| spleen | |
|---|---|
| Spleen | |
| Laparoscopic view of a horse's spleen (the purple and grey mottled organ) | |
| Latin | splen, lien |
| Gray's | subject #278 1282 |
| System | weirdness:) |
| Artery | Splenic artery |
| Vein | Splenic vein |
| Nerve | Splenic plexus |
| Precursor | Mesenchyme of dorsal mesogastrium |
| MeSH | Spleen |
| Dorlands/Elsevier | Spleen |
The spleen (from Greek σπλήν - splēn[1]) is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells (also referred to as erythrocytes) and the immune system.[2] In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock while also recycling iron. As a part of the mononuclear phagocyte system, it metabolizes hemoglobin removed from senescent erythrocytes. The globin portion of hemoglobin is degraded to its constitutive amino acids, and the heme portion is metabolized to bilirubin, which is subsequently shuttled to the liver for removal.[3] It synthesizes antibodies in its white pulp and removes antibody-coated bacteria along with antibody-coated blood cells by way of blood and lymph node circulation. The spleen is brownish.[3][4] Recently, it has been found to contain in its reserve half of the body's monocytes within the red pulp.[5] These monocytes, upon moving to injured tissue (such as the heart), turn into dendritic cells and macrophages while promoting tissue healing.[5][6][7] It is one of the centers of activity of the reticuloendothelial system and can be considered analogous to a large lymph node, as its absence leads to a predisposition toward certain infections.[8]
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The spleen, in healthy adult humans, is approximately 11 centimetres (4.3 in) in length. It usually weighs between 150 grams (5.3 oz)[9] and 200 grams (7.1 oz)[10] and lies in front of the 9th to the 12th thoracic ribs.[10] An easy way to remember the anatomy of the spleen is the 1x3x5x7x9x11 rule. The spleen is 1" by 3" by 5", weighs approximately 7 oz, and lies between the 9th and 11th ribs on the left side.
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.[11]
The germinal centers are supplied by arterioles called penicilliary radicles.[12]
The spleen is unique in respect to its development within the gut. While most of the gut viscera are endodermally derived (with the exception of the neural-crest derived suprarenal gland), the spleen is derived from mesenchymal tissue.[13] 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] |
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| white pulp | Active immune response through humoral and cell-mediated pathways. | Composed of nodules, called Malpighian corpuscles. These are composed of:
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Other functions of the spleen are less prominent, especially in the healthy adult:
Surgical removal causes:[6]
A 28-year follow-up of 740 veterans of World War II who had their spleen removed on the battlefield found that those who had been splenectomized showed a significant excess of mortality from pneumonia (6 rather than the expected 1.3) and a significant excess of mortality from ischemic heart disease (4.1 rather than the expected 3) but not from other conditions.[16]
Disorders include splenomegaly, where the spleen is enlarged for various reasons, such as cancer, specifically blood-based leukemias, and asplenia, where the spleen is not present or functions abnormally.
The word spleen comes from the Greek σπλήν, and is the idiomatic equivalent of the heart in English, i.e. to be good-spleened (εὔσπλαγχνος) means to be good-hearted or compassionate.[17]
In English the word spleen was customary during the period of the 18th century. Authors like Richard Blackmore or George Cheyne employed it to characterize the hypocondriacal and hysterical affections.[18][19] William Shakespeare, in Julius Caesar uses the spleen to describe Cassius' irritable nature. "Must I observe you? must I stand and crouch Under your testy humour? By the gods You shall digest the venom of your spleen, Though it do split you; for, from this day forth, I'll use you for my mirth, yea, for my laughter, When you are waspish."[20]
In French, "splénétique" refers to a state of pensive sadness or melancholy. It has been popularized by the poet Charles Baudelaire (1821–1867) but was already used before in particular to the Romantic literature (18th century). The word for the organ is "la rate."
The connection between spleen (the organ) and melancholy (the temperament) comes from the humoral medicine of the ancient Greeks. One of the humours (body fluid) was the black bile, secreted by the spleen organ and associated with melancholy. In contrast, the Talmud (tractate Berachoth 61b) refers to the spleen as the organ of laughter while possibly suggesting a link with the humoral view of the organ. In the eighteenth- and nineteenth-century England, women in bad humour were said to be afflicted by the spleen, or the vapours of the spleen. In modern English, "to vent one's spleen" means to vent one's anger, e.g. by shouting, and can be applied to both males and females. Similarly, the English term "splenetic" is used to describe a person in a foul mood.
In cartilagenous and ray-finned fish it consists primarily of red pulp and is normally a somewhat elongated organ as it actually lies inside the serosal lining of the intestine. In many amphibians, especially frogs, it takes on the more rounded form and there is often a greater quantity of white pulp.[21]
In reptiles, birds, and mammals, white pulp is always relatively plentiful, and in the latter two groups, the spleen is typically rounded, although it adjusts its shape somewhat to the arrangement of the surrounding organs. In the great majority of vertebrates, the spleen continues to produce red blood cells throughout life; it is only in mammals that this function is lost in the adult. Many mammals possess tiny spleen-like structures known as haemal nodes throughout the body, which, it is presumed, have the same function as the spleen proper.[21] The spleens of aquatic mammals are in some ways dissimilar to those of fully land-dwelling mammals. In general, the spleens of aquatic mammals are bluish in colour. In cetaceans and manatees it tends to be quite small, but in deep diving pinnipeds it can be quite massive, owing to its function of storing red blood cells.
The only vertebrates lacking a spleen are the lampreys and hagfishes. Even in these animals, there is a diffuse layer of haematopoeitic tissue within the gut wall, which has a similar structure to red pulp, and is presumed to be homologous with the spleen of higher vertebrates.[21]
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