16 Questions
What is the average length of the spleen?
12.5 cm
What is the color of a normal spleen?
Dark purple
Which of the following is NOT a cause of splenomegaly?
Right abdominal trauma
What is the importance of identifying the left hemi-diaphragm?
To assess the relationship between the spleen and the diaphragm
What is the echo pattern of a normal spleen?
Homogeneous
Which of the following is a normal variant of the spleen?
Normal-sized spleen
What is the location of the spleen?
Left upper quadrant
What is the purpose of including both sides of the diaphragm in an erect abdominal X-ray?
To rule out perforation of the bowel
What is the maximum normal length of the spleen along its major axis?
15 cm
Which condition is NOT listed as a possible cause of homogeneous splenomegaly?
Diabetes
What should be examined whenever there is splenomegaly?
The liver for size and echogenicity
What is a characteristic feature of echinococcal (hydatid) cysts as described in the text?
Double wall and often septate
Which of the following conditions can cause a non-homogeneous spleen?
Cystic disease
What type of lesion is described as a clearly demarcated, echo-free mass with posterior acoustic enhancement?
Cystic lesion
Which of these findings is pathognomonic for hydatid disease?
A cyst within a cyst
What additional features might be found in hydatid cysts apart from wall thickness variation?
Floating density within the cyst
Study Notes
Spleen Anatomy and Structure
- The spleen is a wedge-shaped organ located in the left upper quadrant, protected by the left 9th to 11th ribs.
- It is soft, highly vascular, and dark purple in color, with an average size of 2.5 cm thick, 7.5 cm broad, and 12.5 cm in length.
- The spleen has two poles (superior and inferior), three borders (superior, inferior, and intermediate), and two surfaces (diaphragmatic and visceral).
- It is enclosed by a thin capsule, which is easily ruptured, and covered by peritoneum, except at the hilum.
Functions and Indications
- The spleen is part of the hematological system and plays a role in immune response, storage of red blood cells, and hematopoiesis.
- Indications for spleen examination include splenomegaly, left abdominal mass, blunt abdominal trauma, left upper abdominal pain, and suspected subphrenic abscess.
- Other indications include jaundice combined with anemia, echinococcosis, ascites, or suspected malignancy, especially lymphoma or leukemia.
Normal Spleen Ultrasound
- The normal spleen shows a uniform homogeneous echo pattern, slightly less echogenic than the liver.
- Identification of the left hemi-diaphragm, splenic hilus, splenic veins, and relationship to the pancreas, left kidney, and renal/splenic relationship is important.
Abnormal Spleen Ultrasound
- Enlarged spleen (splenomegaly) with no absolute criteria for size, but a chronically enlarged spleen may distort and displace the left kidney.
- Homogeneous splenomegaly may be due to tropical splenomegaly, sickle cell disease, portal hypertension, leukemia, metabolic disease, lymphoma, or infections.
- Non-homogeneous spleen with or without splenomegaly may indicate cystic lesions, congenital cysts, echinococcal (hydatid) cysts, or abscesses.
This quiz covers the structure, function, and location of the spleen as an organ of the hematological system. Learn about its role in immune response, storage of red blood cells, and hematopoiesis.
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