Spleen Flashcards
the _____ is the largest single mass of lymphoid tissue in the body
spleen; part of the reticuloendothelial system and synthesizes blood proteins
the spleen is an ______ organ covered with peritoneum over its entire extent
intraperitoneal
the ligament that attaches the spleen to the stomach and the kidney is called the _____
splenorenal ligament
the _____ ligament is significant in that it is composed of the two layers of the dorsal mesentery that separate the lesser sac posteriorly from the greater sac anteriorly
gasrosplenic
normal measurement of the spleen should be ______ in length, and ______ in width, and ______ in thickness
8-13cm; 7cm; 3-4cm; decreases slightly with age
the spleen arteries are subject to ______ because of adequate anastomoses between the vessels are lacking
infarction
the lymph vessels emerge from the splenic hilum, pass through other lymph nodes along the course of the splenic artery, and drain into the _____ nodes
celiac
the spleen is held in place by what ligaments?
lienorenal, gastrosplenic, and phreocolic
the term ______ describes a spleen that has migrated from its normal location in the LUQ
wandering spleen; results when the dorsal mesentery fails to fuse with the posterior peritoneum without supporting ligaments of the spleen
_____ syndromes are associated complex cardiac malformations, bronchopulmonary abnormalities, or visceral heterotaxis (anomalous placement of organs or major blood vessels, including a horizontal liver, malrotation of the gut, and interruption of the IVC with azygos continuation)
asplenic or polysplenic
the normal arrangement of asymmetrical body parts is called _____
situs solitus; the mirror image conditions is called situs inversus; the term situs ambiguous is used when the anatomy falls in between theses two conditions
patients with _____ of the spleen have major problems with serious infection, as their immune response is absent
agenesis
an _____ spleen, or splenunculus, is a more common congenital anomaly, it appears as a homogeneous pattern similar to that of the spleen; usually found in the hilum or inferior border
accessory; results from a failure of fusion of separate splenic masses forming on the dorsal mesogastrium
within the lobules of the spleen are tissues called _____
pulp; red pulp and white pulp
_____ pulp is distributed throughout the spleen in tiny islands; this tissue consists of splenic nodules, which are similar to those found in lymph nodes and contain large number of lymphocytes
white; consists of the malpighian corpuscles, small nodular masses of lymphoid tissue attached to the smaller arterial branches
_____ pulp fills the remaining spaces of the lobules and surrounds the venous sinuses; contain relatively large numbers of red blood cells, which are responsible for its color, along with many lymphocytes and macrophages
red; consists of splenic sinuses alternating with splenic cords
_____ of erythrocytes and the breakdown of hemoglobin occur throughout the entire reticuloendothelial system, but roughly half the catabolic activity is localized in the normal spleen
phagocytosis
in anomalies such as the hemolytic anemias, the splenic phagocytes become engorged with _____ when erythrocyte destruction is accelerated
hemosiderin
_____ is the process of removing the nuclei from the red blood cells
pitting
_____ is the process by which the spleen removes abnormal red blood cells
culling; the spleen also pools platelets in large numbers
sequestration of leukocytes in the enlarged spleen may produce _____
leukopenia
_____ indicates the percentage of RBC’s per volume of blood; abnormally low indicate hemorrhage or internal bleeding within the body
hematocrit
the test for ______ indicates the presences of bacteria within the body; the term sepsis indicates bacteria in the bloodstream
bacteremia
an increase in the number of white cells (_____) present in the blood is usually a typical finding in infection
leukocytosis
abnormal decrease in white blood corpuscles (_____) may be secondary to certain medications or bone marrow disorder
leukopenia
_____ is an abnormal disease in platelets, which may be due to internal hemorrhage
thrombocytopenia
_____ hypoechogenic structures in the area of the splenic hilum may indicate portal hypertension with collateral vessels or enlarged lymph nodes
increased
advanced atrophy is sometimes referred to as _____
autosplenectomy
in acute _____, active hyperemia accompanies the reaction in the moderately enlarged spleen ; in chronic, diffuse enlargement of the spleen occurs
splenic congestion; most common cause is cirrhosis
in systemic diseases leading to _____, the spleen is the most frequent involved organ
amyloidosis; nodular or diffuse; in nodular amyloid is found in the walls of the sheathed arteries and within the follicles, but not in red pulp; in diffuse the follicles are not involved, the red pulp is prominently involved, and the spleen is usually enlarged
with _____ there is bone pain and changes in the skin pigmentation; splenomegaly, diffuse inhomogeneity, and multiple splenic nodules
Gaucher’s disease
