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Abdomen And Superrficial Structures > Spleen > Flashcards

Spleen Flashcards

1
Q

What is the average size the spleen measures to?

A

The average size the spleen measures to :
12cm length
8cm AP
4cm TRV

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2
Q

Where does the Spleen receive arterial blood from?

A

The spleen receives arterial blood from the “splenic artery”

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3
Q

What kind of vascular is the spleen?

A

The spleen is a “high” vascular.

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4
Q

Hemangioma is known as?

A

Hemangioma is known as “most common benign, vascular neoplasm of the spleen and most often affect men 20-50 years”

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5
Q

What does the metastatic lesions found demonstrate? (Think of Toy Story)

A

Most metastatic lesions are found within”spleen demonstrate a “bulls eye”

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6
Q

Spleen extends inferior beyond what margin?

A

Spleen is mobile normally does not extend inferior beyond left costal margin

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7
Q

What happens to the Spleen when size and weight may vary based on ?

A

The spleen decreases in volume and size with advancing age
Increase in size during digestion

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8
Q

What is Heterotaxy known as ?

A

Heterotaxy is known as “ a disruption in the normal embryology development to the left symmetry”

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9
Q

What is asplenia known as?

A

Asplenia is known as “ the congenital absence of the spleen/also known as ivemark syndrome.
-Splenic aplasia may be diagnosed in cases of congenital absence, surgical removal or atrophy resulting from arterial or venous occlusions

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10
Q

What is “SPLENIC HYPOPLASIA (hyposplenia) “

A

SPLENIC HYPOPLASIA (hyposplenia) - a small pathologic spleen resulting from abnormal development or parenchymal involution

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11
Q

What is “POLYSPLENIA” known as ?

A

POLYSPLENIA - presence of multiple smaller spleens of similar size/ rare embryological disorder

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12
Q

What is Accessory spleen known as ?

A

ACCESSORY SPLEEN - a common anatomic variant seen is apx 10 - 30% of the
population-. It occurs when a portion of splenic tissue separates itself from the main body of the spleen and is found in an ectopic position. Most are small and measure apx 2 cms. 75 % of accessory spleens are found near the splenic hilum PG 262 10-5 A B 20% located within the pancreatic tail. On ultrasound they present as round mildly echogenic and homogeneous with posterior enhancement

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13
Q

What is “WANDERING OR ECTOPIC SPLEEN” known as ?

A

WANDERING OR ECTOPIC SPLEEN -a spleen that migrates from the normal LUQ position to other abdomen or pelvic location

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14
Q

Lab values and what might they result?

A

LAB VALUES
1.leukocytosis(abnormally high level of WBCs) may indicate the presence of inflammation, infection hemorrhage carcinoma and acute leukemia
2.leukopenia abnormally low level of WBCSs may result from chemo/radiation therapy, leukemia, viral infection, aplastic anemia, anaphylactic shock, diabetes
3.Hematocrit- percentage of blood volume occupied by RBCs

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15
Q

Can you live without a spleen ?

A

Yes you can live without a spleen

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16
Q

What is “SPLENOMEGALY “

A

SPLENOMEGALY - enlargement of the spleen is one of the most common splenic abnormalities seen in US.

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17
Q

What is the most common cause for splenomegaly?

A

A common cause of splenomegaly is portal congestion secondary to liver cirrhosis (Portal hypertension) increased pressure within the portal venous system that reverses the normal flow through the portal and splenic veins toward the liver.

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18
Q

What blood disorder cause splenomegaly ?

A

Sickle cell disease cause splenomegaly

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19
Q

What is the most common malignant disease affecting the spleen?

A

LYMPHOMA - the most common malignant disease affecting the spleen

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20
Q

Patients with metabolic disorders spleen tends to?

A

In patients with metabolic disorders the spleen may be distended due to the presence of macrophages, vascular compromise and metabolic elements unique to each disease process

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21
Q

What type of splenic cyst are there?

A

Splenic Cysts may be congenital or acquired

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22
Q

What is Congenital cyst defined as?

