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52 Cards in this Set
- Front
- Back
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Spleen Location |
Posterior Lt. Hypochondrium Between fundus of stomach & Diaphram
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Spleen is |
Largest single mass of lymphoid tissue in the body Reticulendothelial system (synthesis of blood protein) Fetal life < 6mo-blood formation (hematopoiesis) fetal life > 6mo-Defense of Body Intraperitoneal organ |
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Spleen Measurements |
9-13cm length ~ 7cm AP 3-4 cm thick
generally a little larger than kidney |
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Blood is supplied to spleen by _____ ______ that travels horizontally along the superior border of the pancreas. |
Splenic Artery |
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_______ is formed by multiple branches within spleen & leaves hilum in a horizontal direction to join the superior mesenteric vein. |
Splenic Vein |
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_______ _______ describes a spleen that has migrated from its normal location in the left upper quadrant. |
Wandering Spleen |
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_______ is complete absence of the spleen.
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Splenic Agenesis (a.k.a. asplenic)
Causes no difficulties however may be part of major congenitital abnormality |
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Accessory Spleen |
a.k.a. splenunculus Common congenital anomaly, failure of fusion found in 30% of pts. sono: homogeneous pattern similar to spleen. Usually found near the hilum |
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Spleen is composed of what two components? |
White Pulp & Red Pulp |
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_______ removes old red blood cells through phagocytosis. |
Red Pulp |
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Defense.
_______ consists of small nodular masses of lymphoid tissue attached to smaller arterial branches. |
White Pulp |
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_______ is the process of removing nuclei from red blood cells. |
Pitting |
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_______ is the process of removing or killing off abnormal red blood cells. |
Culling |
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Indicates percentage of RBC's/volume of blood |
Hematocrit (Hct) |
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Indicates the presence of bacteria in blood. a.k.a. Sepsis |
Bacteremia |
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An increase in WBC's in the blood that may indicate infection, malignancy, Leukemia or post-op. |
Leukocytosis |
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Abnormal decrease in White Blood corpuscle.
Maybe secondary to bone marrow disorder. |
Leukopenia |
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An abnormal decrease in platelets |
Thrombocytopenia |
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Spleen sonographically |
Uniform homogenous mid to low-level echo. More echogenic than that of the liver Smooth, ovoid, even borders, concave inferior surface |
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Splenomegaly |
Enlargemt > 13cm. Most common dz. process encountered by sonographer Volume meas. necessary
s/s: LUQ pain or fullness |
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Amyloidosis |
Spleen is most freq. involved organ.
sono: normal ==> enlarged size Nodular Type: found in walls of sheathed arteries & within follicle but NOT Red Pulp Diffused Type:Red Pulp Predominantly involved, spleen greatly enlarged & Firm. NO Follicle involvement
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Sickle Cell Anemia |
Early stage: (infant & child) spleen enlarged w/marked congestion of red pulp Later Stage: progressive infarction, fibrosis & decrease in size until (Adult) ONLY a sm. mass of fibrous tissue may be found (autospleenectomy)
sono: spleenomegaly, sudden decrease in Hct., Subacute hemorrhage, hypoechoic in periphery of spleen |
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Hemolytic Anemia |
General term applied to anemia linked to decreased life of erythrocytes.
Rate of destruction > bone marrow compensation
The spleen may be enlarged. |
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Polycythemia |
Excess of RBC's |
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Polycythemia Vera |
Chronic disease of unknown origin Involves ALL bone marrow elements s/s: weakness, fatigue, vertigo, tinnitus, irritability, splenomegaly, flush face, redness & pain in extremities, & blue-&-black spots sono: Enlarged, firm, blue-Red, Infarcts & thrombosis |
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Spleenic Abscess |
Uncommon b/c phagocytic activity of spleens efficient reticuloendothelial system & leukocytes. s/s: subtle fever, LUQ tenderness, Abd. pain, Lt. shoulder & flank pain, spleenomegaly sono: simple cystic pattern ==> mixed echo pattern, lesion may be hypoechoic, may have hyperechoic foci (gas/debris), thick or shaggy walls, anechoic (w/o echoes) poor definition |
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AIDS |
Spleenomegaly most common finding multi-organ involvement: liver, kidney, spleen focal lesions sono: moderate spleenomegaly, multiple, hypoechoic & well defined sm. round lesions |
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Splenic infarction |
Most common cause of focal splenic lesions Resulting from occlusion of major splenic artery or branches Almost always result of emboli from heart, mural thrombi or vegatative valve (lt. heart) sono: localized hypoechoic area, fresh infarct: hypoechic healed infarct: echogenic, peripheral, wedge shaped lesion wall Infarct may become nodular or hyperechoic w/time |
