7 he Spleen. 251 



ones being: (1) The suspensory, from the left crus to the 

 inner surface behind the ridge; (2) the gastro-splenic, 

 which, serving as a support for the fundus of the stomach 

 rather than for the spleen, passes from a little behind the 

 former to the hilum of the latter and contains the vasa 

 brevia for the stomach; (3) the reno-splenic, passing as 

 its name indicates, from the kidney to the spleen, contains 

 the splenic vessels; (4) the phreno-colic, stretching from 

 the diaphragm opposite the ends of the tenth and eleventh 

 ribs, to the splenic flexure of the colon, forms a pocket for 

 the support of the spleen. Bloodvessels. The arteries 

 of the spleen are branches of the splenic, which divides 

 into three or four smaller arteries about one and a half 

 inches from the hilum. These latter subdivide into 

 twelve or fifteen twigs which enter the hilum. The splenic 

 vein is about twice as large as the artery, and returns the 

 blood from the pancreas, the spleen, the duodenum, part 

 of the stomach, the omentum, descending colon, sigmoid 

 flexure and part of the rectum. The nerves are derived 

 from the solar plexus and from the right pneumogastric. 

 Landmarks. The upper end of the spleen is a lit- 

 tle above the level of the tip of the ninth dorsal spine, or 

 is opposite to the middle of the body of the tenth dorsal 

 vertebra, and is distant from the spine about one or one 

 and a half inches." The lower end is a little below the 

 level of the eleventh dorsal spine and never extends, ex- 

 cept when diseased or displaced, beyond the line joining 

 the left sterno-clavicular articulation to the tip of the 

 eleventh rib. This lower end is generally situated about 

 the midaxillary line. The body of the spleen lying be- 

 tween these points is obliquely placed under cover of, and 

 parallel to the ninth, tenth and eleventh ribs. To rough- 

 ly outline the situation of the spleen, stand behind the pa- 

 tient and place the left hand, with the thumb flexed on the 



