Spleen

Question 1

where is the spleen located within the abdomen?

Answer 1

upper left quadrant of the abdomen, under cover of the diaphragm and ribcage

Question 2

what is the spleen roughly the size of?

Answer 2

a clenched fist

Question 3

what is the function of the spleen in an adult?

Answer 3

blood filter, removing old red blood cells. It also plays a role in the immune response

Question 4

As the spleen is located under cover of the diaphragm and ribcage, what does this mean?

Answer 4

it cannot be palpated on clinical examination

Question 5

what type of organ is the spleen and what is it surrounded by? except what?

Answer 5

It is an intraperitoneal organ, entirely surrounded by peritoneum (except at the splenic hilum)

Question 6

what lies anteriorly to the spleen?

Answer 6

stomach

Question 7

what lies posteriorly to the spleen?

Answer 7

diaphragm
left lung
ribs 9-11

Question 8

what lies inferiorly to the spleen?

Answer 8

left colic flexure

Question 9

what lies medially to the spleen?

Answer 9

left kidney

tail of the pancreas

Question 10

what is the spleen connected to?

Answer 10

the stomach and kidney by parts of the greater omentum

Question 11

what is the spleen connected to the stomach and kidney by?

Answer 11

greater omentum

Question 12

what is the greater omentum?

Answer 12

a double fold of peritoneum that originates from the stomach

Question 13

what is the ligament that joins the spleen to the stomach?

Answer 13

Gastrosplenic ligament

Question 14

what does the gastrosplenic ligament connect?

Answer 14

connects the spleen to the greater curvature of the stomach

Question 15

what connects the spleen to the kidney?

Answer 15

Splenorenal ligament

Question 16

what does the splenorenal ligament connect exactly?

Answer 16

connects the hilum of the spleen to the left kidney

Question 17

what lies within the splenorenal ligament?

Answer 17

The splenic vessels and tail of the pancreas

Question 18

what shape is the spleen?

Answer 18

slightly oval shape

Question 19

what is the spleen covered by? what does it allow for?

Answer 19

a weak capsule that protects the organ, whilst allowing it to expand in size

Question 20

what can the outer surface of the spleen divided into?

Answer 20

2
diaphragmatic surface
visceral surface

Question 21

what is the diaphragmatic surface of the spleen in contact with?

Answer 21

in contact with diaphragm and ribcage

Question 22

what is the visceral surface of the spleen in contact with?

Answer 22

the other abdominal viscera

Question 23

what are the different borders of the spleen?

Answer 23

anterior, superior, posteromedial and inferior borders

Question 24

what are the posteromedial and inferior borders like?

Answer 24

smooth

Question 25

what are the anterior and superior borders of the spleen like?

Answer 25

anterior and superior borders contain notches

Question 26

what is enlargement of the spleen known as?

Answer 26

splenomegaly

Question 27

what happens in splenomegaly?

Answer 27

the superior border moves inferomedially, and its notches can be palpated

Question 28

what is the spleen like in terms of vascularisation?

Answer 28

The spleen is a highly vascular organ

Question 29

where does the spleen receive its arterial supply from?

Answer 29

splenic artery

Question 30

where does the splenic artery arise from?

Answer 30

coeliac trunk

Question 31

where does the coeliac trunk run?

Answer 31

laterally along the superior aspect of the pancreas, within the splenorenal ligament

Question 32

what happens to the splenic artery as it reaches the spleen?

Answer 32

it branches into five vessels – each supplying a different part of the organ

Question 33

how do the 5 branches of the splenic artery supply different parts of the organ?

Answer 33

These arterial branches do not anastomose with each other – giving rise to vascular segments of the spleen.

Question 34

as the 5 branches do not anastomose, what does this enable the surgeon to do?

Answer 34

This enables a surgeon to remove one of these segments without affecting the others (a procedure known as a subtotal splenectomy)

Question 35

what is the venous drainage of the spleen?

Answer 35

splenic vein

Question 36

what does splenic vein combine?

Answer 36

superior mesenteric vein

Question 37

what does splenic vein and superior mesenteric vein combine to form?

Answer 37

the hepatic portal vein

Question 38

what is the nerve supply to the spleen from?

Answer 38

the coeliac plexus

Question 39

which abdominal organ has the highest incidence of injury?

Answer 39

The spleen

Question 40

when does the rupture of the spleen occur?

Answer 40

when there is a break in its fibroelastic capsule, disrupting the underlying parenchyma

Question 41

what is rupture of the spleen normally caused by?

Answer 41

Rupture is caused by blunt or penetrating trauma

Question 42

what is rupture of the spleen normally associated with?

Answer 42

It is often associated with left rib fractures, with a bony fragment easily tearing the capsule

Question 43

what does the rupture of the spleen result in? why?

Answer 43

As the spleen is a highly vascular organ, its rupture results in profuse bleeding into the peritoneal cavity

Question 44

what is the definitive treatment for rupture of the spleen?

Answer 44

full or partial removal of the spleen