Spleen Flashcards
This is the largest lympatic organ in the body.
spleen
T/F? The spleen is a retroperitoneal organ.
FALSE, it’s peritoneal
This organ filters damaged cells and delivers antigens to the immune system.
spleen
Splenic arteries are sometimes called ___ arteries, due to their appearance on u/s.
brush
The spleen consists of what two kinds of pulp?
white and red
The ___ pulp of the spleen is lymphatic tissue consisting mainly of lymphocytes around arteries.
white
The white pulp of the spleen is ___ tissue consisting mainly of lymphocytes around ___.
lymphatic tissue, arteries
The ___ pulp of the spleen consists of venous sinuses filled with blood and cords of lymphatic cells.
red
The red pulp of the spleen consists of ___ filled with blood and cords of ___ cells.
venous sinuses, lymphatic
T/F? The spleen decreases in size and weight with advancing age.
true
The spleen ___ in volume while digestion is in progress and ___ when it is finished.
increases, returns to normal size
The spleen ___ in much the way that lymphnodes filter lymph.
filter blood
What does the spleen do to old and damaged RBCs?
removes them from the circulating blood
The spleen, like the bone marrow, can…
produce new red blood cells.
The spleen is both hemo___ and hemo___.
-lytic, -poietic
What two components of the spleen are joined at the hilum?
superomedial and inferolateral
The fundus of stomach is ___ to the splenic hilum.
medial and anterior
The diaphragm is ___ to the spleen.
posterior, superior and lateral
The pancreas tail is ___ to the stomach.
posterior
The pancreas tail is ___ to the splenic hilum.
medial and anterior
The lesser sac is ___ to the splenic hilum.
medial and anterior
The left kidney is ___ to the spleen.
medial and inferior
The splenic parenchyma is ___geneous with ___ echoes.
homo-, uniform mid to low level
Name four reasons to u/s the spleen.
- show a mass and its composition
- show the disruption of the splenic texture or outline
- show its size
- show changes in masses
A spleen larger than ___ is considered splenomegaly.
12 cm
Mild to moderate splenomegaly is usually caused by…
infection, portal hypertension, or AIDs.
Marked splenomegaly is usually the result of…
leukemia, lymphoma, or mononucleosis.
Massive splenomegaly is seen in…
myelofibrosis.
This is the most frequently observed abnormality of the spleen.
splenomegaly
Name the five causes of splenomegaly.
- congestive
- hematologic
- infiltrative
- metabolic
- trauma
Congestive splenomegaly is secondary to ___ due to cirrhosis.
portal HTN. May also be caused by anemia.
This blood disorder of ‘uncontrolled RBC production’ causes hyperviscosity, hypercoagulation, and splenomegaly.
polycythemia vera
Polycythemia vera causes this kind of splenic condition.
hematologic splenomegaly
Leukemia and lymphoma can cause this kind of splenic condition.
infiltrative splenomegaly
Sonographically, this appears as a large homogeneous spleen. May contain round focal masses or nodules.
infiltrative splenomegaly
Gaucher’s disease and Niemann-Pick disease can cause this kind of splenic condition.
metabolic cause
Splenomegaly presents with these symptoms…
- LUQ pain due to the stretching of the capule
2. pressure on adjacent organs
Name 4 kinds of splenic cysts.
- infectious
- post-traumatic
- primary congenital
- intrasplenic pancreatic pseudocyst
This splenic condition may be caused by hydatid cysts or echinococcus.
infectious or parasitic cysts
Sonographically, this splenic condition can be identified by the calcifications in the cyst wall and the presence of ‘daughter cysts’.
infectious cysts
What do infectious cysts need to be diagnosed besides history and background info?
percutaneous aspiration
This splenic condition is usually due to the outcome of a hematoma due to trauma.
post-traumatic cysts
Sonographically, these splenic cysts have no cellular lining.
pseudocysts (post-traumatic cysts)
This splenic condition is rare and may be due to polycystic disease.
