THE SPLEEX. 1077 



rather serves to fasten the fundus of the stomach, which, in an empty state, needs 

 support. 



The lig. lieno-renale (Fig. 611) is made of a posterior layer from the greater 

 .iul an anterior layer which forms part of the posterior wall of the lesser sac. 

 It contains the splenic vessels. 



The l.i;i. pkreno-coticwn (incorrectly costo-colic) contributes to the security of 

 the spleen, although unconnected with it. It arises from the diaphragm opposite 

 the anterior ends of the tenth and eleventh ribs, and passes below the spleen 

 downward and inward to the splenic flexure of the colon and to the anterior sur- 

 face of the descending colon. It forms a pocket, with its concavity directed 

 upward and inward, the saccus lienalis, which, in the new-born, regularly receives 

 the spleen. This ligament may also be called the sustentaculum Jienis. supporter 

 of the spleen. By the normal condition of the suspensory, and especially phreno- 

 colic ligament, the spleen retains its position. Should the phreno-colic be re- 

 laxed then the spleen is displaced and its long axis becomes more vertical. In 

 rare cases the normal spleen may sink deep into the abdominal cavity, even to 

 the pelvis. This is called the " wandering spleen." It is liable to atrophy when 

 the splenic artery suffers torsion. There are still two more inconstant ligaments, 

 the U-j. : nale and colico-lienale. The former is present when the 



tail of the pancreas does not reach the lower part of the inner surface of the 

 spleen ; then the visceral peritoneum from below and the lesser sac from above 

 form a short band between these two organs, a part of the lig. lieno-renale. 



The lig. colico-lienale, when present, passes from the basal surface of the 

 spleen downward and outward to the descending colon and joins the great omen- 

 turn. It contributes to the formation of the saccus lienalis. 



The ligaments, altogether, are the lig. gastro-lienale or gastro-splenic omen- 

 turn : lig. phreno-KenaU or suspensory ligament; lig. pTireno-colicum or supporter 

 of the spleen ; lig. lieno-renale, lig. pancreatico-lienale, and lig. colico-lienale, six 

 in number. 



llt-xpirotifin exerts an influence upon the position of the spleen, and especially 

 on the percussion limits. In inspiration it sinks somewhat, and its area of dul- 

 ness is lessened from the overlapping of the lungs. Yet the respiratory motility 

 of the spleen is much less than that of the liver, because the diaphragm exercises 

 less influence over it than upon the liver. Hasse 1 states that in inspiration the 

 spleen is compressed from above downward, and in expiration it passes upward 

 and backward along the tenth rib. Pathological changes in the thoracic cavity, 

 as effusions', will push the spleen down, or ascites and tumors in the abdominal 

 cavity will push it up. 



Vessels and Nerves of the Spleen. The arteries are branches of the splenic ; 

 it divides about 3 cm. internal to the hilus into three or four branches which 

 soon subdivide into twelve or fifteen twigs, which enter the gland. The splenic 

 is about twice as large as the accompanying artery. 



The lymphatic vessels are divided into a superficial and deep set. Sappey con- 

 tends for a superficial set- in man, which is proven in the horse, deer, and pig. 

 The deeper lymphatic vessels follow the blood-vessels, one for each of the larger 

 veins. At the hilus there are five or six trunks which empty into the glands 

 situated there. In their farther course they follow the blood-vessels and unite 

 with the lymphatics of the liver and stomach to form the thoracic duct. 



The nerves come from the coeliac plexus and right vagus, and accompany, 

 sparingly, the splenic artery. 



Structure. The spleen is invested by two coats an external serous and an 

 internal fibro-elastic coat (tunica propria). 



The external or serous coat is derived from the peritoneum : it is thin, smooth, 

 and in the human subject intimately adherent to the fibro-elastic coat. It in 

 almost the entire organ, being reflected from it. at the hilus, on to the great end 

 of the stomach, and at the upper end of the organ on to the Diaphragm. 



l Anh. f. Anat. u. Phys., 1886, s. 208. 



