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Small Parts > Spleen Patho & Lymphatic > Flashcards

Spleen Patho & Lymphatic Flashcards

1
Q

What is wandering spleen?

A

abnormal migration during developmental stages of embryology

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2
Q

Where is the spleen located with wandering spleen?

A

outside of the normal LUQ, somewhere in abd/pelvis

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3
Q

What are the S&S of wandering spleen?

A

asymptomatic, tenderness, possible torsion

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4
Q

What is the sono appearance of wandering spleen?

A

abdominal/pelvic mass, decreased color flow in complete torsioin

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5
Q

What is splenic agenesis?

A

complete embryologic absence of spleen, occurring with addl congenital abnormalities

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6
Q

What is splenic agenesis AKA?

A

asplenia

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7
Q

What are S&S of splenic agenesis?

A

increased risk of infectious disease

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8
Q

What is accessory spleen?

A

collection of splenic tissue separate from the spleen

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9
Q

How many people have splenule(s)?

A

30%

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10
Q

What are S&S of accessory spleen?

A

asymptomatic, palp lump depending on size/location

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11
Q

What is the sono app of accessory spleen?

A

homogenous, iso to spleen, near hilum or sup border

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12
Q

What is splenic atrophy?

A

decrease in splenic tissue volume, technically benign but assoc with wasting diseases

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13
Q

What are S&S of autosplenectomy?

A

asymptomatic, symptoms assoc with causative disease

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14
Q

What is the sono app of splenic atrophy?

A

small spleen or not visualized due to lack of tissue

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15
Q

What are S&S of splenomegaly?

A

infectious patients, metabolic disturbances, hematopoietic disorders

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16
Q

What is the sono app of splenomegaly?

A

changes in size, texture, vascularity, increased volume

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17
Q

What is amyloidosis?

A

excessive production of amyloid proteins in organs, most commonly the spleen

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18
Q

What are S&S of amyloidosis?

A
  • systemic diseases
  • fatigue, weakness
  • joint pain
  • weight loss
  • skin changes
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19
Q

What is the sono app of amyloidosis?

A

enlarged, size depends on amount of build-up

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20
Q

What is Gaucher’s disease?

A

rare metabolic disorder, abnormal accumulation of specific lipid cells in specific organs

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21
Q

Where does Gaucher’s disease mostly affect?

A

liver and spleen

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22
Q

Who is affected by Gaucher’s disease?

A

all ages
50% younger than 8
17% younger than 1

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23
Q

What is the sono app of Gaucher’s disease?

A

splenomegaly, heterogenous spleen, multiple hyperechoic nodules

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24
Q

What is Neimann-Pick disease?

A

metabolic disorder that causes inability to metabolize lipid cells, cells malfunction = apoptosis

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25
Q

Who is affected by Neimann-Pick disease?

A

hepatomegaly, lymphadenopathy, digestive complications

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26
Q

What are S&S of sickle cell anemia?

A
  • fatigue, weakness
  • infections
  • joint pain
  • dizziness
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27
Q

What is the sono app of sickle cell anemia?

A

early: enlarged spleen
late: infarction, fibrosis, atrophy

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28
Q

What is hemolytic anemia?

A

inadequate healthy RBC, decreased lifespan of erythrocytes

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29
Q

What is autoimmune hemolytic anemia?

A

caused by autoimmune response or disease

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30
Q

What do primary and secondary autoimmune hemolytic anemia refer to?

A

primary: without disease
secondary: with disease

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31
Q

What are some causes of autoimmune hemolytic anemia?

A

lymphoma, leukemia, infectious mono

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32
Q

How large are splenules typically?

A

< 1 cm

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33
Q

The spleen should be under ____ cm long

A

12

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34
Q

What percentage of African Americans have sickle cell anemia?

A

8%

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35
Q

What is the sono app of autoimmune hemolytic anemia?

A

splenomegaly

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36
Q

What is polycythemia vera?

A

excess RBC, unknown cause that involves all bone marrow elements

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37
Q

What are S&S of polycythemia vera?

