Spleen Patho & Lymphatic Flashcards
(112 cards)
1
Q
What is wandering spleen?
A
abnormal migration during developmental stages of embryology
2
Q
Where is the spleen located with wandering spleen?
A
outside of the normal LUQ, somewhere in abd/pelvis
3
Q
What are the S&S of wandering spleen?
A
asymptomatic, tenderness, possible torsion
4
Q
What is the sono appearance of wandering spleen?
A
abdominal/pelvic mass, decreased color flow in complete torsioin
5
Q
What is splenic agenesis?
A
complete embryologic absence of spleen, occurring with addl congenital abnormalities
6
Q
What is splenic agenesis AKA?
A
asplenia
7
Q
What are S&S of splenic agenesis?
A
increased risk of infectious disease
8
Q
What is accessory spleen?
A
collection of splenic tissue separate from the spleen
9
Q
How many people have splenule(s)?
A
30%
10
Q
What are S&S of accessory spleen?
A
asymptomatic, palp lump depending on size/location
11
Q
What is the sono app of accessory spleen?
A
homogenous, iso to spleen, near hilum or sup border
12
Q
What is splenic atrophy?
A
decrease in splenic tissue volume, technically benign but assoc with wasting diseases
13
Q
What are S&S of autosplenectomy?
A
asymptomatic, symptoms assoc with causative disease
14
Q
What is the sono app of splenic atrophy?
A
small spleen or not visualized due to lack of tissue
15
Q
What are S&S of splenomegaly?
A
infectious patients, metabolic disturbances, hematopoietic disorders
16
Q
What is the sono app of splenomegaly?
A
changes in size, texture, vascularity, increased volume
17
Q
What is amyloidosis?
A
excessive production of amyloid proteins in organs, most commonly the spleen
18
Q
What are S&S of amyloidosis?
A
- systemic diseases
- fatigue, weakness
- joint pain
- weight loss
- skin changes
19
Q
What is the sono app of amyloidosis?
A
enlarged, size depends on amount of build-up
20
Q
What is Gaucher’s disease?
A
rare metabolic disorder, abnormal accumulation of specific lipid cells in specific organs
21
Q
Where does Gaucher’s disease mostly affect?
A
liver and spleen
22
Q
Who is affected by Gaucher’s disease?
A
all ages
50% younger than 8
17% younger than 1
23
Q
What is the sono app of Gaucher’s disease?
A
splenomegaly, heterogenous spleen, multiple hyperechoic nodules
24
Q
What is Neimann-Pick disease?
A
metabolic disorder that causes inability to metabolize lipid cells, cells malfunction = apoptosis
25
Who is affected by Neimann-Pick disease?
hepatomegaly, lymphadenopathy, digestive complications
26
What are S&S of sickle cell anemia?
- fatigue, weakness
- infections
- joint pain
- dizziness
27
What is the sono app of sickle cell anemia?
early: enlarged spleen
late: infarction, fibrosis, atrophy
28
What is hemolytic anemia?
inadequate healthy RBC, decreased lifespan of erythrocytes
29
What is autoimmune hemolytic anemia?
caused by autoimmune response or disease
30
What do primary and secondary autoimmune hemolytic anemia refer to?
primary: without disease
secondary: with disease
31
What are some causes of autoimmune hemolytic anemia?
lymphoma, leukemia, infectious mono
32
How large are splenules typically?
< 1 cm
33
The spleen should be under ____ cm long
12
34
What percentage of African Americans have sickle cell anemia?
8%
35
What is the sono app of autoimmune hemolytic anemia?
splenomegaly
36
What is polycythemia vera?
excess RBC, unknown cause that involves all bone marrow elements
37
What are S&S of polycythemia vera?
- weakness, fatigue
- vertigo, tinnitus
- irritability
- erythema, painful extremities, contusions
38
What is polycythemia vera?
splenomegaly, infarction, thrombosis
39
What is thalassemia?
inadequate amount of hemoglobin leading to anemia, causes destruction of RBC
40
What is the sono app of splenic infarction?
hypoechoic triangles in the spleen
41
How do you get thalassemia?
inherited
42
What is the sono app of thalassemia?
splenomegaly
43
What are S&S of mono?
- tenderness/swelling in LUQ
- swollen lymph nodes
- fever
- sore throat
44
What is FAST exam?
focused assessment with sonography for trauma
45
What needs to be checked during FAST exam?
- 4 quads
- morisons pouch
- subdiaphragm
- liver/splenic capsules
- bladder/rectal regions
46
What are S&S of trauma?
decreased hematocrit and shock
47
What is being evaluated during a trauma exam?
looking for hemorrhage or free fluid
48
Who is at increased risk of splenic abscess?
- drug use
- endocarditis
- decreased immunity
- trauma
49
What is the sono app of splenic abscess?
- focal collection of purulent material within parenchyma
- target appearance
- splenomegaly
50
What is splenic infarction?
death of focal splenic tissue, can affect segment or entire organ
51
What is splenic infarction the most common cause of?
focal splenic lesions
52
What causes infarction?
occlusion of splenic artery/branches
53
Who is likely to experience splenic infarction?
Pts with
- pancreatitis
- leukemia
- lymph disorders
- SCA
54
What is the sono app of infarction?
acute: hypoechoic wedge
chronic: echogenic wedge
55
What is splenic hemangioma?
proliferation of vascular channels, cluster of blood vessels
56
What is the most common benign splenic tumor?
hemangioma
57
What is the sono app of hemangioma?
