Spleen

Question 1

Purpose of spleen

Answer 1

• reservoir for blood
• major destruction site of old RBC’s
• hemoglobin turns into billirubin & goes to liver to help make bile
• pools platelets
• storage of iron
• erythropoesis
• immune response

Question 2

How are RBC’s destroyed in the spleen?

Answer 2

• removed (culling) & hemoglobin is recycled
• destruction of foreign particles/bacteria (pitting)

Question 3

Erythropoesis

Answer 3

production of RBCs

Question 4

Composed of specialized tissues

Answer 4

• white pulp: contains lymphatic tissues
• red pulp: removes foreign material from RBC

Question 5

Size of spleen

Answer 5

• 12-13cm length (sup to inf), 6-7cm width
• largest lymphatic organ

Question 6

What covers the spleen?

Answer 6

peritoneum, except at hilum

Question 7

Splenic anatomy

Answer 7

• in LUQ
• variable shape/size (consider pt size)
• longest at superior to inferior

Question 8

Where does the splenic artery enter the spleen?

Answer 8

at the hilum

Question 9

Where does the spleen drain?

Answer 9

splenic vein to portal confluence

Question 10

Where does the spleen sit?

Answer 10

sits right up next to diaphragm on the left (hemidiaphragm)

Question 11

Shape of spleen

Answer 11

• longer than it is wide
• convex (bowed out) lateral boarder
• caved inward on medial side where vessels go in & out (opening for peritoneum)

Question 12

Vasculature

Answer 12

• hypoechoic vasculature medially at the hilum
• no vasculature w/in spleen w/out color Doppler
• should be homogenous (similar to kidney)

Question 13

Splenules

Answer 13

extra appendages on the spleen

Question 14

Atrophy

Answer 14

• can occur due to chronic hemolytic anemias (sickle cell), increased fibrosis, scarring from multiple infarcts
• advanced atrophy = autosplenectomy

Question 15

Asplenia

Answer 15

congenital absence of spleen

Question 16

Asplasia

Answer 16

failure of spleen to develop

Question 17

Accessory spleen/splenule

Answer 17

• M/C congenital anomaly of spleen
• usually small, near splenic hilum, isoechoic to spleen

Question 18

Polysplenia

Answer 18

• multiple islands of splenic tissue
• must be able to differentiate from lymphadenopathy

Question 19

Wandering spleen

Answer 19

• spleen is in an ectopic location
• pt may have abdominal or pelvic mass
• torsion may occur

Question 20

Splenomegaly

Answer 20

enlarged spleen