Test 5 Adrenal/Spleen

Question 1

What is a function of the adrenal medulla ?

Answer 1

Synthesizing epinephrine

Question 2

What is hyperadrenalism associated with?

Answer 2

Associated with “Moon face” and “buffalo hump”

Question 3

Which disease is associated with the hypofunction of the adrenal glands?

Answer 3

Addisons

Question 4

What is the primary mineralcorticoid?

Answer 4

Aldosterone

Question 5

Where are the glucocorticoids produced?

Answer 5

Zona fasciculate

Question 6

Written

The adrenal glands have an abundant arterial supply. Other than the adrenal artery branch off of the aorta, list the other two vessels that have an adrenal artery branch:

Answer 6

Renal artery and the inferior phrenic artery

Question 7

True/False:
The adrenal glands have a double venous drainage system

Answer 7

False

Question 8

Which portion of the adrenal gland is responsible for the production of sex hormones?

Answer 8

Zona reticularis

Question 9

True/False
The left adrenal gland lies posterior to the pancreatic tail stomach and lesser sac

Answer 9

True

Question 10

True/False
While in utero, the medulla aids the placenta in synthesizing estrogen

Answer 10

False

Question 11

What are three indications for an exam of the adrenal glands?

Answer 11

-Virilism
-Adrenal mass on CT
-Hypertension

(Note: NOT “increased hematocrit”)

Question 12

True/False
The adrenal glands are positioned at the anteromedial aspect of the kidneys and the two organs are surrounded by Gerotas fascia.

Answer 12

True

Question 13

Which age group of patients have the largest adrenal glands when compared to the kidney?

Answer 13

Infants

Question 14

True/False
The adrenal glands are peritoneal in location

Answer 14

False

Question 15

True/False
The adrenal gland may also be referred to as the supernumerary gland

Answer 15

False

Question 16

What phrase can be used to describe the normal sonographic appearance of the splenic parenchyma?

Answer 16

Homogeneous with mid- to low-level echogenicity.

Question 17

What are three organs that are retroperitoneal?

Answer 17

-psoas muscle
-Aorta
-Kidney

(Note: NOT Spleen)

Question 18

What is the most common splenic variant?

Answer 18

Splenunculus

Question 19

Which splenic vasculature does NOT anastomose?

Answer 19

Intrasplenic arteries do not anastomose

(Veins do anastomose)

Question 20

What is the process that removes circulating erythrocytes that are defective?

Answer 20

Culling

Question 21

The tail of the pancreas is ______ to the spleen

Answer 21

Medial

Question 22

The diaphragm is _________ to the spleen

Answer 22

Posterior, lateral, and superior

Question 23

The adrenal gland is ________ to the spleen

Answer 23

Medial

Question 24

Where are the cords of Billroth located within in the spleen?

Answer 24

Red pulp

Question 25

The splenic vein joins the (blank) to form the (blank) at the confluence.

Answer 25

Splenic vein joins the superior mesenteric vein to form the portal vein at the confluence.

Question 26

This rare congenital disorder occurs in females more than males. It may have other sonographic findings of horseshoe kidneys and an abnormal IVC location.

Answer 26

Asplenia

Question 27

True/False Accessory spleens are always seen at the hilum of the spleen.

Answer 27

False

Question 28

What is something that someone with a wondering spleen would be more prone to?

Answer 28

Torsion

Question 29

True/False: One of the functions of the spleen is to act as a reservoir for blood that can be released back into the bloodstream if needed emergently

Answer 29

True

Question 30

What are three things that could potentially result in erythropenia?

Answer 30

-Hodgkin disease -Acute blood loss -Pernicious anemia (Note: NOT polycythemia vera)

Question 31

True/False: The spleen helps aid in the immune system by producing plasma cells important for the formation of antibodies

Answer 31

True

Question 32

True/False The spleen acts as the primary source of erythropoiesis throughout a persons lifecycle.

Answer 32

False

Question 33

**written** Other than cirrhosis, list two different causes of congestive splenomegaly. Make sure that your answer is not too broad. You do not need to explain your answer but it does need to be specific. There is a difference in trauma and splenic trauma.

Answer 33

1. Portal hypertension 2. Cystic fibrosis

Question 34

True/False: The spleen is predominantly located in the left hyperchondriac region

Answer 34

False

Question 35

**written** Your patient has advanced liver cirrhosis. List two sonographic LUQ findings (you cannot use splenomegaly) and list two physical signs the patient may exhibit

Answer 35

Sonographic findings: - free fluid - more vascularity in the spleen Physical findings: - distended abdomen - jaundice

Question 36

Term for decreased white blood cell count, possibly the result of viral infection or leukemia

Answer 36

Leukopenia

Question 37

Which type of blood cell contains hemoglobin?

Answer 37

Erythrocyte/RBC

Question 38

What is the normal echogenicity of the spleen?

Answer 38

Isoechoic to the liver

Question 39

The spleen receives its blood supply from the splenic artery which branches off of the _______

Answer 39

Celiac axis

Question 40

Name for the process of red blood cell production:

Answer 40

Erythropoiesis

Question 41

If while scanning you locate the spleen in the left lower quadrant, what is the most likely explanation?

Answer 41

Wandering spleen

Question 42

Most common abnormality of the spleen demonstrated in sonography:

Answer 42

Splenomegaly

Question 43

What is the most common cause of splenomegaly?

Answer 43

Portal hypertension

Question 44

Term for the laboratory value of the percentage of blood volume made up of red blood cells

Answer 44

Hematocrit

Question 45

term for the process used by the red pulp to destroy old red blood cells

Answer 45

Phagocytosis

Question 46

Term for tissue death caused by an interruption of the blood supply

Answer 46

Infarct

Question 47

While scanning the spleen, you notice multiple enlarged tortuous vessels in the splenic hilum. Color Doppler confirms that they are vascular in nature. Dilated vessels are also noted within the splenic parenchyma. What is the most likely cause of these findings?

Answer 47

Portal hypertension with collateral varices

Question 48

Primary function of red pulp:

Answer 48

Filtration

Question 49

Term for elevated white blood cell count, usually due to infection

Answer 49

Leukocytosis

Question 50

While scanning the spleen, you notice a small round mass that appears to be separate from the spleen in the region of the splenic hilum. The echotexture of the mass is similar to that of the spleen. What is the most likely diagnosis?

Answer 50

Accessory spleen

Question 51

The spleen is considered grossly enlarged when its length is greater than what measurement?

Answer 51

20 cm

Question 52

A wandering spleen at an increased risk of acquiring which of the following conditions?

Answer 52

Torsion and infarction

Question 53

Hormone secreted by the pituitary gland that causes the adrenal gland to produce and release corticosteroids

Answer 53

ACTH

Question 54

What is the most common appearance of the adrenal adenoma

Answer 54

Small, round, homogeneous hypoechoic lesions

Question 55

Inner portion of the adrenal gland that secretes the catecholamines epinephrine and norepinephrine

Answer 55

Adrenal medulla

Question 56

Outer parenchyma of the adrenal gland that secretes corticoids, including cortisol and aldosterone

Answer 56

Adrenal cortex

Question 57

The adrenal gland is really two glands in one organ. What is the adrenal gland composed of?

Answer 57

Two endocrine glands