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Abdomen Pathology > Spleen > Flashcards

Spleen Flashcards

1
Q

Location of the spleen

A

LUQ, intraperitoneal

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2
Q

size of spleen (adult)

A

12 cm or less - longitudinal length
less than 8 cm - AP
less than 4 cm - wide, TRV

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3
Q

arterial blood supply of spleen

A

splenic artery - from celiac trunk/axis

courses along the superior pancreatic border to the hilum

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4
Q

venous system of spleen

A

splenic vein - joins with the superior mesenteric vein and forms the main portal vein
-splenic vein is located inferior and posterior to the pancreas body

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5
Q

4 normal spleen variants and their definition

A
  1. aplasia - spleen did not develop
  2. hypoplasia - defective development of tissue (under development)
  3. accessory spleen - aka: supernumerary spleen, splenunculus - ectopic splenic tissue
  4. wandering spleen - fusion failure of the dorsal mesentery with the posterior peritoneum
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6
Q

functions of spleen

A

filters blood
reservoir for blood
destroys red blood cells
produces lymphocytes and plasma cells

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7
Q

job of red pulp

A

stores rbcs, filtration

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8
Q

what is congestive splenomegaly and what are some causes

A

enlargement of spleen, increased amount of red pulp

causes: heart failure, cirrhosis, portal hypertension, portal/splenic vein thrombosis, cystic fibrosis, HIV/AIDS

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9
Q

clinical presentations of congestive splenomegaly

A 
LUQ pain
congestion/edema in lower extremities
increased abdominal girth - ascites
caput medusa - portal hypertension 
hepatomegaly
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10
Q

types of systemic infection/inflammation

A 
mononucleosis
tuberculosis
histoplasmosis
schistosomiasis
sarcoidosis
candidiasis
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11
Q

types of focal infection/inflammtion

A

parasitic - echinococcus

abscess

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12
Q

echinococcus infection of spleen

A

s/s: LUQ pain. fever, elevated wbcs

  • focal/solitary cyst with or without daughter cyst
  • hydatid sand with or without infolded membranes
  • egg-shell calcifiction of borders
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13
Q

abscess infection/inflammation of spleen

A

s/s: LUQ pain, fever, elevated wbcs

  • ill-defined, thickened, irregular borders
  • acoustic enhancment is possible
  • shadowing with intraluminal gas
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14
Q

treatment options for infection/inflammation of spleen

A 
antiobiotic therapy
percutaneous drainage with or without scolecoidal therapy
surgical resection 
anthelmintic drug therapy 
high mortalilty rate with abscesses
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15
Q

what is a splenic hamartoma

A 
benign
rare
solitary
non-neoplastic, congenital mass
composed of: normal splenic elements
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16
Q

another name for splenic hamartoma

A

splenoma

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17
Q

sonographic findings of splenomas

A

focal well-defined mass

variable echogenicity

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18
Q

what is a splenic hemangioma

A

congenital mass
benign
composed of vascular epithelial lined channels

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19
Q

what is the most common primary splenic tumor? and what is its incidence?

A

splenic hemangioma

more frequent in males, 20-50 years old

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20
Q

s/s of splenic hemangioma

A

asymptomatic

LUQ pain and fullness

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21
Q

sonographic findings of splenic hemangioma

A

less than 4cm
well defined borders
from hyperechoic to complex with areas of cystic degeneration
may contain foci of speckled calcifications

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22
Q

what is luekemia

A

primary malignancy of the blood-forming tissues characterized by an abnoromal increase in the WBCs

