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Abdominal Sonography > Spleen > Flashcards

Spleen Flashcards

0
Q

What is the average adult spleen size?

A

12 cm – longitudinal
8 cm – transverse
4 cm – thickness

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1
Q

What is the largest lymphoid organ that filters damaged cells, micro organisms and particulate matter?

A

The spleen

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2
Q

What are the indications for splenomegaly?

A

Longitudinal measurement greater than 12 cm or if the spleen is inferior to the lower pole of the left kidney

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3
Q

When is the left lobe of the liver seen anterior to the spleen?

A

If the left lobe is enlarged

Third trimester pregnancy

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4
Q

Where are the fundus of the stomach, lesser sac and pancreatic tail located in relation to the spleen?

A

Medial and anterior to the splenic hilum

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5
Q

What is a normal variant that is commonly found with a spleen?

A

Accessory spleen

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6
Q

Where are accessory spleens normally located?

A

Near the splenic hilum with identical echogenicity to the adjacent spleen

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7
Q

What are splenic granulomas?

A

Focal lesions resulting from previous infections

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8
Q

What are the most common causes of splenic granulomas?

A

Histoplasmosis and tuberculosis

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9
Q

What are some splenic calcifications associated with?

A

Splenic artery wall calcifications
Splenic artery aneurysms calcifications
Pneumocystis carinii infection
Splenic infarcts

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10
Q

List examples of cystic lesions found in the spleen.

A 
Autosomal dominant polycystic disease
Hydatid cysts
Epidermoid cysts
Liquefied infarcts or hematomas
Pancreatic pseudocysts
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11
Q

What are epidermoid cysts of the spleen?

A

True cysts lined by squamous epithelium

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12
Q

What are the most common benign primary neoplasms of the spleen?

A

Hemangiomas

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13
Q

What is the most common metastases to the spleen?

A

Malignant melanoma

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14
Q

How do you metastatic lesions commonly appear in the spleen on ultrasound?

A

Hypoechoic, but the appearance may vary

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15
Q

Splenic infarct are commonly associated with what disease process?

A

Bacterial endocarditis

Splenic artery aneurysms

16
Q

How do you splenic infarcts appear on ultrasound?

A

Wedge shaped hypoechoic lesion

17
Q

What are splenic abscesses a result of?

A

Sepsis due to endocarditis, dental infections or urosepsis

18
Q

How do splenic abscesses appear sonagraphically?

A

Complex cystic lesions

Presence of gas may produce echogenic foci with an associated reverberation artifact

19
Q

What happens to the spleen in sickle cell disease?

A

Spleen enlarges at the end of the first year of life
Spleen remains enlarged because of splenic sequestration
Over time, the spleen becomes fibrotic and shrinks (autosplenectomy)

20
Q

What are different mechanisms that cause splenomegaly?

A 
Congestive
Immune response hypertrophy
RBC destruction hypertrophy
Myeloproliferative
Infiltrative
Neoplastic
21
Q

What is the most common mechanism for splenomegaly?

A

Congestive

Portal hypertension and splenic vein thrombosis

22
Q

What is polycythemia vera?

A

Blood disorder resulting in uncontrolled RBC production causing hyperviscosity and hypercoagulation

23
Q

How does a splenic artery aneurysm appear on x-ray?

A

Calcified circle seen in the left upper quadrant

24
Q

How does a splenic artery aneurysm appear on ultrasound?

A

Cystic mass

If calcified, a hyperechoic shadowing foci near the splenic hilum

25
Q

What are heterotaxy syndromes?

A

Spectrum of situs disorders with a wide range of findings

26
Q

What is situs solitus?

A

Normal asymmetrical arrangement of anatomy

27
Q

What is situs inversus?

A

Mirror image of situs solitus

28
Q

What is situs ambiguous or heterotaxia?

A

Disruption in the development of normal asymmetric arrangement abdominal organs and vessels

29
Q

What are the two classifications of heterotaxy?

A

Polysplenia and asplenia

30
Q

What is polysplenia associated with?

A 
Multiple LUQ spleens
Biliary atresia/absent gallbladder
Intestinal malrotation
Azygous continuation of interrupted IVC
Cardiac defects
31
Q

What is asplenia associated with?

A 
Absent spleen
Midline liver and gallbladder
Intestinal malrotation
Reversed positions of aorta and IVC
Cardiac defects
32
Q

When do splenic subcapsular and intraparenchymal hematomas occur?

A

Trauma where the capsule remains intact

33
Q

When do perisplenic or intraperitoneal hematomas occur?

A

Splenic trauma when the capsule ruptures

34
Q

How does intraperitoneal blood appear on ultrasound?

A

Depends on the age, amount and physical state of the clot

35
Q

What is hematocrit?

A

Volume of red blood cells found in 100ml of blood

36
Q

What is posttraumatic splenosis?

A

Ectopic spleen that occurs in the patient with a history of splenic rupture or surgery where splenic cells implant throughout the peritoneal cavity (autotransplantation)

Abdominal Sonography (12 decks)

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