THE SPLEEN
Gross anatomy of spleen
• The spleen is a lymphoid organ located in the
upper left part of the abdomen under the
ribcage, behind the fundus of the stomach and
the diaphragm. It is 12X7X4 cm in size and 150
gm in weight.
• It has two major functions
1 Removal of particulate matter from circulation
including ageing RBCs.
2 Provision of lymphocytes and antibodies.
.
• The spleen is surrounded by a capsule of dense connective tissue
from which branched trabecula extend into the parenchyma of the
spleen . The parenchyma of the spleen is termed the pulp of the
spleen. Most of the pulp of a fresh, unfixed spleen is a soft, dark red
mass, the red pulp. It consists of large, irregular, thin-walled blood
vessels, the splenic sinusoids, interposed between sheets and
strands of reticular connective tissue, the splenic cords (of Billroth).
Within the red pulp small, oval or rounded greyish white areas, the
white pulp, is formed by lymphoid tissue.
• Branches of the splenic artery divides into trabecular arteries which
enter the white pulp, where they are called central arteries.
Branches of the central artery almost all divide into smaller vessels
in the marginal zone, i.e. the border between the red and white pulp.
Fine branches of the central artery - penicillar arteries (cuboidal
epithelium) - branch again to form arterial capillaries, which, as they
exit the white pulp, are surrounded by a sheath of phagocytotic cells
and reticular fibres. They are now called sheathed arteries. From
here, the blood enters the red pulp. Sheathed arteries may empty
the blood which they carry directly into the splenic sinusoids (closed
circulation, about 90% in cats) or into the reticular connective tissue
of the splenic cords (open circulation). Macrophages are, in addition
to reticular cell, the main resident cell population of the splenic
cords.
• Blood cells which are emptied into the splenic cords re-enter the
blood vessels through the endothelium of the sinusoids. The
endothelial cells are elongated (in cross section they may appear
cuboidal) and oriented along the long axis of the sinusoids. The
endothelium of the sinusoids has no junctional complexes and its
basement membrane is incomplete (forming narrow circular bands
around the endothelial cells with large intervening fenestrations).
Macrophages ingest aged erythrocytes, platelets and other
particulate matter as they pass through the splenic cords.
• The sinusoids continue into the veins of the pulp, which empty into
thin-walled trabecular veins, which eventually coalesce to form the
splenic vein.
• The white pulp surrounds the central arteries as a periarterial
lymphoid sheath (PALS). Lymphocytes of the PALS are likely to be
T-lymphocytes. In addition, we see macrophages and plasma cells
in the PALS. Lymph nodules, formed by B-lymphocytes, are present
along the course of the central arteries. The central arteries are
typically located in the periphery of the nodule.
Development of spleen
• Development begins in the fifth week.
• The mesenchyme located between the two leaves of the dorsal
mesogastrium proliferates and forms the capsule, septa and the
parenchyma of the spleen. The angiogenic mesenchyme forms the
blood vessels and the sinusoids.
• It develops at different foci located close to each other. The
developing foci of spleen increase in size and fuse to form a
lobulated spleen. The lobules disappear before birth and the
notches in the superior border of the adult spleen are the remnants
of the grooves that separate the fetal lobulations.
• As growth proceeds the spleen projects into the left leaf of the
dorsal mesogastrium. As the stomach rotates the left surface of the
dorsal mesogastrium peritoneum over the left kidney. Thus forming
the lienorenal ligament and the gastrolienal ligament.
• Haematopoesis begins in the 8th week and continues up to the 28th
week. However it retains the potential to produce blood cell
formation even in the adult life.
MIDGUT
• Part of the duodenum distal to the opening
of the bile duct, jujenum, ileum, ascending
colon and right 2/3 of the transverse colon.
Development of the midgut
Week 4
Week 5
• In the 4th week the after formation of the head and tail fold the midgut
communicates widely with the yolk sac throughout its length. In the 5th week
the communication between the midgut and the yolk sac is reduced to a
narrow tube, the yolk stalk.
• The gut is suspended from the body wall by the dorsal mesentry. The artery of
the midgut, the superior mesenteric artery extends through the dorsal
mesentry to the gut.
PHYSIOLOGICAL HERNIATION OF THE MIDGUT
early
Week 6 90O CCW
out
• The midgut tube elongates forming a U shaped loop of the gut. The cavity of
the intra embryonic coelom is unable to accommodate the growing gut tube
due to the large liver and developing kidneys. In the sixth week the midgut
herniates into the remains of the extra embryonic coelom in the proximal
part of the umbilical cord.
• The gut loop has a cranial limb and a caudal limb. At the apex of the gut
loop is attached the yolk stalk and the superior mesenteric artery.
PHYSIOLOGICAL HERNIATION OF THE MIDGUT
early
Week 6 90O CCW
out
• While in the umbilical cord the loop rotates along an anterioposterior axis by
90 degrees. The cranial limb comes to the right and the caudal limb to the
left.
• In the tenth week the loop to return to the abdominal cavity. Due to
enlargement of the abdominal cavity and decrease in size of the liver and
the kidneys.
• The small intestine returns first passing posterior to the
superior mesenteric artery and occupying a central
position in the abdomen. The returning small intestine
elongates forming loops. As the large intestine returns it
undergoes a further 180 degrees rotation and comes to
lie on the right side of the abdomen. The caecal bud
comes to lie under the right lobe of the liver. It then
descends to the right iliac fossa. The appendix develops
as the colon descends and hence it frequently lies
posterior to the caecum.
PHYSIOLOGICAL HERNIATION OF THE MIDGUT
early
Week 6
out
90O CCW
~ Week 10
return
Additional 180O CCW
~ Week 11
• The mesentry of the small intestine under goes
considerable rotation and repositioning as the caudal
limb of the gut rotates. It twists around the origin of the
superior mesenteric artery. Later when the ascending
and the descending colon obtain their definitive positions
their mesenteries press against the peritoneum and of
the posterior abdominal wall. After fusion of these layers
the ascending and descending colon become
retropetroneal. Lower end of the caecum and the
sigmoid colon retain their mesenteries. The mesentry of
the transverse colon fuses with the posterior layer of the
greater omentum.
MUCOSA:
• During the 5th and the 6th weeks the endodermal cells
proliferate and obliterate the lumen of gut.
Recannalization is completed by the end of the
embryonic period.
• The intestinal villi form by the 7th to the 9th week in the
duodenum jujenum and proximal ileum. By 11th week
they are formed in the distal ileum. Surface of the villi is
covered by simple columnar epithelium. Goblet cells are
present by the 8th week. Microvilli can be seen on the
surface of the epithelial cells by the 9th week. Mucosal
crypts develop by 10-12 weeks. Paneth cells can be
seen by the 11th and 12th weeks. Enteroendocrine cells
are present by the 9-12 weeks. M cells are present by
the 14th week.
• The morphological appearance of the small intestine
similar to the adult by the 16th week. Muscularis mucosae
can be seen by the 18th week.
MUSCULARIS EXTERNA: Develops from the
splanchnopleuric mesenchyme.
• The longitudinal muscle can be seen by 12 weeks.
Circular muscle develops later. Contraction of the gut
begins by 26-30 weeks. Peristalsis begins from 30-33
weeks.
SEROSA/ ADVENTITIA: Develops from the coelomic
epithelium