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House Hemat > Spleen > Flashcards

Spleen Flashcards

1
Q

Anatomy of the spleen

A specialized connective tissue composed of a 3 dimensional —————- serving as ______ in d path of blood circulation

A

reticular meshwork

filter

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2
Q

Anatomy of the spleen

Selectively clears blood of cells, micro organisms and antigens in ________ called _________

A

Stroma meshes

filtration beds

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3
Q

Sinusal spleen: a.k.a ________ spleen seen in ___________ and accounts for less than _______% of body weight.

A

defence

cats and humans

0.25

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4
Q

Non-sinusal or _______ spleen are seen in _________.

________ and _______ are fibromuscular.

A

storage

herbivores

Capsules and trabeculae

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5
Q

Sinusal spleen:

The immunologically active ______ pulps are particularly prominent where _______,_______, and _______ predominate.

A

white

lymphocytes, macrophages and APCs

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6
Q

Non-sinusal

Usually (light or heavy?) with ______ and thus perform ____________.

May make up ____% of body weight

A

Heavy

stored blood

internal transfusion

1

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7
Q

Spleen receives ____ to _____% of cardiac output or about _____mils/min in humans

A

1; 10

300

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8
Q

Spleen

Weighs an average of _____g in humans and only ___g when totally drained of blood.

A

135

80

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9
Q

Spleen

Involution occurs with ______

  • weighs about _____g in elderly
A

age

70

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10
Q

Splenic structure

The capsule is _________, covered on the external surface by (ciliated or non-ciliated?) _____ ————

A

fibromuscular

Ciliated; cuboidal

mesothelium

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11
Q

Splenic structure

On the medial surface is a ridge called the _______ through which blood vessels traverse the spleen

A

hilus

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12
Q

Splenic structure

Richly branched _______ project into the splenic pulp carrying ______________ and efferrent lymphatics while dividing the pulp into compartments

A

trabeculae

splenic artery and vein

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13
Q

Splenic structure
The capsule is fibromuscular, covered on the external surface by ciliated cuboidal mesothelium(contributing to its high _____________ by _________)

A

splenic haematocrit

pumping fluid out

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14
Q

Splenic structure

The nerve supply accompanies the arterial branches, terminating deep in the pulp as _______ axons that cause the pulp _______ to ______ and _______

A

adrenergic

meshwork

expand and contract.

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15
Q

Splenic structure

The primary cellular element of the pulp is the (branched or non-brnached?) fibroblastic ______ cells which produces slender ______ fibers(_______ fibers)

A

branched

reticular

collagen; reticular

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16
Q

Splenic structure

These collagen fibres(type ____ collagens) together with the ______ cells form the meshwork of the pulp Called the _______ which is what ———-

A

4

reticular

reticulum

filters blood

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17
Q

the reticulum which is what ______(_________)

A

filters blood

filtration bed

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18
Q

the ________ which is what filters blood(filtration bed)

A

reticulum

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19
Q

Structure of the filtration bed

There are two main distinguishable areas of the filtration bed
1._______
2.___________

A

white pulp

red pulp

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20
Q

White pulp:

from the _____, the ______ traverses the stroma carrying with it a branch of the splenic artery (______ artery)

As this artery enters the meshwork of the spleen, its immediately surrounded by distinct layer of reticulum called the _______________. Which itself is encapsuled by the ______________

A

hilus; trabeculae

central

periarterial lymphatic sheath

circumferential reticulum

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21
Q

periarterial lymphatic sheath is not encapsuled by the reticulum

T/F

A

F

It is

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22
Q

The periarterial lymphatic sheath is rich in ????

A

T-lymphocytes

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23
Q

Along the length of the PALS are (small or large?) (flat or round?) follicles scattered on its peripheral surface.

These are ovoid accumulation of ________ which appears as _______ on the cut surface of the spleen

A

Small

Round

B lymphocytes

whitish dots

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24
Q

The follicle is made up of central _______ and outer ________ zones

A

germinal; marginal

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25
Q

As the central artery branches, it _________ as it goes, so likewise is the ______

A

diminish in size

PALS

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26
Q

Function of the white pulps

Majorly __________ and _________ ———— and accessory cells from circulation

A

clears and concentrate

lymphocytes

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27
Q

Function of the white pulps

________ that traffic to and fro the white pulp are the circulating pool

A

Lymphocytes

28
Q

On activation the lymphocytes may remain in the spleen to sustain primary or secondary immune response

T/F

A

T

29
Q

Function of the white pulps

Lymphoid nodules become enlarged as they recruit more ____-lymphocytes from the blood and ———- zone and moves ____ wards forming the ___________

A

B

mantle

in

germinal center

30
Q

The central arterioles now terminate in the _______ zone as it enters the ____ pulp

A

marginal

RED

31
Q

The ________ and ———— thus constitutes the white pulp

A

PALS and lymphoid nodules

32
Q

B and ____ cells have ___ hours to interact as B cells on their way to the _____ center traverse the _______

A

T

few; germinal; PALS

33
Q

B and T lymphocytes exit the spleen via the ______________

A

efferent lymphatics

34
Q

RED PULP

Consists of the meshwork called ________________ along with ________

A

splenic cord of Bilroth

splenic sinuses

35
Q

Arterial vessels that runs from the center of the PALS supply the ______ zone and ____ pulp

A

marginal

red

36
Q

RED PULP

Arterial vessels that runs from the center of the PALS supply the marginal zone and red pulp

These vessels terminate as arterial capillaries and vessels with ______-like flares with (narrowed or widened?) ______________ as the blood runs through numerous interwoven ________

A

trumpet

widened

endothelial slits or pores

filtration beds

37
Q

Functions of the spleen

Non immune function: a _____ of platelets are stored in the spleen, pooling, pitting

A

third

38
Q

Functions of the spleen

Immune function: ———-, ______ , and _________

A

tuftin, primary and secondary

39
Q

Functions of the spleen

Immune function

Large fraction of circulating _____ pool are marginated in the spleen.

