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Flashcards in Spleen Deck (89):
1

What is Grey Turner's Sign

discoloration of the glands due to the necrosis of blood vessels which results in hemorrhage

2

_______- is a fluid collection that develops a well defined wall in response to enzymes

Pseudocyst

3

what is the most common spleen pathology?

Splenomegaly

4

T or F
Is the most common cause of LUQ mass splenomegaly

True

5

diagn. these symptoms
LUQ pain and fullness

splenomegaly

6

what are the causes of splenomegaly?

1. congestion
2. Infection
3. neoplasm
4. hemolytic anemia
5. storage disease
6. trauma

7

diag. these sonographic findings
-measures larger than 8-13 x7-8 x 6 cm
-Tip covers the lower pole of the kidney

Splenomegaly

8

in splenomegaly the tip of the spleen covers the lower pole of the ________

kidney

9

What is the imagin method of choice for splenic trauma

CT

10

what are the 5 most common causes of trauma to the spleen? (

1. MVA
2. Sports Injuries
3. Gunshot wounds
4. Stab wounds
5. Physical abuse

11

what are the trama symptom? (4)

1. LUQ Pain
2. Left shoulder pain
3. Left flank pain
4. dizziness

12

diag. these clinical findings.
-LUQ tenderness
-Hypotension
-decreased hemoglobin

Trauma

13

Diag. these sono findings.
-splenomegaly
-irregular splenic border
-hematoma
-contusion (inhomogeneity)
-subcapular and pericapsular fluid collection
-LT pleural effusion

Trauma

14

what are the 6 sonographic findings for trauma

-splenomegaly
-irregular splenic border
-hematoma
-contusion (inhomogeneity)
-subcapular and pericapsular fluid collection
-LT pleural effusion

15

what is the most common cause of focal splenic lesions?

Infarct

16

Infarct is caused by ______ of the splenic artery or any of its branches

occlusion

17

the result of _______ almost always arise in the heart.

emboli

18

name symptoms of infarct

-acute pain- sudden epidose of infarction
-asymptomatic-old infarcts

19

name sono. findings of infarct?

-early infarcts may be hypoechoic or isoechoic
-older infarct appear hypoechoic or hyperechoic depending on the amount of fibrosis and organized clot

20

name the two classifications of splenic cyst

true or primary cyst
secondary or pseudocyst

21

primary cyst are more common in ?

females

22

primary cyst are associated with what disease?

polycystic kidney disease

23

Secondary cyst are usually associated with_______

trauma

24

T or F
patients with secondary cyst always recall the trauma and are diagnosed quickly?

False
the patient may not recall the trauma, and may go undiagnosed for years

25

Secondary cyst are also caused by?

infection, parasite infarction

26

what is the only parasite that forms splenic cyst?

echinococcus

27

Echinococcus is the only parasite that forms splenic cyst. Appears as an _______lesion with possible ________ cyst and calcification or as a _______ mass with fine internal echoes

anechoic, daughter, solid

28

sono findings
-hypoechoic or anechoic lesion
-well defined walls
-through transmission
-may have internal echoes or debris
-hemorrhage may produce a fluid level

cyst

29

Are calcification common and usually an incidental findings?

Yes

30

Calcifications generally resultr from ?

healed granulomas and show hyperechoic areas

31

what is the most common cause of a granuloma

histoplasmosis and TB

32

T or F
Are abscesses relatively uncommon and usually singular?

True

33

What is an abscess caused by?

bacteria

34

A patient with sickle cell anemia, the abscess formation is often cause by_________?

Salmonella

35

T or F
A damaged spleen provides a good culture medium

True

36

______ trauma predisposes it to abscess formation

Blunt

37

Obese patients are also at increased risk for ________ ________.

abscess formation

38

diag. these symptoms
-vague
-fever
-abdominal pain
-luekocytosis

Abscesses

39

what is the complications of abscesses?

high mortality rate because diagnosis is often delayed

40

Sono findings
-cystic, solid or complex
-in early stages they may appear hyperechoic and may produce posterior shadowing from gas forming organisms
-over time they tend to liuefy and may even calcify

abscess

41

what is the treatment for abscess

-IV antibiotic therapy
-percutaneous drainage with US or CT guidance

42

What is the 2 rare benign primary neoplasm?