A
  • weakness, fatigue
  • vertigo, tinnitus
  • irritability
  • erythema, painful extremities, contusions
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38
Q

What is polycythemia vera?

A

splenomegaly, infarction, thrombosis

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39
Q

What is thalassemia?

A

inadequate amount of hemoglobin leading to anemia, causes destruction of RBC

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40
Q

What is the sono app of splenic infarction?

A

hypoechoic triangles in the spleen

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41
Q

How do you get thalassemia?

A

inherited

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42
Q

What is the sono app of thalassemia?

A

splenomegaly

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43
Q

What are S&S of mono?

A
  • tenderness/swelling in LUQ
  • swollen lymph nodes
  • fever
  • sore throat
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44
Q

What is FAST exam?

A

focused assessment with sonography for trauma

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45
Q

What needs to be checked during FAST exam?

A
  • 4 quads
  • morisons pouch
  • subdiaphragm
  • liver/splenic capsules
  • bladder/rectal regions
46
Q

What are S&S of trauma?

A

decreased hematocrit and shock

47
Q

What is being evaluated during a trauma exam?

A

looking for hemorrhage or free fluid

48
Q

Who is at increased risk of splenic abscess?

A
  • drug use
  • endocarditis
  • decreased immunity
  • trauma
49
Q

What is the sono app of splenic abscess?

A
  • focal collection of purulent material within parenchyma
  • target appearance
  • splenomegaly
50
Q

What is splenic infarction?

A

death of focal splenic tissue, can affect segment or entire organ

51
Q

What is splenic infarction the most common cause of?

A

focal splenic lesions

52
Q

What causes infarction?

A

occlusion of splenic artery/branches

53
Q

Who is likely to experience splenic infarction?

A

Pts with
- pancreatitis
- leukemia
- lymph disorders
- SCA

54
Q

What is the sono app of infarction?

A

acute: hypoechoic wedge
chronic: echogenic wedge

55
Q

What is splenic hemangioma?

A

proliferation of vascular channels, cluster of blood vessels

56
Q

What is the most common benign splenic tumor?

A

hemangioma

57
Q

What is the sono app of hemangioma?

A
  • isolated
  • heterogenous echogenic mass w multiple sm hypo areas
58
Q

What causes heterogeneity of a hemangioma?

A

areas of cystic changes or hemorrhage

59
Q

What is hemangiosarcoma?

A

rare malignant neoplasm rising from vascular endothelium of spleen

60
Q

What are S&S of hemangiosarcoma?

A
  • weakness, fatigue
  • loss of appetite, weight loss
  • tumor rupture, hemorrhage
61
Q

What is the sono app of hemangiosarcoma?

A

cystic/solid components, hyperechoic

62
Q

What is hamartoma?

A

abnormal mixture of cells and tissues, mainly lymphoid tissues

63
Q

Is hamartoma benign?

A

yes

64
Q

What is the sono app of hamartoma?

A

cystic/solid components, iso/hyper echoic

65
Q

What is lymphangioma?

A

malformation of lymphatics, consists of cystic spaces varying in size, may involve other organs

66
Q

Is lymphangioma benign?

A

yes

67
Q

What are S&S of lymphangioma?

A

asymptomatic and possible tenderness in spleen, variable symptoms depending on addl organs

68
Q

What is the sono app of lymphangioma?

A

multiple cysts, solitary or grouped

69
Q

How does lymphoma affect the spleen?

A

spleen is most commonly involved organ, MC Hodgkin’s & Non-Hodgkin’s

70
Q

What is the sono app of lymphoma in spleen?

A
  • difficult to visualize
  • focal or diffuse lesions
  • possible splenomegaly
71
Q

What is the sono app of AIDS lymphoma?

A

uniform decreased echogenicity or focal hypoechoic lesions

72
Q

How does cancer spread to the spleen?

A

hematogenous spread (through blood supply)

73
Q

How common are mets to the spleen?

A

10th MC site of mets

74
Q

What is the sono app of mets to the spleen?

A
  • multiple or solitary
  • nodularity
  • diffuse lesions
  • target or halo lesions
75
Q

What is the immune system?

