The spleen Flashcards
where is the spleen
lies against the diaphragm from ribs 9-11 on the left
its long axis lies along rib 10
describe the size of the spleen
The spleen is:
1 inch thick; 3 inches wide; 5 inches long; weighs 7oz (200g);
lies between the 9th and 11th ribs
what are the functions of the spleen
- Mechanical filtration of red blood cells
- Active immune response through humeral and cell mediated pathways
- Haematopoesis until 5th month of gestation
what are the relations of the renal area of the spleen (inf border)
left kidney
what is the relation of the gastric area of the spleen (sup border)
diaphragm and stomach
what is the relation of the colic area of the spleen (ant extremity)
colon-splenic flexure
where is the peritoneum surrounding the spleen derived from
the dorsal mesentery of the stomach
how is the stomach connected to the spleen
gastrosplenic ligament that carries the left gastroepiploic and short gastric branches of the splenic artery and veins
how is the spleen connected to the post abdo wall
by the lienorenal ligament that carries the splenic artery and vein alongside the tail of the pancreas
what might rib fractures adjacent to the spleen cause
rupture of the spleen causing intraperitoneal haemorrhage
what is the tail of the pancreas related to
splenorenal ligament containing the splenic artery and vein
what is the splenic artery a branch of
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
where is the splenic vein
leaves the hilum and runs behind the tail and body of the pancreas
it joins the sup mesenteric vein to form the portal vein
where does lymph from the spleen drain to
along the course of the splenic artery and then to the coeliac nodes
what is the nerve supply to the spleen
derived from the coeliac plexus (t5-9)
what are the relations of the portal vein
bile duct coeliac trunk duodenum IVC aorta Inf mes. vein
where does the portal vein drain blood from
lower third of the oesophagus to halfway down the anal canal, spleen, pancreas and gallbladder
where is the portal vein
behind the neck of the pancreas by the union of the splenic and sup mesenteric veins
enters the lesser omentum
where is the SMV
anterior to the third part of the duodenum and uncinate process of the pancreas
describe the arrangement of vessels in the free edge of the lesser omentum
portal vein lies behind the hepatic artery with the bile duct to the right of the artery
what does the left gastric vein drain
lower oesophagus and left end of the lesser curve of the stomach to the portal vein
what does the cystic vein drain to
either to portal vein or liver
what does the right gastric vein drain
the right end of the lesser curve of the stomach directly to the portal vein
where are the portosystemic anastomoses
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
what can cause dilations of porto systemic anastomoses
heart disease hepatic vein thrombosis IVC thrombosis portal hypertension cirrhosis due to alchohol, hepatitis etc portal vein thrombosis, splenic vein thrombosis portal vein compression
where does the aorta bifurcate into the common iliac arteries
L4, just left of midline
what are the relations of the abdominal aorta
pancreas, splenic vein, left renal vein, duodenum, cysterna chyli, thoracic duct, azygous vein, IVC
at what level is the coeliac trunk
T12
at what level is the superior mesenteric artery
L1
at what level is the inf mesenteric artry
L3
what are the 3 paired branches of the aorta
middle suprarenal
renal arteries- L1
testicular or ovarian arteries L2
what are the 3 posterior branches of the abdo aorta
inferior phrenic arteries
lumbar arteries
median sacral artery
at what level do the common iliac veins join to become the IVC
L5, behind the right common iliac artery
on what side of the aorta is the IVC
right side
what are the tributaries of the IVC
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
what are the 3 posterior areas of the spleen
gastric area (sup) renal area (lateral) colic area
what must you be careful of during spleenectomy
avoid injuring the tail of the pancreas when ligating spleen vessels
at what level does the portal vein form from the splenic vein and SMV and IMV
L1
what is the normal portal venous pressure
5-10 mmHg
what is the histology of cirrhosis
nodular regenerative hyperplasia
what are the supra hepatic causes of portal hypertension
heart disease
hepatic vein thrombosis
IVC thrombosis
what are the hepatic causes of portal hypertension
cirrhosis
schistomiasis
alcoholic fatty liver
adenoma (benign)
what are the infra hepatic causes of portal hypertension
portal vein thrombosis
splenic vein thrombosis
what level are the renal arteries
L1
what level are the ovarian or testicular arteries
L2
how many lumbar arteries are there
4
what does the inferior phrenic supply
suprarenal and diaphragm
