Spleen Flashcards by Iseoluwa Ojo

Anatomy of the spleen

A specialized connective tissue composed of a 3 dimensional —————- serving as ______ in d path of blood circulation

reticular meshwork

filter

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Anatomy of the spleen

Selectively clears blood of cells, micro organisms and antigens in ________ called _________

Stroma meshes

filtration beds

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Sinusal spleen: a.k.a ________ spleen seen in ___________ and accounts for less than _______% of body weight.

defence

cats and humans

0.25

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Non-sinusal or _______ spleen are seen in _________.

________ and _______ are fibromuscular.

storage

herbivores

Capsules and trabeculae

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Sinusal spleen:

The immunologically active ______ pulps are particularly prominent where _______,_______, and _______ predominate.

white

lymphocytes, macrophages and APCs

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Non-sinusal

Usually (light or heavy?) with ______ and thus perform ____________.

May make up ____% of body weight

Heavy

stored blood

internal transfusion

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Spleen receives ____ to _____% of cardiac output or about _____mils/min in humans

1; 10

300

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Spleen

Weighs an average of _____g in humans and only ___g when totally drained of blood.

135

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Spleen

Involution occurs with ______

weighs about _____g in elderly

age

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Splenic structure

The capsule is _________, covered on the external surface by (ciliated or non-ciliated?) _____ ————

fibromuscular

Ciliated; cuboidal

mesothelium

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Splenic structure

On the medial surface is a ridge called the _______ through which blood vessels traverse the spleen

hilus

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Splenic structure

Richly branched _______ project into the splenic pulp carrying ______________ and efferrent lymphatics while dividing the pulp into compartments

trabeculae

splenic artery and vein

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Splenic structure
The capsule is fibromuscular, covered on the external surface by ciliated cuboidal mesothelium(contributing to its high _____________ by _________)

splenic haematocrit

pumping fluid out

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Splenic structure

The nerve supply accompanies the arterial branches, terminating deep in the pulp as _______ axons that cause the pulp _______ to ______ and _______

adrenergic

meshwork

expand and contract.

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Splenic structure

The primary cellular element of the pulp is the (branched or non-brnached?) fibroblastic ______ cells which produces slender ______ fibers(_______ fibers)

branched

reticular

collagen; reticular

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Splenic structure

These collagen fibres(type ____ collagens) together with the ______ cells form the meshwork of the pulp Called the _______ which is what ———-

reticular

reticulum

filters blood

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the reticulum which is what ______(_________)

filters blood

filtration bed

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the ________ which is what filters blood(filtration bed)

reticulum

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Structure of the filtration bed

There are two main distinguishable areas of the filtration bed
1._______
2.___________

white pulp

red pulp

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White pulp:

from the _____, the ______ traverses the stroma carrying with it a branch of the splenic artery (______ artery)

As this artery enters the meshwork of the spleen, its immediately surrounded by distinct layer of reticulum called the _______________. Which itself is encapsuled by the ______________

hilus; trabeculae

central

periarterial lymphatic sheath

circumferential reticulum

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periarterial lymphatic sheath is not encapsuled by the reticulum

T/F

It is

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The periarterial lymphatic sheath is rich in ????

T-lymphocytes

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Along the length of the PALS are (small or large?) (flat or round?) follicles scattered on its peripheral surface.

These are ovoid accumulation of ________ which appears as _______ on the cut surface of the spleen

Small

Round

B lymphocytes

whitish dots

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The follicle is made up of central _______ and outer ________ zones

germinal; marginal

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As the central artery branches, it _________ as it goes, so likewise is the ______

diminish in size PALS

Function of the white pulps Majorly __________ and _________ ———— and accessory cells from circulation

clears and concentrate lymphocytes

Function of the white pulps ________ that traffic to and fro the white pulp are the circulating pool

Lymphocytes

On activation the lymphocytes may remain in the spleen to sustain primary or secondary immune response T/F

Function of the white pulps Lymphoid nodules become enlarged as they recruit more ____-lymphocytes from the blood and ———- zone and moves ____ wards forming the ___________

B mantle in germinal center

The central arterioles now terminate in the _______ zone as it enters the ____ pulp

marginal RED

The ________ and ———— thus constitutes the white pulp

PALS and lymphoid nodules

B and ____ cells have ___ hours to interact as B cells on their way to the _____ center traverse the _______