hamartoma, cavernous hemangioma

43

hamartoma has _____ and ______ components

solid and cystic(hyperechoic & well defined)

44

T of F
Hamartoma symptoms are RUQ pain

False
hamartoma has NO symptoms

45

what disease may lead to anemia and infection

cavernous hemangioma

46

cavernous hemangioma has a chance of _______ ________.

splenic rupture

47

Cavernous hemangioma has no symptoms unless the spleen ________

enlarges

48

Diag. sono findings
-large inhomogeneous mass with multiple, small hypoechoic areas
- mixed appearences
- may see infarction with coagulated blood

cavernous hemangioma

49

what is the rare malignant primary neoplasm

angiosarcoma

50

angiosarcoma arises from the ______ _______

vascular epithelium

51

what disease presents sonographically as a complex or solid mass?

angiosarcoma

52

The spleen is often involved in cases of _______or ________

lymphoma or leukemia

53

what is the most common malignant disease of the spleen?

lymphoma

54

T or F
Malignant disease of the spleen are difficult to detect?

True

55

Lymphoma is classified as _____ or ________

Hodgkin or non-hodgkin lymphoma

56

which is not easily managed and more common?
Non- Hodgkin or Hodgkin

Non Hodgkin

57

what is the microscopic difference between hodgkin or non-hodgkin?

- can be treated and carries a high recovery rate
-presence of Reed-sternberg cells indicates Hodgkin

58

what are the most common primary of metastases?

breast
lung
skin
ovary

59

what type of aneurysm is rare but life threatening?

splenic artery aneurysm

60

what is the clinical symptoms of splenic artery aneurysm?

-usually asymptomatic
-discomfort in LUQ, shoulder pain, nausea/vomiting

61

what are the predisposing factors of splenic artery aneurysm?

aterosclerosis
infective emboli
infections
trauma
portal hypertension
females of child bearing age

62

what are the sonographic appearence of splenic artery aneurysn?

-cystic mass in area of splenic artery
-To rule out-trace artery from bifurcation at celiac axis to hilum of spleen or area where cystic mass is seen
-doppler may be used to determine artery or pseudocyst
-walls may be calicfied and will be visualized in LUQ in radiograph, if calcified difficult to diagnose aneurysm

63

What is angiosarcoma?

a rare malignant tumor of the spleen that is derived from blood vessels

64

What is Epstein-Barr infection?

a herpes virus that can lead to infectious mononucleous

65

Erythropoiesis

the process of making RBCs

66

What is red pulp

specialized tissue within the spleen that performs its phagocytic function

67

What is white pulp?

specialized lymphatic tissue within the spleen

68

T/F: spleen is retroperitoneal?

False: spleen is intraperitoneal

69

What is the largest lymphatic organ?

spleen

70

When does the spleen begin to develop in gestation?

5th week

71

What is the spleen responsible for in the fetus?

erthryopoiesis

72

In childhood what is the spleen used for?

protection against deadly infection

73

What does the spleen do in adults?

produces lymphocytes and monocytes

74

What is extramedulary hematopoiesis?

when the spleen's hematopoietic function can return in cases of severe anemia

75

What do phagocytes do?

engulf and destroy pathogens

76

What is culling?

spleen removes irregular cells from the bloodstream and retains them

77

What is pitting?

cleaning red blood cells of unwanted material

78

The splenic artery branches off of?

celiac trunk

79

IS the splenic artery ant/sup or post/inf to the splenic vein at the hilum?

ant/sup

80

T/F: The spleen is best visualized with deep inspiration?

True!!

81

How does the spleen compare to the liver sonographically?

isoechoic to liver, or slightly less echogenic

82

What is the most common cause of splenomegaly?

portal hypertension

83

What is the most common benign tumor of the spleen?

hemangioma

84

Small echogenic foci (may shadow)of the spleen most often represent

granulomas

85

All of the following are splenic functions except:
a. storage of iron
b. defense against disease
c. blood reservoir
d. destruction of phagocytic cells

D. destruction of phagocytic cells

86

Estein-Barr infection is best described as

a herpesvirus that can lead to infectious mononucleousis in children

87

What systemic disease results in the development of granulomas within the spleen and throughout the body?

Sarcoidosis

88

T/F: the spleen has a convex inferior margin and a concave superior border

False

89

The splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein?

superior mesenteric vein