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MD3002 Anatomy > Spleen and the Portal and Venous System > Flashcards

Spleen and the Portal and Venous System Flashcards

1
Q

What is the largest lymphoid organ in the body?

A

The spleen

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2
Q

Where is the spleen located in adults?

A
  • Just posterior to stomach
  • Against diaphragm
  • Between ribs 8(9)-11 on the left side
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3
Q

What are the functions of the spleen?

A
  • Removal of blood-borne antigens
  • Removal and destruction of aged or defective blood cells
  • Storing blood platelets and RBC
  • Haematopoiesis in the fetus (-> 5 months in utero)
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4
Q

What makes the spleen similar to a lymph node but also different in its function?

A
  • Lymph nodes filter the lymph

- Spleen filters the blood

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5
Q

The area over Labbe’s triangle becomes dull on percussion as a result of what?

A

Splenomegaly

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6
Q

What is the spleen derived from?

A

Mesoderm

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7
Q

How is the spleen related to the peritoneal cavity?

A

Intraperitoneal except hilum

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8
Q

What is the spleen related to?

A
  • Colon (left colic flexure)
  • Stomach
  • Left kidney
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9
Q

What is the spleen surrounded by?

A

Fibrous capsule from which trabeculae extend inward

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10
Q

What is the superior surface of the spleen like?

A

Serrated (if you can feel notches likely to be enlarged spleen)

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11
Q

What are the 2 main areas of the spleen?

A
  • Where venous sinuses are

- Pulp

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12
Q

What is the diameter of the average erythrocyte?

A

8 microns

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13
Q

How large is the distal end of the trabecular meshwork?

A

3 microns (eryhtrocytes can squezze through it)

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14
Q

What are the 2 sections of the pulp in the spleen?

A
  • White pulp (purple areas) contain WBCs

- Red pulp (surround white pulp and store erythrocytes and removes old ones)

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15
Q

When are the stored RBCs of the spleen released into the bloodstream?

A

During exercise

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16
Q

What does sympathetic innervation of the spleen result in?

A
  • Causes trabecular meshwork and spleen to contract expelling RBCs into venous sinuses and systemic circulation
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17
Q

What is the end product of perforin?

A

Bilirubin

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18
Q

What is the spleen connected to the stomach by?

A

Gastroplenic (gastrolienal) ligament

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19
Q

What does the gastrosplenic ligament contain?

A
  • Left gastroepiploic and short gastric vessels

- May contain accessory spleen

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20
Q

What is the is the spleen connected to the posterior abdominal wall by?

A

Splenorenal ligament

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21
Q

What does the splenorenal ligament contain?

A

Splenic vessels and tail of the pancreas

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22
Q

What is the anterior border of the epiploic foramen?

A

Hepatoduodenal ligament

23
Q

What is the gastrosplenic ligament a remnant of?

A

Dorsal mesentary

24
Q

Where does the splenic artery run from?

A

Along the upper border of the pancreas

25
Q

What does the splenic artery divide into?

A

Branches that enter the spleen at the hilum

26
Q

What is the venous drainage of the spleen?

A
  • Splenic vein runs along the tail and body of pancreas
  • Receives short gastric and left gastro-epiploic veins
  • Behind the neck of the pancreas, joins the superior mesenteric vein to form the hepatic portal vein
27
Q

What is the lymphatic drainage of the spleen?

A
  • Splenic hilar lymph nodes ->pancreatico-splenic nodes -> coeliac nodes
28
Q

What is the nerve supply of the spleen?

A
  • The nerves accompany the splenic artery
  • Sympathetics from T5-9 -> coeliac plexus
  • Para from vagus
29
Q

What 3 veins make up the hepatic portal system?

A
  • Supeior mesenteric
  • Splenic
  • Inferior mesenteric
30
Q

What does the hepatic portal vein drain?

A
  • Lower 1/3 of oesophagus

- Distal half of anal canal as well as spleen, pancreas + gallbladder

31
Q

Where is the hepatic portal vein formed?

A
  • Posterior to the neck of the pancreas

- Crosses the 1st superior part of the duodenum and enters the lesser omentum

32
Q

What does the hepatic portal vein divide into?

