Flashcards in Spleen Deck (150):
Although the spleen is located near the stomach it plays no part in _____.
The spleen is elongate-_____ in shape and of a dull _____ color.
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.
The spleen is similar to a _____ in shape and structure but is much _____.
The spleen is the largest _____ organ in the body.
The spleen is a _____ organ that filters damaged cells and delivers _____ to the immune system.
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
The _____ brings blood to the spleen from the heart.
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.
Blood leaves the spleen through the _____, which becomes part of the _____ that carries the blood to the liver.
The spleen consists of two types of tissue called _____ and _____.
The white pulp of the spleen is lymphatic tissue consisting mainly of _____ around the _____.
The red pulp consists of venous _____ (cavities) filled with blood and cords of _____ cells, such as _____ and _____.
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.
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.
The spleen, along with the liver, removes old and damaged _____ from the circulating blood.
The spleen can also, like _____, produce new red blood cells. It can accordingly be regarded both as a _____ and as a _____ organ.
The terms hemolytic and hemopoietic come from the Greek: hema: _____; luein: _____; poiein: _____.
T or F? The spleen is removable.
In healthy people, the spleen plays a role in immunity against _____.
The shape of the spleen is _____ (adjective).
The spleen consists of 2 components at the hilum:
In the TRV plane, the superior part of the spleen has a typical fat _____ shape.
In the coronal plane, the spleen has a _____ shape.
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.
The diaphragm cradles the spleen _____, _____, and _____.
If the _____ lobe of the liver is large, it may extend into the LUQ, _____ to the spleen.
The fundus of the stomach is _____ and _____ to the splenic hilum.
The pancreas tail lies _____ to the stomach and is also _____ and _____ to the splenic hilum.
What are the 3 organs/parts that are medial and anterior to the splenic hilum?
The left kidney generally lies _____ and _____ to the spleen.
Why perform an ultrasound on the spleen? (4)
-existence of a mass and its composition
-disruption of splenic texture or outline
-progressive changes in masses
Enlargement of the spleen is >_____.
What does splenomegaly demonstrate?
it is not a disease in itself but a sign of an underlying disorder
Mild-to-moderate splenomegaly is usually caused by: (3)
Marked splenomegaly is usually the result of: (3)
Massive splenomegaly is seen in _____.
What is myelofibrosis?
the body making too much scar tissue
What is the most frequently observed abnormality of the spleen?
What are 5 common causes of splenomegaly?
The congestive (can't keep up with its job in the body) cause of splenomegaly is secondary to _____ due to _____. An example is _____.
The main hematologic cause of splenomegaly is
What is a blood disorder that results in uncontrollable RBC production?
Besides splenomegaly, what else does polycythemia vera cause? (2)
The infiltrative cause of splenomegaly is due to _____ and both types of _____ ( _____ and _____).
lymphoma (Hodgkins and non-Hodgkins)
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.
_____ 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.
The metabolic cause of splenomegaly is caused by _____ disease and _____ disease.
What is Gaucher's disease?
a disease where there is a missing fat enzyme
What is the disease that means the body has too much sphingomyelin?
It is _____ (inherited/not inherited).
It means the body is missing a _____ enzyme.
_____ is one of the earliest signs.
It is _____ (inherited/not inherited).
It means the body has too many deposits of _____.
What are the signs and symptoms of splenomegaly?
pressure on adjacent organs
What causes LUQ pain with splenomegaly?
the stretching of the capsule or ligament of the spleen
This mass appears as an echo-free areas with smooth, sharp borders and acoustic enhancement.
The 4 categories of cysts on the spleen are
primary congenital (born with it)
intrasplenic pancreatic pseudocyst
Infection or parasitic cysts may be caused by _____ or _____.
How is an infectious or parasitic cyst identified among the different kinds of cysts?
calcification in the wall
What is needed to be diagnostic for infectious/parasitic cysts? (2)
history and background info
Hydatid cysts result from a _____.
If you open up a hydatid cyst, what does it look like?
With hydatid parasitic cysts, ____ form the cysts and the cysts multiply, creating _____ cysts.
What are post-traumatic cysts caused by?
usually due to hematoma due to trauma
Post-traumatic cysts are referred to as _____ (type of cyst) and ____ (have/don't have) a cellular lining.
This kind of cyst differs from a post-traumatic cyst in that it has a cellular lining.
primary congenital cysts
Another term for primary congenital cysts is ____, which means "_____."
T or F? Primary congenital cysts are rare.
_____ cysts can be due to polycystic disease. The walls may become _____ or may contain low level _____ that can be _____ or debris.
These cysts extend into the spleen and are associated with pancreatitis features.
This pancreatic pseudocyst is uncommon, but associated with a high mortality rate.
Fever + infection =
This kind of pancreatic pseudocyst commonly occurs due to spread of infection, especially from infective endocarditis or most commonly from streptococcus.
