Chapter 6 The Spleen Flashcards
The splenic vein exits the spleen and travels along the:
Posterior border of the pancreatic tail and body
The splenic artery enters the spleen at the
Splenic hilum
superior and anterior to the splenic vein
From the trunk, the splenic artery courses
Laterally toward the spleen
Sonographic appearance of the normal spleen
•isoechoic to the liver
•May be more echogenic
The spleen is best visualized with
Deep inspiration, with the patient lying on the right side
An individual with a wandering spleen could suffer from
Splenic torsion
_____is the implantation of ectopic splenic tissue, Can occur following splenic rupture
Splenosis
Both asplenia and polysplenia have been associated with
- Complex cardiac malformations
- Abnormal location of other organs
______leads to the development of multiple small masses of splenic tissue
Polysplenia
____is the congenital absence of the spleen
Asplenia
Small, round island of splenic tissue is typically located near the splenic hilum or possibly near the tail of the pancreas
Splenule
Massive splenomegaly Can lead to
Spontaneous splenic rupture
The most common cause of splenomegaly is
Portal hypertension
The spleen should never measure more than ______in length and _____in thickness in adults
•12-13cm
•6cm
Clinical findings of splenomegaly (6):
- Papable spleen
- Hemolytic abnormalities (sickle cell)
- Trauma
- Infection
- History of cirrosis, trauma, leukemia, or lymphoma
- Possible elevated WBC or RBC
Clinical findings of splenic abscess (5):
- Fever
- Leukocytosis
- LUQ tenderness
- Left flank pain
- Splenomegaly
Sonographic findings of splenic abscess (3):
- Complex appearance
- Debris or gas (that produces dirty shadowing)
- Hypoechoic
Sonographic findings of splenomegaly (2):
- Enlargement ogreater than 12-13cm in length or 6cm in thickness
- Extends beyond the inferior pole of the left kidney
Clinical findings of simple splenic cyst (2):
- Asymptomatic
- Pain occur with hemorrhage
Sonographic findings of simple splenic cyst
- Rounds
- Smooth-walled mass
- Anechoic mass
- Posterior enhancement
_____is tissue that has been deprived of oxygen will eventually die
Infarct
A splenic infarct May be caused by (5):
- Sickle cell disease
- Bacterial endocarditis
- Tumor embolization
- Vasculitis
- Lymphoma
The _____, which contains RBC and macrophages performs the phagocytic function of the spleen
Red pulp
The lymphatic function of the spleen is performed by the ______, which produces lymphocytes to aid in the immune response
White pulp
The spleen is composed of specialized tissue called
White pulp and red pulp
The spleens hematopoietic function Can return in cases of
Severe anemia
The spleen in the fetus is responsible for
Erythropoiesis
The spleen begins to develop around the
Fifth week of gestation
The spleen is inferior to the
Diaphragm and posterolateral to the stomach
The gastrosplenic ligament attaches the
Spleen to the stomach
The spleen is located
Within the left upper quadrant
The spleens primary objective is to
Filter the peripheral blood
_____, the largest structure of the reticuloendothelial system
The spleen
_____engulf and destroy pathogens
Phagocytes
The spleen Can also clean RBC of unwanted material, a process called
Pitting
The spleen removed irregular RBC from the bloodstream through a process called
Culling
Small echogenic foci scattered throughout the spleen mostly represent
Multiple benign granulomas
The splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein
SMV
______ describes the implantation of ectopic splenic tissue possibly secondary to the splenic rupture
Splenosis
The splenic hamartoma may be discovered more often in individuals with a history of
Tuberous sclerosis
_____is a benign lesion that is a congenital malformation of the lymphocytic system
Lymphangioma
The type of tissue within the spleen that is responsible for its phagocytic function is the
Red pulp
The spleen is an _____ organ
Intraperitoneal
The type of tissue within the spleen that is responsible for its lymphatic function is
White pulp
_____children would least likely suffer from sickle cell anemia
Caucasian
The splenic vein marks the
Posterior aspect of the pancreatic body and tail
Where is the most common location of an accessory spleen
Splenic hilum
What is the splenic process of cleaning RBC of unwanted material
Pitting
Diffuse involvement of lymphoma or leukemia of the spleen will often lead to
Splenomegaly
The splenic artery originates at the
