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*Ultrasound* > Spleen > Flashcards

Spleen Flashcards

1
Q

Although the spleen is located near the stomach it plays no part in _____.

A

digestion

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2
Q

The spleen is elongate-_____ in shape and of a dull _____ color.

A

oval

purplish

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3
Q

The spleen is a _____ organ that lies _____ the stomach, high up on the left side of the abdomen, on a level with the 9 to 11 ribs.

A

lymphatic

behind

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4
Q

The spleen is similar to a _____ in shape and structure but is much _____.

A

lymph node

larger

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5
Q

The spleen is the largest _____ organ in the body.

A

lymphatic

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6
Q

The spleen is a _____ organ that filters damaged cells and delivers _____ to the immune system.

A

peritoneal

antigens

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7
Q

The spleen of an adult human:

1) Weighs about _____ (_____)
2) Is ___-___ ( ___- ___ ) long
3) Is _____ (_____) wide
4) Is _____ (_____) thick.

A

170 grams (6 ounces)
13-15 cm (5-6 inches) long*
7.5 cm (3 inches) wide
4cm (1.5 inches) thick

*Jennifer says up to 12 cm is the common healthy size

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8
Q

The _____ brings blood to the spleen from the heart.

A

splenic artery

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9
Q

The splenic artery enters the spleen through a fissure called the _____ and divides into numerous branches, assuming an appearance rather like a _____; they are sometimes called the _____ arteries.

A

hilum
brush
brush

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10
Q

Blood leaves the spleen through the _____, which becomes part of the _____ that carries the blood to the liver.

A

splenic vein

MPV

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11
Q

The spleen consists of two types of tissue called _____ and _____.

A

white pulp

red pulp

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12
Q

The white pulp of the spleen is lymphatic tissue consisting mainly of _____ around the _____.

A

lymphocytes

arteries

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13
Q

The red pulp consists of venous _____ (cavities) filled with blood and cords of _____ cells, such as _____ and _____.

A

sinuses
lymphatic
lymphocytes
macrophages

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14
Q

The normal spleen:

_____ (increases/decreases) in size and weight with advancing age.

_____ (increases/decreases) in volume while digestion is in progress, and returns to its normal size when it’s finished.

The size can vary in size in accordance with the _____ status of the body.

A

decreases
increases
nutritional

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15
Q

The spleen filters blood in much the way that the lymph nodes filter _____. Lymphocytes in the spleen react to _____ in the blood and attempt to destroy them. _____ then engulf the resulting debris, the damaged _____, and the other large particles.

A

lymph
pathogens
macrophages
cells

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16
Q

The spleen, along with the liver, removes old and damaged _____ from the circulating blood.

A

erythrocytes (RBCs)

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17
Q

The spleen can also, like _____, produce new red blood cells. It can accordingly be regarded both as a _____ and as a _____ organ.

A

bone marrow
hemolytic
hemopoietic

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18
Q

The terms hemolytic and hemopoietic come from the Greek: hema: _____; luein: _____; poiein: _____.

A

blood
to dissolve/destroy
to produce

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19
Q

T or F? The spleen is removable.

A

true

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20
Q

In healthy people, the spleen plays a role in immunity against _____.

A

bacterial infections

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21
Q

The shape of the spleen is _____ (adjective).

A

variable

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22
Q

The spleen consists of 2 components at the hilum:

A

superomedial component

inferolateral component

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23
Q

In the TRV plane, the superior part of the spleen has a typical fat _____ shape.

A

comma

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24
Q

In the coronal plane, the spleen has a _____ shape.

A

inverted comma

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25
Q

Why do we scan the spleen coronally?

A

Because the stomach is anterior to the spleen and is full of air, which makes it impossible to see through.

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26
Q

The diaphragm cradles the spleen _____, _____, and _____.

A

posteriorly
superiorly
laterally

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27
Q

If the _____ lobe of the liver is large, it may extend into the LUQ, _____ to the spleen.

