1. Clarissa Gurbani
Year 3 Medical Student
University of Manchester

2.  Length – approx 12cm (5 inches) in adults
 Weight – approx 160 g
 Colour – deep red
 Position
◦ Between 9th
to 11th
ribs on left side

3. ◦ Splenic artery
 From coeliac trunk (T12), a branch of the abdominal aorta
 Branches into trabecular arteries
 Further branches surrounded by white pulp
 Capillaries discharge blood into red pulp
◦ Splenic vein
 Joins SMV to form hepatic portal vein

4.  Gastrosplenic ligament
◦ Broad band of mesentery
◦ Attaches spleen to lateral border of stomach
 Surfaces
◦ Diaphragmatic – smooth and convex
◦ Visceral – i.e. conforming to shape of:
 Stomach (gastric area)
 Left kidney (renal area)
 Hilum
◦ Pt of communication of splenic vessels with spleen
◦ Groove that marks border between gastric and renal
areas.

6.  Surrounding capsule – collagen + elastic fibres
 Cellular components divided into ‘pulp’:
Red pulp •Function – mechanical filtration of RBCs
•Contains – RBCs, blood components, free and fixed
macrophages
•Sequence of filtration – network of reticular fibres 
blood-filled sinusoids lined with macrophages  small
veins  trabecular veins  hilum
•NB: marginal zone i.e. where red pulp meets white
White pulp •Function – active immune response via humoral and
cell-mediated pathways.
•Composed of nodules (Malpighian corpuscles):
•Lymphoid follicles – rich in B cells
•Periarteriolar lymphoid sheathes (PALS) – rich in T
cells

7. 1. Removal of abnormal RBCs and other
blood components (via phagocytosis)
2. Fe storage (recycled from RBCs)
3. Initiation of immune responses by B
and T cells in response to circulating
antigens

8.  Cannot get above it (ribs overlie the top)
 Dull to percussion (kidneys are resonant due to
underlying bowel)
 Moves more with inspiration towards RIF
 Medial notch

9.  Causes can be divided into:
◦ Infective
◦ Haematological
◦ Neoplastic
 Also can be grouped with associated features
◦ Fever
◦ Lymphadenopathy
◦ Purpura
◦ Arthritis
◦ Ascites
◦ Murmurs
◦ Anaemia
◦ Weight loss and CNS signs
◦ Massive

10.  Infection
◦ Malaria
◦ SBE/IE
◦ Hepatitis
◦ EBV
◦ TB
◦ CMV
◦ HIV
 Sarcoid
 Malignancy

11.  Glandular fever (mono)
◦ Aka infectious mononucleosis
◦ Secondary to EBV infection
 Leukaemias, lymphoma
 Sjogren’s syndrome
◦ Xerostomia (dry mouth), xerophthalmia (dry eyes)
◦ Another cause of xerophthalmia? – Vit A deficiency

12.  Septicaemia
 Typhus
 DIC (Disseminated Intravascular Coagulation)
 Amyloid
 Meningococcaemia

13.  Sjogren’s syndrome
 RA and SLE
 Infection e.g. Lyme
 Vasculitis, Behcet’s

14.  Carcinoma
 Portal HTN

15.  SBE/IE
 Rheumatic fever
 Hypereosinophilia
 Amyloid

16.  Sickle-cell
 Thalassaemia
 Leishmaniasis
 Leukaemia
 Pernicious anaemia
◦ Lack of secretion of intrinsic factor (IF) from gastric
oxyntic cells, which is needed for B12 absorption
 POEM (polyneuropathy, organomegaly,
endocrinopathy, M-protein banding)

17.  Cancer, lymphoma
 TB
 Arsenic poisoning
 Paraproteinaemia

18.  Malaria
 Leishmaniasis
 Myelofibrosis
 Chronic myeloid leukaemia
 Gaucher’s syndrome

19.  The Oxford Handbook of Clinical Medicine, 8th
edition
 Martini’s Fundamentals of Anatomy and
Physiology, 8th
edition
 Macleod’s Clinical Examination, 12th
edition

20.  Thank you!