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Anatomy (TOPNOTCH SUPPLEMENT) > Spleen > Flashcards

Flashcards in Spleen Deck (14):
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Attachment and its contents

To the stomach: gastrosplenic ligament
- short gastric artery & vein
- left gastroepiploic artery & vein

To the kidney: splenorenal ligament
- 5 terminal branches of the splenic artery
- tributaries of splenic vein
- tail of pancreas

1

Location: left hypochondriac region, anterior to ribs 9,10 &11

Does not extend below the costal margin (not easily palpable)
- palpated with patient on R lateral decubitus with the leg flexed

Spleen

2

Usually near the hilum, tail of pancreas or within the gastrosplenic ligament

Accessory spleen

3

Functions of spleen

Removal of old or abnormal RBC

Removal of inclusion bodies from RBC
- e.g. Howell-Jolly bodies (nuclear remnants), Pappenheimer bodies (iron granules) or Heinz bodies (denatured Hgb)

Removal of poor opsonized pathogens

IgM production by plasma cells

Storage of platelets

Protection from infection

4

The largest branch of celiac trunk

Splenic artery

5

Branches of splenic artery

Dorsal pancreatic artery

Great pancreatic artery

Caudal pancreatic artery

Short gastric artery

Left gastroepiploic artery

5 terminal branches:
- supply individual segments of the spleen
- no anastomosis between them (end arteries)
- obstruction results in splenic infarction

6

Joins the superior mesenteric vein to form the portal vein

Splenic vein

7

Nearby structures that may be injured during splenectomy

Gastric wall (if short gastric artery are compromised)

Tail of pancreas (is caudal pancreatic artery are compromised during manipulation of splenorenal ligament)

Left kidney (manipulation of splenorenal ligament)

8

MC complication: atelectasis of left lower lobe of the lung

Post op: thrombocytosis, abnormal RBCs, Howell-Jolly bodies

Splenectomy

9

Due to ⬇️ opsonic production, ⬇️ IgM, ⬇️ bacterial clearance from the blood

S. Pneumonia, H. Influenzae, N. Meningitidis

Overwhelming postsplenectomy sepsis

10

Abnormal RBCs --> multiple infarcts --> autosplenectomy

Sickle cell anemia

11

Spectrum protein deficiency caused by mutation in the gene for ankyrin

Anisocytosis (RBC size variation) & spherocytes

SSX: jaundice, pigmented gall stones, splenomegaly

Tx: splenectomy

Hereditary spherocytosis

12

IgG against a platelet-associated antigen --> rapid platelet destruction

SSX: ⬇️ platelet count, ⬆️ megakaryocyte count, easy bruising, petechiae, mucosal bleeding

Tx: steroids, platelet transfusion, plasmapheresis

Splenectomy only when steroid is ineffective

Immune thrombocytopenic purpura (ITP)

13

Associated with pancreatitis

SSX: gastric varices, upper GI bleeding

Splenic vein thrombosis