Lesson 5A (Part 1)

Question 1

Is the spleen intra or retroperitoneal?

Answer 1

Intraperitoneal

Question 2

What part of the spleen is not intraperitoneal?

Answer 2

The hilum

Question 3

Where is the spleen located? (quadrant, compared to diaphragm, kidney, stomach and pancreas = 5)

Answer 3

1. Left hypochondriac region with the superior aspect extending into the epigastric region
2. Inferior to the diaphragm
3. Anterior to the left kidney
4. Posterior and lateral to the stomach
5. Left lateral to the pancreas

Question 4

What does the spleen do? (4)

Answer 4

1. Removes foreign material from the blood
2. Initiates an immune reaction
   - resulting in production of antibodies and lymphocytes
3. Major destruction site of old red blood cells
   - red blood cells are removed and hemoglobin is recycled
4. Reservoir for blood

Question 5

What is the spleen most sensitive to?

Answer 5

Trauma

Question 6

Why is the spleen most sensitive to trauma?

Answer 6

Due to its vasculature

Question 7

What supplies blood to the spleen?

Answer 7

Splenic artery

Question 8

What drains the spleen of blood?

Answer 8

Splenic vein

Question 9

What makes up the main portal vein? (2)

Answer 9

1. Splenic vein

2. SMV

Question 10

What happens to the splenic vein when portal hypertension occurs?

Answer 10

It may shunt blood directly into the left renal vein

Question 11

What should you do if infarction is suspected on the spleen?

Answer 11

Apply colour doppler and evaluate for the presence of flow

Question 12

What should the sagittal measurements be for the spleen?

Answer 12

13cm or less

- from tip to tip

Question 13

What are normal serum levels in males?

Answer 13

4.6-6.2 million/mmm

Question 14

What are normal serum levels in females?

Answer 14

4.2-5.4 million/mmm

Question 15

What is elevation of serum levels associated with? (2)

Answer 15

1. Polycythemia vera

2. Severe diarrhea

Question 16

What are decreased serum levels associated with? (4)

Answer 16

1. Internal bleeding
2. Hemolytic anemia
3. Hodgkin’s disease
4. Hemangiosarcomas

Question 17

What does the spleen recycle Hb into?

Answer 17

Iron

- basis of bilirubin

Question 18

What conditions is low Hb associated with? (4)

Answer 18

1. Cancer
2. Lymphoma
3. Cirrhosis
4. Internal bleeding

Question 19

What do leukocytes do?

Answer 19

Defends the body from infection

Question 20

What are elevated levels of leukocytes associated with? (4)

Answer 20

1. Infection
2. Leukemia
3. Hemorrhage
4. Malignancy

Question 21

What are decreased levels of leukocytes associated with? (5)

Answer 21

1. Lymphoma
2. Leukemia
3. Viral infection
4. Hypersplenia
5. Diabetes mellitus

Question 22

What is the biggest reason for elevation of leukocytes?

Answer 22

Infection

Question 23

What are elevated levels of hematocrit associated with? (4)

Answer 23

1. Dehydration
2. Shock
3. Polycythemia vera-disorder of bone marrow
4. Infection

Question 24

What are decreased levels of hematocrit associated with? (3)

Answer 24

1. Hemorrhage
2. Anemia
3. Leukemia

Question 25

Hematocrit

Answer 25

% of RBCS in the blood

Question 26

What are some indications for an exam of the spleen? (8)

Answer 26

1. Chronic liver disease 2. Infection 3. Leukocytosis 4. Leukopenia 5. Palpable mass 6. Abdominal pain 7. Fatigue 8. Trauma

Question 27

What is another term for accessory spleen?

Answer 27

Splenule

Question 28

Splenule

Answer 28

Is a common normal variant that is typically located in the splenics hilum - congenital anomaly

Question 29

What does accessory spleen look like? (3)

Answer 29

1. Similar echogenicity as the spleen 2. Small rounded masses < 5cm 3. May be confused with enlarged nodes

Question 30

What modalities are used to confirm an accessory spleen? (2)

Answer 30

1. CT | 2. MRI

Question 31

What happens to the splenules if the spleen enlarges?

Answer 31

So do the splenules

Question 32

What does hypertension affect?

Answer 32

The spleen