Spleen

Question 1

the _____ is the largest single mass of lymphoid tissue in the body

Answer 1

spleen; part of the reticuloendothelial system and synthesizes blood proteins

Question 2

the spleen is an ______ organ covered with peritoneum over its entire extent

Answer 2

intraperitoneal

Question 3

the ligament that attaches the spleen to the stomach and the kidney is called the _____

Answer 3

splenorenal ligament

Question 4

the _____ ligament is significant in that it is composed of the two layers of the dorsal mesentery that separate the lesser sac posteriorly from the greater sac anteriorly

Answer 4

gasrosplenic

Question 5

normal measurement of the spleen should be ______ in length, and ______ in width, and ______ in thickness

Answer 5

8-13cm; 7cm; 3-4cm; decreases slightly with age

Question 6

the spleen arteries are subject to ______ because of adequate anastomoses between the vessels are lacking

Answer 6

infarction

Question 7

the lymph vessels emerge from the splenic hilum, pass through other lymph nodes along the course of the splenic artery, and drain into the _____ nodes

Answer 7

celiac

Question 8

the spleen is held in place by what ligaments?

Answer 8

lienorenal, gastrosplenic, and phreocolic

Question 9

the term ______ describes a spleen that has migrated from its normal location in the LUQ

Answer 9

wandering spleen; results when the dorsal mesentery fails to fuse with the posterior peritoneum without supporting ligaments of the spleen

Question 10

_____ syndromes are associated complex cardiac malformations, bronchopulmonary abnormalities, or visceral heterotaxis (anomalous placement of organs or major blood vessels, including a horizontal liver, malrotation of the gut, and interruption of the IVC with azygos continuation)

Answer 10

asplenic or polysplenic

Question 11

the normal arrangement of asymmetrical body parts is called _____

Answer 11

situs solitus; the mirror image conditions is called situs inversus; the term situs ambiguous is used when the anatomy falls in between theses two conditions

Question 12

patients with _____ of the spleen have major problems with serious infection, as their immune response is absent

Answer 12

agenesis

Question 13

an _____ spleen, or splenunculus, is a more common congenital anomaly, it appears as a homogeneous pattern similar to that of the spleen; usually found in the hilum or inferior border

Answer 13

accessory; results from a failure of fusion of separate splenic masses forming on the dorsal mesogastrium

Question 14

within the lobules of the spleen are tissues called _____

Answer 14

pulp; red pulp and white pulp

Question 15

_____ pulp is distributed throughout the spleen in tiny islands; this tissue consists of splenic nodules, which are similar to those found in lymph nodes and contain large number of lymphocytes

Answer 15

white; consists of the malpighian corpuscles, small nodular masses of lymphoid tissue attached to the smaller arterial branches

Question 16

_____ pulp fills the remaining spaces of the lobules and surrounds the venous sinuses; contain relatively large numbers of red blood cells, which are responsible for its color, along with many lymphocytes and macrophages

Answer 16

red; consists of splenic sinuses alternating with splenic cords

Question 17

_____ of erythrocytes and the breakdown of hemoglobin occur throughout the entire reticuloendothelial system, but roughly half the catabolic activity is localized in the normal spleen

Answer 17

phagocytosis

Question 18

in anomalies such as the hemolytic anemias, the splenic phagocytes become engorged with _____ when erythrocyte destruction is accelerated

Answer 18

hemosiderin

Question 19

_____ is the process of removing the nuclei from the red blood cells

Answer 19

pitting

Question 20

_____ is the process by which the spleen removes abnormal red blood cells

Answer 20

culling; the spleen also pools platelets in large numbers

Question 21

sequestration of leukocytes in the enlarged spleen may produce _____

Answer 21

leukopenia

Question 22

_____ indicates the percentage of RBC’s per volume of blood; abnormally low indicate hemorrhage or internal bleeding within the body

Answer 22

hematocrit

Question 23

the test for ______ indicates the presences of bacteria within the body; the term sepsis indicates bacteria in the bloodstream

Answer 23

bacteremia

Question 24

an increase in the number of white cells (_____) present in the blood is usually a typical finding in infection

Answer 24

leukocytosis

Question 25

abnormal decrease in white blood corpuscles (_____) may be secondary to certain medications or bone marrow disorder

Answer 25

leukopenia

Question 26

_____ is an abnormal disease in platelets, which may be due to internal hemorrhage

Answer 26

thrombocytopenia

Question 27

_____ hypoechogenic structures in the area of the splenic hilum may indicate portal hypertension with collateral vessels or enlarged lymph nodes

Answer 27

increased

Question 28

advanced atrophy is sometimes referred to as _____

Answer 28

autosplenectomy

Question 29

in acute _____, active hyperemia accompanies the reaction in the moderately enlarged spleen ; in chronic, diffuse enlargement of the spleen occurs

Answer 29

splenic congestion; most common cause is cirrhosis

Question 30

in systemic diseases leading to _____, the spleen is the most frequent involved organ

Answer 30

amyloidosis; nodular or diffuse; in nodular amyloid is found in the walls of the sheathed arteries and within the follicles, but not in red pulp; in diffuse the follicles are not involved, the red pulp is prominently involved, and the spleen is usually enlarged

Question 31

with _____ there is bone pain and changes in the skin pigmentation; splenomegaly, diffuse inhomogeneity, and multiple splenic nodules

