Spleen

Question 0

What system does the spleen belong to?

Answer 0

Reticuloendothelial system

*the spleen is the largest of lymphoid tissue

Question 1

Where is the spleen located?

Answer 1

Intraperitoneal
LUQ
Between stomach and diaphragm

Question 2

Histology of the normal spleen

Answer 2

Enclosed by a fibroelastic capsule
Has trabeculae which divide the spleen into compartments filled with
White and red pulp

Question 3

What are the measurements of the spleen?

Answer 3

12 cm long
8 cm trv
4 cm AP

Question 4

What is a useful landmark in identifying the spleen and splenic hilum?

Answer 4

Splenic vein

Question 5

Which ligament attaches the spleen to the dorsal body wall?

Answer 5

Lienorenal ligament

Question 6

Which ligament attaches spleen to the stomach?

Answer 6

Gastroluenal ligament

Question 7

Which ligament supports the spleen inferiorly?

Answer 7

Phreniccocolic ligament

Question 8

What are the functions of the spleen?

Answer 8

Production of lymphocytes
RBC production
Erythrocyte destruction
Hemoglobin breakdown
Bile pigment formation
Filtration and trapping of foreign particles 
Bacteria and virus destruction
Storage of iron

Question 9

What is Aplasia?

Answer 9

Absent spleen

Question 10

What is splenoptosis?

Answer 10

Downward displacement of the spleen

Question 11

What are other names for supernumerary spleen?

Answer 11

Accessory spleen
Splenunculus
Polysplenia

Question 12

What is posttraumatic splenosis?

Answer 12

Following splenic rupture, splenic cells may implant throughout the peritoneal cavity and increase in size, resulting in ectopic spleens

Question 13

What causes splenomegaly?

Answer 13

Increased work load
Portal HTN 
Budd Chiari syndrome
Cirrhosis 
Hepatitis
CHF
Cystic Fibrosis

Question 14

What lab tests are used to evaluate spleen?

Answer 14

Bone marrow test for cancer
Blood protein can r/o multiple myeloma to malaria
Uric acid and ALP to determine presence of leukemia or lymphomas
LFT

Question 15

What are the dilated sinusoids in an enlarged spleen called?

Answer 15

Reflective channels

Question 16

What causes a spleen to rupture?

Answer 16

Blunt trauma
Crushing injury
Spontaneous rupture
Infectious mononucleosis 
Malaria
Typhoid fever

Question 17

Clinical findings of a ruptured spleen

Answer 17

Abdominal pain
Rigid abdomen
No bowel movement
Slow leak may be asymptomatic yet cause hypovolemic shock 
Left pleural effusion

Question 18

Lab findings of splenic rupture

Answer 18

Decreased hematocrit

Low HTC

Question 19

What kind of splenic cysts are there?

Answer 19

Blood
Parasite cyst (Hydatid)
Congenital cyst: epidermoid
Simple cysts: Polycystic disease
Pseudocyst: acute pancreatitis 
Because of high vascularity, pseudocyst may erode the vessels, causing Pseudoaneurysm and bleeding into pseudocyst

Question 20

Etiology of splenic infarct

Answer 20

Bacterial endocarditis 
Sickle cell anemia
Malignant METS 
Hypotension
Occluded vascular supply

Question 21

Sonographic appearance of splenic infarct

Answer 21

Atypical
Echogenicity related to age of infarct
Hypoechoic in early stages
Hyperechoic as time progresses

Question 22

Splenic abscess etiology

Answer 22

Heterogenously disseminated infections 80%
Bacterial endocarditis
Diverticulitis
Osteomyelitis 
Pelvic infections
Trauma
Surgery
Altered immune system

Question 23

Clinical/labs of splenic abscess

Answer 23

Pain 
Fever
Leukocytosis
Bacteremia and septicemia
Blood culture is necessary

Question 24

Sonographic appearance of splenic abscess

Answer 24

``` Irregular borders Septa Internal echoes Thick wall Pleural effusion Reverberation artifact due to gas ```

Question 25

What is Granulomatous Inflammatory Calcifications?

Answer 25

Focal lesions resulting from previous infections

Question 26

Etiology of Granulomatous Inflammatory Calcifications

Answer 26

``` Tuberculosis Histoplasmosis Sarcoidosis Splenic artery Calcifications Reactive hyperplasia Secondary to previous infections Sickle cell disease ```

Question 27

Which the most common benign splenic tumor?

Answer 27

Hemangioma

Question 28

Benign splenic Tumors

Answer 28

``` Hemangioma Fibroma Lymphangioma Chondroma Plamocytoma Sarcoma ```

Question 29

Which is the most common tumor METS to the spleen?

Answer 29

Malignant melanoma

Question 30

Sonographic findings of splenic mets

Answer 30

Discrete solid mass usually hypoechoic but may have mixed echogenicity May be multiple May be complex due to cystic necrosis