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Flashcards in Spleen Deck (150):
1

Although the spleen is located near the stomach it plays no part in _____.

digestion

2

The spleen is elongate-_____ in shape and of a dull _____ color.

oval
purplish

3

The spleen is a _____ organ that lies _____ the stomach, high up on the left side of the abdomen, on a level with the 9 to 11 ribs.



lymphatic
behind

4

The spleen is similar to a _____ in shape and structure but is much _____.

lymph node
larger

5

The spleen is the largest _____ organ in the body.

lymphatic

6

The spleen is a _____ organ that filters damaged cells and delivers _____ to the immune system.

peritoneal
antigens

7

The spleen of an adult human:

1) Weighs about _____ (_____)
2) Is ___-___ ( ___- ___ ) long
3) Is _____ (_____) wide
4) Is _____ (_____) thick.

170 grams (6 ounces)
13-15 cm (5-6 inches) long*
7.5 cm (3 inches) wide
4cm (1.5 inches) thick

*Jennifer says up to 12 cm is the common healthy size

8

The _____ brings blood to the spleen from the heart.

splenic artery

9

The splenic artery enters the spleen through a fissure called the _____ and divides into numerous branches, assuming an appearance rather like a _____; they are sometimes called the _____ arteries.


hilum
brush
brush

10

Blood leaves the spleen through the _____, which becomes part of the _____ that carries the blood to the liver.

splenic vein
MPV

11

The spleen consists of two types of tissue called _____ and _____.

white pulp
red pulp

12

The white pulp of the spleen is lymphatic tissue consisting mainly of _____ around the _____.

lymphocytes
arteries

13

The red pulp consists of venous _____ (cavities) filled with blood and cords of _____ cells, such as _____ and _____.

sinuses
lymphatic
lymphocytes
macrophages

14

The normal spleen:

_____ (increases/decreases) in size and weight with advancing age.

_____ (increases/decreases) in volume while digestion is in progress, and returns to its normal size when it's finished.

The size can vary in size in accordance with the _____ status of the body.

decreases
increases
nutritional

15

The spleen filters blood in much the way that the lymph nodes filter _____. Lymphocytes in the spleen react to _____ in the blood and attempt to destroy them. _____ then engulf the resulting debris, the damaged _____, and the other large particles.

lymph
pathogens
macrophages
cells

16

The spleen, along with the liver, removes old and damaged _____ from the circulating blood.

erythrocytes (RBCs)

17

The spleen can also, like _____, produce new red blood cells. It can accordingly be regarded both as a _____ and as a _____ organ.

bone marrow
hemolytic
hemopoietic

18

The terms hemolytic and hemopoietic come from the Greek: hema: _____; luein: _____; poiein: _____.

blood
to dissolve/destroy
to produce

19

T or F? The spleen is removable.

true

20

In healthy people, the spleen plays a role in immunity against _____.

bacterial infections

21

The shape of the spleen is _____ (adjective).

variable

22

The spleen consists of 2 components at the hilum:

superomedial component
inferolateral component

23

In the TRV plane, the superior part of the spleen has a typical fat _____ shape.

comma

24

In the coronal plane, the spleen has a _____ shape.

inverted comma

25

Why do we scan the spleen coronally?

Because the stomach is anterior to the spleen and is full of air, which makes it impossible to see through.

26

The diaphragm cradles the spleen _____, _____, and _____.

posteriorly
superiorly
laterally

27

If the _____ lobe of the liver is large, it may extend into the LUQ, _____ to the spleen.

left
superior

28

The fundus of the stomach is _____ and _____ to the splenic hilum.

medial
anterior

29

The pancreas tail lies _____ to the stomach and is also _____ and _____ to the splenic hilum.

posterior
medial
anterior

30

What are the 3 organs/parts that are medial and anterior to the splenic hilum?

stomach
pancreatic tail
lesser sac

31

The left kidney generally lies _____ and _____ to the spleen.

medial
inferior

32

Why perform an ultrasound on the spleen? (4)

To demonstrate:

-existence of a mass and its composition
-disruption of splenic texture or outline
-spleen size
-progressive changes in masses

33

Enlargement of the spleen is >_____.

