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Abdomin And Superficial Structures > Spleen > Flashcards

Spleen Flashcards

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1
Q

What system is the spleen part of?

A

Reticuloendothelial system

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2
Q

What process do all cells and tissue exhibit?

A

Phagocytosis

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3
Q

Where does hematopoiesis occur within a fetus?

A

Spleen, liver and bone marrow

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4
Q

Where does hematopoiesis occur postnatally?

A

Bone marrow

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5
Q

What is included within the RE system?

A

Brain, blood, spleen, liver, thymus, bone marrow and lymph nodes

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6
Q

What is blood composed of?

A

RBCs, WBCs, platelets (thrombocytes) and plasma

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7
Q

How many leukocytes are there per cubic mm?

A

5,000 - 10,000

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8
Q

What is leukocytosis?

A

Rapid division of cells in the presence of infection

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9
Q

What is leukopenia?

A

Decrease amount of leukocytes

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10
Q

When is there a decrease of leukocytes?

A

Drug and chemical toxicity and viral infections

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11
Q

What are the 5 different types of leukocytes?

A
  1. Neurophil
  2. Eosinophils
  3. Monocytes
  4. Lymphocytes
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12
Q

What WBCs perform phagocytosis?

A

Neutrophils, eosinophils and monocytes

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13
Q

What WBCs are non-phagocytic cells?

A

Lymphocytes

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14
Q

Describe the 3 processes of immune response

A
  1. Body recognizes the chemical composition of substances and decides if its alien or not
  2. If the body is alien it reacts and produces antibodies and anti-toxins
  3. Body produces memory cells- antibodies and antigens are produce specific antigen
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15
Q

What is a humoral immune response?

A

Antibodies (gamma globulins) are liberated into the plasma by committed lymphocytes

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16
Q

What is a cell mediated immune response?

A

Lymphocyte produces antitoxins that are retained within lymphocyte cell

Lymphocyte attaches to antigen and secretes antitoxin

Both antigen and lymphocyte die and are absorbed

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17
Q

What is the largest unit of the RE system?

A

Spleen

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18
Q

When does the spleen develop?

A

5th week gestation

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19
Q

What type of cells does the spleen arise from?

A

Mesodermal cells

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20
Q

When does the spleen start performing hematopoietic functions?

A

Starting at 11 weeks gestation

This function ends shortly after birth

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21
Q

When does the spleen assume adult function?

A

5th or 6th month gestation

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22
Q

What cavity is the spleen located in?

A

Retroperitoneal

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23
Q

Is the hilum covered in peritoneum?

A

No

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24
Q

Is the spleen encapsulated?