A

left

superior

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28
Q

The fundus of the stomach is _____ and _____ to the splenic hilum.

A

medial

anterior

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29
Q

The pancreas tail lies _____ to the stomach and is also _____ and _____ to the splenic hilum.

A

posterior
medial
anterior

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30
Q

What are the 3 organs/parts that are medial and anterior to the splenic hilum?

A

stomach
pancreatic tail
lesser sac

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31
Q

The left kidney generally lies _____ and _____ to the spleen.

A

medial

inferior

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32
Q

Why perform an ultrasound on the spleen? (4)

A

To demonstrate:

  • existence of a mass and its composition
  • disruption of splenic texture or outline
  • spleen size
  • progressive changes in masses
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33
Q

Enlargement of the spleen is >_____.

A

12cm

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34
Q

What does splenomegaly demonstrate?

A

it is not a disease in itself but a sign of an underlying disorder

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35
Q

Mild-to-moderate splenomegaly is usually caused by: (3)

A

infection
portal HTN
AIDS

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36
Q

Marked splenomegaly is usually the result of: (3)

A

leukemia
lymphoma
infectious mononucleosis

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37
Q

Massive splenomegaly is seen in _____.

A

myelofibrosis

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38
Q

What is myelofibrosis?

A

the body making too much scar tissue

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39
Q

What is the most frequently observed abnormality of the spleen?

A

splenomegaly

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40
Q

What are 5 common causes of splenomegaly?

A 
congestive
hematologic
infiltrative
metabolic
trauma
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41
Q

The congestive (can’t keep up with its job in the body) cause of splenomegaly is secondary to _____ due to _____. An example is _____.

A

portal HTN
cirrhosis
anemia

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42
Q

The main hematologic cause of splenomegaly is

A

polycythemia vera

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43
Q

What is a blood disorder that results in uncontrollable RBC production?

A

polycythemia vera

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44
Q

Besides splenomegaly, what else does polycythemia vera cause? (2)

A

hyperviscosity

hypercoagulation

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45
Q

The infiltrative cause of splenomegaly is due to _____ and both types of _____ ( _____ and _____).

A

leukemia

lymphoma (Hodgkins and non-Hodgkins)

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46
Q

The splenic parenchyma is extremely _____ (homogeneous/heterogeneous) with uniform mid-to-low level _____. It is generally considered that the liver is more _____ (echogenicity) than the spleen, but the spleen parenchyma actually has a _____ echogenicity than the liver (due to its _____ content) or may be _____ (echogenicity) to the liver.

A 
homogeneous
echoes
echogenic
higher
water
isoechoic
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47
Q

_____ is a common primary malignancy of the spleen, usually appearing as diffuse _____ organ _____. Less common forms include a round _____ mass or multiple _____. Splenic involvement is more common with _____ lymphoma than with _____ lymphoma.

A 
lymphoma
homogeneous
enlargement
focal
small nodules
non-Hodgkin
Hodgkin
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48
Q

The metabolic cause of splenomegaly is caused by _____ disease and _____ disease.

A

Gaucher’s

Niemann-Pick

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49
Q

What is Gaucher’s disease?

A

a disease where there is a missing fat enzyme

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50
Q

What is the disease that means the body has too much sphingomyelin?

A

Niemann-Pick

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51
Q

Gaucher’s Disease

It is _____ (inherited/not inherited).
It means the body is missing a _____ enzyme.
_____ is one of the earliest signs.

A

inherited
fat
splenomegaly

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52
Q

Niemann-Pick Disease

It is _____ (inherited/not inherited).
It means the body has too many deposits of _____.

A

inherited

sphingomyelin

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53
Q

What are the signs and symptoms of splenomegaly?

A

LUQ pain

pressure on adjacent organs

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54
Q

What causes LUQ pain with splenomegaly?

