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MD3002 > The spleen > Flashcards

The spleen Flashcards

1
Q

where is the spleen

A

lies against the diaphragm from ribs 9-11 on the left

its long axis lies along rib 10

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2
Q

describe the size of the spleen

A

The spleen is:
1 inch thick; 3 inches wide; 5 inches long; weighs 7oz (200g);
lies between the 9th and 11th ribs

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3
Q

what are the functions of the spleen

A
  1. Mechanical filtration of red blood cells
  2. Active immune response through humeral and cell mediated pathways
  3. Haematopoesis until 5th month of gestation
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4
Q

what are the relations of the renal area of the spleen (inf border)

A

left kidney

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5
Q

what is the relation of the gastric area of the spleen (sup border)

A

diaphragm and stomach

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6
Q

what is the relation of the colic area of the spleen (ant extremity)

A

colon-splenic flexure

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7
Q

where is the peritoneum surrounding the spleen derived from

A

the dorsal mesentery of the stomach

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8
Q

how is the stomach connected to the spleen

A

gastrosplenic ligament that carries the left gastroepiploic and short gastric branches of the splenic artery and veins

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9
Q

how is the spleen connected to the post abdo wall

A

by the lienorenal ligament that carries the splenic artery and vein alongside the tail of the pancreas

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10
Q

what might rib fractures adjacent to the spleen cause

A

rupture of the spleen causing intraperitoneal haemorrhage

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11
Q

what is the tail of the pancreas related to

A

splenorenal ligament containing the splenic artery and vein

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12
Q

what is the splenic artery a branch of

A

the largest branch of the coeliac artery

it runs along the upper border of the pancreas

it divides into six branches that enter the spleen at the hilum

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13
Q

where is the splenic vein

A

leaves the hilum and runs behind the tail and body of the pancreas

it joins the sup mesenteric vein to form the portal vein

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14
Q

where does lymph from the spleen drain to

A

along the course of the splenic artery and then to the coeliac nodes

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15
Q

what is the nerve supply to the spleen

A

derived from the coeliac plexus (t5-9)

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16
Q

what are the relations of the portal vein

A 
bile duct
coeliac trunk
duodenum
IVC
aorta
Inf mes. vein
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17
Q

where does the portal vein drain blood from

A

lower third of the oesophagus to halfway down the anal canal, spleen, pancreas and gallbladder

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18
Q

where is the portal vein

A

behind the neck of the pancreas by the union of the splenic and sup mesenteric veins
enters the lesser omentum

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19
Q

where is the SMV

A

anterior to the third part of the duodenum and uncinate process of the pancreas

20
Q

describe the arrangement of vessels in the free edge of the lesser omentum

A

portal vein lies behind the hepatic artery with the bile duct to the right of the artery

21
Q

what does the left gastric vein drain

A

lower oesophagus and left end of the lesser curve of the stomach to the portal vein

22
Q

what does the cystic vein drain to

A

either to portal vein or liver

23
Q

what does the right gastric vein drain

A

the right end of the lesser curve of the stomach directly to the portal vein

24
Q

where are the portosystemic anastomoses

A

lower third of the oesophagus
halfway down the anal canal
paraumbilical veins

veins of the retroperitoneal colon, duodenum and pancreas and liver anastomose with the renal, lumbar and phrenic veins

25
Q

what can cause dilations of porto systemic anastomoses

A 
heart disease
hepatic vein thrombosis
IVC thrombosis
portal hypertension 
cirrhosis due to alchohol, hepatitis etc
portal vein thrombosis, 
splenic vein thrombosis 
portal vein compression
26
Q

where does the aorta bifurcate into the common iliac arteries

A

L4, just left of midline

27
Q

what are the relations of the abdominal aorta

A

pancreas, splenic vein, left renal vein, duodenum, cysterna chyli, thoracic duct, azygous vein, IVC

28
Q

at what level is the coeliac trunk

A

T12

29
Q

at what level is the superior mesenteric artery

A

L1

30
Q

at what level is the inf mesenteric artry

A

L3

31
Q

what are the 3 paired branches of the aorta

A

middle suprarenal
renal arteries- L1
testicular or ovarian arteries L2

32
Q

what are the 3 posterior branches of the abdo aorta

A

inferior phrenic arteries
lumbar arteries
median sacral artery

33
Q

at what level do the common iliac veins join to become the IVC

A

L5, behind the right common iliac artery

34
Q

on what side of the aorta is the IVC

A

right side

35
Q

what are the tributaries of the IVC

A

hepatic veins
right suprarenal vein, renal veins, right gonadal vein
inf phrenic vein and 4 lumbar veins
two common iliac veins and the median sacral vein

36
Q

what are the 3 posterior areas of the spleen

A 
gastric area (sup)
renal area (lateral)
colic area
37
Q

what must you be careful of during spleenectomy

A

avoid injuring the tail of the pancreas when ligating spleen vessels

38
Q

at what level does the portal vein form from the splenic vein and SMV and IMV

A

L1

39
Q

what is the normal portal venous pressure

A

5-10 mmHg

40
Q

what is the histology of cirrhosis

A

nodular regenerative hyperplasia

41
Q

what are the supra hepatic causes of portal hypertension

A

heart disease
hepatic vein thrombosis
IVC thrombosis

42
Q

what are the hepatic causes of portal hypertension

A

cirrhosis
schistomiasis
alcoholic fatty liver
adenoma (benign)

43
Q

what are the infra hepatic causes of portal hypertension

A

portal vein thrombosis

splenic vein thrombosis

44
Q

what level are the renal arteries

A

L1

45
Q

what level are the ovarian or testicular arteries

A

L2

46
Q

how many lumbar arteries are there

A

4

47
Q

what does the inferior phrenic supply

A

suprarenal and diaphragm

MD3002 (56 decks)

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