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Penny abdomen > Ch. 6 Spleen > Flashcards

Ch. 6 Spleen Flashcards

1
Q

Its the largest structure of the reticuloendothelial system

A

Spleen

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2
Q

It’s an intraperitoneal organ located within the left upper quadrant of the abdomen whose primary objective is to filter the peripheral blood

A

Spleen

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3
Q

The largest lymphatic organ of the body

A

spleen

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4
Q

The _______ plays an important role in defense against infection in children while in adults, it produces lymphocytes and monocytes

A

Spleen

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5
Q

The spleen is responsible for ____________ in the fetus

A

Erythropoiesis

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6
Q

At what week gestation does the spleen begin to develop?

A

5th

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7
Q

What is the role of the spleen in adults?

A

produce lymphocytes & monocytes

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8
Q

RBC production in adults is primarily performed by what?

A

bone marrow

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9
Q

The spleen’s hematopoietic function which can return in cases of severe anemia

A

extramedullary hematopoiesis

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10
Q

What specialized tissue is the spleen composed of?

A

white & red pulp

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11
Q

List the functions of the spleen

A
  1. Defense against disease
  2. Hematopoiesis/erythropoiesis
  3. Destruction and removal of flawed red blood cells and platelets
  4. Blood reservoir
  5. Storage of iron
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12
Q

Although red blood cell production in the adult is primarily performed by the bone marrow, the spleen hematopoietic function can return in cases of ______________.

A

Severe anemia

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13
Q

Specialized lymphatic tissue within the spleen

A

White pulp

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14
Q

Specialized tissue within the spleen that performs its phagocytic function

A

red pulp

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15
Q

A type of cell that Engulfs and destroys pathogens

A

Phagocytes

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16
Q

White pulp of the spleen does what?

A

produces and houses lymphocytes, carrying out the spleens lymphatic tissue

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17
Q

Red pulp of the spleen does what?

A

contains RBC’s and macrophages, performs the phagocytic function

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18
Q

The splenic process of removing irregular red blood cells from the bloodstream

A

culling

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19
Q

The splenic process of cleaning red blood cells of unwanted material

A

pitting

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20
Q

Doppler evaluation of the splenic artery normally demonstrates what kind of flow pattern?

A

low-resistance

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21
Q

What is the vascular anatomy of the spleen?

A

The splenic artery is a branch of the celiac trunk, which may be also referred to as the celiac artery or celiac axis. From the celiac trunk, the splenic artery courses laterally toward the spleen.

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22
Q

The ________ _______ can be confused for the main pancreatic duct in some patients because it takes a similar course in the body.

A

Splenic artery

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23
Q

What is the best patient position to best visualize the spleen?

A

Taking a deep breath with the patient lying on his or her right side

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24
Q

The splenic vein exits the spleen and travels along the posterior border of the pancreatic tail and body. It joins with the ______ posterior to the pancreatic neck to form the portal vein. Flow within the splenic vein will be toward the liver.

A

superior mesenteric vein

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25
Q

What is the normal sonographic appearance of the spleen?

A

Its frequently isoechoic to the liver, although it may be slightly more echogenic

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26
Q

a small, round island of splenic tissue often located near the splenic hilum or tail of pancreas

A

accessory spleen

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27
Q

This is also referred as a splenule, a splenunculus, or a supernumerary spleen

A

Accessory spleen

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28
Q

Where is the accessory spleen usually located?

A

near the hilum or possibly near the tail of the pancreas

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29
Q

The spleen may appear to be divided by a hyperechoic line in some individuals which is called..

A

Splenic cleft

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30
Q

What are the two uncommon congenital anomalies of the spleen?

A

Asplenia and polysplenia

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31
Q

Congenital absence of the spleen

A

asplenia

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32
Q

Development of multiple small masses of the splenic tissue

A

polysplenia

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33
Q

The implantation of ecotopic splenic tissue

A

Splenosis

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34
Q

The size of the spleen varies with ___ & ___.

A

age & sex (decreasing with advanced age)

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35
Q

Asplenia and polyslenia have been associated with

A

cardiac malformations & heterotaxia syndromes (organs in chest/abdomen are abnormally arranged)

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36
Q

Splenosis is a complication of

A

splenic trauma

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37
Q

A highly mobile spleen

A

wandering spleen

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38
Q

An individual with a wandering spleen could suffer from ___________ because of the vessels of the spleen may twist secondary to the hypermobility of the organ

A

Splenic torsion

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39
Q

The twisting of the splenic vasculature causing a disruption in the blood supply to the spleen and subsequent ischemia

A

splenic torsion

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40
Q

What is the most common abnormality of the spleen?

