spleen/abd wall study guide

Question 1

uniform, homogeneous mid to low echo patterns. Texture more echogenic than liver

Answer 1

Normal echotexture

Question 2

Left kindey lies inferior and medial

Answer 2

Describe the location of the spleen in relationship to the left kidney

Question 3

Splenorenal

Phrenicocolic,

Answer 3

2 ligaments that help anchor the spleen

Question 4

Breakdown of hemoglobin, Formation of antibodies and immunity, red cell production, blood reservoir

Answer 4

Common functions of spleen

Question 5

splenic hilum (or tail of pancreas) 1 cm and also have an echo texture.

Answer 5

Common location of accessory spleen

Question 6

reticuloendothelial Considered the largest lymphatic organ production of lymphocytes and plasma cells, antibodies, storage of iron and other metababolites

Answer 6

What system is the spleen part of

Question 7

bright echogenic lesion with or without shadowing Associated with hepatic and pulmonary calcifications. Curvilinear calcification seen in the splenic artery or a splenic artery aneurysm are seen commonly at the splenic hilum Splenic calcifications are associated with pneumocystic carinii Calcification of splenic infarcts can occur in sickle cell disease

Answer 7

Sonographic signs of histoplasmosis

Question 8

tumor (benign and malignant) infarction, abcess and cyst

Answer 8

Major focal defects

Question 9

most common: cavernous hemangioma, hamartoma, cystic lymphangioma Splenomegaly is the first indication of an abnormality. Most of these tumors appear isoechoic compared with the normal splenic parenchyma

Answer 9

Common benign neoplasms

Question 10

hemangiosarcoma, lymphoma, Arises from the vascular endothelium Sonographically complex or solid

Lymphoma- Hodgkin and non-Hodgkin

Differentiation is determined by the presence of Reed-Sternberg cells

Hodgkin has these and the cure rate is very high

Non-Hodgkin is not as easily managed and is more common than Hodgkin lymphoma

Answer 10

Name of the malignant neoplasm

Question 11

associated with left pleural effusion, happens in splenic trauma, 2 types: peri splenic and sub capsular

Answer 11

Splenic rupture

Question 12

dorsal mesentery fails to fuse with peritoneum, no supporting ligaments, presents as mass, intermittent pain, belongs in LUQ pain

Answer 12

Wandering spleen/ ectopic spleen

Question 13

size adult 8-13 cm Length, 7cm diameter, less 5 cm thickness, varies with age, decrease as you get older. splenomegaly : more than 13cm most common manifestation You will feel LUQ pain

Answer 13

Size of spleen/splenomegaly

Question 14

cause liver to get small, spleen gets bigger congestive splenomegaly: portal hypertension look at liver as well if spleens enlarged

Answer 14

Describe the effect of cirrhosis to the spleen

Question 15

}Chronic disease of unknown cause that involves all bone marrow elements
}Characterized by an increase in red blood cell mass and hemoglobin concentration
}Clinical symptoms
◦Weakness and fatigue
◦Vertigo
◦Tinnitus
◦Irritability
◦Splenomegaly
◦Flushing of the face
◦Redness and pain in the extremities
◦Blue-and-black spots

Answer 15

Polycythemia vera

Question 16

◦Spleen is variably enlarged, rather firm, and blue-red.
Infarctions and thromboses are common

Answer 16

Polycythemia vera
}Sonographic findings

Question 17

}Metastases are the result of a hematogenous spread from another primary site.(spread by the blood)
}The spleen is the tenth most common site of metastases, which may originate from the breast, lung, ovary, stomach, colon, kidney, or prostate, as well as from melanoma.
Metastatic tumors may be microscopic, causing no symptoms

Answer 17

Primary tumors that may metastasize to the spleen

Question 18

Active in blood formation during the initial part of fetal life (Hematopoiesis)/ (erythropoiesis) RBC

Answer 18

Hematopoeisis

Question 19

lesser sac

subphrenic

subcapsular

liver

biloma

kidney

general abdominal

appendicel

Answer 19

Sites for abscess formations

Question 20

}Look for findings in the ascitic fluid that would suggest an inflammatory or malignant process
◦Fine or coarse internal echoes
◦Loculation
◦Unusual distribution, matting, or clumping of bowel loops
◦Thickening of interfaces between the fluid and neighboring structures

Answer 20

Malignant/inflammatory ascites

Question 21

}Are extrahepatic loculated collections of bile.
}May develop because of iatrogenic, traumatic, or spontaneous rupture of the biliary tree

Answer 21

Biloma

Question 22

}Incomplete regression of the urachus during development
◦Apex of the bladder continuous with the allantois becomes obliterated and forms a fibrous core, the urachus.
Urachus persists throughout life as a ligament that runs from the apex of the bladder to the umbilicus and is called the median umbilical ligament

Answer 22

Urachal cyst

Question 23

Cystic mass is found between the umbilicus and the bladder; the mass may be small or giant, multiseptated, and extend into the upper abdomen

Answer 23

Urachel cyst
}Sonographic findings

Question 24

◦Cystic with weak internal echoes or a fluid-fluid level if clots or debris are not present
◦Sharp margins
Extrahepatic biloma abscesses are usually crescentric, surrounding and compressing structures with which they come in contact

Answer 24

Biloma Sonographic findings

Question 25

an apron like fold of peritoneum that hands from the greater curvature of the stomach

Answer 25

Greater omentum

Question 26

Patient may have a fever of unknown origin or tenderness and swelling from a postoperative procedure

Answer 26

Clinical symptoms of infection

Question 27

Collection of fluid that occurs after surgery in the pelvis, retroperitoneum, or recess cavities

Answer 27

Lymphoceles

Question 28

◦Generally look like loculated, simple fluid collections.
◦May have a more complex, usually septated, morphology.

Answer 28

Lymphoceles
}Sonographic findings

Question 29

}from loculated ascites is usually possible because the mass effect of a lymphocele that is under tension displaces the surrounding organs.
from other fluid collections is mainly made by aspiration.

Answer 29

Lymphoceles differentiation

Question 30

spread of infection from its usual site via the blood

Answer 30

Sepsis

Question 31

should include pseudocyst, pancreatic abscess, gastric outlet obstruction, and fluid-filled stomach

Answer 31

Differential diagnosis for lesser sac abscess

Question 32

is the serous membrane that forms the lining of the abdominal cavity

It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesothelium supported by a thin layer of connective tissue.

The peritoneum supports the abdominal organs and serves as a conduit for their blood vessels, lymph vessels, and nerves

Answer 32

Peritoneum

Question 33

are similar to those found in the liver and can be distinguished by their intracystic contents such as daughter cysts

Answer 33

Hydatid cyst in the spleen

Question 34

Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida.

hepatosplenic candidiasis may show irregular masses within the spleen, the “wheels within wheels” pattern with the outer wheel representing the ring of fibrosis surrounding the inner echogenic wheel of inflammatory cells

more prevalent in AIDS patients or patientsw with weakened immune systems

Answer 34

Candidiasis

Question 35

◦Demonstration of an abdominal wall defect
◦Presence of bowel loops or mesenteric fat in a lesion
◦Exaggeration of the lesion with strain (Valsalva maneuver)
◦Reducibility of the lesion by gentle pressure

Answer 35

}Sonographic criteria for a hernia

Question 36

}Complications may arise if edema develops or
if the opening constricts to the extent that the protrusion cannot be placed back into position.
}Strangulation (interruption of the blood supply)
of the bowel can also occur in an incarcerated hernia that is not surgically repaired in a timely manner.
}Bowel can become necrotic and require resection.

Answer 36

Abdominal Hernia