A

CONGENITAL
-cysts arising from epithelial or endothelial lining are considered primary or true cysts

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23
Q

What is a acquired or secondary splenic cyst?

A

ACQUIRED or secondary splenic cysts may develop in association with
-inflammation’
-trauma
-parasitic infection

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24
Q

Post traumatic or splenic PSEUDOCYSTS is known as?

A

Post traumatic or splenic PSEUDOCYSTS account for apx 80% of all splenic cysts and are often in sequelae to hematomas. A Capsule of fibrous tissue often develops around resolved subcapsular or intraparenchymal hematomas which ultimately liquefy and forms a traumatic pseudocyst. They only require treatment if they become large and symptomatic.
- In apx 50% of cases delayed splenic rupture may occur
-splenic rupture is a life threatening event when an acute hemorrhage ruptures through splenic capsule and blood spills out into the abdominal cavity

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25
Q

Parasitic cysts are known as ?

A

Parasitic cysts are common among the benign cysts that present worldwide
Parasitic cysts are overwhelmingly echinococcal (hydatid) in origin

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26
Q

LYMPHANGIOMAS is most common in what ages group?

A

LYMPHANGIOMAS

-most common in children

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27
Q

What are a few things that define the abscess?

A

ABSCESSES
-often result from the hematological spread of infection, most often abscesses are multiple due to this
- single focal abscesses are uncommon
-common causes are endocarditis, septicemia and trauma
-diagnosis may be hampered due to absent or subtle symptoms
-due to delay in diagnosis, risk of rupture increases causing a high mortality rate
-symptoms may include LUQ pain, high grade fever, vomiting
- complex appearance on ultrasound with mixed echogenic properties

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28
Q

INFARCTS can be defined as?

A

INFARCTS
- Splenic infarction is an occlusion of a segment of splenic arterial supply, and infarcts secondary to a wide range of pathological causes

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29
Q

Infarcts are seen sonographically?

A

infarcts appear as well-demarcated hypoechoic, wedge shaped or round areas located at periphery with diminished doppler flow PG 270 10-11, A.B

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30
Q

-echogenicity is related to the age of the infarct

A

key sonographic indication is the bright band sign

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31
Q

What is the most common damaged organ in blunt force abdominal trauma

A

spleen is the organ most frequently damaged in blunt abdominal trauma

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32
Q
A

In case of rupture, sonographer should examine pelvis, morrison’s pouch and flanks of the patient for intraperitoneal hemorrhage

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33
Q
A

Hemoperitoneum- blood in the peritoneal cavity- is often indicated as a complex fluid
Found within the lesser and greater sac on both sides of gastrosplenic ligament

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34
Q
A

SPLENIC CALCIFICATIONS
-generally and incidental finding and may occur in association with a wide variety of conditions
-hematological
-infective
-malignant
-vascular
-_____Calcifications may result from previous infarction or hematoma
-echogenic with varying degrees of acoustic shadowing PG 273 10-14

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35
Q
A

LYMPHOMA is the most common malignant disease to affect the spleen

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36
Q
A

Lab results often demonstrate elevated white blood count and anemia Sonographically
-lymphoma may present as isolated hypoechoic masses with poorly defined margins PG 273 10-15A
-in cases of diffuse involvement, the entire splenic parenchyma may demonstrate several tumor-like nodules resulting in heterogeneous appearance 10-15

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37
Q

What is Leukemia primary malignancy of?

A

LEUKEMIA is a primary malignancy of
-bone marrow
-lymph nodes
-spleen

38
Q

People with Leukemia usually experience ?

