TBL16 - Spleen

Question 1

What is the largest lymphatic organ? Where is it positioned? What is it protected by?

Answer 1

1) The spleen, the largest lymphatic organ (function to be studied later), is positioned posteriorly in the left upper quadrant
2) Thus, it is protected by the left 9th - 12th ribs

Question 2

Where is the kidney located in relation to the spleen? Where is the splenic hilum located in relation to the pancreas?

Answer 2

1) The left kidney is posteroinferior to the spleen

2) The splenic hilum is adjacent to the tail of the pancreas

Question 3

Why is the spleen the most frequently injured abdominal organ?

Answer 3

1) The close relationship of the spleen to the ribs that normally protect it can be detrimental when there are rib fractures. Severe blows on the left side may fracture one or more of these ribs, resulting in sharp bone fragments that may lacerate the spleen
2) In addition, blunt trauma to other regions of the abdomen that cause a sudden, marked increase in intra abdominal pressure (e.g., by impalement on the handlebars of a motorcycle) can cause the thin fibrous capsule and overlying peritoneum of the spleen to rupture, disrupting its soft pulp (ruptured spleen). If ruptured, there is profuse bleeding (intraperitoneal hemorrhage) and shock

Question 4

What is the splenic artery a branch of? What does the splenic artery generate and where? What do the short gastric arteries arise from and what do they do?

Answer 4

1) The splenic artery is a tortuous branch of the celiac trunk
2) Near the splenic hilum, the splenic artery generates the left gastroepiploic artery
3) Near the hilum, the short gastric arteries arise from the splenic artery to supply the fundus of the stomach

Question 5

What does the inferior mesenteric vein (IMV) empty into? Where does this course?

Answer 5

The inferior mesenteric vein (IMV) typically empties into the splenic vein, which courses posterior to the pancreas to join the superior mesenteric vein (SMV) at the origin of the hepatic portal vein

Question 6

What is splenomegaly, and where is it palpated?

Answer 6

1) When the spleen is diseased, resulting from, for example, granulocytic leukemia (high leukocyte and white blood cell count), it may enlarge to 10 or more times its normal size and weight (splenomegaly)
2) The spleen is not usually palpable in the adult. Generally, if its lower edge can be detected when palpating below the left costal margin at the end of inspiration, it is enlarged about three times its “normal” size