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''The spleen is an organ found in almost all vertebrates. Similar in structure to a large lymph node, it acts primarily as a blood filter. The word spleen comes from Ancient Greek σπλήν (splḗn).[1]
The spleen plays very important roles in regard to red blood cells (erythrocytes) and the immune system.[2] It removes old red blood cells and holds a reserve of blood, which can be valuable in case of hemorrhagic shock, and also recycles iron. As a part of the mononuclear phagocyte system, it metabolizes hemoglobin removed from senescent red blood cells. The globin portion of hemoglobin is degraded to its constitutive amino acids, and the heme portion is metabolized to bilirubin, which is removed in the liver.[3][4]
The spleen houses antibody-producing lymphocytes in its white pulp and monocytes which remove antibody-coated bacteria and antibody-coated blood cells by way of blood and lymph node circulation. These monocytes, upon moving to injured tissue (such as the heart after myocardial infarction), turn into dendritic cells and macrophages while promoting tissue healing.[5][6][7] The spleen is a center of activity of the mononuclear phagocyte system and is analogous to a large lymph node, as its absence causes a predisposition to certain infections.[8][4]
In humans, the spleen is purple in color and is in the left upper quadrant of the abdomen.[3][9]
The spleen is underneath the left part of the diaphragm, and has a smooth, convex surface that faces the diaphragm. It is underneath the ninth, tenth, and eleventh ribs. The other side of the spleen is divided by a ridge into two regions: an anterior gastric portion, and a posterior renal portion. The gastric surface is directed forward, upward, and toward the middle, is broad and concave, and is in contact with the posterior wall of the stomach. Below this it is in contact with the tail of the pancreas. The renal surface is directed medialward and downward. It is somewhat flattened, considerably narrower than the gastric surface, and is in relation with the upper part of the anterior surface of the left kidney and occasionally with the left adrenal gland.
There are four ligaments attached to the spleen: gastrosplenic ligament, splenorenal ligament, colicosplenic ligament, and phrenocolic ligament.[10]
Measurements[edit]
Height | Spleen length | |
---|---|---|
Women | Men | |
155–159 cm | 6.4–12 cm | |
160–164 cm | 7.4–12.2 cm | 8.9–11.3 cm |
165–169 cm | 7.5–11.9 cm | 8.5–12.5 cm |
170–174 cm | 8.3–13.0 cm | 8.6–13.1 cm |
175–179 cm | 8.1–12.3 cm | 8.6–13.4 cm |
180–184 cm | 9.3–13.4 cm | |
185–189 cm | 9.3–13.6 cm | |
190–194 cm | 9.7–14.3 cm | |
195–199 cm | 10.2–14.4 cm |
The spleen, in healthy adult humans, is approximately 7 centimetres (2.8 in) to 14 centimetres (5.5 in) in length.
An easy way to remember the anatomy of the spleen is the 1×3×5×7×9×10×11 rule. The spleen is 1 by 3 by 5 inches (3 by 8 by 13 cm), weighs approximately 7 oz (200 g), and lies between the 9th and 11th ribs on the left-hand side and along the axis of 10th rib. The weight varies between 1 oz (28 g) and 8 oz (230 g) (standard reference range),[12] correlating mainly to height, body weight and degree of acute congestion but not to sex or age.[13]
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Back of lumbar region, showing surface markings for kidneys, ureters, and spleen
Side of thorax, showing surface markings for bones, lungs (purple), pleura (blue), and spleen (green)
Visceral surface of the spleen
Near the middle of the spleen is a long fissure, the hilum, which is the point of attachment for the gastrosplenic ligament and the point of insertion for the splenic artery and splenic vein. There are other openings present for lymphatic vessels and nerves.
Like the thymus, the spleen possesses only efferent lymphatic vessels. The spleen is part of the lymphatic system. Both the short gastric arteries and the splenic artery supply it with blood.[14]
The germinal centers are supplied by arterioles called penicilliary radicles.[15]
Nerve supply[edit]
The spleen is innervated by the splenic plexus, which connects a branch of the celiac ganglia to the vagus nerve.
The underlying central nervous processes coordinating the spleen's function seem to be embedded into the Hypothalamic-pituitary-adrenal-axis, and the brainstem, especially the subfornical organ.[16]
Development[edit]
The spleen is unique in respect to its development within the gut. While most of the gut organs are endodermally derived, the spleen is derived from mesenchymal tissue.[17] Specifically, the spleen forms within, and from, the dorsal mesentery. However, it still shares the same blood supply—the celiac trunk—as the foregut organs.
Area | Function | Composition |
---|---|---|
red pulp | Mechanical filtration of red blood cells. In mice: Reserve of monocytes[5] |
|
white pulp | Active immune response through humoral and cell-mediated pathways. | Composed of nodules, called Malpighian corpuscles. These are composed of:
|
Other functions of the spleen are less prominent, especially in the healthy adult:
- Spleen produces all types of blood cells during fetal life
- Production of opsonins, properdin, and tuftsin.
- Release of neutrophils following myocardial infarction.[18]
- Creation of red blood cells. While the bone marrow is the primary site of hematopoiesis in the adult, the spleen has important hematopoietic functions up until the 5th month of gestation. After birth, erythropoietic functions cease, except in some hematologic disorders. As a major lymphoid organ and a central player in the reticuloendothelial system, the spleen retains the ability to produce lymphocytes and, as such, remains a hematopoietic organ.
- Storage of red blood cells, lymphocytes and other formed elements. The spleen of horses stores roughly 30 percent of the red blood cells and can release them when needed.[19] In humans, up to a cup (240 ml) of red blood cells is held within the spleen and released in cases of hypovolemia[20] and hypoxia.[21] It can store platelets in case of an emergency and also clears old platelets from the circulation. Up to a quarter of lymphocytes are stored in the spleen at any one time''.
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