Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Lymphoreticular and haematopoeitic > Splenic disorders > Flashcards

Splenic disorders Flashcards

1
Q

Where does splenic artery arise from?

A

celiac artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does splenic artery divide into?

A

into approx. 25 small hilar arteries which enter the spleen on its concave surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the splenic vein drain into?

A

portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the important branches of the splenic artery/ vein serving?

A
  1. left limb of pancreas
  2. greater curvature of stomach (left gastroepiploic)
  3. fundus of stomach (short gastrics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Can dogs and cats normally survive without a spleen?

A

yes - much easier than humans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List 5 functions of the spleen

A
  1. RBC maintenance
  2. iron metabolism
  3. blood reservoir
  4. haematopoiesis
  5. immune functions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

explain the RBC maintenance of spleen

A

1 filtration of blood
2 phagocytosis
3 remodelling RBCs
4 removal of intra-erythrocytic inclusions (e.g. heinz bodies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Outline iron metabolism and the spleen

A

significant iron stores result from continuous removal of old or damaged RBCs from circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Outline spleen as a blood reservoir

A

cats and dogs store 10-20% blood volume in the spleen, ready for acute blood loss/ haemolysis or during strenuous exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Outline spleen and haematopoiesis

A

spleen can resume haemopoietic functions in adult animals when the BM is unable to carry out its normal haemopoietic role

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does the spleen do immunologically

A

major site for clearance of microorganisms and providing immune response. protects against septicaemia. occurs in the white pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What occurs in the red pulp of the spleen?

A

RB maintenance
Fe metabolism
Blood reservoir
Haematopoiesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can a total splenectomy be performed?

A

2 methods

  1. ) Large ventral midline. Remove spleen at tail end and double ligate and transect all the hilar vessels. At head of spleen, try and preserve the short gastric vessels and trasect the gastrosplenic ligament.
  2. ) Quicker method. Ligate the short gastric vessels, left gastroepiploic a + v and the splenic a+ v distal to the branch supplying the pancreas. May be impossible if lots of adhesions or ruptured splenic mass or if anatomy is distorted because of splenic torsion of GDV.
  3. ) Real life = usually a mix of the two
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indications - total splenectomy

A

if neoplasia is known or suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Indications - partial splenectomy

A

localised, benign disease (and 100% sure of this)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Method - partial splenectomy

A

hilar vessels to diseased portion of spleen to be resected are ligated and transected. after a few minutes this will cause a clear demarcation b/w ischaemic and normal spleen which is used as a guideline for resection. Then either:

  1. ) squeeze the splenic tissue along the demarcation line towards the end to be removed and place forceps on the flattened portion (non-crushing intestinal forceps = Doyen). Divide spleen b/w forceps and reove diseased portion. Place 2 rows of mattress sutures in a continuous overlapping pattern next to the forceps and close the cut end of the spleen using a continuous suture pattern of fine absorbable suture.
  2. ) use a stapling device (linear stapler) but make sure there is sufficient tissue for the size of staple. This can reduce surgical time.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the main perioperative considerations for splenectomy?

A
  • ECG monitoring
  • Coagulation tests (PT, APTT)
  • Abdominal retractors and suction
  • Examine entire abdomen
  • Haemostatic forceps adn swabsu
  • Measure blood in suction bottle
  • Gastropexy (breeds at increased risk of GDV but this is not evidenced)
  • Monitor vital parameters and PCV/TP regularly
18
Q

Why are coagulation tests necessary for splenectomy?

A

recommended for animals with intra-abdominal haemorrhage not thought to be due to trauma since DIC can occur with neoplastic splenic lesions and splenic otrsion

19
Q

How much does 1ml of blood weigh?

A

1.3 grams

20
Q

What are the 2 commonest complications of splenectomy?

A

haemorrhage and cardiac arrhythmias

21
Q

What are the complications of splenectomy?