A

Yes

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25
What quadrant does the spleen lye in?
LUQ
26
What rib does the long axis of the spleen lye by?
10th rib
27
What ligaments anchor the spleen in place? (3)
1. Gastrosplenic 2. Splenorenal 3. Phrenocolic
28
What structure is superior/lateral/posterior to the spleen?
Diaphragm
29
What structures are medial to the spleen? (4)
1. Stomach 2. Tail of pancreas 3. Splenic flexure of colon 4. Left kidney
30
What structure is anterior to the spleen?
Stomach
31
What is the average adult size of the spleen?
L: 11cm but not > 12cm W: 7-8cm H: 3-4cm
32
What is the normal size of the spleen?
Up to 12cm
33
What is the moderate size of the splenomegaly?
> 12 -18cm
34
What is the size of severe splenomegaly?
> 18cm
35
When is the spleen is considered enlarged?
In decubitus position: more then twice the size of the kidney Visualize a flattened caudal kidney
36
What occurs to the size of the spleen as you age?
Decreases in size
37
How is the spleen shaped?
Crescent-shaped Lateral- smooth convex side in contact in left hemisphere Medial- concave side contains central hilum
38
What forms the splenic vein?
Smaller splenic veins converging at the hilum
39
The splenic artery branch into how many smaller arteries?
6
40
Which ligament do the vessels course through?
Splenorenal ligament
41
How does the splenic vein communicate with celiac nodes?
Efferent lymphatics
42
Is the spleen essential for life?
No- but immune response may be impaired if removed in childhood
43
How is the spleen divided into lobules?
Via projections of connective tissue capsule
44
What are the 2 types of pulp the lobules are divided into?
1. Red pulp | 2. White pulp
45
Describe red pulp
Venous component Meshwork of splenic sinuses alternating with splenic cords (cords of billroth) Phagocytic cells line the sinusoids
46
Describe white pulp
Tiny islands of lymphatic tissue consisting- lymphocytes and macrophages Major site of immunological activity- lymphatic follicles (malpighian corpuscles) responsible for production of antibodies
47
What is the function of the RE?
Produce lymphatics and plasma cells (antibodies) Storage of iron and metabolites
48
What is the primary function of the spleen?
Filter blood Culling- removes destroys imperfect/defective RBCs Pitting- removes granular inclusions in the RBCs
49
What are other functions of the spleen?
Blood reservoir Erythropoiesis
50
How much blood can the spleen hold?
50-1000ml
51
What takes over erythropoiesis after birth?
Bone marrow
52
Does the spleen retain the ability of erythropoiesis after birth?
Yes
53
What is the pt prep for the spleen?
Overnight fast (6-8 hours)
54
What transducer is used for the spleen?
3.5-5.0 MHz
55
What do you evaluate the spleen for?
Size, position, focal abnormalities and surrounding fluid
56
What does the sagittal plane show in for the long axis?
Superior and inferior tips of spleen
57
How do you image the spleen in the transverse plane?
Always 90deg the long axis
58
When can the spleen be used as a sonographic window?
Pancreatic tail and left kidney
59
What is the sonographic appearance of the spleen?
Homogeneous- low to medium level echos
60
Compare the echogenicity of the spleen to the kidney
More echogenic
61
Compare the echogenicity of the spleen liver
Isoechoic or slightly more echogenic
62
What is a pseudoperisplenic lesion?
Lesion that mimics a sub capsular hematoma or abscess
63
Where is a pseudoperisplenic lesion found?
Left lobe of the liver identified superior to the spleen
64
What type of people are more likely to have a pseudoperisplenic lesion?
Thin pts and children
65
What structures can be mistaken for a mass when scanning the spleen?
Fluid filled stomach or tail of pancreas
66
What is a "born again" spleen?
Hypertrophy of an accessory spleen or other splenic tissue post-splenectomy (due to components of blood)
67
What are the 4 lab tests used to identify function of the spleen?
1. Hematocrit 2. Hemoglobin 3. WBCs 4. Platelets
68
What does hematocrit identify in the blood?
% of RBCs per volume of blood
69
What can cause hematocrit to decrease?
Hemorrhage or internal bleeding
70
What is hemoglobin responsible for?
Protein in RBCs responsible for transporting oxygen
71
What can cause a decrease in hemoglobin?
Acute blood loss, anemia, leukaemia and multiple myeloma
72
What is leukocytosis?
Increased WBC count
73
When can leukocytosis occur?
Acute infection, leukaemia, malignancies and stress
74
What is leukopenia?
Decreased WBC count
75
What is another name for platelets?
Thrombocytes
76
What is thrombocytopenia?
Decreased platelets in blood
77
What conditions can cause thrombocytopenia?
Internal hemorrhage, leukemia or Vit B12 deficiency
78
What is thrombocytosis?
Increased platelets in the blood
79
What conditions can cause thrombocytosis?
Hemorrhage or infective disorders
80
What are other imaging modalities that can look at the spleen?
1. Nuclear medicine- RBC scan (radioactive tracer injected into blood- used to assess morphology of spleen (splenic volume)) 2. CT

Abdomin And Superficial Structures (12 decks)

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