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| The splenic artery arises from the ______ and travels along the _________ aspect of the ______ ______. | celiac axis, poster superior, splenic hilum
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| Most splenic cysts result from____. | trauma
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| Splenomegaly is defined as a length longer than ______ and a width (thickness) of greater than _____. | 13cm, 6 cm
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| The splenic parenchyma is _________ when compared to the liver. | more echogenic
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| What are some of the causes of splenic infarction? | embolic phenomenon as well as thrombosis of splenic artery, splenic vein, and their branches.
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| Small nodules of splenic tissue found in the LUQ near the spleen are referred to as? | splenules, accessory spleens, splenunculi, and supernumerary spleens
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| The splenic vein travels along the _____ aspect of the pancreas to form a confluence with the ______ and _____. | posterior, superior mesenteric vein, portal vein
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| What are some common causes of splenomegaly? | heart failure, portal hypertension, leukemia, lymphoma, hepatitis, mono, general infections, and hemolytic anemia
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| What is splenosis? Describe what causes it and how it appears. | this is a condition that may develop after splenic trauma. It consists of the implantation of splenic tissue onto intraperitoneal surfaces with subsequent vascularization and growth. Nodule are homogenous in their echogenicity and usually round or ovoid.
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| What is the most common primary tumor to spread to the spleen? | malignant melanoma
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| Describe what a splenic infarct looks like songraphically? | wedge shaped, hypoechoic lesion. Early on hypoechoic, later may be more cystic, then calcify or have calcifications.
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| Melastases to the spleen are common/uncommon? | uncommon
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| What are two common granulomatous diseases that may produce multiple small calcifications in the spleen? | histoplasmosis and tb
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| T/f. the spleen is uncommonly involved in victims of upper trauma abdominal trauma. | false
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| What is the best approach when scanning the spleen? | from a high poster lateral intercostal approach with the pt. supine.
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| The spleen is a ______ organ | peritoneal
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| The spleen is located ? | in the left upper quad. Between the stomach and diaphragm.
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| The spleen is the largest lymphoid organ that filters ________ , ______, and ______. | damaged cells, microorganisms, and particulate matter.
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| The spleen is rarely the site of this? | primary disease
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| What are the major functions of the spleen? | active blood formation during fetal life, reservoir for blood, supplies body with blood during emergencies, delivers antigens to the immune system, creates lymphocytes for the destruction and recycling of old RBCs, and the major function is to filter peri
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| What is the major function of the spleen? | to filter peripheral blood
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| This is a soft organ with elastic properties which allows it to distend as blood fills the venous sinuses? | spleen
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| What does the average adult spleen measure? | 12 cm long, 8 cm Trans, 4 cm thick
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| The spleen should not extend past the? | lower pole of the left kidney
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| The splenic artery feeds the spleen what? | oxygenated blood
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| Where does the splenic artery travel? | on the superior body of the pancreas to the spleen.
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| Upon entering the hilum, the splenic artery branches how many time? | 6
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| The splenic vein is formed by? | multiple branches within the spleen.
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| The splenic vein leaves the hilum and goes where? | to the portal vein to the liver
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| The splenic vein travels along the ______ border of the pancreas. | posterior (inferior)
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| What is a name that the medial spleen is called? | visceral surface of the spleen
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| T/F. A normal liver does not touch the spleen. | T
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| When would the liver touch the spleen? | splenomegaly or hepatomegaly
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| The stomach, left kidney, pancreas, and splenic flexure of the colon are located where in relation to the spleen? | medial aspect of the spleen
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| The fundus of the stomach and the lesser sac are where in relation to the spleen? | medical and anterior to the spleen.
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| The tail of the pancreas is located how to the stomach as it approaches the splenic hilum? | posterior to the stomach as it approaches splenic hilum (medial to hilum) tail extends inferior
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| The pancreatic tail curves to hilum of the spleen and extends | inferior
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| The left kidney lies_____ and _____ to the spleen. | Medial and inferior
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| The pancreatic tail is located _______ or ______ to the upper pole of the left kidney in the ______ _____. | anterior, ventral, splenic hilum
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| The accessory spleen is a ____ variant. | normal
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| What size is the normal accessory spleen? | less than 5 cm
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| An accessory spleen can be confused with _____________ and/or a mass in the tail of the pancreas. | enlarged lymph nodes.
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| Sonographically an accessory spleen appears | round and the same echo texture as the spleen.
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| Where are accessory spleens located? | near the hilum
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| An accessory spleen is relatively common and occurs in _____ percent of the population. | 25%
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| Splenic calcifications aka_____. | granulomas
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| What are the two most common causes of granulomas? | TB and Histoplasmosis
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| Splenic calcifications can be what? | old infarcts, splenic arterial aneurism, pt. with AIDS (from pneumocystis coroni infection)
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| Splenic cysts can be caused by what 5 things? | autosomal dominant polycystic disease, hydatid cysts, epidermal cysts, liquefied infarcts or hematomas, or pancreatic pseudo cysts
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| Pancreatic pseudocystics are common In the tail of the _______, | but can eat in to the spleen from the pancreas. They are usually small.