12cm

34

What does splenomegaly demonstrate?

it is not a disease in itself but a sign of an underlying disorder

35

Mild-to-moderate splenomegaly is usually caused by: (3)

infection
portal HTN
AIDS

36

Marked splenomegaly is usually the result of: (3)

leukemia
lymphoma
infectious mononucleosis

37

Massive splenomegaly is seen in _____.

myelofibrosis

38

What is myelofibrosis?

the body making too much scar tissue

39

What is the most frequently observed abnormality of the spleen?

splenomegaly

40

What are 5 common causes of splenomegaly?

congestive
hematologic
infiltrative
metabolic
trauma

41

The congestive (can't keep up with its job in the body) cause of splenomegaly is secondary to _____ due to _____. An example is _____.

portal HTN
cirrhosis
anemia

42

The main hematologic cause of splenomegaly is

polycythemia vera

43

What is a blood disorder that results in uncontrollable RBC production?

polycythemia vera

44

Besides splenomegaly, what else does polycythemia vera cause? (2)

hyperviscosity
hypercoagulation

45

The infiltrative cause of splenomegaly is due to _____ and both types of _____ ( _____ and _____).

leukemia
lymphoma (Hodgkins and non-Hodgkins)

46

The splenic parenchyma is extremely _____ (homogeneous/heterogeneous) with uniform mid-to-low level _____. It is generally considered that the liver is more _____ (echogenicity) than the spleen, but the spleen parenchyma actually has a _____ echogenicity than the liver (due to its _____ content) or may be _____ (echogenicity) to the liver.

homogeneous
echoes
echogenic
higher
water
isoechoic

47

_____ is a common primary malignancy of the spleen, usually appearing as diffuse _____ organ _____. Less common forms include a round _____ mass or multiple _____. Splenic involvement is more common with _____ lymphoma than with _____ lymphoma.

lymphoma
homogeneous
enlargement
focal
small nodules
non-Hodgkin
Hodgkin

48

The metabolic cause of splenomegaly is caused by _____ disease and _____ disease.

Gaucher's
Niemann-Pick

49

What is Gaucher's disease?

a disease where there is a missing fat enzyme

50

What is the disease that means the body has too much sphingomyelin?

Niemann-Pick

51

Gaucher's Disease

It is _____ (inherited/not inherited).
It means the body is missing a _____ enzyme.
_____ is one of the earliest signs.

inherited
fat
splenomegaly

52

Niemann-Pick Disease

It is _____ (inherited/not inherited).
It means the body has too many deposits of _____.

inherited
sphingomyelin

53

What are the signs and symptoms of splenomegaly?

LUQ pain
pressure on adjacent organs

54

What causes LUQ pain with splenomegaly?

the stretching of the capsule or ligament of the spleen

55

This mass appears as an echo-free areas with smooth, sharp borders and acoustic enhancement.

cyst

56

The 4 categories of cysts on the spleen are

infectious
post-traumatic
primary congenital (born with it)
intrasplenic pancreatic pseudocyst

57

Infection or parasitic cysts may be caused by _____ or _____.

hydatid cysts
echinococcus

58

How is an infectious or parasitic cyst identified among the different kinds of cysts?

calcification in the wall

59

What is needed to be diagnostic for infectious/parasitic cysts? (2)

percutaneous aspiration
history and background info

60

Hydatid cysts result from a _____.

parasitic tapeworm

61

If you open up a hydatid cyst, what does it look like?

a honeycomb

62

With hydatid parasitic cysts, ____ form the cysts and the cysts multiply, creating _____ cysts.

parasites
daughter

63

What are post-traumatic cysts caused by?

usually due to hematoma due to trauma

64

Post-traumatic cysts are referred to as _____ (type of cyst) and ____ (have/don't have) a cellular lining.

pseudocysts
don't have

65

This kind of cyst differs from a post-traumatic cyst in that it has a cellular lining.

primary congenital cysts

66

Another term for primary congenital cysts is ____, which means "_____."

epidermoid cysts
"true cyst"

67

T or F? Primary congenital cysts are rare.

True

68

_____ cysts can be due to polycystic disease. The walls may become _____ or may contain low level _____ that can be _____ or debris.

Primary congenital
calcified
echoes
cholesterol crystals

69

These cysts extend into the spleen and are associated with pancreatitis features.

pancreatic pseudocysts

70

This pancreatic pseudocyst is uncommon, but associated with a high mortality rate.

splenic abscess

71

Fever + infection =

abscess!