- isolated
- heterogenous echogenic mass w multiple sm hypo areas
58
What causes heterogeneity of a hemangioma?
areas of cystic changes or hemorrhage
59
What is hemangiosarcoma?
rare malignant neoplasm rising from vascular endothelium of spleen
60
What are S&S of hemangiosarcoma?
- weakness, fatigue
- loss of appetite, weight loss
- tumor rupture, hemorrhage
61
What is the sono app of hemangiosarcoma?
cystic/solid components, hyperechoic
62
What is hamartoma?
abnormal mixture of cells and tissues, mainly lymphoid tissues
63
Is hamartoma benign?
yes
64
What is the sono app of hamartoma?
cystic/solid components, iso/hyper echoic
65
What is lymphangioma?
malformation of lymphatics, consists of cystic spaces varying in size, may involve other organs
66
Is lymphangioma benign?
yes
67
What are S&S of lymphangioma?
asymptomatic and possible tenderness in spleen, variable symptoms depending on addl organs
68
What is the sono app of lymphangioma?
multiple cysts, solitary or grouped
69
How does lymphoma affect the spleen?
spleen is most commonly involved organ, MC Hodgkin's & Non-Hodgkin's
70
What is the sono app of lymphoma in spleen?
- difficult to visualize
- focal or diffuse lesions
- possible splenomegaly
71
What is the sono app of AIDS lymphoma?
uniform decreased echogenicity or focal hypoechoic lesions
72
How does cancer spread to the spleen?
hematogenous spread (through blood supply)
73
How common are mets to the spleen?
10th MC site of mets
74
What is the sono app of mets to the spleen?
- multiple or solitary
- nodularity
- diffuse lesions
- target or halo lesions
75
What is the immune system?
network of tissues and organs that work together to fight off bacteria, infections, viruses, toxins
76
What is the difference between lymphatic and immune systems?
lymphatic system is part of the immune system
77
What is the thymus?
Where lymphocytes mature, lymphatic
78
What are the tonsils/adenoids?
filters bacteria entering mouth/nose, immune
79
What are lymph nodes?
distribute WBCs and filter lymph fluid
80
What does the spleen do?
controls amount of RBCs, produces WBCs, lymphatic
81
What does bone marrow do?
produces RBCs, platelets, WBCs, lymphatic
82
Where are mucous membranes located?
nose, throat, bladder, genitals
83
What is the lymphatic system?
Collects and filters excess fluid and returns it back to bloodstream, vital to immune defense
84
Once fluid is absorbed into lymph ducts, it is known as
lymph fluid
85
What is the lymphatic system made up of?
- lymph nodes
- lymphatic vessels
- lymphatic ducts
- lymph fluid
86
What are lymph vessels?
thin walled vessels that transport lymph fluid around different parts of the body
87
What do afferent lymph vessels do?
Bring lymph into lymph node
88
What do efferent lymph vessels do?
Drain processed lymph from lymph node and back into lymph vessels
89
What kind of tubes are lymph ducts?
Blind ended or non-continuous
90
What direction is lymph fluid transported? How is this ensured?
proximally (up the body), valves in the vessels keep fluid moving proximally
91
How is lymph fluid transported?
lymph ducts, lymph vessels, lymph nodes, lymph vessels, venous system
92
What is lymph fluid?
clear, colorless fluid
contains proteins, minerals, nutrients, damaged cells, cancer cells, foreign particles
93
When is lymph fluid produced?
When fluid leaves the capillary bed in tissues due to hydrostatic pressure
94
What percentage of blood volume becomes lymph?
~ 10%
95
What are lymph nodes?
small bean shaped glands
96
Where are lymph nodes located?
Along lymphatic system throughout body
MC seen on US in axilla, groin, submandib region
97
What do lymph nodes contain?
WBCs used to fight infection while filtering lymph fluid
98
What is the composition of a lymph node?
- hilum
- medulla
- cortex (hypo border)
- surrounded by fibrous capsule
99
What are lymph nodes located closely called?
Lymph node chain
100
How many lymph nodes are in the body? Where are they largest?
600 lymph nodes, largest in axilla, inguinal region, submandib
101
What is the sono app of a normal lymph node?
- hypoechoic to surrounding muscle
- echogenic fatty hilum
- smooth borders
- central hilar vascularity
102
How thick should the cortex of a normal lymph node be?
3 mm max, measure anterior cortex
103
What is compartment 1A?
submental nodes (anteromedial)
104
What is compartment 1B?
submandibular nodes (posterolateral)
105
What is compartment 2A? 2B?
anterior to IJV, posterior to IJV
106
What is compartment 3?
from hyoid bone to cricoid cartilage
107
What is compartment 4?
from cricoid cartilage to clavicle
108
What is compartment 5A? 5B?
superior to cricoid cartilage, inf to cricoid cartilage
109
What is compartment 6?
from hyoid bone to sternal notch
110
What are malignant characteristics of lymph nodes?
- enlarged
- round
- mostly hypoechoic
- loss of hilum
- heterogenous
- thickened cortex
- microcalcs
- cystic components
- ill defined borders
- hypervascular, peripheral flow
111
What should you do when documenting a lymph node in the neck?
Document the palp node and take images of bilateral cervical node chain
112
What should you do when documenting a lymph node in the axilla?
Document palp node and show other surrounding nodes, # of nodes in axilla
