Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Human Anatomy ppt lectures Topic 70 Spleen Notes. - anatomy ppt free download human anatomy ppt lectures, medicine notes ppt, anatomy handwritten notes pdf, mbbs 1st year anatomy notes pdf download, best anatomy notes pdf, human anatomy notes pdf, anatomy easy notes pdf, anatomy notes online, anatomy short notes, Anatomy ppt, Powerpoint Presentations and lecture notes.
Spleen
Lien(l)
Splen (g)
Definition
? A large, highly vascular
lymphoid organ .
? It is the largest of the ductless
glands,
? Its soft, and dark purplish
color.
Anatomy
Shape ? Wedge (Tetrahedral)
Location- Lt. Hypochondrium partly epigastrium
Wedged between the gastric Fundus and the
diaphragm,
lies beneath the 9th to 12th ribs,
The hilum sits in the angle between stomach and the
kidney and is in contact with the tail of the pancreas
? Size & weight ? markedly variable
? Normal y ? not palpable
? Harri's Dictum
? Its related to the odd numbers 1,3,5,7,9,11,
? Thick , Broad, length, weight & relation.
? Position- Axis of spleen
lies obliquely along the long axis of the 10th rib.
Directed- downwards, forwards & lateral y. (45*)
External features-
Two ends, Three borders & Two surfaces.
? Peritoneal Relations-
? Surrounded by peritoneum & suspended by fol owing ligamnets-
? Gastrosplenic ligament- short gastric vessels, lymphatics & symp.
N.
? Lienorenal ligamnet- tail of pancreas, splenic vessels,
? pancreaticospleni lymoh nodes
? phrenicocolic ligamen ? supports only.
? Visceral relations-
visceral & diaphragmatic surface- costodiaphragmatic recess of
pleura, lung, & 9,10,11th ribs of left side.
Blood Supply
? Arteries :
The splenic artery which is the largest branch of
the celiac artery
? Veins :
The splenic vein which joins the superior
mesenteric vein to form the portal vein
? Lymph drainage :
The lymph vessels emerge from the hilum and
drain into the celiac nodes .
? Lymph drainage :
The lymph vessels emerge from the hilum and drain into the celiac nodes .
Nerve Supply- sympathetic fibres are derived from the coeliac plexus,
vasomotor in nature.
Functions of the spleen
? the spleen processes foreign antigen
Immune
? Make bacteria and fungi more susceptible to
function
phagocytosis.
? Macrophages capture cel ular and noncel ular
material from the blood and plasma includes
bacteria, especial y pneumococci
Filter function
?
culling
Removal of effete, platelets and red cel s
? removing the inclusions from red cel s and returning
the repaired red cel to the circulation
Pitting
? up to 30--40 per cent of blood platelets are
Pooling
sequestered within the spleen.
? removal of iron from ingested degraded haemoglobin
during red cel cul ing and return the iron to the
plasma.
Iron reutilisation
? PALPATION OF THE SPLEEN
? SPLENOMEGALY
? SPLENECTOMY
? SPLENIC PUNCTURE
? SPLENIC INFARCTION- Kehr's sign.
SPLENOMEGALY
What is splenomegaly ?
? Splenomegaly is an enlargement of the spleen beyond its normal size
Symptoms and signs
Symptoms:
? Abdominal pain
? chest pain
? back pain
Signs:
? palpable left upper quadrant
? Abdominal mass
Causes of splenomegaly
Infection
Infarctio
Cel ular
n and
prolifera
injury
Causes of
tion
splenom
egaly
Cel ular
Congesti
infiltrati
on
on
1- Infection
Bacterial
Viral
Protozoal
2- Cellular Proliferation
Malignancies
Anemia
? leukemia
? Spherocytosis
? lymphoma
? Hemolytic
? Sarcoidosis
? Myelofibrosis
? pernicious
3- Congestion
Portal hypertension
Hepatic vein obstruction
Congestive heart failure
4- collagen disease :
Felty's
Still's
syndrome syndrome
Felty's syndrome
? Felty syndrome is characterized by the
combination of:
1. rheumatoid arthritis
2. splenomegaly
3. Neutropenia
5-Infarction and Injury
? Embolism from ; bacterial endocarditis
1
, AF, MI
? Splenic artery or vein thrombosis
2
? Hematoma
3
Hypersplenism
? Definition:
Hypersplenism is a type of disorder which causes the
spleen to rapidly and prematurely destroy blood
Types & causes
1ry
? The problem within the spleen
itself.
hypersplenism
? chr. malaria
? TB
2ry
? Polycythemia vera
? Tumors.
hypersplenism ? Portal hypertension
Symptoms & signs
? Symptoms of anemia
RBC
? Symptoms of leukopenia & recurrent
WBC
infections
? Symptoms of thrombocytopenia
platelets
+ splenomegaly
Diagnosis & ttt
History taking
Clinical examination
Imaging studies
Laboratory investigation
Treat underlying dis.
splenectomy
SPLENECTOMY
Splenectomy
? Definition:
A splenectomy is the total or partial surgical removal of
the spleen
Indication of Splenectomy
? Trauma:
A- accidental
B- during surgical procedure of
surrounding structures
? As a part of other procedures:
eg. Radical gastrectomy in gastric carcinoma. Total or
distal pancreatectomy.
? Hematological conditions:
? A- RBC:
?
- Hereditary spherocytosis
?
- Thalassaemia
?
- SCA
?
- Autoimmune hemolytic anemia (AIHA)
? B- WBC:
?
- CML)
?
- Lymphomamanagement
? C- Platelets:
? - Idiopathic thrombocytopaenic purpura
(ITP)
? Vascular conditions:
? a- Splenic Artery Aneurysm
? b- Portal hypertension (only if there are
symptomatic esophageal varices) which we
called it segmental portal hypertension.
? Tumors or Abscess:
? primary tumors of the spleen
? Splenic Abscess(Both are rare conditions)
? Others: like cysts in spleen which could be
congenital, degenerative or parasitic like in hydatid
dis.
? Remember that :
There are two diseases for which a splenectomy is the
only treatment--primary cancers of the spleen and
hereditary spherocytosis (HS)
Pre Operative Preparation
1.VACCINATIONS
2.PLT Transfusion
3. Steroids
Special Pre-Op Preparations
In SCD:
1 Prevention of hypoxia [ O2 ]
2 hydration
3 Antibiotics
4 Blood!!!!
Types
partial
laparoscopic
complete
open
splenectomy
Laparoscopic splenectomy
? Removal through several small incisions.
? hospital stay.
? postoperative pain.
? risk of get infection
? Leave smaller scars.
? Remove only middle size enlarged spleen.
Complete splenectomy
Removal of enlarged
Removal of ruptured
spleen
spleen
? Performed under
? Common cause of
general anesthesia.
rupture is accidental
? One of the open surgery.
trauma.
? Most common
? To avoid bleeding, we
technique used if we
ties the splenic artery
have .....
before removing the
ruptured organ.
Partial splenectomy
? Removes only part.
? Useful to reduces pain caused by splenomegaly.
? The pt. is less vulnerable to infection.
Complications
co Earmplicyations Late complications
Postoperative complications
? Lung:
Atelactasis
Pleural effusion
Subphrenic
abscess
Postoperative complications
? Stomach
Dilatation
Perforation
Fistula
Haematemesis
? Pancreas
Abscess
Pancreatitis
Fistula
Postoperative complications
? Haematological
increase in Plts
&WBC.
? Postsplenectomy
Septicaemia
D/T *H.inf
*St.pneum
*N.mening
This post was last modified on 05 April 2022