72

This kind of pancreatic pseudocyst commonly occurs due to spread of infection, especially from infective endocarditis or most commonly from streptococcus.

splenic abscess

73

Fever + infection + underlying issue =

splenic abscess!

74

Fever, pain, leukocytosis*** and a LUQ mass is a sign of

a splenic abscess

75

How does a splenic abscess appear sonographically?

variable

76

This is a traumatic abnormality of the spleen and is associated with rib fractures.

hematoma

77

What is the choice modality for a hematoma?

CT

78

How does a hematoma appear sonographically?

variable

79

This kind of splenic mass is uncommon but can be caused by a number of diseases.

solid focal lesion

80

This is the most common solid focal lesion and it results from previous _____ infections, which are seen as a _____, bright, _____ lesion with or without shadowing.

granulomatous
focal
echogenic

81

What are the most common causes of granulomas? (2)

histoplasmosis
TB

82

What is the disease that is spread by the inhalation of bird/bat poop?

histoplasmosis

83

Granulomas may occur in patients with _____.

sarcodosis

84

What is sarcodosis?

inflammation of the lymph nodes

85

With granulomatous disease, calcification in the _____ is common.

splenic artery

86

Granulomas are clusters of _____ cells.

immune

87

Primary malignancies of the spleen are very rare, but if there is one, it is probably _____.

lymphoma

88

Splenic metastasis occurs most commonly with malignant _____.

melanoma

89

After melanoma, the next 2 most common splenic mets comes from the _____ and the _____.

breast
lung

90

This is the most common benign neoplasm of the spleen.

hemangioma

91

A hemangioma is usually isolated with variable appearance, sonographically. But mostly, they look like _____.

liver hemangiomas

92

What is a common cause of focal splenic lesions?

splenic infarctions

93

The appearance of a splenic infarction typically appears as a _____, _____, _____ lesion (3)

peripheral
wedge-shaped
HYPOechoic

94

With splenic infarctions, when it becomes chronic, the wedge-shaped characteristic becomes _____.

HYPERechoic

95

Any wedge-shaped lesion in the spleen will be an _____. So if, on the boards, you see ANY wedge-shaped image, pick _____, whether it’s hypoechoic or hyperechoic.

infarct

96

The most common cause of a splenic infarct is

bacterial endocarditis

97

Besides bacterial endocarditis, what are other causes of splenic infarcts? (4)

leukemia
lymphoma
tumor emboli
sickle cell anemia

98

Splenic nodules are present with these 3 conditions:

Gauchers Disease
Schistosomiasis
Candidiasis (wheel within a wheel)

99

What is the choice diagnostic imaging modality for splenic trauma? Why? What is the modality that may be used for follow-up?

CT
because more upper abdominal pathology can be identified with one exam
ultrasound

100

T or F? Subcapsular or perisplenic hematomas are seen with ultrasound with high accuracy.

True

101

Inside capsule =

subcapsular

102

Outside capsule =

perisplenic

103

This is a hematoma that occurs with splenic trauma in which the splenic capsule remains intact.

subcapsular (AKA intraparenchymal)

104

Another term for subcapsular is

intraparenchymal

105

How does a subcapsular hematoma look sonographically?

crescent-shaped fluid collection, inferior to the diaphragm

106

This appears as a crescent-shaped fluid collection, inferior to the diaphragm.

subcapsular hematoma

107

This hematoma occurs with splenic trauma in which the splenic capsule ruptures.

perisplenic hematoma (AKA intraperitoneal)

108

Another term for perisplenic hematoma is

intraperitoneal

109

T or F? A ruptured spleen is a serious condition. Without emergency treatment, a ruptured spleen can cause life-threatening bleeding. An enlarged spleen may rupture spontaneously.

True

110

What are the classic symptoms of a ruptured spleen? (2-ish)

abdominal pain and tenderness

111

What are possible more severe symptoms of a ruptured spleen? (4-ish)

internal bleeding could cause blood pressure to drop, may become lightheaded or confused, with blurred vision and fainting

112

This can cause severe hemorrhage and shock (in splenic rupture).

tearing of splenic vessels

113

If tearing of the splenic vessels happens with splenic rupture, what is a really bad possible outcome?

death can occur within minutes (even in the best situations, death cannot be prevented)

114

This refers to when blood collects due to splenic injury, it irritates the diaphragm, causing referred pain to the shoulder tip.

