Davies SPLEEN Flashcards

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Questions and Answers

What structures are in contact with the spleen?

Left hemidiaphragm (correct)

Pancreas (correct)

Splenic flexure of the colon (correct)

Stomach (correct)

What view provides the best long axis image of the spleen?

Oblique view

Sagittal view

Transverse view

Intercostal coronal view with patient supine (correct)

What are some causes of mild to moderate splenomegaly?

Portal hypertension

Infection

AIDS

All of the above (correct)

What have you most likely detected if you find a small, rounded mass at the splenic hilum that is homogeneous and isoechoic with the spleen?

Accessory spleen Signup and view all the answers

What is the most common finding in the spleen in patients with AIDS?

Moderate splenomegaly Signup and view all the answers

What is the typical appearance of a hypoechoic, wedge-shaped lesion within the spleen?

Splenic infarction Signup and view all the answers

What would be most helpful in improving diagnostic confidence with a finding of a hypoechoic, wedge-shaped lesion within the spleen?

Evaluate the lesion with color Doppler Signup and view all the answers

What condition do you suspect if you detect moderate splenomegaly and dilated, tortuous vessels at the splenic hilum?

Portal hypertension Signup and view all the answers

What additional evaluation should you perform if you find moderate splenomegaly and dilated tortuous vessels suggestive of portal hypertension?

Evaluate the liver and portal vein Signup and view all the answers

Which structure will you detect at the splenic hilum?

Splenic vein Signup and view all the answers

What is the relationship of the pancreatic tail to the spleen?

Inferomedial Signup and view all the answers

What term can be used to describe the normal sonographic appearance of the splenic parenchyma?

Homogenous with mid to low level echogenicity Signup and view all the answers

What transducer would provide the highest resolution images of the spleen?

5.0 MHz curved linear array Signup and view all the answers

What is true regarding the spleen?

Intraperitoneal organ, located in left upper quadrant, lies between the fundus of the stomach and the diaphragm, average adult spleen measures 12 cm in length, decreases in size and weight with advancing age Signup and view all the answers

What are some pitfalls you might encounter in ultrasound scanning of the spleen?

Intercostal scanning may produce rib shadows obscuring the splenic parenchyma, in hepatomegaly, the left lobe of the liver may be mistaken for the spleen, a mass in the tail of the pancreas may be confused with a splenic mass, an accessory spleen may be confused with an enlarged lymph node Signup and view all the answers

What findings of the spleen are commonly seen in a patient with histoplasmosis?

Multiple focal, bright echogenic granulomatous lesions throughout the spleen Signup and view all the answers

The splenic vein drains into what?

Portal vein Signup and view all the answers

What is associated with a history of recent blunt left-sided trauma in a motor vehicle accident?

Splenic laceration, subscapular hematoma of the spleen, free fluid, perisplenic hematoma Signup and view all the answers

What do multiple hyperechoic masses within the spleen most likely represent in a patient with malignant melanoma?

Metastasis Signup and view all the answers

What should you do if you detect a calcified ring at the splenic hilum during abdominal sonography of a patient with portal hypertension and splenomegaly?

Evaluate the area with color Doppler Signup and view all the answers

What are some features you would detect in a splenic cyst?

Anechoic appearance Signup and view all the answers

Study Notes

Spleen Anatomy and Relationships

Located in the left upper quadrant, significant structures in contact with the spleen include the left hemidiaphragm, stomach, pancreas, and splenic flexure of the colon.
The splenic hilum contains the splenic vein.

Ultrasound Techniques and Findings

The best long-axis image of the spleen is obtained using the intercostal coronal view with the patient in a supine position.
A 5.0 MHz curved linear array transducer provides the highest resolution images of the spleen.
Moderate splenomegaly is typically associated with portal hypertension and infections, including AIDS.

Spleen Conditions and Diagnostic Indicators

Detection of a small, homogeneous, isoechoic mass at the splenic hilum usually indicates an accessory spleen.
Splenic infarction presents as a hypoechoic, wedge-shaped lesion within the spleen.
In cases of blunt left-sided trauma, associated findings may include splenic laceration, subscapular hematoma, free fluid, and perisplenic hematoma.

Disease Associations

HIV/AIDS patients generally show moderate splenomegaly on ultrasound.
Histoplasmosis can result in multiple focal, bright echogenic granulomatous lesions throughout the spleen.
Multiple hyperechoic masses in patients with malignant melanoma suggest metastasis to the spleen.

Complications and Evaluation Strategies

Portal hypertension can be assessed through the presence of moderate splenomegaly and dilated tortuous vessels at the hilum, prompting evaluation of the liver and portal vein.
Color Doppler evaluation is critical for assessing lesions suggestive of infarction or for investigating calcified rings at the splenic hilum during ultrasound.

Normal Sonographic Characteristics

The normal splenic parenchyma appears homogeneous with mid to low-level echogenicity and can present challenges in ultrasound due to potential pitfalls, such as:
- Rib shadows obscuring splenic parenchyma during intercostal scanning.
- Mistaking the left lobe of the liver for the spleen in hepatomegaly.
- Confusing masses in the tail of the pancreas with splenic masses.

Splenic Cyst Features

Splenic cysts are characterized by smooth borders, posterior acoustic enhancement, an anechoic appearance, and a rounded shape.

Spleen Overview

The average adult spleen measures approximately 12 cm in length and is classified as an intraperitoneal organ. It tends to decrease in size and weight with age.

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Description

Test your knowledge about the spleen with these flashcards. This quiz covers anatomical relationships, imaging views, and sonographic techniques associated with the spleen. Perfect for students in sonography or ultrasound training.