A

the stretching of the capsule or ligament of the spleen

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55
Q

This mass appears as an echo-free areas with smooth, sharp borders and acoustic enhancement.

A

cyst

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56
Q

The 4 categories of cysts on the spleen are

A

infectious
post-traumatic
primary congenital (born with it)
intrasplenic pancreatic pseudocyst

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57
Q

Infection or parasitic cysts may be caused by _____ or _____.

A

hydatid cysts

echinococcus

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58
Q

How is an infectious or parasitic cyst identified among the different kinds of cysts?

A

calcification in the wall

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59
Q

What is needed to be diagnostic for infectious/parasitic cysts? (2)

A

percutaneous aspiration

history and background info

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60
Q

Hydatid cysts result from a _____.

A

parasitic tapeworm

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61
Q

If you open up a hydatid cyst, what does it look like?

A

a honeycomb

62
Q

With hydatid parasitic cysts, ____ form the cysts and the cysts multiply, creating _____ cysts.

A

parasites

daughter

63
Q

What are post-traumatic cysts caused by?

A

usually due to hematoma due to trauma

64
Q

Post-traumatic cysts are referred to as _____ (type of cyst) and ____ (have/don’t have) a cellular lining.

A

pseudocysts

don’t have

65
Q

This kind of cyst differs from a post-traumatic cyst in that it has a cellular lining.

A

primary congenital cysts

66
Q

Another term for primary congenital cysts is ____, which means “_____.”

A

epidermoid cysts

“true cyst”

67
Q

T or F? Primary congenital cysts are rare.

A

True

68
Q

_____ cysts can be due to polycystic disease. The walls may become _____ or may contain low level _____ that can be _____ or debris.

A

Primary congenital
calcified
echoes
cholesterol crystals

69
Q

These cysts extend into the spleen and are associated with pancreatitis features.

A

pancreatic pseudocysts

70
Q

This pancreatic pseudocyst is uncommon, but associated with a high mortality rate.

A

splenic abscess

71
Q

Fever + infection =

A

abscess!

72
Q

This kind of pancreatic pseudocyst commonly occurs due to spread of infection, especially from infective endocarditis or most commonly from streptococcus.

A

splenic abscess

73
Q

Fever + infection + underlying issue =

A

splenic abscess!

74
Q

Fever, pain, leukocytosis*** and a LUQ mass is a sign of

A

a splenic abscess

75
Q

How does a splenic abscess appear sonographically?

A

variable

76
Q

This is a traumatic abnormality of the spleen and is associated with rib fractures.

A

hematoma

77
Q

What is the choice modality for a hematoma?

A

CT

78
Q

How does a hematoma appear sonographically?

A

variable

79
Q

This kind of splenic mass is uncommon but can be caused by a number of diseases.

A

solid focal lesion

80
Q

This is the most common solid focal lesion and it results from previous _____ infections, which are seen as a _____, bright, _____ lesion with or without shadowing.

A

granulomatous
focal
echogenic

81
Q

What are the most common causes of granulomas? (2)

A

histoplasmosis

TB

82
Q

What is the disease that is spread by the inhalation of bird/bat poop?

A

histoplasmosis

83
Q

Granulomas may occur in patients with _____.

A

sarcodosis

84
Q

What is sarcodosis?

A

inflammation of the lymph nodes

85
Q

With granulomatous disease, calcification in the _____ is common.

A

splenic artery

86
Q

Granulomas are clusters of _____ cells.

A

immune

87
Q

Primary malignancies of the spleen are very rare, but if there is one, it is probably _____.

A

lymphoma

88
Q

Splenic metastasis occurs most commonly with malignant _____.

A

melanoma

89
Q

After melanoma, the next 2 most common splenic mets comes from the _____ and the _____.

A

breast

lung

90
Q

This is the most common benign neoplasm of the spleen.

A

hemangioma

91
Q

A hemangioma is usually isolated with variable appearance, sonographically. But mostly, they look like _____.

