Lesson 5A (Part 1) Flashcards
Is the spleen intra or retroperitoneal?
Intraperitoneal
What part of the spleen is not intraperitoneal?
The hilum
Where is the spleen located? (quadrant, compared to diaphragm, kidney, stomach and pancreas = 5)
- Left hypochondriac region with the superior aspect extending into the epigastric region
- Inferior to the diaphragm
- Anterior to the left kidney
- Posterior and lateral to the stomach
- Left lateral to the pancreas
What does the spleen do? (4)
- Removes foreign material from the blood
- Initiates an immune reaction
- resulting in production of antibodies and lymphocytes - Major destruction site of old red blood cells
- red blood cells are removed and hemoglobin is recycled - Reservoir for blood
What is the spleen most sensitive to?
Trauma
Why is the spleen most sensitive to trauma?
Due to its vasculature
What supplies blood to the spleen?
Splenic artery
What drains the spleen of blood?
Splenic vein
What makes up the main portal vein? (2)
- Splenic vein
2. SMV
What happens to the splenic vein when portal hypertension occurs?
It may shunt blood directly into the left renal vein
What should you do if infarction is suspected on the spleen?
Apply colour doppler and evaluate for the presence of flow
What should the sagittal measurements be for the spleen?
13cm or less
- from tip to tip
What are normal serum levels in males?
4.6-6.2 million/mmm
What are normal serum levels in females?
4.2-5.4 million/mmm
What is elevation of serum levels associated with? (2)
- Polycythemia vera
2. Severe diarrhea
What are decreased serum levels associated with? (4)
- Internal bleeding
- Hemolytic anemia
- Hodgkin’s disease
- Hemangiosarcomas
What does the spleen recycle Hb into?
Iron
- basis of bilirubin
What conditions is low Hb associated with? (4)
- Cancer
- Lymphoma
- Cirrhosis
- Internal bleeding
What do leukocytes do?
Defends the body from infection
What are elevated levels of leukocytes associated with? (4)
- Infection
- Leukemia
- Hemorrhage
- Malignancy
What are decreased levels of leukocytes associated with? (5)
- Lymphoma
- Leukemia
- Viral infection
- Hypersplenia
- Diabetes mellitus
What is the biggest reason for elevation of leukocytes?
Infection
What are elevated levels of hematocrit associated with? (4)
- Dehydration
- Shock
- Polycythemia vera-disorder of bone marrow
- Infection
What are decreased levels of hematocrit associated with? (3)
- Hemorrhage
- Anemia
- Leukemia
Hematocrit
% of RBCS in the blood
What are some indications for an exam of the spleen? (8)
- Chronic liver disease
- Infection
- Leukocytosis
- Leukopenia
- Palpable mass
- Abdominal pain
- Fatigue
- Trauma
What is another term for accessory spleen?
Splenule
Splenule
Is a common normal variant that is typically located in the splenics hilum
- congenital anomaly
What does accessory spleen look like? (3)
- Similar echogenicity as the spleen
- Small rounded masses < 5cm
- May be confused with enlarged nodes
What modalities are used to confirm an accessory spleen? (2)
- CT
2. MRI
What happens to the splenules if the spleen enlarges?
So do the splenules
What does hypertension affect?
The spleen
