Chapter 11 : The Spleen

The normal adult spleen measures approximately ____________ ?

B. 11 cm in length, 7 cm in width, and 4 cm in thickness. - It is the predominant organ in the left upper quadrant, and is divided into the superior and medial portion, inferior and lateral portion, and splenic hilum.

______________ splenic abnormalities is most commonly linked to infective endocarditis ?

B. Abscess - Is rare and infective endocarditis is an inflammation of the inner tissues of the heart. It can carry over to the spleen since they are connected to one another.

Patients with a history of portal hypertension have an increased risk of developing a splenic ____________ ?

D. Artery aneurysm - Localized dilatation of the splenic artery, and risk factors do include portal hypertension is asymptomatic left upper quadrant pain with nausea and vomiting.

The most common benign neoplasm of the spleen is a ___________ ?

D. Cavernous hemangioma - It consists of large blood-filled cystic spaces, is the most common benign splenic neoplasm and is usually asymptomatic and is well-defined hyperechoicsplenic mass.

______________ structures carries carbon dioxide back to the lungs ?

D. Hemoglobin - Is an oxygen-carrying pigment of the red blood cells, and it carries oxygen from the lungs to the cells and carbon dioxide from the cells back to the lungs.

The most common clinical finding associated with a hemangiosarcoma is ______________ ?

A. Anemia -A hemangiosarcoma is a rare splenic malignancy, and has left upper quadrant pain and anemia ( a decreased in hemoglobin levels in the blood.)

Leukopenia is defined as a white blood cell count _____________ ?

A. Below 4000 - With leukopenia your body isnt producing the wbc you need to fight off infection in your body.

____________ Pathologies is associated with a " wheel within a wheel" appearance on ultrasound ?

A. Candidiasis - Is multiple splenic infections that start to look like a wheel, and is usually associated with patients with autoimmune disorders.

_____________ is an indication for an ultrasound of the spleen ?

A. Fatigue - Because the spleen can be enlarged and that can cause fatigue in a person.

Splenic infarction is most commonly associated with an embolism originating from ___________ structures ?

A. Heart - Is usually associated with subacute bacterial endocarditis which will eventually start to effect the spleen because it is a very vascular structure.

__________________ Conditions is most likely to demonstrate an elevated hematocrit ?

A. Infection - Hematocrit has to deal with percentage of red blood cells in the blood, and with an infection the blood cells will increase.

Hemangiosarcoma involving the spleen frequently metastasizes to ______________ organs ?

A. Liver - Is a rare splenic malignancy where anemia is most common and it frequently metastasizes to the liver.

___________ splenic pathologies is associated with granulomatosis ?

B. Calcifications - Is asymptomatic, and granulomatosis usually is an inherited disorder of leukocytes bacterial infection.

Multiple splenic infection is a predisposing factor for ______________ conditions ?

B. Candidiasis - Is associated with patients with autoimmune disorders and is accompanied with fever and splenomegaly is also a target lesion or "wheel within a wheel".

The splenic artery is a branch of __________ vascular structures ?

B. Celiac Axis - With the splenic artery it arises from the celiac axis , and courses along superior pancreatic borders, dividing into six branches after entering the splenic hilum.

A patient presents with a history of portal hypertension. The spleen is expected to demonstrate ______________ ?

B. Enlargement - It is because of the congestion that builds up in the portal vein, that it starts to affect the spleen and how it filters out the blood, so it starts to backup.

A hemanigosarcoma located in the spleen on ultrasound would appear as a _____________ ?

B. Hyperechoic or complex mass - In ultrasound it looks hyperechoic or complex mass and it will frequently metastasize to the liver.

In cases of portal hypertension, the spelnic vein is most likely to shunt blood directly into the ___________ ?

B. Left renal vein - Because of the obstruction that happens in portal hypertension, the splenic vein will take over and shunt the blood.

____________ conditions is most likely associated with a decrease in leukocytes ?

B. Lymphoma - Is a malignant disorder involving the lynphoreticular system. Is a hypoechoic splenic masses with ill-defined margins and it can demonstrate splenomegaly.

