SPLEEN

-largest reticuloendothelial organ in the body

-arise from primitive ​mesoderm​ as an outgrowth of the left side of the dorsal mesogastrium by
5th week of gestation
-is evident in an embryo 8 mm long
-assumes a hematopoietic role until the ​5th month of gestation

ANATOMY
-abdominal surface of the diaphragm separates the spleen from the ​lower left lung ​and ​pleura
& the ​ninth to eleventh ribs
-visceral surface faces the abdominal cavity and contains gastric, colic, renal and pancreatic
impressions
Spleen size​ & ​weight ​varies: with age & diminish in elderly & in those w/ underlying pathologic
conditions
Average adult spleen: 7-11 cm in length & weighs 150 g (range, 70- 250 g)

Superior border​: separates the diaphragmatic surface from the gastric impression of the
visceral surface & often contains one or two notches (pronounced when the spleen is greatly
enlarged)

It is suspended in position by several ​ligaments​ and ​peritoneal folds ​to the:

● colon (​splenocolic ligament​),
● the stomach (​gastrosplenic ligament​),
● the diaphragm (​phrenosplenic ligament​), and
● the kidney, adrenal gland, and tail of the pancreas (​splenorenal ligament​)

Gastrosplenic ligament​: contains the ​short gastric vessels​; the remaining ligaments are
avascular

BLOOD SUPPLY
Spleen derives most of its blood from the ​splenic artery​ (the longest and most tortuous of the 3
main branches of the celiac artery)
Splenic artery​: characterized by the pattern of its terminal branches
● Distributed type of splenic artery​: the most common (70%) and is distinguished by a
short trunk w/ many long branches entering over ¾ of the spleen's medial surface
● Marginal type of splenic artery​: less common (30%) has a long main trunk dividing
near the hilum into short terminal branches & enter over 25-30% of the spleen medial
surface.

*receives also some of its blood supply from the ​short gastric vessels​ that branch from the ​left
gastroepiploic artery​ running within the gastrosplenic ligament
Splenic vein​: joins the ​superior mesenteric vein ​to form the portal vein and accommodates
the ​major venous drainage of the spleen

When a normal, freshly excised spleen is sectioned, the cut surface is ​finely granular ​&
predominantly dark red​ with ​whitish nodules ​distributed across its expanse
-reflects the spleen microstructure

Splenic parenchyma ​is composed of 2 main elements: ​red pulp ​(constitute approx 75% of
total splenic volume, and ​white pulp
-at the interface between the red and white pulp is the ​narrow marginal zone ​(where
lymphocytes are more loosely aggregated)

Red Pulp​: consist of blood filled ​sinusoids ​and ​splenic cords

White Pulp​: small masses consist of ​lymphoid nodules a ​ nd the ​periarteriolar lymphoid
sheaths ​(​PALS​)

Branching from the hilum, small ​trabecular arteries ​leave the trabecular connective tissue &
enter the parenchyma as arterioles enveloped by PALS >>

Blood enters the ​red pulp​ thru cords comprised of ​fibroblasts & reticular fibers​ (w/c contain
many macrophages & lack an endothelial lining)

Blood then passes from these 'open' cords to venous sinuses & ultimately drains into
tributaries of the splenic vein

Sinuses of the red pulp are lined by endothelial cells​ (it contain unique stress fibers that
connect the endothelial cells & contain actin and myosin-like filaments capable of producing a
sliding action) >> when activated, these filaments can create slits or gaps bet endothelial
filaments thru w/c blood can pass from the cords

Aging erythrocytes with stiffer membranes get stuck trying to pass into the sinus & are
phagocytized by macrophages w/n the red pulp

Red pulp​: serves as a ​dynamic filtration system, enable macrophages to remove

microorganisms, cellular debris, antigen-antibody complexes & senescent erythrocytes
from the circulation

Around the terminal millimeters of splenic arterioles, ​periarticular lymphatic sheath ​replaces
the native adventitia of the vessel
(this sheath comprised of ​T lymphocytes & intermittent aggregations of B lymphocytes or
lymphoid follicles​)

Marginal zone​: 2 specific types of macrophages reside there:

 ● Marginal zone macrophages​: play an important role in the targeting and clearance of
certain bacterial pathogens
● Marginal zone metallophilic macrophages​: the main producers of interferons A and B
in response to a viral challenge

PHYSIOLOGY
-spleen is contained by a ​1-2 mm thick capsule​ >> it is rich in ​collagen ​& contains some
elastic fibers​, but contain ​few or no smooth muscle cells
Total splenic inflow of blood is approx. 250-300 ml/min

1. Spleen acts as the ​major site for clearance f​ rom the blood of damaged or aged red
blood cells
2. Spleen can also ​serve as extramedullary site for hematopoiesis
3. Recycle iron​ (RBC are destroyed intravascular >> released hemoglobin is then bound
to haptoglobin >> scavenged from the circulation by the spleen)
4. Role in ​host defense​ (both ​innate & adaptive immune responses​) occur w/n the
spleen
5. Circulating monocytes are converted w/n red pulp into fixed macrophages thus accounts
for ​spleen's remarkable phagocytic activity
6. Spleen appears to be major source of the protein ​properdin​ (important in the initiation of
the alternate pathway of complement activation)