Spleen

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1

The spleen is covered by ______ and is therefore considered _______.

The spleen is covered by peritoneum and is therefore considered intraperitoneal.

2

What is the largest single mass of lymphoid tissue in the body?

Spleen

3

What is the spleen responsible for starting in the embryonic period?

hematopoiesis

4

What is hematopoiesis?

production of RBC & WBC

5

What system is the spleen in?

lymphatic & reticuloendothelial

6

What is the function of the spleen?

reservoir for blood

plays a role in phagocytosis & immunity

7

What is the spleen rarely a site for?

primary disease

8

What is the most important measurement of the spleen?

superior to inferior

9

What is the superior to inferior measurement of the spleen?

12 - 13 cm

10

What is the medial to lateral measurement of the spleen?

6 - 7 cm

11

What is the anterior to posterior measurement of the spleen?

5 - 6 cm

12

why is the superior to inferior measurement of the spleen important?

determines splenomegaly

13

If the spleen is less than ___ cm there is cause for concern.

9

14

What is the location of the spleen?

left hypochondrium

15

What is the sonographic appearance of splenic hemangiosarcoma?

complex mass

rare in spleen

16

What holds the spleen in place?

ligaments:

gastrosplenic

lienorenal

phrenocolic

17

Where is the subphrenic space?

between the stomach and left half of the diaphragm

18

What makes up the left border of the spleen?

splenic flexure

pancreatic tail

some stomach

19

What is the superior border of the spleen?

left hemidiaphragm

20

The splenic artery is _____.

tortuous

21

What delegates the superior border of the spleen?

splenic artery

22

Where is the splenic vein?

splenic vein

23

Where do all vessels enter/exit spleen?

hilum

24

Explain the path of lymphatic vessels of the spleen.

follow the path of the splenic artery to celiac nodes of the arota

25

Where do the splenic nerves come from?

celiac plexus

26

An adrenal mass will displace the splenic vein _____.

anteriorly

27

What are the anomalies of the spleen?

wandering spleen

splenic agenesis

accessory spleen

28

Wat is a wandering spleen?

painful condition of loose splenic ligaments

spleen can torse

29

What is splenic agenesis?

rare condition of no spleen

30

What is an accessory spleen?

very small extra spleen usually found near hilum

31

What do B cells attack?

bacteria

32

What do T cells attack?

cancer cells

33

What is leukopenia?

WBC deficiency

34

Where is the red pulp?

splenic sinus - long irregular channels

splenic cords

35

What is white pulp?

lymphatic tissue in the spleen

36

What is the main role of red pulp?

produce cells for phagocytosis

37

What is culling?

eliminating

Ex. hemolysis

38

What is pitting?

get rid of damaged part

39

What is the function of white pulp?

lymphatic tissue

malpighian corpuscles produce lymphocytes

40

What is the function of the spleen?

production of lymphocytes

production of antibodies

storage of iron

storage of metabolites

phagocytosis of RBC (graveyard)

development of mature RBCs

reservoir of blood

41

What is the problem when the spleen hold the blood too long?

damages blood cells

splenomegaly

42

What is the sonographic appearance of the spleen?

fine homogeneous

low level echoes

similar to liver

crescent shape in transverse

concave superiorly

convex inferiorly

43

What is splenic atrophy?

occurs in wasting disease

44

What is autosplenectomy?

complete atrophy of the spleen

45

What causes splenic atrophy?

sickle cell

hemolytic anemies

46

What is the most common splenic disorder?

splenomegaly

47

What is splenomegaly?

enlargement of the spleen

48

What causes splenomegaly?

trauma

congestive splenomegaly

infection

storage disease

immunologic inflammatory disease

49

What infections can cause splenomegaly?

hepatitis

TB

Malaria

Syphilis

Aids

Mono

50

What storage diseases can cause splenomegaly?

Diabetes mellitus

hemochromatosis

51

What is an example of immunologic inflammatory disease that can cause splenomegaly?

Systemic Lupus Erythematosus

52

What is Splenic Congestion?

Active hyperemia in the spleen

53

What is hyperemia?

increased blood flow

54

What is the sonographic appearance of Acute Splenic Congestion?

active hyperemia

moderate splenomegaly

transient

55

What is the sonographic appearance of Chronic Splenic Congestion?

diffuse enlargement

56

What is the most common cause of Splenic Congestion?

portal hypertension

57

What is splenic infarcts?

dead splenic tissue

caused by occlusion of a segment of the splenic artery

58

What is usually the cause of splenic infarcts

thrombus from left side of the heart that cause small area of dead tissue

59

What is the presentation of splenic infarcts?

sharp pain on left side

60

What is diffuse Splenic diseases?

****Erythropoietics

sickle cell

hereditary spherocytosis

hemolytic anemia

chronic anemia

polycythemia vera

myeloproliferative disease

61

What is the average life span of a RBC?