Metastasis to the spleen most commonly originates from ___________ malignancies ?

B. Melanoma - Is a rare disease and is asymptomatic and is typically hypoechoic or target lesions.

A patient with an accessory spleen will most likely present with ______________ symptoms ?

B. No symptoms - An accessory spleen, is an improper splenic fusion and is nodules of normal splenic tissue commonly located near the splenic hilium.

In a 40-year-old patient, splenomegaly is suggested after the length of the spleen exceeds __________ cm ?

C. 13 cm - Splenomegaly has to do with CHF, cirrhosis, infection, diabetes mellitus, is asymptomatic and can sometimes have abdominal pain.

Normal hemoglobin levels should not exceed ___________ g/dL ?

C. 20 g/ dL - Has to do with the iron in your system, and has to with the red blood cells. If you exceed the normal levels you could be at risk for developing multiple diseases.

A hematoma located below splenic capsule most commonly appears on ultrasound as a _____________ ?

C. Crescent-shaped fluid collection inferior to the diaphragm - A hematoma is a rare benign neoplasm composed of lymhphoid tissue.

_____________ benign neoplasms is composed of lymphoid tissue ?

C. Hamartoma - Is a rare benign neoplasm that is composed of lymphatic tissue. Is asymptomatic and can look like an abdominal mass.

The location of the spleen is best described as ______________ ?

C. Lateral to the stomach -It is an intraperitoneal organ, and is located in the left hypochondriac region with the superior aspect extending into the epigastric region, and is located inferior to the diaphragm and anterior to the left kidney.

A clinical finding associated with splenic infarction may include _____________ ?

C. No symptoms - Is an occlusion of the main splenic artery or one of its branches. Is an emboli from the heart and is associated with subacute bacterial enodcarditis, leukemia, and etc. Is usually asympotmatic with left upper quadrant pain.

A congenital anomaly of the spleen associated with gastrointestinal, cardiovascular, and biliary anomalies is most consistent with ____________ ?

C. Polysplenia syndrome - Is multiple small spleens, and usually vaires with associated congenital anomalies and are located along the greater curvature of the stomach.

The splenic vein joins the superior mesenteric vein to form the ____________ ?

C. Portal vein - The spleen is located on the lateral side of the pancreas and the SMV is superior to the pancreas to form the portal vein they both combine.

Hematocrit is defined as the percentage of _____________ ?

C. Red blood cells in the blood -Hematocrit is the percentage of red blood cells in the blood. Is elevated with dehydration, shock, polycythemia vera and diabetes mellitus.

The most common location of an accessory spleen is near the _____________ ?

C. Splenic hilum - An accessory spleen is a nodule of normal splenic tissue. Is an improper splenic fusion and is a common variant incidentally found in 30% of the population. It is round or oval in shape and is of variable size.

_____________ structures is recycled into iron by the spleen ?

D. Hemoglobin - They carry oxygen from the lungs to the cells and carbon dioxide from the cells back to the lungs. The spleen recycles the red blood cells into iron.

A patient arrives at the emergency department following a mortal vehicle accident. An abdominal ultrasound is most likely ordered to evaluate for _____________ conditions ?

D. Hemoperitoneum - Is the presence of blood in the peritoneum cavity. When a person is in a motor vehicle accidents, they have no protection and it can cause damage to a persons abdomen.

Gain settings should be placed to demonstrate the normal spleen as _____________ ?

D. Isoechoic to the normal liver - The spleen is moderately echogenic homogenous parenchyma that is isoechoic to slightly hypoechoic compared to the liver.

The spleen is predominately located in _____________ quadrants ?

D. Left hypochodrium - It is an intraperitoneal organ, and is predominately located in the left hypochondriac region with the superior aspect extending into the epigastric region. It is located lateral to the pancreas.

Leukocytosis is defined as a white blood cell count _______________ ?

D. above 20,000 - With leukocytosis, it means that your body is fighting off an infection, and because of that your wbc are over producing and trying to fight the infection, that is why your blood cells would be so elevated.