Answer 31

Gaucher's disease

Question 32

_____ disease is a rapidly progressing fatal disease that predominantly affects female infants; hepatomegaly, digestive disturbance, and lymphadenopathy

Answer 32

niemann-pick

Question 33

_____ abnormalities include sickle cell, hereditary spherocytosis, hemolytic anemia, chronic anemia, polycythemia vera, thalassemia, and myeloproliferative disorders

Answer 33

erythropoietic; produce an isoechoic pattern

Question 34

in the early stages _____ the spleen is enlarged with marked congestion of the red pulp; later it undergoes progressive infarction and fibrosis and decreases in size

Answer 34

sickle cell anemia; may develop subacute hemorrhage that appears as a hyopechoic area in the periphery of the spleen

Question 35

in congenital or hereditary _____, an intrinsic abnormality of the red cells give rise to erythrocytes that are small and spheroid rather than normal, flattened, biconcave disks

Answer 35

spherocytosis; the spleen destroys sphercytes selectively; the results are bone marrow of spherocytosis and increased destruction of these cells

Question 36

_____ is the general term applied to anemia linked to decreased life of the erythrocytes; when the rate of destruction is greater than the bone marrow can compensate for

Answer 36

hemolytic anemia

Question 37

_____ hemolytic anemia can occur in its primary form without underlying disease, or it may be seen as a secondary disorder in patients already suffering from some disorder of this system

Answer 37

autoimmune

Question 38

______ is an excess of red blood cells; increase in red blood cell mass and hemoglobin concentration; vertigo, redness and pain in extremities, and blue-and-black spots

Answer 38

polycythemia; polycythemia vera is a chronic disease of unknown cause that involves all the bone marrow elements

Question 39

______ hemoglobinopathy differs from the others in that an abnormal molecular form of hemoglobin is not present; instead suppression of synthesis of beta or alpha polypeptide chains occurs resulting in deficient synthesis of normal hemoglobin

Answer 39

thalassemia; vary large spleen

Question 40

______ abnormalities include reactive hyperplasia resulting from acute or chronic infection

Answer 40

granulocytopoietic; splenomegaly with a diffusely hypoechoic pattern; histoplasmosis and tuberculosis are the most common causes

Question 41

______ is a disease characterized by reticuloendothelial hyperactivity and varying degrees of lipid storage in phagocytes are included; spleen appears isoechoic

Answer 41

reticuloendotheliosis

Question 42

in _____ disease, sometimes called nonlipid reticuloendotheliosis, proliferation or reticuloendothelial cells occurs in all tissues, but particularly in the splenic lymph nodes and bone marrow

Answer 42

letterer- siwe; found in children younger than 2 years; hepatosplenomegaly, fever, and pulmonary involvement

Question 43

______ disease is benign and chronic, in spite of many feature similar to those of Letterer-siwe disease, it usually affects children older than 2

Answer 43

Hand-Schuller-Christian; chronic course, diabetes, and moderate hepatosplenomegaly

Question 44

in majority of patients with splenic _____ the infection is spread from distant foci in the abdomen, or inflammatory process extends directly from adjacent organs

Answer 44

abscess; splenomegaly; irregular, ill defined borders; may have internal septa

Question 45

splenic ______ if acute shows wedge-shaped hypoechoic area; chronic shows wedge-shaped echogenic area (base points to periphery); look for splenic atrophy

Answer 45

infarction; related to primary diagnosis; commonly a result from emboli that arises in the heart

Question 46

patients with mycobacterial _____ show tiny, diffuse echogenic foci throughout the spleen

Answer 46

infection

Question 47

in patients with AIDS the most common finding is _____

Answer 47

splenomegaly; also could have focal lesions

Question 48

blunt trauma has 2 outcomes; if the capsule is intact, the outcome may be interparenchymal or subcapsular _____, if the capsule ruptures, a focal or free intraperitoneal hematoma may form

Answer 48

hematoma

Question 49

most splenic _____ are considered secondary caused by trauma, infection, or infarction

Answer 49

cysts; echinococcus is the only parasitic splenic cyst; look for tissue compression

Question 50

hematoma may be solitary or multiple and is considered well-defined but not encapsulated; consists of _____ tissue or a combination of sinuses and structures equivalent to pulp cords of normal splenic tissue

Answer 50

lymphoid; has both solid and cystic components; hyperechoic

Question 51

_____ is usually an isolated inhomogeneous echogenic mass with multiple small hypoechoic areas; complications occur when the tumor increases in size to cause a splenic rupture

Answer 51

cavernous hemangioma; infarction with coagulated blood or fibrin in the cavities may be seen

Question 52

_____ is a benign malformation of the lymphatics, consisting of endothelium-lined cystic space

Answer 52

cystic lymphangioma; multicystic appearance

Question 53

_____ is a rare malignant neoplasm arising from the vascular endothelium of the spleen; mixed cystic patters resemble that of a cavernous hemangioma

Answer 53

hemangiosarcoma

Question 54

the spleen is commonly involved in _____; four patterns 1) diffuse involvement 2) focal small nodular lesions 3) focal large nodular lesions, and 4) bulky disease

Answer 54

lymphoma

Question 55

metastases are the result of a _____ spread from another primary site; may originate in the breast, lung, ovary, stomach, colon, kidney, or prostate or from melanoma

Answer 55

hematogenous