Kehr's Sign

115

A ruptured spleen is typically caused by a blow to the _____ (area) abdomen or the left lower _____. Sporting mishaps, fist fights and car accidents are common causes. An injured spleen may rupture soon after the abdominal trauma or, in some cases, days or even _____ after the injury.

left upper
chest
weeks

116

An enlarged spleen, which may be caused by various underlying problems — from mononucleosis and other infections, to liver disease and blood cancers — may sometimes rupture with _____.

trauma to the abdomen

117

How can the spleen rupture during 3rd trimester pregnancies?

Large abdomen pushes the LLL anteriorly to the spleen

118

What is the most significant complication of mononucleosis?

ruptured spleen

119

What is the splenic rupture sign that refers to fluid in the lesser and greater sacs on both sides of the gastrosplenic ligament?

Butterfly sign

120

The Butterfly sign refers to fluid in the ____ and ____ on both sides of the ____ ligament.

lesser sac
greater sac
gastrosplenic

121

This occurs when the splenic vascular supply, parenchyma, or capsule has been disrupted.

splenic rupture

122

The appearance of this ranges from a cystic, hypoechoic mass to a complex area in the periphery of the splenic parenchyma.

splenic rupture

123

Splenic rupture can appear as a cystic, _____ (echogenicity) mass.

HYPOechoic

124

A splenic rupture can appear as a _____ area in the _____ of the splenic parenchyma.

complex
periphery

125

_____ is the autotransplantaion of splenic tissue, following splenic injury.

splenosis

126

If a rupture is small, how is it treated?

surgical repair

127

If a rupture is bad (typically, it is) how is it treated?

splenectomy

128

This might be needed with splenectomy surgery if the patient has lost a large amount of blood in the trauma that caused the rupture of the spleen.

transfusions

129

This is a slender tube equipped with a camera lens and light, used for splenectomy surgery.

laparoscope

130

A person can live an active life without a spleen, but they are more likely to contract serious or life-threatening _____. If the spleen is removed, the doctor may recommend _____ and _____ vaccines. _____ may be recommended as well, especially if there are any other conditions that increase the risk of serious infections.

infections
pneumonia
flu
antibiotics

131

What is the condition in which the spleen ruptures and splenic cells implant through the peritoneal cavity, resulting in "ectopic spleens?"

post-traumatic splenosis

132

What is the most common finding in patients with AIDS in a splenic ultrasound? (50-70% of patients)?

moderate splenomegaly

133

Moderate splenomegaly is noted to be more frequent in _____-transmitted HIV infection, than in _____-transmitted HIV infection.

sexually
IV drug

134

Focal splenic lesions may cause opportunistic infections such as (5):

candida
pneumocystis carini
mycobacterium avium
Kaposi's sarcoma
lymphoma

135

Congenital anomalies:

A normal variant which may be confused with enlarged lymph nodes around the spleen, or with masses in the pancreas tail.

accessory spleen (AKA splenunculi)

136

____% of people have an accessory spleen.

25

137

Another term for accessory spleen is

splenunculi

138

Splenunculi (AKA accessory spleen) is easy to recognize as small, round masses <____, located near the splenic _____, with echogenicity identical to the _____.

5cm
hilum
spleen

139

From where does an accessory spleen get blood supply?

splenic artery

140

What vessel drains an accessory spleen?

splenic vein

141

This represents nodules of normal spleen tissue.

accessory spleen

142

T or F? After a splenectomy, an accessory spleen can enlarge and take the place and function of the original spleen.

True

143

This is an abnormal inferior displacement of the spleen.

splenic ptosis

144

What are some causes of splenic ptosis? (3) and why?

extreme weight loss
weak ab muscles
splenomegaly

They cause the splenic ligaments to become dysfunctional.

145

This congenital anomaly is found in unusual locations. It may be mistaken for a mass that could undergo torsion, which would result in acute abdominal pain.

wandering spleen

146

With a wandering spleen, the cause is the long ____ mesentery of the ____ mesentery failed to fuse with the _____ peritoneum.

mobile
dorsal
posterior

147

This means "absent spleen"...

asplenia

148

What is asplenia?

When the spleen is absent OR not fully developed (hypoplastic).

149

This term means "multiple spleens"....

polysplenia

150

What does hypoplastic mean?

not fully developed