Spleen Flashcards
What type of organ is the spleen and where is it located?
Lymphoid, intraperitoneal organ located in the left hypochondrium
What is the size of the spleen in length, AP, & TRV?
Length: 13cm, AP: 7 cm, TRV: 4cm
What is the shape of the spleen comparable to?
Half moon
Lateral to tail of pancreas, splenic flexure of colon, left kidney, left adrenal gland, & Posterior to stomach, anterior to left hemidiaphragm is the location of ?
Spleen
What is the normal size of the spleen in SAG?
8-13 cm
What are the two major splenic ligaments?
Gastrosplenic & splenorenal (lienorenal)
Which ligament attaches the spleen to the greater curvature of the stomach?
Gastrosplenic
Which ligament attaches the spleen to the left kidney?
Splenorenal
What are the other ligaments that help support the spleen? (5)
Phrenicosplenic, splenocolic, pancreaticosplenic, phrenicocolic, and pancreaticocolic ligaments
How is the spleen supplied with blood?
Splenic artery
How is the blood drained from the spleen?
Splenic vein
What are the two types of tissue in the spleen?
Red and white pulp tissue
culling, pitting function, erythropoiesis, platelet blood cell reservoir, and defense against diseases are the functions of?
The spleen
What are the lab values of the spleen? (5)
Hematocrit, hemoglobin, RBC count, WBC count, and CBC count
What does the red pulp consist of?
Branching venous sinuses
What does the red pulp contain? (3)
Lymphocytes, macrophages, & RBC
which pulp macrophages engulf and destroy foreign particles, such as bacteria, that may be carried in the blood as it flows through the sinuses?
Red pulp
What is white pulp?
Round masses that are scattered through red pulp
What does white pulp surround?
Arteriole
which pulp is Composed of malpighian corpuscles, contains Lymphatic follicles—responsible for production of antibodies?
White pulp
What are the main functions of the spleen? (5)
Filters blood,
plays a part in immune system,
blood reservoir,
forms red blood cells,
& produces plasma cells
Which two lab values are most important regarding the spleen?
Hematocrit and bacteremia
Which lab value indicates the percentage of RBCs per volume of blood?
Hematocrit
Which lab value indicates an abnormal decrease in platelets?
Thrombocytopenia
Which lab value indicates an abnormal increase in RBC mass?
Polycythemia
Which lab value indicates the presence of bacteria within the body?
Bacteremia
Which lab value indicates an increase in WBCs typically found in infection?
Leukocytosis
Which lab value indicates an abnormal decrease in white blood corpuscles?
Leukopenia
What are the five congenital/anomaly variants of the spleen?
Asplenia,
polysplenia,
accessory spleen (splenunculi),
splenic clefts, and
ectopic spleen
Which congenital variant is the absence of the spleen from birth?
Asplenia
Which congenital variant is more common and may be found in up to 30% of patients?
Accessory spleen
Which congenital variant consists of multiple smaller spleens?
Polysplenia
multiple spleens, intestine malrotations, IVC anomalies, biliary atresia, visceral heterotaxia, short pancreas, and cardiac defects are the anomalies for what variant?
Polysplenia
which congenital variant migrates from the normal LUQ position to other abdomen or pelvic location?
Ectopic/ wandering
uniform homogeneous echo texture, medium level echoes, isoechoic or slightly hyperechoic to liver, highly echogenic left hemidiaphragm, smooth contour, and splenic vessel in hilum is the normal US appearance of?
Spleen
What are the pitfalls of splenic imaging? (3)
-LLL can mimic splenic abscess or subcapsular hematoma,
-spleen can be mistaken for renal mass, -adrenal & pancreatic tumor mimic splenic mass
In splenomegaly, the spleen measures greater than?
13cm
What are the causes of splenomegaly? (5)
Storage diseases,
autoimmune diseases,
trauma,
dialysis,
and sarcoidosis
What are the general infections of the spleen? (6)
Mononucleosis,
Tuberculosis,
Histoplasmosis,
Schistosomiasis,
Sarcoidosis,
& Candidiasis
what demonstrates multiple hypoechoic lesion with central echogenic ring (wheel-in-wheel sign & target pattern)? ❗️
Splenic candidiasis
What are the four major non-traumatic causes of focal splenic defects?
Infarction, abscess, cyst, and tumor
What is splenic infarct?
The occlusion of splenic artery segment
Where does the emboli originate in splenic infarct?
Heart
hypoechoic, wedge shaped oriented toward periphery lesion is the US appearance of?
Acute infarct
the lesion will become more echogenic with age of infarct is the US appearance of?
Chronic infarct
What is the US appearance of early infarct?
Hypoechoic or isoechoic to spleen
What is the US appearance of late infarct?
Hyperechoic or hypoechoic
High-grade fever, leukocytosis, LUQ pain & tenderness, vomiting, referred pain to the chest or shoulder are the symptoms of? ❗️
Splenic abscess
Irregular shaggy borders, Solid, Cystic, Complex, Dirty shadowing, DIFFERENTIAL DIAGNOSES - hematoma, degenerating neoplasm are the US appearance for? ❗️
Splenic abscess
What are the two types of splenic cysts?
