SPLEEN

Question 1

The spleen is a ________ organ located in the LUQ between the stomach and diaphragm.

Answer 1

peritoneal

Question 2

The average adult spleen measures ________ in the longitudinal dimension.

Answer 2

12 cm

Question 3

The stomach, left kidney, pancreas and splenic flexure of the colon is located on the ________ surface of the spleen.

Answer 3

visceral (medial)

Question 4

The fundus of the stomach, lesser sac and the pancreatic tail are ________ & ________ to the splenic hilum.

Answer 4

anterior

medial

Question 5

The tail of the pancreas is located ________ to the stomach and lesser sac as it approaches the splenic hilum.

Answer 5

posterior

Question 6

The left kidney is located ________ & ________ to the spleen.

Answer 6

inferior

medial

Question 7

The pancreatic tail is located ________ to the upper pole of the kidney in the splenic hilum.

Answer 7

anterior

Question 8

________ is a normal variant this is commonly found near the splenic hilum and is less than 5 cm in diameter.

Answer 8

accessory spleen

Question 9

________ are focal lesions in the spleen that are a result of previous infections. They are seen as bright echogenic lesions, with or without shadowing.

Answer 9

granulomas

Question 10

________ & ________ are the most common causes of granulomas.

Answer 10

histoplasmosis

tuberculosis

Question 11

________ of the spleen are true cysts lined by squamous epithelium. Typically are solitary averaging ________ cm in sz. The wall may be calcified and the internal contents may appear echogenic.

Answer 11

epidermoid cyst

Question 12

________ can erode into the spleen due to their proximity. It may weaken vessels causing pseudoaneurysms and bleeding into the cyst.

Answer 12

pancreatic pseudocyst

Question 13

________ are the most common benign primary neoplasm of the spleen.

Answer 13

hemangioma

Question 14

________ more frequently mets to the spleen followed by breast and lung cancer.

Answer 14

malignant melanoma

Question 15

splenic infarcts are common in patients with ________ & ________.

Answer 15

bacterial endocarditis

splenic artery aneurysm

Question 16

splenic infarct present as a ________ on ultrasound.

Answer 16

peripheral wedge shaped hypoechoic lesion

Question 17

________ may be a result of sepsis due to endocarditis, dental infections or urosepsis.

Answer 17

splenic abscess

Question 18

________ is due to mutant hemoglobin S resulting in sickling of RBC.

Answer 18

sickle cell disease

Question 19

complications of sickle cell disease include:

Answer 19

anemia (decreased RBC's /HGB)
infection (decrease immunity)
acute chest syndrome (decreased O2 sat)
pain (vascular occlusion and ischemia)
stroke (TCD monitoring)
cholecystitis (due to chronic hemolysis)
pulmonary HTN

Question 20

The spleen begins to ________ at the end of the first year of life.

Answer 20

enlarge

Question 21

The spleen remains enlarged at the end of the first year of life due to ________ and repeated infarction, over time, the spleen becomes more fibrotic and shrinks (autosplenectomy), typically before the end of childhood.

Answer 21

splenic sequestration (pooling of sickled cells)

Question 22

The most common mechanism leading to an enlarged spleen is ________. Examples of this include ________ & ________.

Answer 22

congestive
portal HTN
splenic vein thrombosis

Question 23

The spleen is located in the LUQ, so when it enlarges it extends in the ________, ________ & ________ direction.

Answer 23

anterior
medial
inferior

Question 24

________ is a blood disorder resulting in uncontrolled RBC production causing hyperviscosity and hypercoagulation.

Answer 24

polycythemia vera

Question 25

polycythemia vera may be the cause of ________, ________, ________, or ________.

Answer 25

splenomegaly budd-chiari syndrome portal vein thrombosis splenic infarcts

Question 26

________ is typically seen as a cystic mass, or if calcified, a hyperechoic shadowing foci typically in the area of the splenic hilum.

Answer 26

splenic artery aneurysm

Question 27

________ is due to early embryonic disturbances that occur prior to six weeks of gestation. This is where a normally lateral organ is centrally located.

Answer 27

heterotaxia (situs ambiguous)

Question 28

________ & ________ are two different classifications of heterotaxia.

Answer 28

polysplenia | asplenia

Question 29

________ is a classification of heterotaxia that is known as left-sided predominance.

Answer 29

polysplenia

Question 30

________ is a classification of heterotaxia that is known as right-sided predominance.

Answer 30

asplenia

Question 31

what abnormalities are associated with polysplenia?

Answer 31

``` multiple LUQ spleens biliary atresia (absent GB) intestinal malrotation azygous continuation of the interrupted IVC (70%) cardiac defects ```

Question 32

What abnormalities are associated with asplenia?

Answer 32

``` absent spleen midline liver and GB intestinal malrotation reversed positions of the AO and IVC cardiac defects ```

Question 33

________ or ________ hematomas result when the splenic capsule remains intact.

Answer 33

subcapsular | intraparenchymal

Question 34

________ or ________ hematomas result with capsule rupture.

Answer 34

perisplenic | intraperitoneal

Question 35

________ is utilized in the ER to document the presence of free fluid in the peritoneal cavity.

Answer 35

focused assessment with sonography for trauma (FAST)

Question 36

________ is the volume of RBCs in 100 ml of blood. blood spillage outside the circulatory system will result in a decrease of this.

Answer 36

hematocrit

Question 37

patients with a hx of splenic rupture or surgery, splenic cells may implant throughout the peritoneal cavity (autotransplantation) resulting in ectopic spleen. This occurrence is called ________.

Answer 37

posttraumatic splenosis