A

liver hemangiomas

92
Q

What is a common cause of focal splenic lesions?

A

splenic infarctions

93
Q

The appearance of a splenic infarction typically appears as a _____, _____, _____ lesion (3)

A

peripheral
wedge-shaped
HYPOechoic

94
Q

With splenic infarctions, when it becomes chronic, the wedge-shaped characteristic becomes _____.

A

HYPERechoic

95
Q

Any wedge-shaped lesion in the spleen will be an _____. So if, on the boards, you see ANY wedge-shaped image, pick _____, whether it’s hypoechoic or hyperechoic.

A

infarct

96
Q

The most common cause of a splenic infarct is

A

bacterial endocarditis

97
Q

Besides bacterial endocarditis, what are other causes of splenic infarcts? (4)

A

leukemia
lymphoma
tumor emboli
sickle cell anemia

98
Q

Splenic nodules are present with these 3 conditions:

A

Gauchers Disease
Schistosomiasis
Candidiasis (wheel within a wheel)

99
Q

What is the choice diagnostic imaging modality for splenic trauma? Why? What is the modality that may be used for follow-up?

A

CT
because more upper abdominal pathology can be identified with one exam
ultrasound

100
Q

T or F? Subcapsular or perisplenic hematomas are seen with ultrasound with high accuracy.

A

True

101
Q

Inside capsule =

A

subcapsular

102
Q

Outside capsule =

A

perisplenic

103
Q

This is a hematoma that occurs with splenic trauma in which the splenic capsule remains intact.

A

subcapsular (AKA intraparenchymal)

104
Q

Another term for subcapsular is

A

intraparenchymal

105
Q

How does a subcapsular hematoma look sonographically?

A

crescent-shaped fluid collection, inferior to the diaphragm

106
Q

This appears as a crescent-shaped fluid collection, inferior to the diaphragm.

A

subcapsular hematoma

107
Q

This hematoma occurs with splenic trauma in which the splenic capsule ruptures.

A

perisplenic hematoma (AKA intraperitoneal)

108
Q

Another term for perisplenic hematoma is

A

intraperitoneal

109
Q

T or F? A ruptured spleen is a serious condition. Without emergency treatment, a ruptured spleen can cause life-threatening bleeding. An enlarged spleen may rupture spontaneously.

A

True

110
Q

What are the classic symptoms of a ruptured spleen? (2-ish)

A

abdominal pain and tenderness

111
Q

What are possible more severe symptoms of a ruptured spleen? (4-ish)

A

internal bleeding could cause blood pressure to drop, may become lightheaded or confused, with blurred vision and fainting

112
Q

This can cause severe hemorrhage and shock (in splenic rupture).

A

tearing of splenic vessels

113
Q

If tearing of the splenic vessels happens with splenic rupture, what is a really bad possible outcome?

A

death can occur within minutes (even in the best situations, death cannot be prevented)

114
Q

This refers to when blood collects due to splenic injury, it irritates the diaphragm, causing referred pain to the shoulder tip.

A

Kehr’s Sign

115
Q

A ruptured spleen is typically caused by a blow to the _____ (area) abdomen or the left lower _____. Sporting mishaps, fist fights and car accidents are common causes. An injured spleen may rupture soon after the abdominal trauma or, in some cases, days or even _____ after the injury.

A

left upper
chest
weeks

116
Q

An enlarged spleen, which may be caused by various underlying problems — from mononucleosis and other infections, to liver disease and blood cancers — may sometimes rupture with _____.

A

trauma to the abdomen

117
Q

How can the spleen rupture during 3rd trimester pregnancies?

A

Large abdomen pushes the LLL anteriorly to the spleen

118
Q

What is the most significant complication of mononucleosis?

A

ruptured spleen

119
Q

What is the splenic rupture sign that refers to fluid in the lesser and greater sacs on both sides of the gastrosplenic ligament?

