Viscera (heart, lungs, liver, gastrointestinal tract)
Spleen
Splen (Lien)
- Origin
- Intraperitoneal organ in the left hypochondrium, nestled against the diaphragm beneath ribs 9-11
- Insertion
- Suspended by the gastrosplenic ligament (short gastric vessels) and splenorenal ligament (splenic vessels and pancreatic tail)
- Function
- Largest lymphoid organ: blood filtration and culling of senescent erythrocytes (red pulp), adaptive immune responses against encapsulated bacteria (white pulp), and platelet storage
- Innervation
- Splenic plexus from the celiac plexus (sympathetic T6-T8)
- Movement & chain
- Moves inferomedially on inspiration
- Palpation
- Not normally palpable; palpable in splenomegaly extending past the left costal margin on inspiration in the right lateral position (Castell's sign)
- Clinical
- Splenic rupture following blunt abdominal trauma (massive intraperitoneal hemorrhage, hemoperitoneum, Kehr's sign - referred pain to left shoulder), hypersplenism, overwhelming post-splenectomy infection (OPSI).
- Segmental innervation
- T6-T8 spinal levels (phrenic C3-C5 Kehr's sign)
- In clinical practice
- Post-splenectomy immunization against encapsulated organisms (S. pneumoniae, N. meningitidis, H. influenzae), hemodynamic monitoring for splenic laceration, antibiotic prophylaxis counseling
- Region in the model
- Viscera (heart, lungs, liver, gastrointestinal tract)