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| Splenic calcifications (granulomas) can be – | small or large in quantity
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| These are true cysts lined by squamous epithelium and may measure as much as 10 cm and calcify and interior turn echogenic | Epidermoid cysts
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| These are commonly in the tail of the pancreas and erode into the spleen | pancreatic pseudo cysts
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| This is a benign splenic tumor | hemangioma
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| This is the most common benign primary neoplasm of the spleen | hemangioma (these are hyperechoic and small same as in liver)
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| What is the most common malignant splenic tumor? | malignant melanoma
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| The appearance of malignant tumors of the spleen are rare and commonly look | hypoechoic(but the appearance varies widely)
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| Splenic infarcts are common in patient with ______ and _______. | bacterial endocarditis and splenic artery aneurysms.
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| Splenic infarcts present as | wedge shaped hypo echoic lesions in the spleen.
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| T/F. Splenic abscesses are hard to get. | false they are easy
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| Splenic infection is associated with | general abdominal infections (examples: appendicitis, GB infection, and pericarditis
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| Songraphically, a splenic abscess is seen as | hypo or hyper echoic or many other appearances such as looking anechoic with debris and have "dirty shadows" they can liquify and become anechoic and calcify or have calcification's
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| Damaged splenic tissue is susceptible to _________, with filtered bacteria available in the spleen. | infection
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| Common causes of splenomegaly(17) | viral infections, bacterial infections, malaria, schistomsmoiasis, rheumatoid arthritis (im sys), hemolytic anemia, leukemia, lymphoma,, portal hypertension, congestive heart failure, mono, TB, lupus (im sys), storage disease, and sickle cell (acute)
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| Splenomegaly is moderate with ____ and______ pts. | HIV and AIDS
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| Congestive Splenomegaly is due to _________. | a back up due to infections or a problem outside of the spleen
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| Congestive splenomegaly (6) | heart failure, portal hypertension, cirrhosis, cystic fibrosis, portal or splenic vein thrombosis, acute splenic sequestration crisis of sickle cell anemia.
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| In acute sickle cell anemia the liver is | enlarged
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| In chronic sickle cell anemia the liver is | small and fibrous
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| When the spleen is enlarged, it extends | anterior, medial, and inferior because the diaphragm is in the way
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| In the earlier stages of sickle cell anemia, infants and children, the spleen is enlarged with marked_______ | congestion
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| The spleen undergoes progressive infarction with chronic sickle cell anemia and becomes fibrosis and ________ in size until only a small mass of echogenic fibrosis tissue may be found. | decreases (it will then blend in with the fat and tissue around it)
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| When does sickle cell crisis occur? | in the early stages of the disease
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| What is sickle cell crisis? | splenomegaly and sudden decrease in hematocrit (may develop a sub acute hemorrhage that appears as a hypoechoic area in the periphery of the spleen.)
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| Spleen damage and shrinking down of spleen now it is nonfunctional and the pt. is at risk of infection | auto splenectomy
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| Splenic artery aneurysm sonographic appearance | cystic mass or calcified area in the hilum in area of splenic artery
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| This may be seen in the left upper quadrant as a calcified circle on an xray | splenic artery aneurysm.
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| Heterotaxia aka | situs ambiguous
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| This is the disruption in the development of the normal asymmetric arrangement of abdominal organs and vessels | heterotaxia (the disarrangement of abdominal structures)
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| 2 types of heterotaxia | polysplenia and asplenia these are congenital, may be seen in utero and are lethal
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| Polysplenia | defined as bilateral left sidedness, associated with multiple spleens, biliary atresia (absent gb), intestinal malrotation, cardiac defects, and absent portion of IVC absent (hepatic veins drain directly into rt atrium)
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| Asplenia | defined as bilateral right
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| Splenic trauma is most commonly due to ___________ in the abdomen. | blunt trauma
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| Splenic trauma is life threatning because | it contains approx.. one unit of blood at any given time.
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| This is the modality of choice is spleen injury is suspected from blunt force trauma | CT
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| 2 types of splenic trauma | intraparenchymal (subcapsular) and perisplenic (intraperitoneal) hematomas
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| Intraparenchymal (subcapsular) hematomas | the capsule around the spleen stays intact
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| Perisplenic (intraperitoneal) hematoma | capsule ruptures. Will have blood from spleen around spleen or around pelvis (ascites blood)
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| Which type of splenic hemtoma is harder for ultrasound to detect? | intraparenchymal (subcapsular) is harder
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| What is posttraumatic splenosis | when a pt. with a past splenic rupture has cell inplanted in the pertoneal cavity that results in an ectopic spleen.
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| All of the following may cause splenomegaly except:infectious mono, portal vein thrombosis, splenic infarct, or cirrhosis | splenic infarct
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| The vessel that courses along the posterior aspect of the body and the tail of the pancreas | splenic vein
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| A pt. in the late stages of sickle cell anemia will have a spleen that is | small and echogenic
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| A wedge shaped lesion with in the spleen is associated with | splenic infarct
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| This is a pitfall you might encounter in sonography of the spleen | left side of liver may be mistaken for spleen in hepatomegaly, mass in the tail of the pancreas may be confused with a splenic mass, an accessory spleen may be confused with an enlarged lymph node.
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| The splenic vein drains into what | the portal vein
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