A

splenomegaly

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41
Q

the spleen should never measure more than ___ in length and ____ in thickness

A

12cm; 5cm

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42
Q

Reduction in the number of leukocytes in the blood

A

leukopenia

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43
Q

Splenic size varies with age, size and gender but should not exceed

A

12-13 cm in length, 6 cm in thickness

44
Q

As the spleen enlarges, it tends to become more

A

hypoechoic

45
Q

What is the most common cause of splenomegaly?

A

portal hypertension

46
Q

Suspicion of splenomegaly should arise when the spleen extends

A

beyond the inferior pole of the left kidney

47
Q

When portal hypertension is suspected as the cause of splenomegaly what should be closely evaluated?

A

splenic hilum for evidence of varices

48
Q

Massive splenomegaly can lead to

A

spontaneous splenic rupture

49
Q

If portal hypertension is suspected, a sonographer should closely evaluate the _____________.

A

Splenic hilum

50
Q

A herpesvirus that can lead to infectious mononucleosis

A

Epstein-Barr infection

51
Q

True or False: Epstein-Barr infection will typically result in splenomegaly in both adults and children.

A

True

52
Q

A cyst in the spleen that results from the parasitic infestation of an organ by a tapeworm Echinococcus granulosus

A

hydatid cyst

53
Q

Caused by staphlyococcus aureus, streptococcus, salmonella

A

pyogenic abscess

54
Q

A history of ___ increases the patients likelihood of developing a pyogenic abscess

A

bacteremia

55
Q

Fungal abscess most often results from what?

A

Candida

56
Q

Who’s more likely to be affected by a fungal abscess?

A

immunocompromised

57
Q

Area in the spleen that has become necrotic owing to a lack of oxygen, sudden onset of LUQ pain

A

splenic infarct

58
Q

In the chronic stage, splenic infarct tend to appear more ___ compared to adjacent normal tissue

A

echogenic

59
Q

Clinical findings of ______:
Palpable, enlarged spleen
Hemolytic abnormalities
Trauma
Infection
Possible elevated white blood cell and/or red blood cell count

A

splenomegaly

60
Q

Sonographic findings of ______:
1. Enlargement of the spleen to greater than 12 to 13 cm in length or 6 cm in thickness
2. Spleen extends beyond the inferior pole of the left kidney

A

splenomegaly

61
Q

Clinical findings of ______:
1. Asymptomatic
2. Pain can occur with hemorrhage

A

simple splenic cysts

62
Q

Sonographic findings of ______
1. Round
2. Smooth-walled mass
3. Anechoic mass
4. Posterior enhancement

A

simple splenic cysts

63
Q

Clinical findings of ______
1. fever
2. leukocytosis
3. LUQ tenderness
4. left flank pain
5. splenomegaly

A

splenic abscess

64
Q

Sonographic findings of ______
1. Complex appearance
2. May contain debris or gas (that produces dirty shadowing)
3. Can be completely hypoechoic
4. Fungal abscess may appear as small solid masses or have a target or bull’s-eye appearance
5. Color Doppler will demonstrate increased flow around the mass but not within it

A

splenic abscess

65
Q

An area within the spleen that has become necrotic because of a lack of oxygen

A

splenic infarct

66
Q

Sickle cell disease, bacterial endocarditis, tumor embolization, vasculitis, lymphoma can be causes of??

A

Splenic infarct

67
Q

The ____________ is typically seen sonographically as a hypoechoic, wedge-shaped mass.

A

Splenic infarct

68
Q

Clinical findings of _____
1. sudden onset of LUQ pain

A

splenic infarct

69
Q

Sonographic findings of ______
1. acute infarct - hypoechoic, wedge-shaped mass within the spleen
2. chronic infarct - hyperechoic, wedge-shaped mass within the spleen

A

splenic infarct

70
Q

The spleen is often injured in cases of ________ ______.

A

Blunt trauma

71
Q

Clinical findings of_______
1. blunt trauma to the LUQ
2. severe LUQ pain
3. decreased hematocrit level indicating active bleeding

A

splenic trauma

72
Q

Sonographic findings of ______
1. Acute hemorrhage—complex or hypoechoic
2. Middle stage—echogenic (with clot formation) or isoechoic
3. Later stages of hemorrhage—anechoic or hypoechoic
4. Chronic hematomas may have a complex appearance or calcified walls

A

splenic trauma

73
Q

The most common benign tumor of the spleen

A

Hemangioma

74
Q

The most common mass of the spleen is?

