DMS 211 Spleen Workbook

Trabeculae

A fibrous capsule surrounds the spleen and ________ project from the capsule into the organ, dividing the spleen into several compartments.

Accessory spleen

Following a splenectomy, an ________ _______ may enlarge and assume the functions of the removed spleen.

C. Bacterial infection

Leukocytosis is the typical response to which of the following conditions? A. Lupus erythematous B. Chemotherapy C. Bacterial infection D. Hemorrhage

D. Granulomatous

Splenic calcifications usually result form which disease? A. Splenomegaly B. Lymphocytic C. Angiosarcomas D. Granulomatous

12-13; 7; 3-4

The average spleen measures_______ cm in length, _______ cm in width, and ________ cm in thickeners.

Diaphragm; left kidney

When imaging the spleen in the Sagittarius plane, views should always include the left _____ to evaluate for ascites or pleural fluid and the interface with the ________

C. Sickle cell anemia

Which of the following may cause a small, shrunken spleen? A. Mononucleosis B. Acquired immunodeficiency syndrome C. Sickle cell anemia D. Portal hypertension

a well-defined, hypoechoic, wedge-shaped lesion is seen within the splenic parenchyma. given the patient's history of sickle cell crisis, the most likely diagnosis is splenic infarct

A 12-year-old patient with a history of sickle cell disease presents in a sickle cell crisis with severe left upper quadrant pain. Described what is seen in this image of the spleen. What is the most likely diagnosis?

Spelnomegaly

Enlarged spleen

Hypoechoic; hyperechoic; splenomegaly; normal

In patients with both Hodgkin disease and non-Hodgkin lymphoma, the spleen may contain focal _________ or ________ masses, may exhibit diffuse _________, or may appear sonographically _______.

A. Spleen B. LT kidney

Label this image:

A. Stomach B. Gastrosplenic ligament C. Visceral Peritoneum D. Parietal peritoneum E. Spleen F. Splenorenal ligament G. LT kidney H. Abdominal aorta I. IVC J. RT kidney

Label this image:

Hematocrit

Laboratory value of the percentage of blood volume made up of re blood cells

Rupture; subscapular; peritoneal; liquefaction

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.

Erythrocyte

Red blood cell; contains hemoglobin

D. Could be hyperechoic or hypoechoic but doe not correlate with the cause of the enlargement

Sonographically what is the splenic echogenicity when splenomegaly occurs? A. Does not change B. Always becomes more hypoechoic C. Always becomes more hyperechoic D. Could be hyperechoic or hypoechoic but doe not correlate with the cause of the enlargement

Splenorenal; left renal; IVC

The most common varice to occur in cases of portal hypertension is the _______ collateral, which diverts blood from the splenic vein

C. 13 cm

The spleen is considered enlarged when it's length is greater than what measurement? A. 9 cm B. 11 cm C. 13 cm D. 15 cm

Peritoneal; hilum

The spleen is located in the _______ Cavity and is covered by peritoneum except at the splenic ________.

Stomach; left kidney; splenic flexors of colon; pancreatic; diaphragm

The spleen is located posterior to the ________, lateral to the _______ _____, _______ ________ _______, and _________ tail, and anterior to the _________.

Red; white; white; red

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.

D. Celiac axis

The splenic artery branch's off which artery to supply blood to the spleen? A. Aorta B. Superior mesenteric C. Pancreatic D. Celiac axis

Immune; phagocytose

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

Lienorenal; gastrosplenic; phrenicocolic

Three ligaments help hold the spleen in its position in the left upper quadrant. 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.

C. Frequently a side effect of chemotherapy?

What is leukopenia? A. A normal finding B. The result of severe inflammation C. Frequently a side effect of chemotherapy D. An increase in the number of white blood cells in circulation

D. Portal hypertension

What is the most common cause of splenomegaly? A. Mononucleosis B. Lymphoma C. Sickle cell anemia D. Portal hypertension

C. Splenomegaly

What is the most common sonographically visualized abnormality of the spleen? A. Splenic rupture B. Splenic abscess C. Splenomegaly D. Lymphoma

B. Isoechoic to the liver

What is the normal echogenicity of the spleen? A. Heterogenous B. Isoechoic to the liver C. Hyperechoic to the liver D. Hypoechoic to the liver

the arrow is pointing to an accessory spleen, which is a normal variant and asymptomatic in most cases. in cases of splenectomy, the accessory spleen can enlarge and take over the function of the removed spleen. In cases of hematologic disorders, this may casue a relapse in symptoms

What structure is the arrow pointing to in this image? What is the significance of this structure?

