sheet 39 ::: the final one ::: edited :)

---The final anatomy sheet----
*In the name of Allah*

SPLEEN

What is the spleen ??
- its largest lymphoid gland in the body

Where is it?
It is located in the left hypochondriac region
Sheltered below left dum of diaphragm

It has three function:
1. storing your extra R.B.Cs
2.storing the old (worn-out) R.B.S
3. important for immunity.


Note: it is a completely intraperitoneal organ , except at its hilum.

Now let us have a glance on its parts :

It has the following parts :

2 surfaces : (1) convex diaphragmatic surface related to the left 9th , 10th , 11th Ribs
- with its axis parallel to left tenth rib -

) Concave visceral surface related to the stomach


2 Poles : (1) upper pole
(2) lower pole


please see page 2..

2 Borders : (1) superior border ( notched )
(2) inferior border ( sharp , smooth)


what about its arterial supply and venus drainage ???

Arterial supply ----> splenic artery (which is a branch from ciliac artery )

Venus drainage ----> Splenic vein ( which end at the portal vein )


Do know, my dear colleague ,that the Spleen follow the [ all or none ] rule !
That means that when its ruptured it should be removed , because if not it will cause a huge internal bleeding..


That’s enough about the spleen ….. lets talk briefly about pancreas




Pancreas


Little notes :
- acompound retroperitoneal endocrine and exocrine gland ( about 15 cm )
- comma-shaped extending from the 2nd of duodenum to the hilum of spleen
- located in the epigastric and left hypochondriac regions.


Has the following part :

1- HEAD : within concavity of the dudenum , received common and accessory pancreatic duct , bile duct course from behind !
2 -NECK : having the portal vein located behind it

please see page 3…..
3 - BODY : logest part , triangular in C.S splenic vein passing behind it
Splenic artery passing superior to it.

We said before that it is an endocrine and an exocrine gland at the same time.…..

Endocrine part : with in islets of langerhands : secreting 2 hormones :
1. Insulin : lowering the suger level in the blood
2. glucagon: elevating the suger level in the blood
Exocrine part :pancreatic duct : secrete to 2nd part of dudenum by :
- main pancreatic duct - accessory pancereatic duct

4 - TAIL : located at the hilum of spleen


good note : in future when you have a patient you should lay him/her on his/her back this is called “ supine ( recompetent) position “
**********************************






First you should all meet Nerdoosh ! He is an expert at embryology and he is helping us out with the last embryo sheet !!

Nerdoosh : before I start I feel I should straighten out a couple of things !

1-Blast : Original
2-Cyst: Sac
1+2 = BLASTOYCYST = ORIGINAL SAC

3-Mere : Subdivision
1+3= Blastomere = ORIGINAL SUBDIVISION


And with this my lecture shall begin !

This is a Continuation of the series of events of day 13 :

By the end of the second week the blastocyst is completely implanted and the endometrial implantation defect is healed .

Bleeding might occur occasionally !

Nerdoosh : it is around the 28th day of the lady's menstrual cycle !
14, ovulation day + ~ 13 days of pregnancy = 28!!!!!


Cellular columns from Cytotrophoblast invade the Syncytiotrophoblast forming the Primary Villi which is the beginning of placenta.

** I think you should start concentrating! New stuff starts here!


Primary villi will form secondary villi and then tertiary villi which is the final form of placenta.

At this time the intercommunication between the embryo – embryonic blood to be specific – and its mother's blood starts . However ,this communication is not complete ! Both are separated by a highly selectively permeable membrane.

*Nerdoosh : This permeable membrane is selective ! Not all that comes into mommy's blood will pass through… Nutrients are an exception and unfortunately so are the viral particles of measles and AIDS.

** :) If you guys just take a look at the hand out of this lecture you will notice something called "Connecting stalk" , this stalk forms the umbilical cord later on ! :) **


Once the embryo enters its third week , at day 15 , Gastrulation occurs .

Nerdoosh : Gastrulation is a process during which the morphology of the embryo is restructured by cell migration . It will change from a Bilaminar embryonic disk into a Trilaminar embryonic disk.

** You might want to take a look at your hand outs :) **

*Rapid development marks the beginning of the embryonic period : 3rd week – 8th week

*********************

Gastrulation explained!

1-At the beginning of the 3rd week a narrow line called the primitive streak is formed at the middle of the still Bilaminar embryonic disk.

2-Epiblast from the periphery will migrate towards the primitive streak, forming an elevation or a groove called "primitive groove".
3- Some of the migrating epiblast cells will migrate downward in the groove forming mesoderm ( it is between epiblast and hypoblast )
4-some will go down further to replace the hypoblast and give endoderm
5- Remaining cells will replace the epiblast and form the ectoderm. And with this the embryo is Trilaminar :)

Nardoosh: at this point I think we all arrived at the same conclusion! All body layers are derived from the epiblast!!

· Each layer is responsible for the formation of certain organs during the embryonic development.
1- Ectoderm: Nervous system + Epidermis of the skin.
2- Endoderm: Endothelial lining of digestive system, respiratory system etc.
3- Mesoderm: muscles, tendons, ligaments, bones, cartilage & blood vessels !