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Spleen's most commonly injured as a result of _______ _______ _______. |
Blunt Abdominal Trauma
splenic hematoma or subcapsular hematoma
sono: life saving diagnpsis for pts. i.e. Emergency laporotomy |
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Splenic cyst's |
Parasitic or nonparasitic in origin. Most secondary cysts by trauma, infection or infarction sono: hypoechoic==> anechoic foci w/well defined walls & increased through transmission. sm.==>very lg. Internal echo w/increase Gain. hemorrhage==>fluid level Infectious cysts==> calcifications Post traumatic cysts==>no cellular lining (a.k.a. pseudo cyst) may also have calcification |
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_______ is the only parasite that forms splenic cysts . It is uncommon in the US |
Echinococcus is the only parasite that forms cysts |
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Hamartoma |
Asymptomatic. Solitary or multiple Considered well defined but not encapsulated sono: Both solid & cystic components hyperechoic |
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Rare in the pediatric age group |
Symptomatic Splenic Hamartomas |
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Cavernous Hemangioma |
Isolated inhomogeneous echogenic mass Multiple sm. hypoehoic areas. Asymptomatic Symptomatic only when size of spleen increases & compresses other organs SONO: variable, well defined echogenic ==> complex pattern, infarction |
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Hemangiosarcoma |
Rare malignant neoplasm Arising from vascular endothelium of spleen
sono: mixed cystic US pattern, resemvles cavernous hemangioma, can be hyperechoic |
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Lymphoma |
Spleen is commonly involved SONO: difficult to see, When seen typically hypoechoic w/some focal areas, 4 patterns: 1) Diffuse involvement 2) Focal sm. nodular lesion 3) Focal Lg. nodular lesion 4) Bulky dz. Type1&2 predominantly low-grade Lymphoma & Hodgkin dz. |
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Metasases |
10th most common site Origin: breast, lung, ovary stomach, colon, kidney, prostate or melanoma Result of hematogenous spread microscopic sono: Melanoma deposit==>hypoechoic , hyper echo than lymphoma, some echo dense |
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Gaucher's Dz. |
~ 50% < 8 y.o. & 17% < 1 y.o. s/s: chronmic course w. bone pain & skin PIGEMENTATION
sono: spleenomegaly, diffused inhomogeneity, multiple nodules (well defined hypoechoic lesions). Irregular hyperechoic or mixed Nodules |
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Niemann-Pick Dz. |
Predominantly Female
s/s: hepatomegaly, GI disturbances, lymphadenopathy |
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Diffuse Dz. |
Erythropoietic Abnormalities include: sickle cell, hereditary spherocytosis, hemolytic anemia, polycythemia vera, thalassemia & myeloproliferative disorders |
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Congenital Spherocytosis |
Intrinsic abnormality of RBC's
Hereditary or Congenital
Erythrocytes are sm & spherical instead of biconcave disk |
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Autoimmune HemoLytic Anemia |
sono: Spleen variably enlarged
1-without dz. 2-pt. with Lymphoma, Leukemia, Infectious Mononucleosis |
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Thalassemia |
Spleen severly involved. vary in size & shape
sono: Spleen very large, seemingly to fill entire abd. cavity |
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Myeloproliferative Disorder |
include : chronic & acute myelogenous leukemia, polycythemia vera, myelofibrosis, megakaryocyctic leukemia & erythroleukemia sono: isoechoic US pattern, parenchyma hypoechoic compared to liver |
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Granulocytpoietic Abnormalities |
include: reactive hyperplasia resulting from acute/chroni infection
sono: spleenomegaly, diffusely hypoechoic pattern, Bright echogenic lesion with/without shadowing (pt. w/hx. granulo. infect.) May also have calcium in splenic artery |
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Reticuloendotheliosis |
Hyperactive Reticulendotheia & varying degree of storage of lipids in phagocytes
sono: isoechoic |
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Letterer-Siwe Disease |
a.k.a. nonlipid reticuloendotheliosis Proliferation of Reticuloendothelial cells in all tissues generally < 2 y.o. s/s: hepatospleenomegaly, fever, Pulm. involvement, Rapidly FATAL sono: moderately enlarged |
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Hand-Schuller-Christain disease |
Similar to Letterer-Siwe Dz. generally >2 y.o. s/s: chronic course, DM, hepatospleenomegaly
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Lymphopoietic Abnormalities |
include: lymphocytic leukemias, lymphoma, Hodgkin dz.
sono: diffusely hypoechoic spleenic pattern w/ focal lesions non-Hodgkin lymphoma-isoechoic pattern |
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Spenic Infection |
Most prominent feature-spleenomegaly sono: hepatosplenic candidiasis- "Wheel within wheel" pattern w.central hypoechoic area or "Bull's Eye" Pattern, hypoechoic nodule, hyperechoic nodule Mycobacterial- tiny diuffuse echogenic foci throughout spleen TB (active)-echo poor cystic masses
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Cystic Lympangioma |
Benign malformation of Lymphatics Predominantly somatic soft tissue (neck, retroperitoneum, etc) Involve Multi-organ system or confined to solitary organ ( liver spleen, kidney, colon)
sono:Appears as a mass w/extensive cystic replacemnt of splenic parenchyma |
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Splenic Ligaments |
Spleenorenal Ligament: (peritoneal ligament) attaches spleen to stomach & Kidney Gastrosplenic Ligament: separate lesser & greater sac Lienorenal Ligament: Phrenicocolic Ligament: |
