Lesson 16 (Part 2)

Question 1

What is the normal volume for the spleen?

Answer 1

60-200mL

Question 2

What is the average weight of the spleen?

Answer 2

<150g on autopsy

• 80-300g average
• depends on age/gender

Question 3

What happens to the spleen with increasing age?

Answer 3

Its size and weight decreases

- even smaller in women

Question 4

What is the echogenicity of the spleen compared to the liver and the left kidney?

Answer 4

Hyperechoic

Question 5

What is the echotecture of the spleen?

Answer 5

The parenchyma is homogenous

Question 6

What is normal to see in the spleen as a patient ages?

Answer 6

Calcified arteries

Question 7

What level do you measure the spleen in sagittal?

Answer 7

At the level of the hilum

- longest point

Question 8

Is the spleen routinely scanned in an abdomen exam?

Answer 8

Yes

Question 9

What are the 2 positions you can scan the spleen in?

Answer 9

1. Supine
   - left intercostal coronal approach
2. Right lateral decubitus

Question 10

What are common maneuvers when scanning the spleen? (3)

Answer 10

1. Small breath in
2. Large breath in
3. Shallow breathing
   - or no breathing

Question 11

What can help with identifying the location of the hilum? (2)

Answer 11

1. Splenic vein

2. Splenic artery

Question 12

Why is scanning intercostally difficult?

Answer 12

Have to be directly in between the ribs, otherwise we will see shadow in our image

Question 13

Why is scanning the spleen superiorly difficult?

Answer 13

Because of the lungs

- cant see through air

Question 14

Why is scanning subcostaly not always possible?

Answer 14

Gas

Question 15

What are 3 pitfalls when scanning the spleen?

Answer 15

1. Ribs
2. Gas
   - close to the stomach
3. Lungs/diaphragm

Question 16

What structures can the spleen get confused with?

Answer 16

The liver

- elongated left lobe

Question 17

What other modalities can help to further demonstrate challenging cases related to the spleen? (2)

Answer 17

1. CT

2. MRI

Question 18

What cells does the spleen arise from?

Answer 18

Mesenchymal cells

Question 19

Where are mesenchymal cells located?

Answer 19

Between layers of the dorsal mesentery

Question 20

What do mesenchymal cells differentiate to form? (2)

Answer 20

1. Splenic pulp

2. Splenic capsule

Question 21

What does the base of the dorsal mesentery fuse with?

Answer 21

The posterior peritoneum

Question 22

What does the fusing of the base of the dorsal mesentery and the posterior peritoneum form?

Answer 22

The splenorenal ligament

Question 23

What are 5 examples of normal variants/congenital anomalies?

Answer 23

1. Accessory spleen
2. Asplenia
3. Polysplenia
4. Wandering
5. Ectopic

Question 24

What is the most common normal variants/congenital anomalies?

Answer 24

Accessory spleen

Question 25

What is accessory spleen also known as?

Answer 25

Splenule

Question 26

Accessory spleen

Answer 26

Homogenous isoechoic mass similar to the spleen

Question 27

Where is the splenule typically found? (2)

Answer 27

1. At the hilum | 2. Inferior border of the spleen

Question 28

Asplenia

Answer 28

Complete absence of the spleen - rare - may occur as part of a major congenital abnormality

Question 29

Polysplenia

Answer 29

Multiple small accessory spleens

Question 30

Wandering spleen

Answer 30

Migrated from its normal location in the LUQ

Question 31

What happens the the dorsal mesentery with a wandering spleen?

Answer 31

It fails to fuse properly with the posterior peritoneum

Question 32

What does the wandering spleen lack?

Answer 32

Supporting ligaments | - doesnt fuse so it doesnt have proper ligaments

Question 33

Ectopic

Answer 33

The spleen is located in the abdominal cavity outside of where it should be