The spleen and liver

Question 1

What structure mirrors the anterior border of the spleen?

Answer 1

Stomach

Question 2

What structures mirror the posterior border of the spleen?

Answer 2

Diaphragm
Ribs 9-11
Left lung

Question 3

What structures are found at the medial border of the spleen?

Answer 3

Left kidney

Tail of pancreas

Question 4

What structures are in contact with the superior border of the spleen?

Answer 4

Diaphragm

Costodiaphragmatic recess

Question 5

What structures mirror the inferior border of the spleen?

Answer 5

Left colic flexure

Question 6

In which abdominal quadrant is the spleen located?

Answer 6

Upper left (left hypochondrium)

Question 7

What ribs protect the spleen from trauma?

Answer 7

Ribs 9-11

Question 8

What are the 3 functions of the spleen?

Answer 8

Blood filter (removing old RBCs)
Immunofiltration (site of B and T lymphocytes)
Platelet/WBC storage

Question 9

What are the two ligaments of the spleen? What structures do they connect?

Answer 9

Gastrosplenic ligament:
Splenic hilum –> greater curvature of stomach

Splenorenal ligament:
Splenic hilum –> left kidney

Question 10

What structures are found at the splenic hilum?

Answer 10

Splenic artery
Splenic vein
Lymph vessels
Sympathetic vasomotor fibres

Question 11

What is the innervation of the spleen?

Answer 11

Splanchic nerve via coeliac plexus

Question 12

What is the path of lymph drainage from the spleen?

Answer 12

Pancreaticosplenic nodes –> celiac nodes

Question 13

Outline the path of the splenic artery

Answer 13

Branches from the celiac trunk, across pancreas, splits into 6 central arteries at splenic hilum

Question 14

Outline the path of the splenic vein

Answer 14

Leaves hilum, superior mesenteric, portal vein

Question 15

What is the red pulp of the spleen? What percentage of splenic volume is this?

Answer 15

Sinusoid and vascular sinuses filled with blood

Majority of splenic parenchyma (80%)

Question 16

What is the white pulp of the spleen? What percentage of splenic volume is this?

Answer 16

Aggregations of lymphoid tissue

20%

Question 17

What are the marginal zones of the spleen?

What is their function?

Do these zones have any other names?

Answer 17

Interface between lymphoid (white) and non-lymphoid (red) pulp

High perfusion at an decreased rate- enhances reactions between lymphocytes and antigens

Perilymphoid tissue/follicular tissue

Question 18

What are the long term implications of a splenectomy?

Answer 18

Immunisations and vaccinations

Lifelong Abx prophylaxis

Question 19

What are the four lobes of the liver?

Answer 19

Caudate (top)
Quadrate (bottom)
Left and right

Question 20

What are the four ligaments of the liver?

Answer 20

Hepatoduodenal
Hepatogastric
Left and right triangular (connect to diaphragm)

Question 21

Functionally, the quadrate lobe of the liver is related to which other lobe?

Answer 21

Left lobe

Question 22

Functionally, the caudate lobe of the liver is related to which other lobe?

Answer 22

Right lobe

Question 23

What structures enter and exit the liver at the porta hepatis?

Answer 23

Portal vein
Hepatic artery (branch of celiac trunk)
Common bile duct (exiting)

Question 24

What percentage of blood supply comes from the hepatic artery and portal veins respectively?

Answer 24

25% hepatic artery

75% portal vein (from spleen)

Question 25

What is unique about the hepatic vein?

Answer 25

Drains into IVC but DOESN’T exit the liver at the porta hepatis