A
  • Haemorrhage (technical failure or DIC)
  • Cardiac arrhythmias
  • Ischaemic pancreatitis and gastritis
  • possible increased risk of infection (probably only significant in immunosuppressed animals)
  • previous infection with haemoparasites (babesia, ehrlichia, mycoplasma) may become evident
22
Q

How should you manage cardiac arrhythmias due to splenectomy?

A
  • ECG monitoring (before, during, after surgery)
  • preoperative stabilisation with fluids
  • antidysrhythmic meds if necessary
23
Q

What are the most common types of splenomegaly in dogs and cats?

A
  • dogs = localised splenomegaly

- cats = diffuse splenomegaly

24
Q

T/F: just because a spleen is palpable, does not necessarily imply it is abnormal and not all enlarged spleens are palpable (especially if abdominal effusion is present)

A

True

25
Q

Causes - localised splenomegaly

A

NON-NEOPLASTIC: haematoma, abscess, nodular hyperplasia, infarction, cyst. (infarction occurs with multiple concurrent medical conditions so splenectomy is unlikely to be curative of all problems)
NEOPLASIA: Benign (haemangioma, leiomyoma, fibroma, lipoma) or malignant (HSA, fibrosarcoma, leiomyosarcoma, any other sarcoma)

26
Q

Causes - diffuse splenomegaly

A

INFECTION: bacterial, fungal, viral, parasitic
CONGESTION: drugs (barbiturates), splenic torsion +/or GDV, right-sided CHF
NEOPLASIA: acute/chronic leukaemia, systemic MCT (esp cats), lyphima, multiple myeloma, malignant histiocytosis
IMTP: splenectomy only if refractory to tx with immunosuppressive drugs

27
Q

When is FNA useful for splenomegaly?

A

Cases of diffuse splenomegaly (usually cats)

28
Q

What happens if you FNA a localised haematoma or HSA?

A

FNA often produces blood

29
Q

When is ultrasound useful for splenomegaly?

A

reliably diagnoses a splenic mass and can differentiate liver and splenic masses and evaluate the abdomen for possible metastatic diseases

30
Q

Where do HSA metastasize to?

A 
liver
omentum
mesentery
brain
right atrium
subcutaneous tissue
31
Q

T/F: 50% dogs with splenic HSA have concurrent right arial HSA

A

False - 25%

32
Q

T/F: HSA is grossly indistinguishable from haemangioma or aematoma

A

True - separating these ddx may be challenging on histopathology

33
Q

What diagnostics should you do with all animals with a splenic mass/

A

thoracic radiographs or CT to look for pulmonary mets

34
Q

MST for dogs with HSA without metastases undergoing total splenectomy

A

3-12 weeks without chemotherapy

around 6 months with chemotherapy

35
Q

What post-op chemotherapy might be used for dogs post-splenectomy for HSA?

A

various combinations of drugs including doxorubicin, cyclophosphamide and vincristine. RVC usually uses cyclophosphamide/ doxorubicin for 6 cycles

36
Q

Causes - splenic trauma

A

RTA
fall from a height
overall uncommon
splenic laceration - penetrating or iatrogenic injury

37
Q

Tx - splenic trauma

A

Surgical - not usually performed as haemorrhage either self-resolving or injuries are so severe that they are fatal before initiation before surgery

38
Q

Tx - mild splenic laceration

A

suture of the splenic capsule and/or omentum sewn over the lesion

39
Q

Tx - severe or persistent haemorrhage of spleen

A

ligation of splenic vessels involved followed by partial or total splenectomy as appropriate to deal with any ischaemia produced,

40
Q

What is splenosis?

A

After rupture of the spleen, multiple small splenic nodules called splenosis may be seen throughout the abdomen.

  • one type of ectopic splenic tissue
  • acquired condition
  • defined as autoimplantation of one or multiple focal deposits of splenic tissue in various compartments of the body
  • abdominal: typically small, sessile (grow on serial/peritoneal surfaces) and multiple. Can grow quite sizeable. If isolated intrahepatically can cause serious diagnostic problems.
41
Q

What fixes the head of the spleen to the abdomen?

A

gastrosplenic ligament

Lymphoreticular and haematopoeitic (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions