Spleen Notes

Question 1

What is an accessory spleen?

Answer 1

A nodule of normal splenic tissue commonly located near the splenic hilum.

Question 2

What is anemia?

Answer 2

A decrease in hemoglobin levels in the blood.

Question 3

What is asplenia syndrome? What are three thingsis it assocaited with?

Answer 3

1. Absence of the spleen
2. Associated with:
   - Two right lungs
   - Midline liver
   - Gastrointestinal and urinary anomalies.

Question 4

What is bilateral left-sidedness? What is normally present? What anomalies are common?

Answer 4

1. A syndrome in which normally unpaired organs develop more symmetrically in mirror image
2. Two spleens, one on each side, are usually present
3. Cardiovascular anomalies are common.

Question 5

What is a hamartoma? What is also known as?

Answer 5

A rare benign neoplasm composed of lymphoid tissue, also known as splenoma.

Question 6

What is hematocrit?

Answer 6

The percentage of red blood cells in the blood.

Question 7

What is the function of hemoglobin?

Answer 7

Carries oxygen from the lungs to the cells and returns carbon dioxide back to the lungs.

Question 8

What is an intraparenchymal hematoma?

Answer 8

Hematoma located within the splenic parenchyma.

Question 9

What is leukemia?

Answer 9

Proliferation of white blood cells.

Question 10

What is leukocytosis?

Answer 10

White blood cell count above 20,000 mm3.

Question 11

What is leukopenia?

Answer 11

White blood cell count below 4000 mm3.

Question 12

What is lymphoma?

Answer 12

Malignant disorder involving the lymphoreticular system.

Question 13

What is polycythemia vera? What does this result in?

Answer 13

1. A slow-growing cancer in which your bone marrow makes too many red blood cells
2. Results in thickening the blood and slowing its flow, which may cause blood clots.

Question 14

What is polysplenia? What are four things this assocaited with?

Answer 14

1. Multiple small spleens
2. Aassociated with
   - Two left lungs
   - Gastrointestinal
   - Cardiovascular
   - Biliary anomalies.

Question 15

What is sickle cell anemia? What are five things this disorder lead to?

Answer 15

1. A genetic mutation in African Americans resulting in altered shape and phasicity of red blood cells
2. Leading to:
   - Increased blood viscosity
   - Stasis
   - Small vessel occlusion
   - Infarction
   - Necrosis.

Question 16

What is a splenic artery aneurysm?

Answer 16

A localized dilatation of the splenic artery.

Question 17

What is splenic infarction?

Answer 17

Occlusion of the main splenic artery or one of its branches.

Question 18

What is a subcapsular hematoma?

Answer 18

Hematoma located between the splenic capsule and parenchyma.

Question 19

What is a wandering spleen?

Answer 19

Refers to an abnormal location of the spleen.

Question 20

What are the functions of the spleen? 5

Answer 20

1. Removes foreign material from the blood
2. Initiates an immune reaction
3. Destroys old red blood cells
4. Serves as a reservoir for blood
5. Involved in erythropoiesis in the fetus.

Question 21

Where is the spleen located?

Answer 21

Intraperitoneal organ predominantly located in the left hypochondriac region, inferior to the diaphragm and anterior to the left kidney.

Question 22

What does the splenic artery arise from and how does it enter the spleen? The spelnic vein enters the liver how?

Answer 22

1. The splenic artery arises from the celiac axis, dividing into six branches after entering the splenic hilum
2. The splenic vein joins the superior mesenteric vein to form the main portal vein.

Question 23

What is an accessory spleen? How common is this?

Answer 23

Improper splenic fusion, commonly found in 30% of the population.

Question 24

What is splenomegaly?

Answer 24

Enlargement of the spleen, defined as a length exceeding 13 cm in adults.

Question 25

What are normal serum levels for erythrocytes?

Answer 25

Male: 4.6 to 6.2 million/mm3; Female: 4.2 to 5.4 million/mm3.

Question 26

What are normal serum levels for leukocytes?

Answer 26

4500 to 11,000 mm3.

Question 27

What are normal serum levels for hematocrit?

Answer 27

Male: 40 to 54 mL/dL; Female: 37 to 47 mL/dL.

Question 28

What are normal serum levels for hemoglobin?

Answer 28

Male: 13 to 18 g/dL; Female: 12 to 16 g/dL.

Question 29

What is the most common benign splenic neoplasm?

Answer 29

Cavernous hemangioma.

Question 30

Splenic candidiasis is assocaited with what kind of disorders?

Answer 30

Multiple splenic infections associated with patients with autoimmune disorders.

Question 31

What is the clinical finding of splenic rupture? (s/s) 3

Answer 31

1. Left upper quadrant pain 2. Tachycardia 3. Decrease in hematocrit.

Question 32

What are LUQ pain Acute injury stage characteristics? What may it demonstrate?

Answer 32

1. Peripheral hypoechoic wedge-like mass with well-defined margins. 2. May demonstrate variable shape and irregular wall margins.

Question 33

LUQ pain Chronic Stage characteristics? 2

Answer 33

1. Hyperechoic mass (fibrosis) with well-defined margins 2. Splenic atrophy.

Question 34

Common causes of splenic trauma

Answer 34

Blunt abdominal trauma, splenomegaly, infectious disorder.

Question 35

Clinical findings of splenic trauma? (s/s) 7

Answer 35

1. Asymptomatic 2. Left upper quadrant pain 3. Tachycardia 4. Palpable mass 5. Abdominal pain 6. Decrease in hematocrit 7. Hypovolemic shock.

Question 36

Sonographic findings in splenic trauma? What may it demonstrate? Subcapsular ruptures appear as what?

Answer 36

1. Hypoechoic or complex mass 2. May demonstrate posterior acoustic enhancement. 3. Subcapsular rupture appears as a crescent-shaped fluid collection.

Question 37

Differential considerations for splenic trauma. 6

Answer 37

Evaluate abdominal cavity for: 1. Free fluid 2. Recent splenic infarction 3. Abscess 4. Cyst 5. Pleural effusion 6. Malignancy of the spleen.

Question 38

How common are hemangiosarcoma? What demographics are affected?

Answer 38

1. Rare splenic malignancy 2. Typically in individuals aged 50–60 years.

Question 39

Common clinical findings of hemangiosarcoma. 8 (s/s)

Answer 39

1. Anemia 2. Left upper quadrant pain 3. Weight loss 4. Fatigue 5. Fever 6. Leukocytosis 7. Thrombocytopenia 8. GI bleeding.

Question 40

Sonographic findings of hemangiosarcoma. 2

Answer 40

1. Hyperechoic or complex mass 2. Splenomegaly.

Question 41

Differential considerations for hemangiosarcoma. 4

Answer 41

1. Frequently metastasizes to the liver 2. Abscess 3. Hematoma 4. Cavernous hemangioma.

Question 42

Clinical findings of leukemia 9 (s/s)

Answer 42

1. Proliferation of white blood cells 2. Male prevalence 3. Lymphadenopathy 4. Palpable spleen 5. Joint pain 6. Weakness 7. Fever 8. Easy bruising 9. Recurrent infections.

Question 43

Sonographic findings of leukemia. 5

Answer 43

1. Elevated white blood cells (WBC) 2. Anemia 3. Diffuse increase in parenchyma echogenicity 4. Hypoechoic or hyperechoic nodules. 5. Splenomegaly

Question 44

What is Lymphoma? How can we categorize it generally?

Answer 44

1. Malignant disorder involving the lymphoreticular system 2. Divided into Hodgkin’s and non-Hodgkin’s.

Question 45

Common clinical findings of lymphoma. (s/s) 7

Answer 45

1. Male prevalence 2. Lymphadenopathy 3. Low-grade fever 4. Weight loss 5. Fatigue 6. Night sweats 7. Anemia.

Question 46

Sonographic findings of lymphoma. 4

Answer 46

1. Elevated WBC (lymphocytes) 2. Hypoechoic splenic mass(es) 3. Ill-defined margins 4. May demonstrate splenomegaly.

Question 47

Common metastatic lesions to the spleen. 4

Answer 47

1. Melanoma 2. Breast 3. Lung 4. Ovary.

Question 48

Characteristics of splenic candidiasis. 3

Answer 48

1. Asymptomatic 2. Typically multiple hypoechoic or target lesions 3. Multiple abscesses.