A

LEUKEMIA
-patients with leukemia are primarily males who present with
-anemia
-elevated WBC
-excessive bruising
-fatigue
-recurrent infections
-pallor
-Splenomegaly may be the only sonographic finding

39
Q
A

ANGIOSARCOMA
-are aggressive primary malignant vascular neoplasms
` -are most common among patients 50-60 years who may exhibit
-LUQ mass
-pain
-malaise
-fever
-anemia
-weight loss

40
Q
A

METASTASIS: transfer primary cancerous lesions to another organ
-relatively uncommon to spleen

41
Q
A

-most metastatic lesions found within spleen demonstrate a “bulls eye”

42
Q

What

A
  1. HEMANGIOMA PG 275 10-18 A,B,C
    -most common benign, vascular neoplasm of the spleen and most often affect men 20-50 years
43
Q
A
  1. HAMARTOMA
    -also referred to as splenoma’s are rare vascular proliferation tumors composed of varying mixtures of tumor tissue and normal splenic tissue
44
Q

The head of the pancreas is located?

A

The head of the pancreas is located to the “right and inferior to the body and the tail”

45
Q

The body of the pancreas is located?

A

The body of the pancreas lies anterior to the aorta, smv “ superior mesenteric vein” and left renal vein

46
Q

The tail of the pancreas is located ?

A

The tail is located bordered posteriorly by the splenic vein.

47
Q

What is the definition of the uncinate process?

A

The uncinate process is “a curved projection of pancreatic tissue extending posterior and medial from the head.

48
Q

What groups are known as endocrine cells?

A

islets of langerhans are groups of endocrine cells.

49
Q

What two things supply the pancreas with blood ?

A

Blood supply to the pancreas is provided by branches of the splenic artery and the pancreaticduodenal arteries.

50
Q
A

Small groups of ACINI cells which secrete digestive enzymes clustered in multiple lobules surrounding a tributary duct. The smaller ducts merge into increasing larger ducts and empty into the main pancreatic duct or the DUCT OF WIRSUNG. Enzymes secreted by the pancreas are carried by the main pancreatic duct into the alimentary tract by the Ampulla of Vater, near this ampulla the main pancreatic duct merges with the distal common bile duct to form a single channel into the duodenum

51
Q
A

insulin is released by pancreas via negative feedback system meaning when the blood glucose rises above a certain level the beta cells immediately secrete insulin, when the blood glucose level falls, insulin secretion decreases
-abnormalities of insulin secretion result in impairment of metabolic functions throughout the body…… DIABETES is a result of this imbalance

52
Q
A

-exocrine function of the pancreas is to secrete enzymes referred to as pancreatic juice, that aid in food breakdown and digestion

53
Q

What are the 4 enzymes that the pancreas secretes?” ( ALTC)

A
  • the 4 enzymes secreted by the pancreas are;
    1. Amylase
    2. Lipase
    3. Trypsinogen
    4. Chymotrypsinogen
54
Q
A

PANCREAS DIVISUM - is the most common congenital anomaly, it results from a failure of the fusion of the dorsal and ventral pancreatic buds

55
Q

Lab value

A
  • Amylase - enzyme essential in the digestion of carbohydrates
    Increased levels can indicate pancreatic disease
56
Q

Lab value

A

Lipase - a fat-splitting enzyme excreted by the pancreas

57
Q

Lab value

A

Fat excretion- STEATORRHEA - increased fecal fat is symptomatic of pancreatitis, weight loss and oily stool are often associated with pancreatic steatorrhea

58
Q
A

The pancreatic duct/duct of Wirsung is frequently visualized measuring 3mm or less PG 248 Fig 9-7

59
Q

Define Cystic fibrosis?

A

CYSTIC FIBROSIS - is the most common lethal genetic defect in the caucasian population

60
Q

How will the pancreas be seen on ultrasound?

A

On ultrasound the pancreas will appear hyperechoic and small and hypo echoic areas representing pancreatic fibrosis may be seen

61
Q

What is Acute Pancreatitis seen as?

A

ACUTE PANCREATITIS - all or part of the pancreas is inflamed
- 2 most common causes are biliary tract disease and excessive alcohol intake
- Characterized by an edematous enlarged gland,

62
Q

How will acute pancreatitis seen on sonography?

A

SONOGRAPHIC APPEARANCE
- Inflamed pancreas appears enlarged and hypoechoic

63
Q

Pancreatic Pseudocyst is known as ?