A

Butterfly sign

120
Q

The Butterfly sign refers to fluid in the ____ and ____ on both sides of the ____ ligament.

A

lesser sac
greater sac
gastrosplenic

121
Q

This occurs when the splenic vascular supply, parenchyma, or capsule has been disrupted.

A

splenic rupture

122
Q

The appearance of this ranges from a cystic, hypoechoic mass to a complex area in the periphery of the splenic parenchyma.

A

splenic rupture

123
Q

Splenic rupture can appear as a cystic, _____ (echogenicity) mass.

A

HYPOechoic

124
Q

A splenic rupture can appear as a _____ area in the _____ of the splenic parenchyma.

A

complex

periphery

125
Q

_____ is the autotransplantaion of splenic tissue, following splenic injury.

A

splenosis

126
Q

If a rupture is small, how is it treated?

A

surgical repair

127
Q

If a rupture is bad (typically, it is) how is it treated?

A

splenectomy

128
Q

This might be needed with splenectomy surgery if the patient has lost a large amount of blood in the trauma that caused the rupture of the spleen.

A

transfusions

129
Q

This is a slender tube equipped with a camera lens and light, used for splenectomy surgery.

A

laparoscope

130
Q

A person can live an active life without a spleen, but they are more likely to contract serious or life-threatening _____. If the spleen is removed, the doctor may recommend _____ and _____ vaccines. _____ may be recommended as well, especially if there are any other conditions that increase the risk of serious infections.

A

infections
pneumonia
flu
antibiotics

131
Q

What is the condition in which the spleen ruptures and splenic cells implant through the peritoneal cavity, resulting in “ectopic spleens?”

A

post-traumatic splenosis

132
Q

What is the most common finding in patients with AIDS in a splenic ultrasound? (50-70% of patients)?

A

moderate splenomegaly

133
Q

Moderate splenomegaly is noted to be more frequent in _____-transmitted HIV infection, than in _____-transmitted HIV infection.

A

sexually

IV drug

134
Q

Focal splenic lesions may cause opportunistic infections such as (5):

A 
candida
pneumocystis carini
mycobacterium avium
Kaposi's sarcoma
lymphoma
135
Q

Congenital anomalies:

A normal variant which may be confused with enlarged lymph nodes around the spleen, or with masses in the pancreas tail.

A

accessory spleen (AKA splenunculi)

136
Q

____% of people have an accessory spleen.

A

25

137
Q

Another term for accessory spleen is

A

splenunculi

138
Q

Splenunculi (AKA accessory spleen) is easy to recognize as small, round masses <____, located near the splenic _____, with echogenicity identical to the _____.

A

5cm
hilum
spleen

139
Q

From where does an accessory spleen get blood supply?

A

splenic artery

140
Q

What vessel drains an accessory spleen?

A

splenic vein

141
Q

This represents nodules of normal spleen tissue.

A

accessory spleen

142
Q

T or F? After a splenectomy, an accessory spleen can enlarge and take the place and function of the original spleen.

A

True

143
Q

This is an abnormal inferior displacement of the spleen.

A

splenic ptosis

144
Q

What are some causes of splenic ptosis? (3) and why?

A

extreme weight loss
weak ab muscles
splenomegaly

They cause the splenic ligaments to become dysfunctional.

145
Q

This congenital anomaly is found in unusual locations. It may be mistaken for a mass that could undergo torsion, which would result in acute abdominal pain.

A

wandering spleen

146
Q

With a wandering spleen, the cause is the long ____ mesentery of the ____ mesentery failed to fuse with the _____ peritoneum.

A

mobile
dorsal
posterior

147
Q

This means “absent spleen”…

A

asplenia

148
Q

What is asplenia?

A

When the spleen is absent OR not fully developed (hypoplastic).

149
Q

This term means “multiple spleens”….

A

polysplenia

150
Q

What does hypoplastic mean?

A

not fully developed

*Ultrasound* (14 decks)

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