie

A
  • Posterior to stomach
  • Against the diaphragm
  • Between ribs 8 (9)- 11 on left side
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2
Q

Where is the long axis of the spleen

A

Along the 10th rib

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3
Q

Functions of the spleen

A
  • Removal of blood-borne antigens
  • Removal and destruction of aged/defective RBCs
  • Haematopoiesis in foetus
  • Storing blood platelets
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4
Q

Where is the spleen in relation to the peritoneum

A

Intraperitoneal (except hilum)

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5
Q

What is the spleen surrounded by

A

A fibrous capsule, from which trabeculae extend inwards

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6
Q

What is the spleen related to

A
  • Colon (left colic flexure)
  • Stomach
  • Left kidney
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7
Q

Describe the superior border of the spleen

A

Notched

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8
Q

What connects the spleen to the stomach

A

Gastrosplenic ligament

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9
Q

What does the gastrosplenic ligament contain

A
  • Left gastroepiploic and short gastric vessels

- May contain accessory spleen

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10
Q

What connects the spleen to the posterior abdominal wall

A

Splenorenal ligament

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11
Q

What does the splenorenal ligament contain

A
  • Splenic vessels

- Tail of the pancreas

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12
Q

Arterial supply of spleen

A

Splenic artery (runs along upper border of pancreas)

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13
Q

Venous drainage of spleen

A

-Splenic vein (rungs along tail and body of pancreas) and receives short gastric and left-gastroepiploic veins

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14
Q

Where is the hepatic portal vein formed

A

Behind the neck of the pancreas

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15
Q

Lymphatic drainage of spleen

A

Splenic hilar lymph nodes - pancreatic-splenic nodes - coeliac nodes

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16
Q

Nerve supply of spleen

A
  • Greater splanchnic nerve - coeliac plexus

- Parasympathetics from vagus

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17
Q

Which artery do the nerves follow

A

Splenic artery

18
Q

What arteries form the hepatic portal system

A
  • Splenic
  • Superior mesenteric
  • Inferior mesenteric
19
Q

What does the hepatic portal vein drain

A
  • Lower 1/3 of oesophagus
  • Distal half of anal canal
  • Spleen
  • Pancreas
  • Gallbladder
20
Q

Which omentum does the hepatic portal vein enter

A

Lesser omentum

21
Q

Which ligament does the hepatic portal vein run in

A

Hepatoduodenal ligament

22
Q

Describe the hepatic portal system

A
  • Portal vein enters liver and its branches supply the sinusoids from which blood passes into central veins (which pass to IVC)
  • In sinusoids, portal venous blood mixes with oxygenated blood from the hepatic artery proper
23
Q

Describe the oesophageal anastamosis

A
  • Lower 1/3 of oesophagus
  • Oesophageal branches of left gastric vein (portal vein)
  • Oesophageal veins drainage the middle 1/3 of oesophagus (azygous to SVC)
24
Q

Describe the anastomosis halfway down the anal canal

A
  • Superior rectal vein drainage the upper 1/2 of the anal canal (portal vein)
  • Middle and inferior rectal veins (internal iliac and internal pudendal to IVC)
25
Q

Describe the anastomosis around the umbilicus

A
  • Para-umbilical veins (left branch of portal vein)

- Epigastric veins (femoral external iliac, internal thoracic and axillary veins to IVC and SVC)

26
Q

Describe the anastamosis around the posterior abdominal wall

A
  • Veins of secondarily retroperitoneal organs (portal vein)

- Veins of body wall (systemic veins)

27
Q

What is a re-canalized ductus arteriosus called

A

Vein of Retzius

28
Q

Prehepatic causes of portal hypertension

A
  • Portal vein thrombosis

- Splenic vein thrombosis

29
Q

Hepatic causes of portal hypertension

A
  • Hepatic tumours
  • Cirrhosis
  • Parasitic infections (e.g. Schistosomiasis)
30
Q

Posthepatic causes of portal hypertension

A
  • Cardiac disease (tricuspid stenosis, constrictive pericarditis)
  • Hepatic vein thrombosis
31
Q

Consequences of portal hypertension

A
  • Oesophageal varices
  • Caput medusae
  • Haemorrhoids
32
Q

Describe the position of the abdominal aorta

A
  • Retroperitoneal
  • Begins at T12
  • Descends to level of L4
33
Q

What does the abdominal aorta bifurcate into

A

Common iliac arteries (slightly left of midline)

34
Q

Visceral branches of abdominal aorta

A
  • Coeliac trunk (T12/L1)
  • Middle suprarenal arteries
  • Superior mesenteric artery (L1)
  • Renal arteries (L1/2 disk)
  • Testicular or ovarian arteries (L2)
  • Inferior mesenteric artery (L3)
35
Q

Parietal branches of abdominal aorta

A
  • Inferior phrenic arteries
  • x4 lumbar arteries
  • Median sacral artery
36
Q

Describe the position of the IVC

A

-Retroperitoneal

37
Q

What forms the IVC and where

A
  • Union of common iliac veins

- Behind right common iliac artery at level of L5

38
Q

Describe the ascension of IVC

A
  • Right side of aorta

- Pierces the diaphragm at T8

39
Q

What veins does the IVC receive

A
  • Hepatic veins
  • Right inferior phrenic vein
  • Right suprarenal vein (left drains into left renal/left inferior phrenic)
  • Both renal veins
  • Right gonadal vein (left drains into left renal)
  • Lumbar veins
40
Q

What are the veins of origin of the SVC

A
  • 2 common iliac veins

- Median sacral vein

41
Q

Where do the 1st and 2nd lumbar veins drain

A

Both into IVC and ascending lumbar veins - azygous and hemiazygous

MD3002 (14 decks)

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