Spleen

Question 1

Nature

Answer 1

1. Most important component in the lymphatic system
2. In living, it is highly vascular, soft, and friable

Question 2

Site

Answer 2

1. In left hypochondrium, but its posterior end extends into epigastric region
2. It lies between stomach fundus and diaphragm

Question 3

Size

Answer 3

1 inch thick
3 inches in breadth
5 inches in length

Question 4

Weight

Answer 4

7 ounces in weight

Question 5

Shape

Answer 5

2 borders:
1. Superior
2. Inferior
2 ends:
1. Medial (posterior)
2. Lateral (anterior)
2 surfaces:
1. Diaphragmatic surface
2. Visceral surface

Question 6

Superior border

Answer 6

1. Sharp
2. Marked by one or more notches near lateral end

Question 7

Inferior border

Answer 7

1. Rounded
2. Smooth

Question 8

Medial end

Answer 8

1. Tapering
2. Directed upwards, backwards, and medial

Question 9

Lateral end

Answer 9

1. Broad
2. Directed downwards, forwards, and lateral

Question 10

Diaphragmatic surface

Answer 10

1. Smooth
2. Convex
3. Directed lateral
4. Related to diaphragm which separates it from lower part of left pleura, lung, 9th, 10th, 11th ribs with their intercostal muscles

Question 11

Visceral surface

Answer 11

1. Directed medial towards abdominal cavity
2. Presented hilum and 4 impressions:
   - Gastric
   - Renal
   - Colic
   - Pancreatic

Question 12

Gastric impression

Answer 12

1. Above hilum
2. Related to stomach fundus

Question 13

Renal impression

Answer 13

1. Below hilum
2. Related to front of left kidney

Question 14

Colic impressions

Answer 14

1. Near lateral end
2. Related to left colic flexure

Question 15

Pancreatic impression

Answer 15

1. Just below hilum lateral end
2. Related to pancreas tail

Question 16

Hilum

Answer 16

1. Anterosuperior slit between gastric and renal impressions
2. Allows passage of splenic vessels, lymphatics, and nerves

Question 17

Surface anatomy

Answer 17

1. Lies opposite 9th, 10th, q1th ribs with its long axis parallel to 10th rib
2. Its medial end lies 1.5 inch from midline posterior, while its lateral end lies in left mid-Axillary line

Question 18

Peritoneal covering

Answer 18

1. Completely covered by peritoneum
2. Related to lesser sac left extremity (splenic recess)
3. Has 3 peritoneal ligaments:
   - Gastrosplenic
   - Leinorenal
   - Phrenicocolic

Question 19

Gastrosplenic ligament extent

Answer 19

Extends between upper lip of spleen Hilum and upper part of stomach greater curvature

Question 20

Gastrosplenic content

Answer 20

1. Short gastric and left gastroepiploic vessels (from splenic artery to stomach greater curvature)
2. Lymphatics and pancreaticosplenic lymph nodes
3. Extra-peritoneal fat and autonomic nerve fibers
4. Accessory splenules in some cases

Question 21

Leinorenal ligament extent

Answer 21

Extends from lower lip of spleen Hilum to front of left kidney

Question 22

Leinorenal ligament contents

Answer 22

1. Splenic vessels
2. Tail of pancreas
3. Lymphatics and pancreaticosplenic lymph nodes
4. Extraperitoneal fat and autonomic nerve fibers

Question 23

Phernicocolic ligament

Answer 23

1. Extends between left colic flexure and diaphragm undersurface
2. Supports spleen from below

Question 24

Blood supply

Answer 24

1. Splenic artery
2. Splenic vein

Question 25

Splenic artery

Answer 25

5 terminal branches (end arteries)

Question 26

Splenic vein

Answer 26

Runs behind pancreas body and joins superior mesenteric vein forming portal vein

Question 27

Lymphatic drainage

Answer 27

1. Red bulb has no lymphatics 2. Few lymphatics arise from capsule and trabeculae to drain into pancreaticosplenic lymph nodes (along splenic artery)

Question 28

Factors supporting in position

Answer 28

1. Intraabdominal pressure 2. Positions of surrounding organs 3. Peritoneal ligaments

Question 29

Function

Answer 29

1. Formation of RBC’s during intrauterine life 2. Destruction of old RBC’s, foreign materials, and toxins 3. Blood and iron reservoir

Question 30

Applied anatomy: enlargement and position

Answer 30

1. In living adult, normal spleen (or even enlargement less than 2-3 times) can not be felt 2. Position can be determined only by percussion

Question 31

Applied anatomy: spleen swelling

Answer 31

1. If it is enlarged 2-3 times, it can be felt as a swelling in left hypochondrium 2. Splenic swelling is characterized by presence of notch or notches on it superior border 3. It usually enlarges towards right iliac fossa due to direction of spleen long axis and presence of phrenico-colic ligament

Question 32

Applied anatomy: pain in spleen

Answer 32

Pain due to splenic diseases is felt in left hypochondrium