Spleen Flashcards
What is Grey Turner’s Sign
discoloration of the glands due to the necrosis of blood vessels which results in hemorrhage
_______- is a fluid collection that develops a well defined wall in response to enzymes
Pseudocyst
what is the most common spleen pathology?
Splenomegaly
T or F
Is the most common cause of LUQ mass splenomegaly
True
diagn. these symptoms
LUQ pain and fullness
splenomegaly
what are the causes of splenomegaly?
- congestion
- Infection
- neoplasm
- hemolytic anemia
- storage disease
- trauma
diag. these sonographic findings
- measures larger than 8-13 x7-8 x 6 cm
- Tip covers the lower pole of the kidney
Splenomegaly
in splenomegaly the tip of the spleen covers the lower pole of the ________
kidney
What is the imagin method of choice for splenic trauma
CT
what are the 5 most common causes of trauma to the spleen? (
- MVA
- Sports Injuries
- Gunshot wounds
- Stab wounds
- Physical abuse
what are the trama symptom? (4)
- LUQ Pain
- Left shoulder pain
- Left flank pain
- dizziness
diag. these clinical findings.
- LUQ tenderness
- Hypotension
- decreased hemoglobin
Trauma
Diag. these sono findings.
- splenomegaly
- irregular splenic border
- hematoma
- contusion (inhomogeneity)
- subcapular and pericapsular fluid collection
- LT pleural effusion
Trauma
what are the 6 sonographic findings for trauma
- splenomegaly
- irregular splenic border
- hematoma
- contusion (inhomogeneity)
- subcapular and pericapsular fluid collection
- LT pleural effusion
what is the most common cause of focal splenic lesions?
Infarct
Infarct is caused by ______ of the splenic artery or any of its branches
occlusion
the result of _______ almost always arise in the heart.
emboli
name symptoms of infarct
- acute pain- sudden epidose of infarction
- asymptomatic-old infarcts
name sono. findings of infarct?
- early infarcts may be hypoechoic or isoechoic
- older infarct appear hypoechoic or hyperechoic depending on the amount of fibrosis and organized clot
name the two classifications of splenic cyst
true or primary cyst
secondary or pseudocyst
primary cyst are more common in ?
females
primary cyst are associated with what disease?
polycystic kidney disease
Secondary cyst are usually associated with_______
trauma
T or F
patients with secondary cyst always recall the trauma and are diagnosed quickly?
False
the patient may not recall the trauma, and may go undiagnosed for years
Secondary cyst are also caused by?
infection, parasite infarction
what is the only parasite that forms splenic cyst?
echinococcus
Echinococcus is the only parasite that forms splenic cyst. Appears as an _______lesion with possible ________ cyst and calcification or as a _______ mass with fine internal echoes
anechoic, daughter, solid
sono findings
- hypoechoic or anechoic lesion
- well defined walls
- through transmission
- may have internal echoes or debris
- hemorrhage may produce a fluid level
cyst
Are calcification common and usually an incidental findings?
Yes
Calcifications generally resultr from ?
healed granulomas and show hyperechoic areas
what is the most common cause of a granuloma
histoplasmosis and TB
T or F
Are abscesses relatively uncommon and usually singular?
True
What is an abscess caused by?
bacteria
A patient with sickle cell anemia, the abscess formation is often cause by_________?
Salmonella
T or F
A damaged spleen provides a good culture medium
True
______ trauma predisposes it to abscess formation
Blunt
Obese patients are also at increased risk for ________ ________.
abscess formation
diag. these symptoms
- vague
- fever
- abdominal pain
- luekocytosis
Abscesses
what is the complications of abscesses?
high mortality rate because diagnosis is often delayed
Sono findings
- cystic, solid or complex
- in early stages they may appear hyperechoic and may produce posterior shadowing from gas forming organisms
- over time they tend to liuefy and may even calcify
abscess
what is the treatment for abscess
- IV antibiotic therapy
- percutaneous drainage with US or CT guidance
What is the 2 rare benign primary neoplasm?