A

Pancreatic PSEUDOCYSTS - are encapsulated collections of byproducts of tissue destruction, are common findings with severe disease. They range from 5 to 16% in acute pancreatitis

64
Q

What is Chronic Pancreatitis?

A

CHRONIC PANCREATITIS
-results from repeated bouts of acute pancreatitis

65
Q
A

Sonographic findings vary: because gross anatomic changes may not occur in course of the disease, sonography may not detect abnormalities In cases where changes have occurred the pancreas most frequently is heterogeneous with increased echogenicity PG253 9-17 -may be enlarged with irregular borders
-the pancreatic duct may be dilated 9-18
-sonographic landmark of chronic pancreatitis is the presence of calcifications within the parenchyma 9-19 & 9-20

66
Q
A

NEOPLASTIC DISEASE
Malignant tumors of the pancreas is the 4th leading cause of cancer related deaths in the US

67
Q

What is Adenocarcinoma? “Think Carcinoma-Cancer!”

A

ADENOCARCINOMA - single most common malignant lesion

68
Q

Tell me about Insulinomas and gastronomas.

A

INSULINOMAS AND GASTRINOMAS are the most common type of endocrine tumors(80%) - Tumors of endocrine origin are referred to as neuroendocrine tumors or islet cell tumors - Far less common than exocrine neoplasms
- Most are solid and small making difficult to detect on ultrasound

69
Q

What do solid pancreatic tumors generally look like?

A

SOLID pancreatic tumors are generally hypoechoic pg 255 9-21
-more often appear as poorly marginated, complex masses found in pancreatic head 9-22 -makes of majority of pancreatic tumors (SOLID)

70
Q

Tell me about Cystic neoplastic lesions?

A

CYSTIC neoplastic lesions
-polycystic disease-autosomal dominant disease characterized by the presence of multiple small cysts in the kidney liver and less commonly the pancreas

71
Q

Acini cells

A

Cells that perform exocrine functions secreting digestive enzymes

72
Q

Alpha cells

A

Cells that perform endocrine functions secreting glucagon

73
Q

Amylase

A

Enzymes that digest carbohydrates

74
Q

Beta cells

A

Cells that perform endocrine functions secreting insulin

75
Q

Delta cells

A

Cells that perform endocrine function secreting somatostatin

76
Q

Endocrine

A

Secreting into blood and tissue

77
Q

Glucagon

A

Hormone secreted by the Alpha cells that functions to increase activity of phosphorylase

78
Q

Insulin

A

Hormone secreted by beta cells that functions to increase the uptake of the glucose and amino acids by most body cells

79
Q

Exocrine

A

Secreting into a duct

80
Q

Islets of Langerhans

A

Endocrine portion of the pancreas made up of alpha cells and beta cells; which is the source of insulin and glucagon; also called pancreatic islet

81
Q

Lipase

A

Fat-digesting enzyme

82
Q

Phlegmon

A

Diffuse inflammatory reaction to infection spreading along fascia pathways; producing edema and swelling

83
Q

Pseudo

A

AbnormL or dilated cavity resembling a true cyst but not lined with epithelium

84
Q

Somatostatin

A

Hormone secreted by the delta cells that functions to regulate insulin and glucagon production

85
Q

Erythrocyte

A

Red blood cell; contains hemoglobin and is responsible for transporting oxygen

86
Q

Hematocrit

A

Laboratory value of the percentage of blood volume made up of red blood cells; can be low in cases of anemia, blood loss, leukemia

87
Q

Erythropoiesis

A

Process of red blood cells production, occurs in the fetal spleen from the fifth to the sixth month of fetal life after which the bone marrow assumes the function

88
Q

Infarct

A

Tissue death caused by an interruption of blood supply

89
Q

Leukocyte

A

White blood cell; main function is to protect against and fight infection in the body

90
Q

Leukocytosis

A

Elevated white blood cell count usually owing to infection

91
Q

Leukopenia

A

Decreased white blood cell count; can be a result of many factors including viral infection and leukemia

Abdomen And Superrficial Structures (9 decks)

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