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Flashcards in Spleen Deck (37)
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Functions

Breakdown hemoglobin, form bile pigment, form antibodies, resovoir for blood.

Iron storage, defense against disease, erythropoiesis

1

The stomach is _ to the splenic hilum

Anterior and medial

2

The tail of the panc is ___ to the st

Posterior

3

The left kid is __ to the spleen

Inferior medial

4

The tail of the panc is ___ to the upper pole of the left kid

Anterior

5

Name 5 structures that appear as cystic splenic masses

Cystic degenerations of infarcts or hematomas

Cyst assoc with PCK

Parasitic cysts (echinococcol)

Epidermoid cyst

Panc pseudocyst

6

Spleen location, length

Intraperitoneal
9-11 rib LUQ
< 13 cm L
Covered by capsule and peritoneum except hilum

7

Ligaments

Lienorenal
Gastrosplenic
Phrenocolic

8

White and Red Pulp

Filters blood

White pulp consist of lymphatic tissue, lymphatic follicles, antibody production

Red pulp is framework of reticular cells and fibers known as cords of Billroth that surround the venous sinusoids. Monocytes and macrophages

9

Aplasia

No spleen
Rare
Assoc with lethal malformations (❤️)

10

Hypoplasia

Small spleen
More common than Aplasia

11

Accessory spleen

Extra small spleen
Usually in hilum
< 5 cm
Isoechoic with spleen
May look like tumor or lymphadenopathy

Connecting vessel from accessory spleen to normal spleen

12

Ectopic spleen / wandering spleen

Due to lack of ligaments, can torse & infarct
< .5%
Females 90%
Prophylactic splenectomy

Assoc with extreme weight loss, weak abd muscle, splenomegaly, multiparous females

13

Polysplenia

2 spleens

Assoc with vasc anomalies, biliary atresia, CHD, abnl situs

14

Reasons for splenomegaly

Chronic inflammatory disease, malaria, TB, portal HTN, cirrhosis, hemolytic disease, sickle cell, thalecemia, infiltrative disease, leukemia, Hodgkin's lymphoma, metabolic disease, gauschers's, Nieman Picks, trauma, hematoma

Portal HTN, aids, infection

15

Splenomegaly

> 12 cm L

16

Cyst

PKD, simple cyst, acquired post inflammatory, trauma, parasitic, neoplastic

17

Abscess

Due to infection
Usually multiple
Fever, abd pain, lt chest & shoulder pain

Complex, ring down from gas

18

Infarcts

Wedge shape hypo lesion, no Doppler

Caused by occlusion of vessels
Sudden onset of LUQ pain
Usually from emboli (❤️ clot)

MC assoc with endocarditis
Leukemia, sickle cell anemia, lymphoma, vasculitis, valvular heart disease, pancreatitis, mets

Wedge shape
Round, well defined, hypo initially then hyper

19

Trauma

Organ most often damaged with trauma
Car accidents MC cause

LUQ pain, dec hematocrit, syncope, hypotension

Assoc with rupture

Splenomegaly, hematoma may appear any echogenicity, splenic laceration/fracture,

free fluid, sub capsular hematoma, perisplenic hematoma, splenic laceration

20

Structures in contact with the spleen

Left hemidiaphragm
Stomach
Pancreas
Splenic flexure of colon

21

Best spleen long axis view

Intercostal coronal view with patient supine

22

Portal HTN shows

Moderate splenomegaly and dilated tortuous vessels at the splenic hilum

Evaluate liver and portal vein

23

Pancreatic tails are ____ to spleen

Inferior medial

24

Spleen echo texture

Homogeneous, mid to low level echoes

25

Transducer for splenomegaly

5MHz curvilinear

26

Spleen

LUQ, intraperitoneal, lies between the fundus of the stomach and the diaphragm, meas < 12 cm, normal spleen dec in size and weight with age

27

Pitfall

Inter coastal produces rib shadowing
Hepatomegaly left liver lobe may be mistaken for spleen
Mass in tail of panc may be confused with splenic mass
Accessory spleen may be confused with a large lymph node

28

Histoplasmosis US findings

Multiple focal bright echogenic granulomatous lesions throughout spleen

29

Splenic vein drains into

Portal Vein