T few; germinal; PALS

B and T lymphocytes exit the spleen via the ______________

efferent lymphatics

RED PULP Consists of the meshwork called ________________ along with ________

splenic cord of Bilroth splenic sinuses

Arterial vessels that runs from the center of the PALS supply the ______ zone and ____ pulp

marginal red

RED PULP Arterial vessels that runs from the center of the PALS supply the marginal zone and red pulp These vessels terminate as arterial capillaries and vessels with ______-like flares with (narrowed or widened?) ______________ as the blood runs through numerous interwoven ________

trumpet widened endothelial slits or pores filtration beds

Functions of the spleen Non immune function: a _____ of platelets are stored in the spleen, pooling, pitting

third

Functions of the spleen Immune function: ———-, ______ , and _________

tuftin, primary and secondary

Functions of the spleen Immune function Large fraction of circulating _____ pool are marginated in the spleen. (Slow or Fast?) transit of blood in the red pulp allows close contact of ______ with antibody and complement coated cells and microorganisms and senescent cells entrapped

neutrophils Slow ; macrophage

Half of of platelets are stored in the spleen, pooling, pitting T/F

F a third of platelets

Hypersplenism In 1899, chauffard proposed that increased splenic activity results in ________ This served as the basis for the first ever ________ in 1910 by Suthaland and Burghard in a patient with __________

haemolysis splenectomy hereditary spherocytosis

The normal and abnormal function of the spleen is traceable to its two major functions: __________ and _______ of blood in the red pulp and __________ in the white pulp.

Filtration and immune surveillance antibody synthesis

Hypersplenism occurs when these functions are 1. appropriately increased as in _____ or _____, or 2. inappropriately increased as in ————

Hereditary spherocytosis , or immune Thrombocytopenic purpura portal hypertension

Hypersplenism As enunciated by Darmalek: hyperplenism is usually associated with _______________, causes ________,with compensatory __________ and is corrected by ______

splenomegally cytopaenias BM hyperplasia splenectomy

Pathogenesis of hypersplenism Ideally spleen serves to filter senescent red cells by passing _____% of blood flow through the ____________ mesh of the red pulp studded with _______. The blood then reenters the circulation via (narrow or wide?) slits measuring _______, in the endothelium of the venous sinuses.

10 non endothelialized macophages Narrow 1-3 um

Pathogenesis of hypersplenism With ————— or __________, spleen may become over worked with consequent _________ and then __________ for ___________

red cell membrane defects or immune disorders hypertrophy sequester normal cells for destruction.

Splenomegally due to variety of causes usually increases the ____________________ causing inappropriate __________ of both normal abnormal cells, therefore cytopaenia results

proportion of blood channeled through the red pulp hypersplenic sequestration

Causes of splenomegally Idiopathic:_______ Hereditary disorders: ____,______,________

TSS HS, CH, thalassemias

Causes of splenomegally Connective tisssue disorders: ______, Metabolic disorders:_______, glycogen storage disease, _____,______

SLE amyloidosis neimann picks, gauchers

Causes of splenomegally Malignancies: _____,__________, hairy cell leukamias,cll Infections: viral, fungal, parasitic(_______)

cml,myelofibrosis leishmaniasis

Causes of splenomegally Cardio-vascular: CHF, _______, _________________ obstruction, liver chirrosis

budd-chiari splenic/portal vein

Tropical splenomegaly syndrome (TSS) Aka ____________ Follows immunological ___________ due to repeated ________ over a (short or long?) period of time

Hyperactive malarial splenomegaly over-stimulation malarial infection Long

Tropical splenomegaly syndrome (TSS) Seen in malaria endemic areas(_______,______) Its characterized by :

Africa, india

Tropical splenomegaly syndrome (TSS) Its characterized by : __________ enlargement ______megaly marked elevation in serum Ig____ level elevated anti malarial ______ marked ___________ marked ________ and _________ infiltration of the pulp 7. blood smear for malaria parasite is usually (positive or negative?)

massive spleen hepato M; antibodies dilated sinusoids erythrophagocytosis and lymphocyte Negative

Clinical features of TSS may include: _______ ,_________

Anaemia Thrombocytopaenia

Management of TSS 1. exclude all other causes of splenomegaly 2.____________ followed by prolonged ____________

Antimalarial drug antimalarial prophylaxis

The spleen is the site for primary extramedullary hematopoesis T/F

The capsule of the spleen is _____ and _________, allowing it to ______, or else it will rupture

Fibrous Elastic Expand

PCV is lower in the spleen than other places T/F

F Higher

______ follicle is found in the marginal zone ______ follicle is found in the germinal zone

Primary Secondary

Primary follicle is found in the _______ Secondary follicle is found in the _________

marginal zone germinal zone

CLASSICAL definition of hypersplenism ??

Is an exaggerated abnormal function of the spleen which usually results in pancytopenia , BM hyperplasia which is corrected after splenectomy

TSS Long term antimalarial therapy causes reduction of the spleen . The drug used is ______ (_______)

paludrine proguanil

CH ???

Cranio facial hyperplasia

Chemical produced by the spleen against encapsulated organisms is ???

Tuftin

Spleen Flashcards

(65 cards)