120 days

62

What is the average life span of a RBC of a person with sickle cell?

10-20 days

63

What is sickle cell anemia?

abnormal hemoglobin causes RBCs:

course

sticky fall apart

fagile

64

What is the sonographic appearance of the spleen in pediatric patients?

splenomegaly

65

What is the sonographic appearance of the spleen in adult patients?

small fibrosed

autosplenoectomy

66

What is Spherocytosis?

splenomegaly caused by increased activity of the spleen trying to destroy spherical erythrocytes

Spleen hates spherical RBCs!

67

What is Thalassemia?

genetic disease in mediterranean of abnormal hemoglobin

overactivity of the spleen caused by misshaped erythrocytes

****Spleen can fill abdomen******

68

What is Hemolytic anemia?

destruction of erythrocytes faster than the bone marrow can produce them

69

What is polycythemia Vera?

hemoglobin greater mass and more concentrated

spleen sees as abnormal

causes splenomegaly

70

What are lymphopoietic abnormalities?

lymphocytic leukemia

lymphoma

hodgkin's diesease

71

What is the sonographic appearance of the spleen with:

lymphocytic leukemia

lymphoma

hodgkin's disease

Splenomegaly

72

What is Granulocytopoiesis Abnormalities?

hyperplasia from infection

tuberulosis

histoplasmosis

sarcoidosis

73

What is the sonographic appearance of patients with previous Granulocytopoiesis?

bright reflections in spleen (SPECKS)

with/ without shadowing

74

What is the cause of Granulocytopoiesis?

some people lack the ability to break down bacteria

75

What is tuberculosis?

bacteria

76

What is histoplasmosis?

fungi

77

What is sarcoidosis?

development of lumps of tissue

idiopathic

78

What are Reticuloendothelial Abnormalities?

Gaucher's disease

Letter-Siwe Disease

Hand-Schuller-Christian Disease

79

Picture of spleen abnormality

Which of the following does the image represent?

A) sever hydro

B) gaucher's disease

C) simple cyst

B) gaucher's disease

*only spleen pathology

80

What is Gaucher's disease?

Reticuloendothelial Abnormality

50% under 8 years old

81

What is the sonographic appearance of patients with Gaucher's disease?

isoechoic spleen

splenomegaly

nodules

inhomogeneous

82

What is the presentation of patients with Gaucher's disease?

bone pain

changes in skin pigments

83

What is Letter-Siwe Disease?

Affects Spleen!

Reticuloendothelial Abnormality

rapidly fatal disease of infants

isoechoic

84

What is Hand-Schuller-Christian Disease?

Reticuloendothelial Abnormality

similar to Letter-Siwe Disease except not fatal

85

A splenic abscess has a ____ mortality rate.

high

86

What is the most common cause of a splenic abscess?

endocarditis

87

What are the causes of endocarditis?

staph

strep

ecoli

sominella

88

What is a splenic abscess?

complex

uncommon

variable echo patterns

Not a simple cyst

poorly defines

gas shadowing

89

What is the most prominent feature of a splenic infection?

splenomegaly

will also have focal abnormalities

90

What is the sonographic appearance of the spleen in AIDS patients?

splenomegaly

will also have focal abnormalities

91

What does the location of blood depend on with splenic Trauma?

condition of the splenic capsule

92

What is the most common cause of splenic trauma?

blunt abdominal trauma

93

What are the two locations of a splenic hematoma?

intracapsular

Free intraperitoneal

94

If splenic capsule remains intact where will a hematoma occur?

intracapsular

95

If splenic capsule ruptures where will a hematoma occur?

Free intraperitoneal

96

What is the sonographic appearance of Splenic trauma?

splenomegaly

irregular borders

focal hematomas

97

What pathology could cause spontaneous rupture of the spleen?

splenitis

leukemia

mononucleosis

cavernous hemangioma

98

What is the only parasitic cyst of the spleen?

echinococcal cyst

99

What happens to the parasite after the cyst is formed?

dies and calcifies

100

What is the sonographic appearance of an echinococcal cyst of the spleen?

anechoic or solid

daughter cysts

complex

101

What is a nonparasitic cyst in the spleen?

rare

possible internal echos due to hemorrhage

102

What is a hamartoma?

contains adipose

asymptomatic lesion composed of lymphoid tissue

103

What is the sonographic appearance of splenic Hamartoma?

solid/cystic

hyperechoic

104

What is possible with a splenic cavernous hemangioma?

spleen can rupture

asymptomatic when small

105

What is the sonographic appearance of a cystic lymphangioma?

rarely found in the spleen - only when cancer is widely spread

multicystic

106

What is a common cause of mets in the spleen?

breast canccer

107

What is the sonographic appearance of splenic hemangiosarcoma?

complex amss

rare in spleen

108

What is the sonographic appearance of splenic Lymphoma?

difficult to view on U/S

hypoechoic focal lesion