A

Right and left terminal branches

33
Q

Do the hepatic portal veins have valves?

A

No, nor do its tributaries

34
Q

What percent of blood to the liver is carried by the portal vein?

A

70%, 30% is arterial

35
Q

What lobe does blood from the superior mesenteric vein primarily go to?

A
  • Right lobe

- Blood from inferior mesenteric and splenic vein go primarily to left caudate and quadrate lobes

36
Q

What are hepatic lobules?

A

Building block of the liver tissue, consisting of a portal triad, hepatocytes arranged in linear cords between a capillary network, and a central vein

37
Q

What is the portal triad?

A
  • Component of hepatic lobule
  • Found in 6 corners of hepatic lobules
  • Branch of portal vein
  • Branch of hepatic artery proper
  • Bile canaliculi
38
Q

Where does blood drain from hepatocytes?

A
  • Central veins
  • > Hepatic veins
  • > Inferior Vena Cava
39
Q

What can porto-systemic anastomoses also be known as?

A

Porto-caval anstomoses

40
Q

Where can porto-systemic anastomoses be found?

A
  • Lower 1/3 of oesophagus
  • Halfway down anal canal
  • Around umbilicus - Para-umbilical veins + epigastric veins
  • Post. abdominal wall - behind ascending and descending colon - secondary retroperitoneal organs - not as large
41
Q

What can increased flow through porto-systemic anastomoses cause?`

A
  • Oesophageal varices
  • Haemorrhoids (piles)
  • Caput medusae
42
Q

What parts of the colon are scondarily retroperitoneal?

A
  • Ascending and descending colons have mesentaries
43
Q

What can the prehaptic causes of portal hypertension be?

A
  • Portal vein thrombosis

- Splenic vein thrombosis

44
Q

What can the hepatic causes of portal hypertension be?

A
  • Hepatic tumours (benign, malignant or metstatic)
  • Cirrhosis (alcohol abuse, hepatitis, etc.)
  • Parasitic infestations (e.g schistosomiasis)
45
Q

What can the posthepatic causes of portal hypertension be?

A
  • Cardiac disease (severe tricuspid stenosis, restrictive cardiomyopathy, constrictive pericarditis)
  • Hepatic vein thrombosis
  • Inferior vena cava thrombosis
46
Q

What can haemorrhoids be due to?

A
  • Portal hypertension
  • Obesity
  • Pregnancy
  • Sedentary life
47
Q

Where is the abdominal aorta located, where does it runs from?

A
  • Retroperitoneal
  • Begins in aortic hiatus of the diaphragm at T12 (in the midline)
  • Lies on the vertebral column and descends to the level of L4
  • Bifurcates into common iliac arteries (slightly left of the midline)
48
Q

What are the visceral branches of the abdominal aorta?

A
  • Coeliac trunk (T12/L1)
  • Middle suprarenal arteries
  • Superior mesenteric artery (L1)
  • Renal arteries (L1/2)
  • Testicular or ovarian arteries (L2)
  • Inferior mesenteric arteries (L3)
49
Q

What are the parietal branches of the abdominal aorta?

A
  • Inferior phrenic arteries
  • 4x Lumbar arteries
  • Median sacral artery
50
Q

Where is the Inferior Vena Cava located in relation to the peritoneum?

A

Retroperitoneal

51
Q

What is the Inferior vena cava formed by and where?

A
  • Union of the common iliac veins
  • Behind right common iliac artery
  • At the level of L5
52
Q

What veins drain into the Inferior Vena Cava?

A
  • Hepatic veins
  • Right inferior phrenic vein
  • Right suprarenal vein (left vein drains into the left renal vein or left inf. phrenic vein)
  • Both renal veins
  • Right gonadal vein (left vein drains into left renal vein)
  • Lumbar veins
    Veins of origin: 2 common iliacs and median sacral vein
53
Q

What do the 1st and 2nd lumbar veins drain into?

A
  • IVC

- + Ascending lumbar veins -> azygos and hemiazygos

MD3002 Anatomy (14 decks)

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