The Spleen

___ is a very rare condition that leads to a congenital absence of the spleen

Asplenia

the spleen is located in the ____ cavity and is covered by peritoneum except at the splenic ____

peritoneal; hilum

focal lesions of the spleen include all of the following EXCEPT

splenomegaly

what is the most common sonographically visualized abnormality of the spleen

splenomegaly

the most common varice to occur in cases of portal hypertension is the ____ collateral, which diverts blood from the splenic vein to the ____ vein and finally into the ____

splenorenal; left renal; IVC

the spleen is located posterior to the ____, lateral to the ___ ____, _________ and ____ tail, and anterior to the _____

stomach; left kidney; splenic flexure of the colon; pancreatic; diaphragm

which of the following statements regarding the function of the red pulp is false

the red pulp is responsible for erythropoiesis throughout our lives

which of the following statements regarding the anatomy of the spleen is FALSE

the spleen is a retroperitoneal organ

the average spleen measures ___ cm in length, ____ cm in width and ____ cm in thickness

12; 7; 3-4

the spleen is considered enlarged when its length is greater than

13 cm

the removal of defective and worn out RBCs occurs in the cords of ____

Billroth

Erythrocyte

Red blood cell; contains hemoglobin

following a splenectomy, an ____ may enlarge and assume the functions of the removed spleen

accessory spleen

while scanning the spleen, you notice a small round mass that appears to be separate from the spleen in the region of the splenic hilum. The echo texture of the mass is similar to that of the spleen. What is the most likely diagnosis

accessory spleen

what may splenic calcifications be the result of

all of the above

sonographically, when splenomegaly occurs, the echogenicity of the spleen

could be hyperechoic or hypoechoic but does not correlate with the cause of the enlargement

what is leukocytosis typically the response to

bacterial infection

the spleen receives its blood supply from the splenic artery, which is a branch of the

celiac axis

leukopenia

decreased white blood cell count, possibly the result of viral infection or leukemia

when imaging the spleen in the sag plane, view should always include the left ___ to evaluate for ascites or pleural fluid and the interface with the _____

diaphragm; left kidney

leukocytosis

elevated white blood cell count, usually due to infection

splenomegaly

enlarged spleen; greater than 13cm

which of the following ligaments does NOT help stabilize the spleen

falciform ligament

the red pulp is responsible for ____ the peripheral blood. These functions include removal of the ___ or ___ blood cells and storage of the _____

filtering; worn out; defective; platelets

what is leukopenia

frequently a side effect of chemotherapy

the most common benign vascular lesion of the spleen is the ____

hemangioma

in patients with both hodgkins and non hodgkins lymphoma, the spleen may contain focal ___ or ____ masses, may exhibit diffuse ____ or may appear sonographically ____

hyperechoic; hypoechoic; splenomegaly; normal

the white pulp is part of the ____ system as it is a source of lymphocytes, macrophages and antibodies. In addition, the white pulp can ____ bacteria that have bypassed the lymph nodes

immune; phagocytose

patients who are ____ are more susceptible to fungal and bacterial abscesses of the spleen

immunocompromised

the splenic vein joins with the ____ and can be seen posterior to the tail and body of the pancreas. Posterior to the ___ of the pancreas, the splenic vein joins with the _____ to form the main portal vein

inferior mesenteric vein; neck; superior mesenteric vein

what is the normal echogenicity of the spleen

isoechoic to the liver

hematocrit

laboratory value of the percentage of blood volume made up of red blood cells

three ligaments help hold the spleen in its position in the LUQ. The _____ ligament attaches the spleen to the left kidney. The ____ ligament attaches the spleen to the stomach and the _____ ligament, although not directly attached to the spleen, helps support its inferior end

lienorenal; gastrosplenic; phrenicocolic

the most common malignant disease that affects the spleen is ___. Sonographically, ___ may present if the spleen is diffusely infiltrated.

lymphoma; splenomegaly

what is the most common cause of splenomegaly

portal hypertension

while scanning the spleen, you notice multiple enlarged tortuous vessels in the splenic hilum. Color Doppler confirms that they are vascular in nature. Dilated vessels are also noted within the splenic parenchyma. What is the most likely cause of these findings

portal hypertension with collateral varices

acquired splenic cysts are _____, ____ or ____ in origin.

post inflammatory; traumatic; parasitic

erythropoiesis

process of red blood cell production

phagocytosis

process used by the red pulp to destroy old red blood cells

the spleen is made up of __ and __ pulp. The ___ pulp is composed of lymphatic tissue and the ___ pulp is composed of venous sinuses capable of storing more than 300 mL of blood

red; white; white; red

patients with splenic infarcts are at risk for splenic ____. Signs to watch out for include increasing ___ hemorrhage, free ____ blood and expanding ____ area within the infarct

rupture; sub capsular; peritoneal; liquefaction

which of the following may cause a small, shrunken spleen

sickle cell anemia

a patient with sickle cell disease presents for an abdominal sonogram complaining of recent LUQ pain. A hypoechoic wedge shaped lesion is seen in the spleen. What is this typical of

splenic infarct

infarct

tissue death caused by an interruption of the blood supply

what is a wandering spleen at an increased risk for

torsion and infarction

a fibrous capsule surrounds the spleen and ____ project from the capsule into the organ, dividing the spleen into several compartments

trabeculae

a ten year old patient presents for an abdominal sonogram following blunt abdominal trauma that occurred during a bicycle accident. which of the following would be an unusual finding in this patient

varices in the splenic hilum

while performing an abdominal US, you are having difficulty locating the spleen in its normal location in the LUQ. As you scan the entire left side, you locate what appears to be the spleen in the LLQ. What is the most likely explanation of this finding

wandering spleen (AKA ectopic spleen, floating spleen)

leukocyte

white blood cell; protects and fights against infection in the body