A

benign hemangioma

75
Q

Clinical findings of a ______
1. Asymptomatic
2. Pain occurs with hemorrhage

A

Splenic Hemangioma

76
Q

Sonographic findings of ______
1. Well-defined, hyperechoic mass

A

Splenic Hemangioma

77
Q

Small echogenic calcifications that result from inflammation of the tissue in that area

A

granulomas

78
Q

Small echogenic foci scattered throughout the spleen most likely represent

A

multiple benign granulomas

79
Q

Granulomas can be found in patients who have a history of:

A
  1. Histoplasmosis
  2. Tuberculosis
  3. Sarcoidosis
80
Q

Clinical findings of ______ Disease of the Spleen:
1. asymptomatic
2. may have a history of histoplasmosis, tuberculosis, or sarcoidosis

A

Granulomatous

81
Q

Sonographic findings of ______ Disease of the Spleen:
1. Small, echogenic foci that may shadow

A

Granulomatous

82
Q

Benign splenic mass that has been associated with Beckwith-Weidermann syndrome and tuberculous sclerosis

A

Splenic hamartoma

83
Q

These tumors have been associated with Beckwith-Weidermann syndrome and tuberous sclerosis

A

Splenic hamartoma

84
Q

Clinical findings of ______:
1. asymptomatic
2. pain can occur with rupture
3. patient may have history of beckwith-weidemann syndrome or tuberous sclerosis

A

Splenic Hamartoma:

85
Q

Sonographic findings of _______
1. hypoechoic mass or masses (echotexture can vary however)
2. color doppler may reveal hypervascularity

A

Splenic Hamartoma

86
Q

What is the primary malignant tumor of the spleen?

A

Angiosarcoma

87
Q

Diffuse involvement of lymphoma or leukemia of the spleen will often lead to:

A

splenomegaly

88
Q

What is the most common malignancy of the spleen?

A

lymphoma

89
Q

Lymphoma can be classified as

A

Hodgkin lymphoma or non-Hodgkin lymphoma

90
Q

The ____________ cells indicates Hodgkin lymphoma

A

Reed-Sternberg

91
Q

Clinical findings of _______:
1. LUQ pain
2. Fever
3. Weight loss
4. Malaise

A

Splenic Malignancy

92
Q

Sonographic findings of _______:
1. Diffuse - splenomegaly
2. Focal - hypoechoic masses

A

Splenic Malignancy

93
Q

benign lesion that is a congenital malformation of the lymphatic system

A

splenic lymphangioma

94
Q

Clinical findings of _______:
1. Nausea
2. LUQ pain
3. Abdominal distention

A

Splenic Lymphangioma

95
Q

Sonographic findings of ______:
1. Multicystic masses
2. Masses may contain hypoechoic or anechoic locules and hyperechoic septations

A

Splenic Lymphangioma

96
Q

Echogenic line within the spleen immediately following trauma

A

laceration

97
Q

Splenic rupture can lead to implants of ectopic tissue referred as

A

splenosis

98
Q

Most common mass of the spleen is the

A

benign hemangioma

99
Q

The presence of ___ indicates Hodgkin’s lymphoma which can be treated and carries a high recovery rate

A

Reed-Sternberg cells

100
Q

Which lymphoma type is more common in the spleen, but not as easily managed

A

non-hodgkins lymphoma

101
Q

The most common primary locations of metastatic disease to the spleen are

A

breast, lung, skin (melanoma), ovary

102
Q

Benign tumor of the spleen composed of lymph spaces, congenital malformation of the lymphatic system, more common in children

A

splenic lymphangioma

103
Q

A group of inherited blood disorders that affect hemoglobin (ex. sickle cell anemia)

A

sickle cell disease

104
Q

Those with _____ have abnormal, crescent-shaped RBC’s that tend to attach to each other and obstruct normal vascular channels, causing many complications. More common in African-American, Middle East, Mediterranean, and Hispanic children of Caribbean descent in the US.

A

Sickle cell anemia

105
Q

The gradual fibrosis and dysfunction of the spleen secondary to a disease

A

autosplenctomy

106
Q

Occasionally, focal masses (round, hypoechoic) of normal splenic tissue may be noted in _____

A

sickle cell disease

107
Q

Patients undergoing a ______ may have decreased hematocrit and complain of bone pain. These patients are at increased risk for gallstones, multiple organ damage, blindness, and stroke.

A

sickle cell crisis

Penny abdomen (11 decks)

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