True and secondary
Which cyst is due to epidermoid, dermoid, and polycystic disease?
True
Which cyst is due to pseudocysts, hemorrhagic, and abscess?
Secondary
which cyst has a solitary/ unilocular US appearance?
True
which cyst has a variable appearance related to cause?
Secondary
What symptoms might a patient present with in a case of splenic trauma?
Hypovolemic shock and LUQ pain
automobile accident, sports injury, gunshot and stab wounds, and physical abuse are the causes of?
Splenic trauma
in splenic trauma bleeding can occur in what 2 places?
Within spleen and through capsule
subcapsular or intraparenchymal hematoma that is hypoechoic, isoechoic, hyperechoic, or complex, as related to age is the US appearance of? ❗️
Intracapsular splenic trauma
blood in intraperitoneal cavity, retroperitoneal cavity, paracolic gutters, Morrison’s Pouch, posterior cul de sac is the US appearance of? ❗️
Rupture of capsule splenic trauma
What is the most dangerous development of splenic trauma?
Hypovolemic shock
Healed granulomas, Splenic artery calcification, Splenic aneurysm calcifications, Splenic infarcts, Old hematomas, & cysts with calcified walls are the causes of? ❗️
Splenic calficiation
What is the most common benign vascular neoplasm of the spleen and affect 20-50 year old men?
Hemangiomas
What is a rare, lymphoid tissue, solitary or multiple?
Hamartoma
What is a lymphatic malformation with a US appearance similar to hemangioma?
Cavernous lymphangioma
When do complications arise in the case of a cavernous lymphangioma?
When the tumor increases in size
infarction with coagulated blood or fibrin in the cavities may be seen but is unspecific is called a? ❗️
cavernous hemangioma
What are the two malignant splenic neoplasms?
Angiosarcoma and lymphoma
What is a rare, large malignant tumor of the spleen with a similar appearance to a hemangioma?
Angiosarcoma
associated with Hodgkin’s and non Hodgkin’s lymphoma, US appearance includes hypoechoic or hyperechoic lesions within spleen, splenomegaly may or may not be present would be what?
Lymphoma
splenic leukemia is a primary malignancy of the (3)?
Bone marrow, lymph nodes, spleen
What would you diagnose if the patient presents with fever, fatigue, weight loss, anemia, and increased WBC?
Splenic leukemia
The most common malignant disease to affect spleen including, Hodgkin, and Non-Hodgkin lymphoma is called?
Splenic lymphoma
hypoechoic, hyperechoic, bull’s eye, target sign with hypoechoic halo is the US appearance of?
Metastases (splenic neoplasm)
What are the three retroperitoneal compartments?
Anterior pararenal, perirenal or perinephric, and posterior pararenal
Which retroperitoneal compartment is located anterior to Gerota’s fascia?
Anterior pararenal
Which compartment contains pancreas, distal cbd, second third and fourth duodenum, and portion of ascending and descending colon?
Anterior pararenal
Which retroperitoneal compartment is enclosed by Gerota’s fascia?
Perirenal or perinephric
which compartment contains kidney, perinephric fat, adrenal glands, and aorta ivc?
Perirenal or perinephric
Which retroperitoneal compartment lies posterior to Gerota’s fascia?
Posterior pararenal space
Which retroperitoneal compartment contains no organs and only fat?
Posterior pararenal space
Kidneys,Adrenalglands,Ureters,Duodenum,Ascending Colon, Descending Colon,Pancreas,Great Vessels,Nerves are the structures of? ❗️
Retroperitoneum
A Chronic inflammatory process that results in fibrous tissue proliferation affecting and encasing aorta, IVC, ureters causing hydronephrosis and affects middle aged men is called? ❗️
Retroperitoneal fibrosis
A hypoechoic smoothly marginated clump or layer in para-aortic region is the US appearance of? ❗️
Retroperitoneal fibrosis
What are common fluid collections in the retroperitoneum? (4)
Abscesses, hematomas, urinomas, lymphoceles
which fluid collection is pus collection?
Abscesses
which fluid collection is blood collection?
Hematoma
which fluid collection is urine collection?
Urinomas
which fluid collection is a lymph fluid collection?
Lymphoceles
What are the fluid collections in the retroperitoneum? (5)
Lymphocele, urinoma, lymphangioma, primary retroperitoneal cysts, and retroperitoneal hemorrhage
what are liposarcoma, leiomjjyosarcoma, rhabdomyosarcoma, myxosarcoma, and fibrosarcoma to the retroperitoneum?
Malignant masses
what are lipoma, leiomyoma, rhabdomyoma, myxoma, and fibroma to the retroperitoneum?
Benign tumors
Enlarged lymph nodes, Present as multiple hypoechoic masses on ultrasound, May displace surrounding structures (called the Mantle Effect is the US appearance of?
Lymphadenopathy