primary congenital cysts or epidermoid cysts
Sonographically, this splenic condition appears as cysts with a cellular lining (that may be calcified) and may contain low level echoes that can be choesterol crystals or debris.
primary congenital cysts
This splenic condition is uncommon but is associated with a high mortality rate.
splenic abscess
This splenic condition commonly occurs due to spread of infection, esp from infective endocarditis or stretococcus.
splenic abscess
Clinically, this splenic condition presents with fever, pain, leukocytosis, and LUQ mass.
splenic abscess
Sonographically, this splenic condition appears variable with irregular borders.
splenic abscess
This splenic condition is a traumatic abnormality associated with rib fractures.
hematoma
This uncommon splenic condition often results from previous granulomatous infections.
solid masses or focal lesions
Sonographically, this splenic condition appears as focal, bright, echogenic lesions with or without shadowing.
solid masses or focal lesions
The most common causes of granulomatous infection are…
histoplasmosis and tuberculosis
Primary malignancies of the spleen are ___.
extremely rare
This is the most common cause of splenic metastases.
malignant melanoma (followed by breast and lung cancer)
This is the most common benign neoplasm of the spleen.
hemangiomas
Sonographically, this splenic condition appears as an isolated but variable neoplasm, much like it does in the liver.
hemangiomas
This is a common cause of focal splenic lesions.
infarctions
Sonographically, this splenic condition appears as a peripheral, wedge-shaped lesion.
infarctions
T/F? Splenic infarctions are hypoechoic.
FALSE, they’ll be hypoechoic when acute and hyperechoic when chronic.
This splenic condition is commonly caused by bacterial endocarditis.
infarcts
Splenic nodules can be caused by…
Gaucher’s disease
Schistosomiasis
Candidiasis
This occurs with splenic trauma in which the capsule remains intact.
subcapsular or intraparenchymal hematoma
Sonographically, this splenic condition appears as a cresent shaped fluid collection inferior to the diaphragm.
subcapsular hematoma
This occurs with splenic trauma in which the capsule ruptures.
perisplenic or intraperitoneal hematoma
T/F? An enlarged spleen may rupture spontaneously.
true
Clinically, this splenic condition presents as abd pain and tenderness. The patient may become lightheaded, confused, faint, or have blurred vision.
splenic rupture
T/F? If the splenic vessels tear, death can occur within minutes.
true
What is Kehr’s sign?
Referred pain in the shoulder’s tip from the collected splenic blood irritating the diaphragm.
A ruptured spleen is typically caused by…
a blow to the LUQ or the left lower chest.
This is the most significant complication of mononucleosis.
ruptured spleen
Sonographically, this splenic condition appears as fluid in the lesser and greater sacs on both side of the gastrosplenic ligament. ‘butterfly sign’
ruptured spleen
This is the autotransplantation of splenic tissue following splenic injury.
splenosis
This condition results when splenic cells implant throughout the peritoneal cavity following a rupture.
ectopic spleens
This is the most common splenic u/s finding in patients with AIDs.
moderate splenomegaly, seen in 50-70% of patients
Focal lesions on the spleen may cause opportunistic infections like…
- candida
- pneumocystis carnii
- mycobacterium avium
- Kaposi’s sarcoma
- lymphoma
This may be confused with enlarged lymhnodes around the spleen or with masses in the pancreas tail.
accessory spleen or splenunculi
What percentage of people have an accessroy spleen?
25%
T/F? An accessory spleen has an echogenicty identical to the spleen.
true
This is an abnormal inferior displacement of the spleen.
splenic ptosis
This splenic condition can be due to extreme weight loss, weak abdominal muscles and splenomegaly which would cause the ligaments to become dysfunctional.
splenic ptosis
A wandering spleen is when…
the spleen in found lower in the abdominal cavity.
A wandering spleen may be inclined to…
torsion.
This describes an absent or underdeveloped spleen.
asplenia
This term literally means multiple spleens.
polysplenia