Celiac trunk
A sickle cell crisis will often lead to
Splenomegaly
_______is a congenital anomaly in which the spleen is divided into two portions by a band of tissue
Splenic cleft
The spleen removes irregular cell from the bloodstream through a process called
Culling
An area within the spleen that has become necrotic because of a lack of oxygen is called
Splenic infarct
What systemic disease resulted in the development of granulomas within the spleen and throughout the body
Sarcoidosis
A complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the
Hydatid cyst
_______is a benign lesion that is a congenital malformation of the lymphatic system
Splenic lymphangioma
Lymphangiomas are most commonly found in
Children
Patients undergoing a sickle cell crisis may have (2):
•decreased hematocrit
•bone pain
Angiosarcomas will appear Sonographically as a
Complex, solid mass
Sonographic findings of splenic malignancy
•diffuse: splenomegaly
•focal: hypoechoic masses
____is the most common malignancy of the spleen
Lymphoma
What are the two types of lymphoma
•hodgkins lymphoma
•nonhodgkin lymphoma
The presents of reed-sternberg cells indicate
Hodgkin’s lymphoma
What lymphoma can be tested and Caries a high recovery rate
Hodgkin’s lymphoma
Sonographic findings of granulomatous disease of the spleen (1):
- Small, echogenic foci that May shadow
Clinical findings of a splenic hemangioma (2):
- Asymptomatic
- pain occurs with hemorrage
splenic rupture can lead to implants of ectopic splenic tissue rereferred to as:
Splenosis
_____is the most common benign tumor of the spleen
hemangioma
_____is a group of inherited blood disorders that includes sickle cell anemia
sickle cell disease
those with ______have abnormally, crescent shaped RBC that have a tendency to attach to each other and obstruct normal vascular channels
sickle cell anemia
clinical findings of a splenic infarct (1):
- sudden onset of LUQ pain
_____ happens with time and with recurrent sickle cell crisis the spleen will eventually become fibrotic and atrophy
Autosplenectomy
A child suffering from sickle cell disease often has an
Enlarged spleen during a sickle cell crisis
A patient with a wandering spleen would have an increased risk for:
splenic torsion
A rare malignant tumor of the spleen that consists of blood vessels is a/an:
Angiosarcoma
the splenic artery is a branch of the:
celiac trunk (celiac artery)
What is the most common sonographic appearance of a splenic hemangioma
Echogenic
The process of making RBC is termed
Erythropoiesis
Multiple, small echogenic foci scattered throughout the spleen in a patient with a history of toxoplasmosis most often likely represents:
Granulomas
the most common cause of splenomegaly is:
portal hypertension
The splenic artery marks the:
Superior aspect of the pancreatic body and tail
Epstein-Barr infection is best described as:
A herpes virus that can lead to infectious mononucleosis
Clinical findings of a splenic hemangioma (2):
- Asymptomatic
- Pain occurs with hemorrhage
Clinical findings of splenic lymphangioma (4):
- nausea
- LUQ pain
- Abdominal distention
- Splenomegaly
Clinical findings of splenic malignancy (4):
- LUQ pain
- fever
- Weight loss
- Malaise
Clinical findings of splenic trauma (3):
- blunt trauma to the LUQ
- LUQ pain
- decreased hematocrit
Sonographic findings of splenic hamartoma (2):
- Hypoechoic mass or masses (echotexture can vary)
- Hypervascularity
Clinical findings of splenic hamartoma (3):
- Asymtomatic
- pain can occur with rupture
- patient may have a history of Beckwith-weide-mann syndrome or tuberous sclerosis
Clinical findings of granulomatous disease of the spleen (2):
- Asymptomatic
- history of histoplasmosis, tuberculosis, or sarcoidosis
Sonographic findings of splenic trauma (4):
- Acute hemorrhage (complex or hyperechoic)
- Middle stage (echogenic with clot formation)
- Later stage (anechoic or hypoechoic)
- Chronic hematomas may have a complex appearance
Sonographic findings of a splenic infarct (2):
- Acute infarct (hypoechoic, wedge shaped mass within the spleen)
- chronic infarct (hyperechoic, wedge shaped mass within the spleen)
Sonographic findings of splenic lymphangioma (2):
- multicystic masses
- masses may contain hypoechoic or anechoic locules and hyperechoic septations
Functions of the spleen (5):
- defense against disease
- hematopoiesis/erythropoiesis
- destruction and removal of flawed RBC and platelets
- Blood reservoir
- Storage of iron