Nardoosh: Mesoderm is obviously the most important layer of all 3 layers ( AKA: germ layers ) .

With this I shall bid you farewell and leave room for Wa3d's and 3attili's longest dedication ever! Those 2 are breaking the record of the longest dedication written in the history of sheet writing if there is such a thing !



We, wa3d w 3abdelra7man , hope that we introduced a understandable and easy-to-study sheet :)

We feel obliged to thank Dr. Maher Hadidi for all the effort he exerted in teaching this course :)

We also wish you people the best grades in this course and future ones … Inshallah we will all make amazing doctors in the future ! Just remember: If you are going through hell , keep going on ! ** WE DIDN'T MAKE IT UP , SUM1 REALLY SAID THAT ! **


AND Finally we want to dedicate this sheet to our beloved friends and to all our colleagues in this faculty……

Shu r2yak 3attili nebda bel ladies be ma eno ladies first ?

Zein Najada ( eta oshkot ) , Haya Qudah ( finally a dedication … Yeppieeeee w 3attili b7gezlik el marah ele jay ! ) , Jamila 7iesat ( a7la ta7yeh la sokan jomhoriet al sal6 al sha8i8a ) , Suzan Mbydeen ( sum people r still waiting 4 that mansaf gurl ) , As7ar Tarawna , ala2 7jazi , Shatha 3attili ( 3ala rasi che guevara ) Dania Dahmash , Bayan 5door,saja 3r3r , Suzan Momani , Ruba al mu7taseb , Lamoosh jamal , Sawsan tabaza , Sondos al 5ateeb , Elham Qudah (dedication ^2 :P) , Batoul 3toom , Nadine 3adayleh , , Dana mel7em Tamara Darweesh , raya 7alawani , magd 5adr, amal 7osban ,Manar Jwainat , Fara7 mashagbeh , 3abeer 5watra, samar 68a68a , muna talal ( 3al 3afyeh:P) , ala2 jabre ( el m63m mo elhm :) ) , dana 6awalbieh ,Samar al ra7meh , nisreen abu 3osbeh , rawan 3'azal , rasha jabra , ala2 3abid, jeelan , suzan al musa , Isra2 zawawi , dina 3ammari , aya bani kinana , rozana ziadat , asma , lana 7adadin , ruba halaseh, dina ramini , razan abu dieh , rawan ( lovek 4 taking psycho :D ) ,ala2 7laisi, aseel abu shanab , du3a2 jara7 , du3a2 abu jame3, aseel al sayed ,dima , nadia ,rawan sale7,nuha, ,yasmeen el so5on , anne nimri !!

And with no further delay, the guys :

Ahmed el isa ,(abuel3ss) , ,fr7an el kooz ( jovial ) ,) wa2el 6o8an (alf mabrook:P) , ayyoub (yellow smile ), , 5alid 7gair (4-2-4) , m7md abu hanieh ( abu gor3a ;) , w aseem samara ( kasha6a),shaker borhm , hammam realat , m7md shawaf ( 3a rasi kol el i6allieh )fadi halaseh, yezan 3tom( ml7 3l sala6a) , martin qaqesh(kef el shbab) , bashar el rama7i , 3omar el lozzi ( neshfat el mae) , nidal matani (no visa,no league, no thing :D), 3’aleb 5rfan , 7amzeh 9araiera , m2moon sha3ban (ma bnnsak) , yazeed neef , abu 7alaweh , mo2ayad kettane ,sami 3abdeen , a7mad 3abed, 3amer 7ajaj,m7md saree3 , m7md maslamani , Bandar maslamani, 7amzeh jassar ( elsalam la allah ;p) , m7md el sboo3 , 7amzeh 9bai7 , , rami yagi, hashim abu m7fooz, zain rostom ( 3ala rasi walla) , nemer sh5shier , 3mr el 5alili , 3esa 38el , zaid 8ndeel, 3omar dodeen , bashar sharma ,7anna barghoth , tamimi ,8osai abu 3azzam , zaidon , 3bdelr7man el 56eeb , m7md 3’naem (pre-sheet), mostafa aburahmeh , a7mad abu 5adegieh, , m7md 8awasme , abu qamar , abu d3aig ( allah be3en 3l basa6 ), a7mad shalabe , el shareef , 3omar radaiedeh , yazan radaideh ( m5drat ) , , laith 7addad , osama , yazeeed 8aesieh , waleed 8adre , osama farrogeh ( farrogte) , mohanned ( ya 7abibi la t3eed wrae) ,A7mad 7orani ( hay dedication 3ashan ma t7ke 3an el sheet tb3tna!)

Ma azon nsena 7ada… :P

Wa 5etamoha mesk m3 wa3d Sweilmyeen w 3bdelra7man 3attili :D ….
Best wishes..

---WE LOVE YOU ALL, THANK YOU ALL---

Note:- organic final exam will be from (3:00-5:00) PM
-islamic culture final exam will be on 4/6/2008 at 11:30 in IT

** Corrections are in purple bold...becareful !!