Spleen Flashcards
(89 cards)
1
Q
What is Grey Turner’s Sign
A
discoloration of the glands due to the necrosis of blood vessels which results in hemorrhage
2
Q
_______- is a fluid collection that develops a well defined wall in response to enzymes
A
Pseudocyst
3
Q
what is the most common spleen pathology?
A
Splenomegaly
4
Q
T or F
Is the most common cause of LUQ mass splenomegaly
A
True
5
Q
diagn. these symptoms
LUQ pain and fullness
A
splenomegaly
6
Q
what are the causes of splenomegaly?
A
- congestion
- Infection
- neoplasm
- hemolytic anemia
- storage disease
- trauma
7
Q
diag. these sonographic findings
- measures larger than 8-13 x7-8 x 6 cm
- Tip covers the lower pole of the kidney
A
Splenomegaly
8
Q
in splenomegaly the tip of the spleen covers the lower pole of the ________
A
kidney
9
Q
What is the imagin method of choice for splenic trauma
A
CT
10
Q
what are the 5 most common causes of trauma to the spleen? (
A
- MVA
- Sports Injuries
- Gunshot wounds
- Stab wounds
- Physical abuse
11
Q
what are the trama symptom? (4)
A
- LUQ Pain
- Left shoulder pain
- Left flank pain
- dizziness
12
Q
diag. these clinical findings.
- LUQ tenderness
- Hypotension
- decreased hemoglobin
A
Trauma
13
Q
Diag. these sono findings.
- splenomegaly
- irregular splenic border
- hematoma
- contusion (inhomogeneity)
- subcapular and pericapsular fluid collection
- LT pleural effusion
A
Trauma
14
Q
what are the 6 sonographic findings for trauma
A
- splenomegaly
- irregular splenic border
- hematoma
- contusion (inhomogeneity)
- subcapular and pericapsular fluid collection
- LT pleural effusion
15
Q
what is the most common cause of focal splenic lesions?
A
Infarct
16
Q
Infarct is caused by ______ of the splenic artery or any of its branches
A
occlusion
17
Q
the result of _______ almost always arise in the heart.
A
emboli
18
Q
name symptoms of infarct
A
- acute pain- sudden epidose of infarction
- asymptomatic-old infarcts
19
Q
name sono. findings of infarct?
A
- early infarcts may be hypoechoic or isoechoic
- older infarct appear hypoechoic or hyperechoic depending on the amount of fibrosis and organized clot
20
Q
name the two classifications of splenic cyst
A
true or primary cyst
secondary or pseudocyst
21
Q
primary cyst are more common in ?
A
females
22
Q
primary cyst are associated with what disease?
A
polycystic kidney disease
23
Q
Secondary cyst are usually associated with_______
A
trauma
24
Q
T or F
patients with secondary cyst always recall the trauma and are diagnosed quickly?
A
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
