Download Spleen

SPLEEN
OBJECTIVES
 Discuss
the gross features of the
spleen
 Give its blood and nerve supply
 Give its lymphatic drainage
 Describe the Inguinal Lymph nodes
POSITION OF SPLEEN
 The
spleen lies in
the left
hypochondrium
between the
stomach and
diaphragm.
 It has two ends,
three borders and
two surfaces.
MEASUREMENTS:
-1 inch (thickness) x 3 inches (Breadth) x 5 Inches
(length).
- Weight: 875 gram (7 ounces).
- Surface anatomy: Behind left 9, 10, 11 ribs.

S
URFACE ANATOMY :
It lies parallel to the
ribs number 9, 10 , and
11 on the left side.
 The long axis of the
spleen lies parallel to
the 10th rib.
 Its medial end lies 1 1/2
inches from the spine
of T. 10, while the
lateral end lies just
behind the midaxillary line.
SHAPE :

3 borders, 2 ends, 2
surfaces.
A. Ends
 1) lateral end (Broad)
 2) medial end (tapering)
B. Borders
 Upper(Anterior)
border: Sharp & notched


Lower
(Posterior)border:
(Broad)
Intermediate border:
thick, incomplete.
Extends from the medial
end till the hilum).
Surfaces
 1-
Diaphragmatic surface:
Convex, Related to the diaphragm which separates
it from 3 structures :------- Lower part of left pleura,
- Base of left lung,
- Left 9, 10, 11 ribs.
2- VISCERAL SURFACE:
-
Concave, irregular, directed to the abdominal cavity.
Contains the hilum and impressions for 4 abdominal
organs:
1- Gastric impression (related to posterior wall of
fundus of stomach).
2- Renal impression.
3- Colic impression (left colic flexure).
4- Pancreatic impression (tail of pancreas).
PERITONEAL RELATIONS
The spleen is completely covered by peritoneum
of the greater sac except at the hilum.

It is attached and related to the following
ligaments:
1- Gastro-splenic ligament
2- Lieno-renal ligament.

PERITONEAL
CONNECTIONS
1-Gastrosplenic ligament:
 from the fundus and
greater curvature of
stomach to the hilum of
spleen.
2- Lienorenal ligament:
 From the lower border of
the hilum of spleen to the
anterior surface of kidney.
CONTENTS
-THE GASTROSPLENIC LIGAMENT CONTAINS:
- SHORT GASTRIC VESSELS
- LEFT GASTROEPIPLOIC VESSELS
- LYMPH NODES
THE LIENO-RENAL LIGAMENT CONTAINS:
- SPLENIC VESSELS
- TAIL OF PANCREAS
- LYMPH NODES
Arterial Supply:
 Splenic artery (branch of the
coeliac trunk).
 It has a tortuous course at the
upper border of the pancreas.
 It passes with the tail of the
pancreas in the lieno-renal
ligament.
 At the hilum it divides into 5 or
6 splenic branches.
Venous drainage:
 The spleen is drained by the splenic vein that passes
on the posterior surface of the pancreas to unite with
superior mesenteric vein to form the portal vein
posterior to the neck of the pancreas.
CLINICAL NOTES:

Splenomegaly
 It
is an enlargement of the spleen beyond its
normal size. Many disorders, including
infections, anemias, can cause an enlarged
spleen. Enlarged spleen extends downward
and medially (due to the presence of the
phrenico-colic ligament that prevents its direct
downward descent). The splenic notch(s) may
be felt by palpation through the anterior
abdominal wall.
 Injury
of the spleen is common due to fracture
of the 9, 10, 11 ribs, automobile accidents,
during playing contact sports, or due to
penetrating wounds of the lower left thorax.
ACCESSORY SPLEENS
Accessory
spleens are common
(10-15% of people). They are
found at the hilum of spleen, the
lieno-renal, or the gastro-splenic
ligaments.
The
tail of pancreas is in close
relation to the hilum of spleen so
it could be injured during
splenectomy (surgical removal of
the spleen).
SPLEENECTOMY

Spleen removal is surgery to remove a diseased or
damaged spleen the organ that helps the body fight
infections. ...Its attachments to other organs are gently
cut.
INGUINAL LYMPH NODES
INGUINAL LYMPH NODES
I- Superficial inguinal
LNs:
Site: In the proximal region of
the femoral triangle.
No: 12- 20
Two groups:
A- Horizontal group:
i- Medial:
It drains: Anterior abdominal
wall below umbilicus, lower
part of anal canal, external
genitalia (male and female).
ii- Lateral:
It drains; buttock and back
below iliac crest.
B- Vertical group:
It drains the lower
limb. It is present at
the end of the great
saphenous vein.
All the above groups
of LNs send
efferents to deep
inguinal and
external iliac LNs.
INGUINAL LYMPH NODES CONT.
II- Deep inguinal LNs:
- Site: Deep to deep fascia
on the medial side of the
femoral vein.
- No: 1-3. One of them may
lie in the femoral canal
(lymph node of Cloquet).
- Afferent: from deep
lymphatics of the lower
limb and from superficial
inguinal LNs.
- Efferent: to external
iliac LNs