_____ disease is a rapidly progressing fatal disease that predominantly affects female infants; hepatomegaly, digestive disturbance, and lymphadenopathy
niemann-pick
_____ abnormalities include sickle cell, hereditary spherocytosis, hemolytic anemia, chronic anemia, polycythemia vera, thalassemia, and myeloproliferative disorders
erythropoietic; produce an isoechoic pattern
in the early stages _____ the spleen is enlarged with marked congestion of the red pulp; later it undergoes progressive infarction and fibrosis and decreases in size
sickle cell anemia; may develop subacute hemorrhage that appears as a hyopechoic area in the periphery of the spleen
in congenital or hereditary _____, an intrinsic abnormality of the red cells give rise to erythrocytes that are small and spheroid rather than normal, flattened, biconcave disks
spherocytosis; the spleen destroys sphercytes selectively; the results are bone marrow of spherocytosis and increased destruction of these cells
_____ is the general term applied to anemia linked to decreased life of the erythrocytes; when the rate of destruction is greater than the bone marrow can compensate for
hemolytic anemia
_____ hemolytic anemia can occur in its primary form without underlying disease, or it may be seen as a secondary disorder in patients already suffering from some disorder of this system
autoimmune
______ is an excess of red blood cells; increase in red blood cell mass and hemoglobin concentration; vertigo, redness and pain in extremities, and blue-and-black spots
polycythemia; polycythemia vera is a chronic disease of unknown cause that involves all the bone marrow elements
______ hemoglobinopathy differs from the others in that an abnormal molecular form of hemoglobin is not present; instead suppression of synthesis of beta or alpha polypeptide chains occurs resulting in deficient synthesis of normal hemoglobin
thalassemia; vary large spleen
______ abnormalities include reactive hyperplasia resulting from acute or chronic infection
granulocytopoietic; splenomegaly with a diffusely hypoechoic pattern; histoplasmosis and tuberculosis are the most common causes
______ is a disease characterized by reticuloendothelial hyperactivity and varying degrees of lipid storage in phagocytes are included; spleen appears isoechoic
reticuloendotheliosis
in _____ disease, sometimes called nonlipid reticuloendotheliosis, proliferation or reticuloendothelial cells occurs in all tissues, but particularly in the splenic lymph nodes and bone marrow
letterer- siwe; found in children younger than 2 years; hepatosplenomegaly, fever, and pulmonary involvement
______ disease is benign and chronic, in spite of many feature similar to those of Letterer-siwe disease, it usually affects children older than 2
Hand-Schuller-Christian; chronic course, diabetes, and moderate hepatosplenomegaly
in majority of patients with splenic _____ the infection is spread from distant foci in the abdomen, or inflammatory process extends directly from adjacent organs
abscess; splenomegaly; irregular, ill defined borders; may have internal septa
splenic ______ if acute shows wedge-shaped hypoechoic area; chronic shows wedge-shaped echogenic area (base points to periphery); look for splenic atrophy
infarction; related to primary diagnosis; commonly a result from emboli that arises in the heart
patients with mycobacterial _____ show tiny, diffuse echogenic foci throughout the spleen
infection
in patients with AIDS the most common finding is _____
splenomegaly; also could have focal lesions
blunt trauma has 2 outcomes; if the capsule is intact, the outcome may be interparenchymal or subcapsular _____, if the capsule ruptures, a focal or free intraperitoneal hematoma may form
hematoma
most splenic _____ are considered secondary caused by trauma, infection, or infarction
cysts; echinococcus is the only parasitic splenic cyst; look for tissue compression
hematoma may be solitary or multiple and is considered well-defined but not encapsulated; consists of _____ tissue or a combination of sinuses and structures equivalent to pulp cords of normal splenic tissue
lymphoid; has both solid and cystic components; hyperechoic
_____ is usually an isolated inhomogeneous echogenic mass with multiple small hypoechoic areas; complications occur when the tumor increases in size to cause a splenic rupture
cavernous hemangioma; infarction with coagulated blood or fibrin in the cavities may be seen
_____ is a benign malformation of the lymphatics, consisting of endothelium-lined cystic space
cystic lymphangioma; multicystic appearance
_____ is a rare malignant neoplasm arising from the vascular endothelium of the spleen; mixed cystic patters resemble that of a cavernous hemangioma
hemangiosarcoma
the spleen is commonly involved in _____; four patterns 1) diffuse involvement 2) focal small nodular lesions 3) focal large nodular lesions, and 4) bulky disease
lymphoma
metastases are the result of a _____ spread from another primary site; may originate in the breast, lung, ovary, stomach, colon, kidney, or prostate or from melanoma
hematogenous