Fever + infection + underlying issue =
Fever, pain, leukocytosis*** and a LUQ mass is a sign of
a splenic abscess
How does a splenic abscess appear sonographically?
This is a traumatic abnormality of the spleen and is associated with rib fractures.
What is the choice modality for a hematoma?
How does a hematoma appear sonographically?
This kind of splenic mass is uncommon but can be caused by a number of diseases.
solid focal lesion
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.
What are the most common causes of granulomas? (2)
What is the disease that is spread by the inhalation of bird/bat poop?
Granulomas may occur in patients with _____.
What is sarcodosis?
inflammation of the lymph nodes
With granulomatous disease, calcification in the _____ is common.
Granulomas are clusters of _____ cells.
Primary malignancies of the spleen are very rare, but if there is one, it is probably _____.
Splenic metastasis occurs most commonly with malignant _____.
After melanoma, the next 2 most common splenic mets comes from the _____ and the _____.
This is the most common benign neoplasm of the spleen.
A hemangioma is usually isolated with variable appearance, sonographically. But mostly, they look like _____.
What is a common cause of focal splenic lesions?
The appearance of a splenic infarction typically appears as a _____, _____, _____ lesion (3)
With splenic infarctions, when it becomes chronic, the wedge-shaped characteristic becomes _____.
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.
The most common cause of a splenic infarct is
Besides bacterial endocarditis, what are other causes of splenic infarcts? (4)
sickle cell anemia
Splenic nodules are present with these 3 conditions:
Candidiasis (wheel within a wheel)
What is the choice diagnostic imaging modality for splenic trauma? Why? What is the modality that may be used for follow-up?
because more upper abdominal pathology can be identified with one exam
T or F? Subcapsular or perisplenic hematomas are seen with ultrasound with high accuracy.
Inside capsule =
Outside capsule =
This is a hematoma that occurs with splenic trauma in which the splenic capsule remains intact.
subcapsular (AKA intraparenchymal)
Another term for subcapsular is
How does a subcapsular hematoma look sonographically?
crescent-shaped fluid collection, inferior to the diaphragm
This appears as a crescent-shaped fluid collection, inferior to the diaphragm.
This hematoma occurs with splenic trauma in which the splenic capsule ruptures.
perisplenic hematoma (AKA intraperitoneal)
Another term for perisplenic hematoma is
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.
What are the classic symptoms of a ruptured spleen? (2-ish)
abdominal pain and tenderness
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
This can cause severe hemorrhage and shock (in splenic rupture).
tearing of splenic vessels
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)
This refers to when blood collects due to splenic injury, it irritates the diaphragm, causing referred pain to the shoulder tip.
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.
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
How can the spleen rupture during 3rd trimester pregnancies?
Large abdomen pushes the LLL anteriorly to the spleen
What is the most significant complication of mononucleosis?
What is the splenic rupture sign that refers to fluid in the lesser and greater sacs on both sides of the gastrosplenic ligament?
The Butterfly sign refers to fluid in the ____ and ____ on both sides of the ____ ligament.
This occurs when the splenic vascular supply, parenchyma, or capsule has been disrupted.
The appearance of this ranges from a cystic, hypoechoic mass to a complex area in the periphery of the splenic parenchyma.
Splenic rupture can appear as a cystic, _____ (echogenicity) mass.
A splenic rupture can appear as a _____ area in the _____ of the splenic parenchyma.
_____ is the autotransplantaion of splenic tissue, following splenic injury.
If a rupture is small, how is it treated?
If a rupture is bad (typically, it is) how is it treated?
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.
This is a slender tube equipped with a camera lens and light, used for splenectomy surgery.
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.
What is the condition in which the spleen ruptures and splenic cells implant through the peritoneal cavity, resulting in "ectopic spleens?"
What is the most common finding in patients with AIDS in a splenic ultrasound? (50-70% of patients)?
Moderate splenomegaly is noted to be more frequent in _____-transmitted HIV infection, than in _____-transmitted HIV infection.
Focal splenic lesions may cause opportunistic infections such as (5):
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)
____% of people have an accessory spleen.
Another term for accessory spleen is
Splenunculi (AKA accessory spleen) is easy to recognize as small, round masses <____, located near the splenic _____, with echogenicity identical to the _____.
From where does an accessory spleen get blood supply?
What vessel drains an accessory spleen?
This represents nodules of normal spleen tissue.
T or F? After a splenectomy, an accessory spleen can enlarge and take the place and function of the original spleen.
This is an abnormal inferior displacement of the spleen.
What are some causes of splenic ptosis? (3) and why?
extreme weight loss
weak ab muscles
They cause the splenic ligaments to become dysfunctional.
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.
With a wandering spleen, the cause is the long ____ mesentery of the ____ mesentery failed to fuse with the _____ peritoneum.
This means "absent spleen"...
What is asplenia?
When the spleen is absent OR not fully developed (hypoplastic).
This term means "multiple spleens"....