A

network of tissues and organs that work together to fight off bacteria, infections, viruses, toxins

76
Q

What is the difference between lymphatic and immune systems?

A

lymphatic system is part of the immune system

77
Q

What is the thymus?

A

Where lymphocytes mature, lymphatic

78
Q

What are the tonsils/adenoids?

A

filters bacteria entering mouth/nose, immune

79
Q

What are lymph nodes?

A

distribute WBCs and filter lymph fluid

80
Q

What does the spleen do?

A

controls amount of RBCs, produces WBCs, lymphatic

81
Q

What does bone marrow do?

A

produces RBCs, platelets, WBCs, lymphatic

82
Q

Where are mucous membranes located?

A

nose, throat, bladder, genitals

83
Q

What is the lymphatic system?

A

Collects and filters excess fluid and returns it back to bloodstream, vital to immune defense

84
Q

Once fluid is absorbed into lymph ducts, it is known as

A

lymph fluid

85
Q

What is the lymphatic system made up of?

A
  • lymph nodes
  • lymphatic vessels
  • lymphatic ducts
  • lymph fluid
86
Q

What are lymph vessels?

A

thin walled vessels that transport lymph fluid around different parts of the body

87
Q

What do afferent lymph vessels do?

A

Bring lymph into lymph node

88
Q

What do efferent lymph vessels do?

A

Drain processed lymph from lymph node and back into lymph vessels

89
Q

What kind of tubes are lymph ducts?

A

Blind ended or non-continuous

90
Q

What direction is lymph fluid transported? How is this ensured?

A

proximally (up the body), valves in the vessels keep fluid moving proximally

91
Q

How is lymph fluid transported?

A

lymph ducts, lymph vessels, lymph nodes, lymph vessels, venous system

92
Q

What is lymph fluid?

A

clear, colorless fluid
contains proteins, minerals, nutrients, damaged cells, cancer cells, foreign particles

93
Q

When is lymph fluid produced?

A

When fluid leaves the capillary bed in tissues due to hydrostatic pressure

94
Q

What percentage of blood volume becomes lymph?

A

~ 10%

95
Q

What are lymph nodes?

A

small bean shaped glands

96
Q

Where are lymph nodes located?

A

Along lymphatic system throughout body
MC seen on US in axilla, groin, submandib region

97
Q

What do lymph nodes contain?

A

WBCs used to fight infection while filtering lymph fluid

98
Q

What is the composition of a lymph node?

A
  • hilum
  • medulla
  • cortex (hypo border)
  • surrounded by fibrous capsule
99
Q

What are lymph nodes located closely called?

A

Lymph node chain

100
Q

How many lymph nodes are in the body? Where are they largest?

A

600 lymph nodes, largest in axilla, inguinal region, submandib

101
Q

What is the sono app of a normal lymph node?

A
  • hypoechoic to surrounding muscle
  • echogenic fatty hilum
  • smooth borders
  • central hilar vascularity
102
Q

How thick should the cortex of a normal lymph node be?

A

3 mm max, measure anterior cortex

103
Q

What is compartment 1A?

A

submental nodes (anteromedial)

104
Q

What is compartment 1B?

A

submandibular nodes (posterolateral)

105
Q

What is compartment 2A? 2B?

A

anterior to IJV, posterior to IJV

106
Q

What is compartment 3?

A

from hyoid bone to cricoid cartilage

107
Q

What is compartment 4?

A

from cricoid cartilage to clavicle

108
Q

What is compartment 5A? 5B?

A

superior to cricoid cartilage, inf to cricoid cartilage

109
Q

What is compartment 6?

A

from hyoid bone to sternal notch

110
Q

What are malignant characteristics of lymph nodes?

A
  • enlarged
  • round
  • mostly hypoechoic
  • loss of hilum
  • heterogenous
  • thickened cortex
  • microcalcs
  • cystic components
  • ill defined borders
  • hypervascular, peripheral flow
111
Q

What should you do when documenting a lymph node in the neck?

A

Document the palp node and take images of bilateral cervical node chain

112
Q

What should you do when documenting a lymph node in the axilla?

A

Document palp node and show other surrounding nodes, # of nodes in axilla

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