hamartoma, cavernous hemangioma
hamartoma has _____ and ______ components
solid and cystic(hyperechoic & well defined)
T of F
Hamartoma symptoms are RUQ pain
False
hamartoma has NO symptoms
what disease may lead to anemia and infection
cavernous hemangioma
cavernous hemangioma has a chance of _______ ________.
splenic rupture
Cavernous hemangioma has no symptoms unless the spleen ________
enlarges
Diag. sono findings
- large inhomogeneous mass with multiple, small hypoechoic areas
- mixed appearences
- may see infarction with coagulated blood
cavernous hemangioma
what is the rare malignant primary neoplasm
angiosarcoma
angiosarcoma arises from the ______ _______
vascular epithelium
what disease presents sonographically as a complex or solid mass?
angiosarcoma
The spleen is often involved in cases of _______or ________
lymphoma or leukemia
what is the most common malignant disease of the spleen?
lymphoma
T or F
Malignant disease of the spleen are difficult to detect?
True
Lymphoma is classified as _____ or ________
Hodgkin or non-hodgkin lymphoma
which is not easily managed and more common?
Non- Hodgkin or Hodgkin
Non Hodgkin
what is the microscopic difference between hodgkin or non-hodgkin?
- can be treated and carries a high recovery rate
- presence of Reed-sternberg cells indicates Hodgkin
what are the most common primary of metastases?
breast
lung
skin
ovary
what type of aneurysm is rare but life threatening?
splenic artery aneurysm
what is the clinical symptoms of splenic artery aneurysm?
- usually asymptomatic
- discomfort in LUQ, shoulder pain, nausea/vomiting
what are the predisposing factors of splenic artery aneurysm?
aterosclerosis infective emboli infections trauma portal hypertension females of child bearing age
what are the sonographic appearence of splenic artery aneurysn?
- cystic mass in area of splenic artery
- To rule out-trace artery from bifurcation at celiac axis to hilum of spleen or area where cystic mass is seen
- doppler may be used to determine artery or pseudocyst
- walls may be calicfied and will be visualized in LUQ in radiograph, if calcified difficult to diagnose aneurysm
What is angiosarcoma?
a rare malignant tumor of the spleen that is derived from blood vessels
What is Epstein-Barr infection?
a herpes virus that can lead to infectious mononucleous
Erythropoiesis
the process of making RBCs
What is red pulp
specialized tissue within the spleen that performs its phagocytic function
What is white pulp?
specialized lymphatic tissue within the spleen
T/F: spleen is retroperitoneal?
False: spleen is intraperitoneal
What is the largest lymphatic organ?
spleen
When does the spleen begin to develop in gestation?
5th week
What is the spleen responsible for in the fetus?
erthryopoiesis
In childhood what is the spleen used for?
protection against deadly infection
What does the spleen do in adults?
produces lymphocytes and monocytes
What is extramedulary hematopoiesis?
when the spleen’s hematopoietic function can return in cases of severe anemia
What do phagocytes do?
engulf and destroy pathogens
What is culling?
spleen removes irregular cells from the bloodstream and retains them
What is pitting?
cleaning red blood cells of unwanted material
The splenic artery branches off of?
celiac trunk
IS the splenic artery ant/sup or post/inf to the splenic vein at the hilum?
ant/sup
T/F: The spleen is best visualized with deep inspiration?
True!!
How does the spleen compare to the liver sonographically?
isoechoic to liver, or slightly less echogenic
What is the most common cause of splenomegaly?
portal hypertension
What is the most common benign tumor of the spleen?
hemangioma
Small echogenic foci (may shadow)of the spleen most often represent
granulomas
All of the following are splenic functions except:
a. storage of iron
b. defense against disease
c. blood reservoir
d. destruction of phagocytic cells
D. destruction of phagocytic cells
Estein-Barr infection is best described as
a herpesvirus that can lead to infectious mononucleousis in children
What systemic disease results in the development of granulomas within the spleen and throughout the body?
Sarcoidosis
T/F: the spleen has a convex inferior margin and a concave superior border
False
The splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein?
superior mesenteric vein
