Ch 11- Pediatric Spleen Flashcards
The Spleen is an ______ located in the _______.
1) intraperitoneal organ
2) LUQ
The spleen is part of the _______ system ( responsible for ____)
1) Reticuloendothelial system
2) Phagocytosis
Phagocytosis is the engulfing & destroying of ________ & their _____, _____ & _____, & taking them out of the circulating blood
1) damaged/old cells
2)debris
3) foreign materail
4) Pathogens
The spleen is the _______ organ composed primarily of the _____ & it is a component of the _______. It is ______ for life.
1) largest lymphoid
2) lymph tissue
3) body’s defense system
4) not essential
The sonographic appearance of the spleen in the neonate is ____ or ____ relative to the kidneys. By the end of the first years of life, it becomes ____ relative to the kidneys.
1) Iso or
2)Hypoechoic
3)hyperechoic
The accessory spleen arises from failure of the ______ of ______ to fuse during development of the spleen, which results in _____ of splenic tissue
1) individual clumps
2) mesenchyme
3) small nodules
Accessory spleen is usually ____ & found at the ______.
1) single
2) splenic hilum
Accessory spleens are usually single, but they may also be ______ & located anywhere, especially along the____ or _____
1) Multiple
2) splenic vessels
3) omental layers
Splenic tissue may be found attached to the left ovary or scrotum due to the relationship of _____, _____ & _______
1) splenic
2) mesonephric
3) left gonadal development
Accessory spleen may atrophy if the _________
Spleen is removed
The spleen is highly mobile & on a long/absent pedicle. This may result in a _______
Wandering spleen
wandering spleen is common in _________ syndrome.
Prune- belly syndrome
In acute torsion, a large, hypoechoic spleen will be seen due to _____ & ______. In chronic torsion the spleen will be _____ & ______ to image
1) Infarction
2) congestion
3) small
4) difficult to image
Polysplenia, a heterotaxy syndrome with multiple splenules, is more common in ______
Females
Asplenia , or ______, absence of the spleen, is more common in ________ & diagnosed in _____
1) right isomerism
2) Males
3) neonates
With polysplenia, patient’s present with a ______ Liver, _____ bowel, _____ agenisis, ______atresia, _____ agenisis, bilat _____ & a interupted ______ with _______ or _________, ______ & a ________ pancreas
1) Midline liver
2) malrotated bowel
3) GB agenesis
4) Biliary atreasia
5) Renal agenesis
6) bilobed lungs
7) intrahepatic IVC
8) azygos or hemiazygos continuation
9) non-cyanotic heart disease
10) semi-annular panc ( AKA Left Isomerism)
Asplenia is associated with complex _______, _____ of the great vessels, ______ agenesis, Bilat ______, _____ , ______ kidney & ______ liver.
1) cyanotic congenital heart disease
2) transposition
3) GB
4) trilobed lungs
5)imperforate anus
6) horseshoe kidney
7) transverse liver
List the causes of Splenomegaly (11)
1) Hepatomegaly
2) leukemia
3) ECMO
4) infiltrative storage disorder
5) Mononucleosis
6) infection
7) focal lesions
8) portal HTN
9) heart failure
10) Lymphoma
11) hemolytic anemias
A small spleen may be due to ….
1) infarction due to wandering spleen or sickle cell
2) congenital absence or hypoplasia
3) partial splenectomy
4) Celiac disease
5) Fanconi anemia
(a rare inherited disorder, common in persons of Jewish decent & south Africans, that lead to bone marrow failure)
Splenic cyst may be congenital (__________) or acquired (_________). They may rupture & become _______.
1) true epithelial or epidermoid
2) false or pseudocyst ( poet-traumatic)
3) Infected
it is _______ to differentiate between congenital cyst & acquired cyst Sonographically.
not possible
Congenital cysts have an _____ lining & _____ walls.
1) epithelial lining
2) imperceptible walls
Cyst secondary to a hematoma or infective process will ________
have no epithelial lining
Post-traumatic cysts have _____ walls that may be ____
1) thicker walls
2) calcified
Epidermoid cysts are primary _____ cyst which may have ______ present in the cyst or wall. They may be septated & have internal echos due to ____
1) congenital cyst
2) calcifications
3) hemorrhage
Hydatid cysts result from ______ or ______(due to___). They are _____, may be ____ or ____ & have _____.
1) ruptured liver cyst
2)systemic infection
3) due to parasites
4) well defined
5) single or multiple
6) wall calcifications
Lymphangiomas of the spleen are ____, ____, ____ of _____, filled with _____, which have ______.
