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DMST 254 ABD 1 > The Spleen > Flashcards

The Spleen Flashcards

1
Q

What is the bodies Reticuloendothelial system (RE)?

A

All cells and tissues that exhibit phagocytosis

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2
Q

What is the Reticuloendothelial system’s function?

A

One of the body’s major defense systems against infection

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3
Q

RE cells also have other functions besides defense depending on what?

A

The organ in which they are located

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4
Q

What is hematopoiesis?

A

Formation of blood cells

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5
Q

Where does hematopoiesis happen in the fetus? 3

A

Spine, liver and bone marrow

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6
Q

Where does Hematopoiesis happen post Nataly?

A

Bone marrow

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7
Q

What is included in the RE system? 5

A
  1. Brain
  2. Blood
  3. Spleen, liver and thymus
  4. Bone marrow
  5. Lymph nodes
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8
Q

What is the composition of blood?

A

Comprised of RBC’s (erythrocytes), WBCs (leukocytes), platelets (thrombocytes) and plasma

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9
Q

What is the main role of Leukocytes?

A

Immunity

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10
Q

What happens to leukocytes in the presence of a infection?

A

They increase

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11
Q

What happens to decrease WBC? 3

A

Drug/ chemical toxicity, viral infection

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12
Q

There are how many different types of WBCs?

A

5

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13
Q

What is the immune response? 3

A
  1. recognition of substance. Body determines whether or not it is alien
  2. If alien, the body produces antibodies or antitoxins
  3. The body produces memory cells should the alien substance be encountered again
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14
Q

What are humoral?

A

Antibodies (gamma globulins) which are liberated into the plasma by committed lymphocytes

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15
Q

What is cell mediated immune response? 3 (How it is done)

A

Done in three ways
1. Lymphocytes produces antitoxins that are retained within the lymphocytes cell
2. Lymphocyte attaches itself to the antigen and secretes the antitoxin
3. Both antigen and lymphocyte die and are absorbed

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16
Q

What is the largest unit of the RE system?

A

The Spleen

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17
Q

What is the main role of the spleen?

A

Body defense mechanism

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18
Q

Is it easy to scan the spleen?

A

Nope

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19
Q

When does the Spleen develop?

A

5th week of gestation

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20
Q

What does the spleen arise from?

A

Mesoderm

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21
Q

When does hematopoesis start at postpartum?

A

~11 weeks ends shortly after birth

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22
Q

What area of the peritoneum is the spleen located in? Is it an encapsulated structure? What section of the abdomen is it located in? What area of the ribs is it located by? and what is it anchoured down by?

A
  1. Intraperitoneal
  2. Encapsulated
  3. Left hypochondrium
  4. Long axis of the 10th rib
  5. Anchored by gastrosplenic splenorenal, and phrenocolic ligament
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23
Q

Where is the spleen in relation to the diaphragm?

A

Superior/ lateral/ Posterior

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24
Q

What is the organs/structures is the spleen medial to? 3

A
  1. Stomach
  2. Tail of pancreas
  3. splenic flexure of the left kidney
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25
Q

How is the spleen in relation to the stomach

26
Q

What is the size/ shape of the spleen?

A

Length: usually 12cm
Width: 7-8 cm
Height: 3-4 cm

27
Q

The size of the spleen can be divided into three categories, what are they?

A
  1. Normal: up to 12 cm
  2. Moderately splenomegaly: >12cm - 18cm
  3. Severe splenomegaly: over 18 cm
28
Q

How can we determine if the spleen is enlarged?

A

If the spleen is more than 2x the size of the kidney if you visualize a flatten caudal kidney

29
Q

Can the spleen decrease in size?

A

Yes, with age

30
Q

What is the shape of the spleen?

A

Crescent shaped

31
Q

How is the splenic vein formed?

A

Several veins converge at the splenic hilum to form the splenic vein

32
Q

What vessels course through the splenorenal ligament?

A

Main vessels

33
Q

Vessels (veins, arteries, and Lymphatics) enter and leave where?

A

Splenic hilum

34
Q

Do we need a spleen to live?

35
Q

What is the spleen divided into?

A

Lobules via projections of the connective tissue capsule

36
Q

What does the spleen lobules contain? 2

A

Two types of pulp
1. Red pulp
2. White pulp

37
Q

What is red pulp? What lines it? 3

A
  1. Venous component
  2. Splenic sinuses alternating with splenic cords
  3. Phagocytic cells line the sinusoids
38
Q

What is the white pulp of the spleen? 3

A
  1. Tiny islands of lymphatic tissue (malpighian corpuscles) in the spleen
  2. Contains lymphocytes and macrophages
  3. Produces antibodies
39
Q

What is the function of the RE system? 2

A
  1. Produce lymphocytes and antibodies
  2. Storage of iron and metabolites
40
Q

What are the organ specific functions of the RE system? 3

A
  1. Filter blood
  2. Blood reservoir
  3. Erythropoiesis
41
Q

What kind of probe do we use for scanning the spleen?

42
Q

What does a patient need to do prior to coming in for a splenic scan?

A

Overnight fast

43
Q

What windows are used to scan the spleen?

A

Intercostal/ subcostal windows used

44
Q

What planes do we scan the spleen in?

A

Sag and trans

45
Q

What kind of approach do we generally need to scan the spleen?

A

A high posterolateral approach

46
Q

What do we assess the spleen for? 4

A
  1. Size
  2. Position
  3. Focal abnormalities
  4. Fluid collections
47
Q

When attempting to get a high posterolateral window how might we attain this view?

A
  1. Patient can extend/ relax arm over head to create a larger window
  2. Use varying degrees of patient inspiration/ expiration to maximize visualization
48
Q

What does the spleen look like sonographically?

A
  1. Extremely homogenous (low- medium level echoes)
49
Q

How does the spleen compare to the kidney sonographically ?

A

More echogenic

50
Q

How does the spleen compare to the liver sonographically?

A

It is isoechoic or slightly more echogenic to the liver

51
Q

What are some pitfalls of scanning the spleen? 2

A
  1. Pseudoperisplenic lesion
  2. Fluid filled stomach and tail of pancreas may be mistaken for a mass
52
Q

Where do pseudoperisplenic lesions occur? Who does it affect? What does it mimic?

A
  1. Occurs in thin patients
  2. Left lobe of liver superior to spleen
  3. Mimics subcapsular hematoma, abscess
53
Q

What is the accessory spleen?

A

Small variant found near the hilum

54
Q

What is a born again spleen?

A

Hypertrophy of a accessory spleen or other splenic tissue post splenectomy

55
Q

What are some splenic lab tests? 4

A
  1. Hematocrit
  2. Hemoglobin
  3. WBC
  4. Platelets
56
Q

What is a hematocrit test? What does decreased hematocrit indicate?

A
  1. Test for volumes of RBCs in whole blood sample
  2. Decrease indicates hemorrhage
57
Q

Why does hemoglobin decrease?

A

decreased in acute blood loss, anemia, leukemia, multiple myeloma

58
Q

What does the WBC test, test for?

A
  1. Leukocytosis (increased count)
  2. Leukopenia (decreased count)
59
Q

What does the platelet test, test for? 2

A
  1. Thrombocytopenia: (Decreased count/ internal hemorrhage/ leukemia/ vitamin B12 deficiency)
  2. Thrombocytosis: (hemorrhage/ infective disorders)
60
Q

How does Nuclear medicine test the Spleen?

A

Scintigraphy (RBC scan) used to assess morphology of spleen

DMST 254 ABD 1 (26 decks)

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