SPLEEN

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Q.1 What is the position of the spleen in the abdomen?

The spleen lies obliquely along the long axis of the 10th rib. It lies mainly in the left hypochondrium but the posterior end extends into epigastrium.

It is directed downwards, forwards and laterally.

Q.2 What is the average size and weight of spleen?

Spleen is 1 inch thick, 3 inches broad, 5 inches long, 7 ounces in weight

Q.3 What are the ends, borders, and surfaces of the spleen?

Ends:

• Anterior: Expanded, directed downwards, forwards, and laterally.
• Posterior: Rounded, directed upwards, backward and medially.

Borders:

• Superior:
  Sharp, notched near anterior ends, separates diaphragmatic surface from gastric impression.
  
  
• Inferior:
  More rounded and separates renal impression from the diaphragmatic surface.
  
  
• Intermediate border:
  Rounded and separates gastric and renal impressions.

Surfaces:

• Diaphragmatic surface: convex.
• Visceral surface: Concave and has the following impressions:

• Gastric impression: For fundus of stomach.
• Renal impression: For the left kidney.
• Colic impression: For left flexure of colon.
• Pancreatic impression: For the tail of the pancreas.

Q.4 Name the structures lying at the hilum of the spleen?

The hilum transmits splenic vessels and nerves. It provides attachment to gastrosplenic and lienorenal ligaments.

Q.5 What are the peritoneal ligaments attached to spleen?

• Gastrosplenic ligament
• Lienorenal ligament
• Phrenico-colic ligament.
  
  

Q.6 What are the structures lying in the gastrosplenic ligament?

• Left gastroepiploic vessels
• Short gastric vessels
• Lymphatics
• Sympathetic nerves
• Fat
  
  

Q.7 Name the structure lying in the Lienorenal ligament?

It contains:

• Tail of pancreas
• Splenic vessels
• Pancreaticosplenic lymph nodes
• Lymphatics
• Sympathetic nerves
• Fat
  
  

Q.8 What is the blood supply to the spleen?

 Spleen is mainly supplied by a splenic artery which is a branch of the celiac trunk.

It runs tortuously to the left along the superior border of the pancreas and finally enters into the splenic helium.

Q.9 Name the tributaries of splenic vein.

• Short gastric
• Left gastroepiploic
• Pancreatic and
• Inferior mesenteric vein
  
  

Q.10 What are the functions of the spleen?

The spleen has the following functions:

• Phagocytosis:
  By the reticular cells, free macrophages, and endothelial cells. They remove cell debris and old RBCs and other blood cells and micro-organisms.
• Hemopoiesis:
  Important during fetal life. lymphopoiesis continues throughout life.
• Immune response:
  Under antigenic stimulation increased lymphopoiesis occurs in spleen
• Storage of RBCs
  
  

Q.11 What is the developmental origin of spleen?

From the left layer of cephalic part of dorsal mesogastrium, into a number of nodules which fuse to form a lobulated mass.

Q.12 What are the ‘Accessory spleen’?

These are the splenic nodules which have failed to fuse to form a lobulated mass.

Q.13 What is Kehr’s sign?

Splenic infarction due to obstruction of branches of the splenic artery causes referred pain in the left shoulder due to irritation of the undersurface of the diaphragm by effused blood.