(Slow or Fast?) transit of blood in the red pulp allows close contact of ______ with antibody and complement coated cells and microorganisms and senescent cells entrapped

A

neutrophils

Slow ; macrophage

40
Q

Half of of platelets are stored in the spleen, pooling, pitting

T/F

A

F

a third of platelets

41
Q

Hypersplenism

In 1899, chauffard proposed that increased splenic activity results in ________

This served as the basis for the first ever ________ in 1910 by Suthaland and Burghard in a patient with __________

A

haemolysis

splenectomy

hereditary spherocytosis

42
Q

The normal and abnormal function of the spleen is traceable to its two major functions:

__________ and _______ of blood in the red pulp and __________ in the white pulp.

A

Filtration and immune surveillance

antibody synthesis

43
Q

Hypersplenism occurs when these functions are

  1. appropriately increased as in _____ or _____, or
  2. inappropriately increased as in ————
A

Hereditary spherocytosis , or immune Thrombocytopenic purpura

portal hypertension

44
Q

Hypersplenism

As enunciated by Darmalek: hyperplenism is usually associated with _______________, causes ________,with compensatory __________ and is corrected by ______

A

splenomegally

cytopaenias

BM hyperplasia

splenectomy

45
Q

Pathogenesis of hypersplenism

Ideally spleen serves to filter senescent red cells by passing _____% of blood flow through the ____________ mesh of the red pulp studded with _______.

The blood then reenters the circulation via (narrow or wide?) slits measuring _______, in the endothelium of the venous sinuses.

A

10

non endothelialized

macophages

Narrow

1-3 um

46
Q

Pathogenesis of hypersplenism

With ————— or __________, spleen may become over worked with consequent _________ and then __________ for ___________

A

red cell membrane defects or immune disorders

hypertrophy

sequester normal cells for destruction.

47
Q

Splenomegally due to variety of causes usually increases the ____________________ causing inappropriate __________ of both normal abnormal cells, therefore cytopaenia results

A

proportion of blood channeled through the red pulp

hypersplenic sequestration

48
Q

Causes of splenomegally

Idiopathic:_______

Hereditary disorders: ____,______,________

A

TSS

HS, CH, thalassemias

49
Q

Causes of splenomegally

Connective tisssue disorders: ______,

Metabolic disorders:_______, glycogen storage disease, _____,______

A

SLE

amyloidosis

neimann picks, gauchers

50
Q

Causes of splenomegally

Malignancies: _____,__________, hairy cell leukamias,cll

Infections: viral, fungal, parasitic(_______)

A

cml,myelofibrosis

leishmaniasis

51
Q

Causes of splenomegally

Cardio-vascular: CHF, _______, _________________ obstruction, liver chirrosis

A

budd-chiari

splenic/portal vein

52
Q

Tropical splenomegaly syndrome (TSS)

Aka ____________

Follows immunological ___________ due to repeated ________ over a (short or long?) period of time

A

Hyperactive malarial splenomegaly

over-stimulation

malarial infection

Long

53
Q

Tropical splenomegaly syndrome (TSS)

Seen in malaria endemic areas(_______,______) Its characterized by :

A

Africa, india

54
Q

Tropical splenomegaly syndrome (TSS)
Its characterized by :

__________ enlargement

______megaly

marked elevation in serum Ig____ level

elevated anti malarial ______

marked ___________

marked ________ and _________ infiltration of the pulp

  1. blood smear for malaria parasite is usually (positive or negative?)
A

massive spleen

hepato

M; antibodies

dilated sinusoids

erythrophagocytosis and lymphocyte

Negative

55
Q

Clinical features of TSS

may include: _______ ,_________

A

Anaemia

Thrombocytopaenia

56
Q

Management of TSS

  1. exclude all other causes of splenomegaly

2.____________ followed by prolonged ____________

A

Antimalarial drug

antimalarial prophylaxis

57
Q

The spleen is the site for primary extramedullary hematopoesis

T/F

A

T

58
Q

The capsule of the spleen is _____ and _________, allowing it to ______, or else it will rupture

A

Fibrous

Elastic

Expand

59
Q

PCV is lower in the spleen than other places

T/F

A

F

Higher

60
Q

______ follicle is found in the marginal zone

______ follicle is found in the germinal zone

A

Primary

Secondary

61
Q

Primary follicle is found in the _______

Secondary follicle is found in the _________

A

marginal zone

germinal zone

62
Q

CLASSICAL definition of hypersplenism
??

A

Is an exaggerated abnormal function of the spleen which usually results in pancytopenia , BM hyperplasia which is corrected after splenectomy

63
Q

TSS

Long term antimalarial therapy causes reduction of the spleen .

The drug used is ______ (_______)

A

paludrine

proguanil

64
Q

CH ???

A

Cranio facial hyperplasia

65
Q

Chemical produced by the spleen against encapsulated organisms is ???

A

Tuftin

House Hemat (29 decks)

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