Test Ch 15 & 17 Flashcards
Where does the spleen lie in reference to the diaphragm?
The spleen lies between the left hemidiaphragm. The diaphragm can be seen located close to the proximal superolateral surface of the spleen. Posteriorly the diaphragm, left pleura, left lung and ribs are in contact with the spleen
p.422
What region is the spleen located?
Left Hypochondrium
p.422
The spleen lies posterior to what?
Posteriorly, the diaphragm, left pleura, left lung and ribs are in contact with the spleen
p.422
What is the normal width of the spleen?
7 cm
p.424
Lymph nodes emerge from the splenic hilum and course around what vessel?
Splenic Artery
p.424
Why might you get splenomegaly? (what doesn’t belong)
Mild/Moderate: Infection, Portal Hypertension or AIDS. Moderate: Leukemia, Lymphoma, or Infectious Mononucleosis.
Massive: Myelofibrosis
Splenomegaly with Focal Lesions: Lymphomatous Involvement, Metastatic Disease or Hematomas.
Also Collagen-Vascular Disease, Congestion, Extramedullary Hematopoiesis, Hemolytic Anemia, Infection, Neoplasm, Storage Disease or Trauma.
p.431-432
What is an abnormal decrease in platelets?
Thrombocytopenia
p.427
What is the normal sonographic appearance of the spleen?
Homogenous with low level echoes. Similar to liver but more echogenic
p.427
How does the spleen generally appear in the early stages of sickle cell anemia?
Enlarged with marked congestion of red pulp
p.432
What are the functions of the spleen?
Fights Infections Produces lymphocytes & plasma cells Produces RBC's and antibodies Stores iron and metabolites Hematopoiesis p.427
What is the most common reason for splenic infarction?
Emboli that arise from the heart, produced from mural thrombi or from vegetation on the values of the left side of the heart
p.435
The spleen is variable in size and shape, what doesn’t belong?
Shapes: -ovoid with smooth, even borders and a convex superior and concave inferior surface is normal -orange segment -tetrahedral -triangular Size: -8 to 13 cm in length -7cm in width -3 to 4 cm in thickness -decreases slightly in size with age -may depend on nutritional status of the body p.424
Where is the accessory spleen typically located?
At the hilum or inferior border
p.425
Where does the splenic vein course along?
Posteromedial border of the pancreas
p.424
What are some causes of splenic rupture other than trauma?
cavernous hemangioma
What is a primary tumor that metastases to the spleen?
Breast, lung, ovary, stomach, colon, kidney, prostate
p.439
What is the best position to image spleen?
Measured: Longitudinal, from the upper margin to inferior margin at the long axis
Best position to image spleen: Steep right decubitus
p.428
What are the others areas that should be examined when evaluating splenic rupture? (what doesn’t belong)
4 quadrants: Morison's pouch Subdiaphragmatic areas Liver and splenic capsule Bladder and anterior rectal area p.436
When sonographic signs are present in a patient with histoplasmosis, what might you see?
Calcifications
p.433
What is a spleen that has migrated from its original location?
Wandering Spleen
p.425
What is the major function of the spleen?
To filter the peripheral blood, active in the body’s defense against disease
What size does the spleen exceed when it is considered splenomegaly?
13 cm
p.428
Atrophy of the spleen occurs with which of the following?
Normal individuals, Wasting disease, Chronic Hemolytic Anemias, particularly Sickle Cell
p.429
What is the chronic disease of unknown causes that involves bone marrow?
Polycythemia Vera
p.433
What is massive splenomegaly caused by?
Myelofibrosis
p.431
What ligament is the lateral extension of the greater omentum that connects the gastric greater curvature to the splenic hilum?
Gastrosplenic Ligament
p.464
What is the ligament on the left lateral border of lesser sac and separates lesser sac from renal splenic recess?
Splenorenal Ligament
p.
What are the characteristics of inflammatory or malignant ascites?
Fine or coarse internal echoes
Loculation
Unusual distribution, matting or clumping of bowel loops Thickening of interfaces between the fluid & neighboring structures
p.466
What are differential diagnoses of a lesser sac abcess?
Pseudocyst Pancreatic Abscess Gastric Outlet Obstruction Fluid Filled Stomach p.467
What are the most common primary lesions to develop peritoneal metastasis?
I believe this is Ovaries, Colon and Stomach but it is phrased differently in the workbook ( Most common primary sites, not lesions.)
p.472
wkbk p. 152
What are the most common site(s) for an abdominal abcess?
Hepatic recesses and Perihepatic spaces followed by the pelvis
p.
Which is the most emergent abdominal surgery?
Acute appendicitis
p 470
What is an extrahepatic fluid collection that develops from spontaneous rupture of the biliary tree?
Biloma Abscess
p.469
What is a cystic mass between the umbilicus and bladder called?
Urachal Cyst
p.471
What structure lies freely over the intestines, similar to an apron?
Greater Omentum
p.462
Fluid collects in the most _____ areas of the abdomen and pelvis.
dependent
p.463 fig.17-3
What is the double layer of peritoneum extending from the liver to the lesser curvature of the stomach?
Lesser Omentum
What are clinical signs and symptoms of infection?
fever, pain, elevated WBC, swelling, redness
Kidney abcesses are classified by their ____.
Location
What is the smooth membrane that lines the entire abdominal cavity?
Peritoneum
What is a lymophocele defined as?
A collection of fluid that occurs after surgery in the pelvis, Retroperitoneum or recess cavities
What is the superior portion of the subhepatic space called?
Morisons Pouch
p 464
What structure is able to adhere to disease organs?
Greater Omentum
p 462
What is the peritoneal line?
The peritoneal line is seen as a discrete linear echogenicity in the deepest layer of the abdominal wall
p 465-466
What is the most common benign neoplasm of the spleen?
Hamartoma
p 438
What is the spread of infection in the bloodstream?
Sepsis
What is inflammation of the peritoneum called?
Peritonitis
What are the clinical findings of splenic trauma?
LUQ pain or tenderness, left shoulder pain, left flank pain, dizziness hypotension and decreased hemoglobin
What is the most common cause for splenomegaly?
portal hypertension
What is the “wheels with in the wheels” pattern?
Hepatosplenic Candidiasis
What is an increase in white blood cells?
Leukocytosis
What is the storage disease in which fat and proteins are deposited abnormally?
Gauchers Disease
what spectral analysis is used for PW & CW doppler?
Fast Fourier Transform
what spectral analysis is used for color flow doppler?
autocorrelation (slightly less accurate, but faster)
what does bi-directional doppler use?
phase quadrature processing
what are wall filters used for?
To reject “clutter”
what is color flash aka?
ghosting
what do wall filters eliminate?
color in slow flows, they do not change fast flows
