Clinical Approaches to Primary and Secondary Splenic Disorders Flashcards
As the splinic artery is going through the spleen to the margins, what is its final destination? and what did it have to go through to get to that final destination?
final destination: red pulp; had to go through white pulp to get there
What is the red pulp?
this sinusoidal network that allows for the blood to be filtered to get rid of any abnormal RBCs or platelets
what is the white pulp comprised of?
the marginal zone, which is an area where lots of macrophages are at; periarterial sheet (PALS); primary follicle
what is the role of the marginal zone in the spleen?
responsible for clearing debris including encapsulated organisms
what is the role of the periarterial sheet (PALS)?
it is mainly composed of T cells
what is the role of the primary follicle?
houses B cells- antibody production
What disease could be associated with splenomegaly?
portal hypertension
what are three main examples of diseases that cause hypersplenism?
sickle cell anemia, hereditary spherocytosis, and idiopathic thrombocytopenic purpura
how does a life-threatening sickle cell anemia hypersplenism due to splenic sequestration present?
there is pooling of blood in the spleen; it presents with an acute drop in Hgb, rapid enlargement of the spleen, and hypotension
How do you evaluate the spleen on the physical exam?
using castell’s point
which imaging modality is great for detecting splenomegaly?
FAST scan
What is the most common cause of splenic rupture?
trauma
splenic rupture can result in what?
bleeding all throughout the abdomen
how might you test for splenic rupture?
using the kehr’s sign
what is the kehr’s sign?
irritation of the phrenic nerve by sub-diaphragmatic bleeding; patient experiences left shoulder pain which is elicited in recumbent position with legs raised