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23
Q

what are some blood-forming tissues

A

bone marrow
lymph nodes
spleen

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24
Q

luekemia is more common in

A

males

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25
s/s of leukemia
``` easily bruises or bleeds pallor - pale in color fatigue recurrent infection non healing minor wounds ```
26
lab findings for leukemia
increased WBCs and anemia
27
a patient with leukemia comes in for an ultrasound - their spleen would look
enlarged - splenomegaly
28
what is lymphoma
primary malignancy of the lymphatic system
29
s/s of lymphoma
``` asymptomatic node enlargement **cervical, supraclavicular, axillary, inguinal low grade fever night sweats fatigue weight loss coughing abnormal pressure and congestion of face, neck and chest ```
30
sonographic findings of lymphoma
focal mass hypoechoic poorly defined margins diffuse splenomegaly
31
what is another name for hemangiosarcoma
splenic angiosarcoma
32
incidence and outcome of angiosarcoma
very rare 50-60 years of age poor prognosis - 80% mortality rate within 6 months of dx
33
lab findings for angiosarcoma
anemia | thrombocytopenia
34
s/s of angiosarcoma
``` abdominal mass LUQ pain fatigue fever weight loss GI bleeding ```
35
sonographical findings of angiosarcoma/hemangiosarcoma
splenomegaly solitary, complex mass multiple nodules of vaying size
36
what are true cyst
congenital cyst | have an epithelial or endothelial lining
37
true cyst are also called
epidermoid cyst | congenital cyst
38
true cyst are usually unilocular or multilocular
unilocular
39
post traumatic cyst - aka - incidence
aka Splenic pseudocyst accounts for 80% of all splenic cyst DOES NOT HAVE epithelial lining
40
3 infectious cyst
abscess granulomatous pneumocystis carinii
41
splenic cyst may sonographically appear as
``` anechoic, hypoechoic well defined walls posterior enhancement internal echoes fluid-fluid level wall thickening wall califications ```
42
types of blood disorders
hemolytic anemia extramedullary hematopoiesis sickle cell anemia polycythemia vera
43
what is hemolytic anemia
disorder in which rbcs are destroyed faster than they are being produced
44
what is extramedullary hematopoiesis
where the production of RBCs and platelets occurs outside the bone marrow
45
myelofibrosis is cancer of the bone marrow. What are some of its clinical associations
anemia splenomegaly extramedullary hematopoiesis progressive fibrosis of bone marrow
46
what is sicke cell anemia and what does it cause?
a genetic mutation in African Americans which causes the RBC to have an altered shape and plasticity
47
what does sickle cell anemia lead to
``` increased blood viscosity stasis small vessel occlusion infarction necrosis ```
48
if a child has sickle cell anemia, how will their spleen be as children compared to as an adult
as a child - splenomegaly | as an adult - atrophic spleen
49
what does chronic hemolytic anemia lead to
jaundice
50
what is polythemia vera
an acquired myeloproliferative disorder | the bone marrow produces too much RBCS, WBCS and platelets
51
what does polythemia vera cause
``` increase in blood viscosity poor profusion elevated hematocrit, rbcs and hemoglobin decreased oxygen saturation of blood splenomegaly thrombosis ```
52
types of storage diseases
``` Gaucher disease Diabetes mellitus Niemann - Pick disease Amyloidosis Histiocytosis Hemochromatosis ```
53
What is Gaucher disease? Who does it most commonly affect? s/s sonographic findings
- genetic disorder - children under 8 yrs - bone pain and skin pigmentation - splenomegaly, diffuse inhomogeneous nodular texture, fibrosis and infarction
54
storage disease - diabetes mellitus
vascular infarcts secondary to diabetes iniced small vessel atherosclerotic diease
55
what is Niemann-Pick disease
a fatal storage disease affects female infants hepatomegaly, digestive issues, lymphadenopathy
56
what is amyloidosis
systemic abnormal amyloid distribuition nodular and diffuse splenomegaly
57
what is Histiocyosis
fatal thrombocytopenia associated with hypersplenism (excessive removal of cellular blood components) splenomegaly
58
what is hemochromatosis
excessive absorption and storage of iron = organ damage | iron deposits typically in liver = cirrhosis = portal hypertension and splenomegaly
59
what is infarction
when the blood supply to the area is compromised = ischemia and then necrosis
60
most common cause of foccal splenic defects
infarction
61
hypovolemic shock is a clinical presentation of what
truama to the spleen, blunt ot penetrating force
62
the spleen is the most frequently intraperitoneal organ in blunt abdominal trauma T or F
true
63
sonographic findings of trauma
- hematoma (subcapsular or intraparencymal) - hemoperitoneum or hemoretroperitoneum with capsular rupture - depending on age and progression * *earlystage - anechoic to hypoechoic * *later stage - echogenic bledding with splenic parenchyma - left pleural effusion
64
what is asplenia syndrome - what is is associated with
congenital abscene of spleen | -associated with bilateral right sideness
65
what is polysplenia syndrome
multiple islands of splenic tissue | -may have bilateral left-sidedness
66
which has these sonographic appearences - biliary atresia - genitourinary anomalies - abnormal liver location - azygous/hemiazygous continuation of IVC with interruption of hepatic segment
polysplenia syndrome
67
accessory spleens are most often located where
at the hilum
68
the sonographic appearance of the spleen in relationship to liver
isoechoic or hyperechoic and homogeneous
69
the most common focal neoplasm in the spleen is what
a cavernous hemangioma
70
risk factors for splenic infarction
``` bacterial endocarditis atherosclerosis sickle cell disease polycythemia splenomegaly gaucher disease portal hypertension vascular compromise of splenic artery ```

Abdomen Pathology (1 decks)

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