C. Splenomegaly

Which of the following is NOT included as a focal lesion of the spleen? A. Cysts B. Infarcts C. Splenomegaly D. Granulomas

A. Falciform ligament

Which of the following ligaments does NOT help stabilize the spleen? A. Falciform ligament B. Lienorenal ligament C. Gastrosplenic ligament D. Phrenicocolic ligament

B. The spleen is a retroperitoneal organ

Which of the following statements regarding the anatomy of the spleen is FALSE? A. The spleen is surrounded by a fibrous capsule B. The spleen is a retroperitoneal organ C. The spleen is located in the left hypochondrium D. The spleen lies posterior to the stomach

A. The red pulp is responsible for erythropoiesis throughout our liver

Which of the following statements regarding the function of the red pulp is FALSE? A. The red pulp is responsible for erythropoiesis throughout our liver B. In cases of severe hemorrhage, the red pulp may release its reservoir into the bloodstream C. Red pulp is responsible for the removal of worn-out red blood cells D. The red pulp removes defective cells such as sickle and thalassemic cells from circulation

D. Wandering spleen

While performing an abdominal sonography, you are having difficulty locating the spleen in its normal location in the left upper quadrant. As you scan the entire left side, you located what appears to be the spleen in the left lower quadrant. What is the most likely explanation for this finding? A. Asplenia B. Accessory spleen C. Situated increases D. Wandering spleen

B. 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 echotexture of the mass is similar to that of the spleen. What is the most likely diagnosis? A. Splenic metastasis B. Accessory spleen C. Splenic hemangioma D. Ruptures spleen

A. portal hypertension with collateral varices

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? A. Portal hypertension with collateral varices B. Lymphoma with metastases C. Splenic rupture with bleeding outside the capsule D. Accessory spleen near the splenic hilum

Congenital aplasia

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

An irregular, hypoechoic collection is seen near the hilum of the spleen. Given the patient's history of abdominal trauma, a hematoma is the most likely diagnosis. the remainder of the spleen should be evaluated as well as the splenic capsule to look for a subcapsular hematoma. the pelvis, the paracolic gutters, and posterior right subhepatic space should be evaluated for free fluid. the hematocrit may be decreased in cases of hemorrhage

A 10-year-old girl presents for a sonogram of the spleen following a bicycle accident. Describe what is seen in this sagittal image of the spleen. What is the most likely diagnosis? What other areas in the abdomen will you evaluate based on these findings? Which lab value may be associated with this finding?

D. Varices in thee splenic hilum

A 10-year-old patient presents for an abdominal sonogram following blunt abdominal trauma that occurs during a bicycle accident. Which of the following would be an unusual finding in this patient? A. Subcapsular hematoma B. Free fluid in the peritoneum C. Hematoma within the splenic parenchyma D. Varices in the splenic hilum

D. Splenic infarct

A patient with sickle cell disease presents for an abdominal sonogram complaining of recent left upper quadrant pain. A hypoechoic wedge shaped lesion is seen in the spleen. What is their typical of? A. Lymphoma B splenic rupture C. Splenomegaly D. Splenic infarct

B. Torsion and infarction

A wandering spleen is at an increased risk of acquiring which of the following conditions? A. Splenic rupture B. Torsion and infarction C. Splenomegaly D. Leukemia and lymphoma

Postinflammatory; traumatic; parasitic

Acquired splenic cyst are ________, __________, or ________ in origin

Leukopenia

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

Leukocytosis

Elevated white blood cell count, usually due to infection

A. Spleen B. Diaphragm C. Hilum

Label this image:

Immunocompromised;

Patients who are _________ are more susceptible to fungal and bacterial abscesses of the spleen.

Erythropoiesis

Process of red blood cell formation

Phagocytosis

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

Hemangioma

The most common benign vascular lesion of the spleen is the ___________.

Lymphoma; splenomegaly

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

Filtering; worn-out; defective; platelets

The red pulp is responsible for _______ the peripheral blood. These functions include removal of ________ or ________ blood cells and the storage of _______.

Billroth

The removal of defective and worn-out red blood cells occurs in the cords of ________

Inferior mesenteric vein; neck; superior mesenteric vein

The splenic vein joins with the _______ _______ ______ and can be seen posterior to the tail an body of the pancreas. Posterior to the ________ of the pancreas, the splenic vein joins with the ______ ______ ______ to form the main portal vein.

Infarct

Tissue death caused by an interruption of the blood supply

Leukocyte

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