1) rare
2) multiple
3) cystic spaces
4) variable thickness
5) lymph
6) have vascular septations
Hemangiomas are ______ of the spleen, they are ____ in appearance to those in the liver of adults.
1) common benign neoplasms
2) similar
Hemangiomas of the spleen are associated with ____, ______, ______ & ______
Their apparence varies due to _________
1) Beckwith-Wiedeman Syndrome
2) Klippel-Trenunay-Weber syndrome
3) Turner syndrome
4) Kasabach- Merrit syndrome (a large hemangioma which causes platelet trapping & damage resulting in disseminated intravascular coagulation which may be fatal)
5) The size of the vessels
Abscesses in the spleen have ___ walls & _______ & are usually _____ in size
1) Thick walls
2) internal echoes
3) > 1.5 cm
Abscesses form due to the ______ through the _____
1) spread of infection
2) bloodstream
A abscess is a collection of ____ within the splenic parenchyma..
Pus
Children who develop splenic abscesses are usually _______
Immunocompromised
These abscesses can be spread due to _____, an _____, ____ or ____. They may also be associated with _____.
1) appendicitis
2)empyema
3)osteomyelitis
4) ear infections
5) bacterial endocarditis
Fungal abscesses are seen in cases of ____, ____ & ____.
1) candida
2) aspergillus
3) cryptococcus
Fungal abscesses have a ____ appearance & are _____
1) bulls eye or target apperance
2) very small
Candida abscesses occur in _______ children
immunocompromised
Cat-scratch disease can cause ________.
Multiple splenic abscesses
Splenic Calcifications may be due to ______ or ____.
1) Histoplasmosis
2) TB
Neoplastic Conditions of the spleen include ____ & _____, which are most common. The spleen be involved in a ____ or ___ manner
1) Lymphoma
2) Leukemia
3) focal
4) diffuse
Lymphoma may cause _____ of the spleen, & focal ___ lesions within th3e parenchyma will be seen which have a ___ or ___ appearance .
1) enlargement
2) hypoechoic
3) hypo- or hyperechoic
In Leukemia, a ___ or ____ parenchyma will be seen with ____ of the spleen. _____ are sometimes seen.
1) hypo- or hyperechoic
2) enlargement
3) small focal lesions
Langerhans Cell histiocytosis is proliferation of the histocytes involving the ____, ____, _____ & _____
1) skin
2) bone marrow
3) reticuloendothelial system
4) lungs
Langerhans Cell histiocytosis an _____ spleen with multiple focal _____ nodules is encountered.
1_ enlarged
2) hypoechoic
Gaucher disease is a _______ disorder where the _____ is lacking.
1) congenital storage disorder
2) enzyme glucocerebrosidase
Gaucher disease this enzyme _______
Breaks down a fatty substance
Without the enzyme, glucocerebroside ________ & accumulates in the ___ & ___. It causes ___ or ____ nodules in the spleen
1) builds up to toxic levels
2) liver
3) Spleen
4) hyper or hypoechoic
Extramedullary hemopoiesis (failure of RBC development in the bone marrow), ______ & _____ of the spleen occur.
1) infarction
2) fibrosis
The spleen is very vulnerable to ______
infection
Sonographically, infarcts appear ______
Wedge- shaped
List the conditions causing splenic infarction. (5)
1) Sickle cell
2) splenic torsion
3) cardiac emboli
4) vascular disease
5) portal HTN (rarely)
Following a splenic infarction, ____ formation, or _________ with _______ may occur.
1) pseudocyst
2) rupture of the infection
3) abscess formation
Splenic Peliosis is a rare condition associated with ___, ____ & ______. It is also associated with a rare tropical parasitic infection, _____ which occurs in the _____.
1) TB
2) Steroid therapy
3) hematologic malignancies
4) Leishmaniasis
5) Middle Eaet
_____ spaces are seen in the spleen with Splenic Peliosis
Blood-filled spaces
Trauma in the spleen is usually due to ________
Abdominal trauma
The spleen is the _________ in children. ___ is the preferred imaging modality.
1) most commonly injured solid organ
2) CT
With splenic trauma abn include ____, a _____, ____, ____ or ____ of the spleen.
1) laceration
2) a subscasular hematoma
3) a hematoma
4) fracture
5) rupture
Splenic bleeding is acutely ____ sonographically & may be ________from normal splenic tissue.
1) hyperechoic
2) may be difficult to distinguish
Subscapular fluid will present as a ___________ seen __________.
1) Crescent-shaped
2) just beneath the capsule
If a splenic rupture occurred, _____ in the _____ or rest of the abdomen will be found.
1) fluid
2) flank
When the spleen is injured, splenic tissue __________. This is called ______.
1) scatters throughout the peritoneal cavity
2) Splenosis
