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SPLEEN Wedge shaped, intraperitoneal, and mobile organ Between fundus…
SPLEEN
Wedge shaped, intraperitoneal, and mobile organ
Between fundus of stomach & diaphragm
Occupies
• Left hypochondrium (Mainly)
• Epigastrium (Partly)
Spleen NOT Palpable (Normally)
• Usually purplish, pulpy mass about the size and shape of one's fist
• Most vulnerable abdominal organ
• Soft, vascular (sinusoidal) mass with a relatively delicate fibroelastic capsule
• Largest lymphatic organ
• Lymphatic Drainage
Splenic lymphatic to pancreaticosplenic lymph nodes
•
Nerve Supply
Splenic plexus: derived from
Celiac Plexus
mostly are postsynaptic sympathetic fibers to smooth muscle of the splenic capsule, trabeculae, and intrasplenic
• PERITONEAL RELATIONS
– Surrounded by peritoneum except at hilum
– Suspended by following ligaments:
Gastrosplenic ligament
(to greater curvature of stomach). Contain short gastric and Left gastroepiploic vessels
Lienorenal ligament:
contains splenic BVs and tail of pancreas
– supported by following ligament —>
phrenicocolic ligament
BLOOD SUPPLY
• Arterial Supply
Splenic Artery (largest br of celiac) Course is along upper margin of body and tail then divides into five or more branches that enter the hilum
– No anastomosis btw branches leads to vascular segments (2 in 84% & 3 in 16%)
• Venous Drainage
Splenic Vein (formed by several tributaries) on posterior surface of pancreas joins SMV to form Portal vein.
Clinical
Splenomegaly
Rupture of the Spleen
Splenectomy and Splenomegaly
Accessory Spleen(s)
Splenic Needle Biopsy and
Splenoportography
• External Features
:
Directed downwards , forwards & laterally making an angle of about 45 degrees with the horizontal
Lies obliquely along the long axis of the 10th rib
Surfaces
(2): Diaphragmatic and Visceral ( = Medial )
DIAPHRAGMATIC SURFACE
(Convex, Smooth)
RELATIONS:
Diaphragm separates spleen from
Costodiaphragmatic recess of left pleura
lung ( left )
9th, 10th,11th ribs ( left )
VISCERAL SURFACE
(Concave, Irregular, Has Impressions)
• Impressions for visceral relations
Hilum
Lies on the inferomedial part of the
gastric impression along the long axis of the spleen
Transmits splenic vessels & nerves
Provides attachment to gastrosplenic & lienorenal ligaments
Pancreatic
Between the hilum & colic impression for the tail of the pancreas
Colic
– Occupies a triangular area adjoining the
anterior end of spleen
– For the splenic flexure of the colon
– Related to phrenicocolic ligament
Renal
– Between inferior & intermediate borders
– For the anterior surface of left kidney
Gastric
– Largest & most concave impression
– Between superior & intermediate borders
– For the fundus of stomach
Borders (3)
:
Inferior
Rounded
Intermediate
Rounded
Directed to the right
Superior
,
Notched near the anterior end
Notching indicates lobulated form of spleen in early fetal life
Ends / Extremities (2)
Posterior
– Rounded
– Directed upwards, backwards & medially
– Rests on the upper pole of left kidney
Anterior
– Expanded
– More like a border
– Directed downwards & forwards
– Reaches midaxillary line
General features:
Remember: (Odd No: 1,3,5,7,9 - 11)
Thick - 1 inch,
Broad- 3 inch,
Long - 5 inch,
Weight - 7 ounces,
Ribs- 9 to 11th