This slide demonstrates the different structures of the spleen.

Clinical Case

While on duty in the casualty ward, you receive an emergency call from the sister in the day ward. A patient you admitted earlier the day for observation after a car accident was going into shock. The skin of the left hypochondrial area was severely bruised by the seat belt and because you were worried that he may have suffered a deceleration injury to the internal organs, you decided to have him observed for 24 hours. When you see the patient in the ward, he is anxious and presents with tachycardia and hypotension, all signs of shock due to acute loss of blood. Suspecting a ruptured spleen, you refer him to surgery for an emergency laparotomy. What is the path that blood follows through the spleen? Which type of connective tissue forms the splenic capsule? Which other fibres would you expect to find in the capsule? Which structures originate from the capsule? What is the white pulp? Why does the white pulp appear basophilic in H&E slides? Where would you find the central artery and why would it occupy an eccentric position? Where would the cords of Billroth and what do they consist of? Why does the red pulp appear red and what is its primary function? What are the characteristics of the splenic venous sinuses?

Microscopy

This is a low magnification of the spleen demonstrating the capsule and white and red pulps. Fig 64-001

This is a magnification of the white and red pulp of the spleen. Fig 64-002

This is a very high magnification of the red pulp of the spleen demonstrating the different structures. Fig 64-003

This is a very high magnification of the white pulp demonstrating the different structures. Fig 64-004

This is a very high magnification of the structure of the peri-arterial lymphoid sheaths. Fig 64-005

This is a very high magnification of the spleen stained with silver to demonstrate the reticular fibers around and in between the sinusoids. Fig 64-006

Memorandum
Clinical Case	Fig 64-001	Fig 64-002	Fig 64-003
	Fig 64-004	Fig 64-005	Fig 64-006