Sx of the Haemolymphatic System Flashcards
What are the main components of the haemolymphatic system?
Lymph, lymphatic vessels, LN’s, cisterna chyli, thoracic duct
peripheral lymphatic organs –> spleen, tonsils, thymus, BM, GALT
What are the main lymph nodes in the head?
Parotid, mandibular, retropharyngeal
What are the main lymph nodes in the neck?
superficial and deep cervical
What are the main lymph nodes in the forelimb?
Axillary lymph center (axillary and accessory axillary lymph nodes)
What lymph nodes & how many are present in the parietal group of the thorax?
Ventral: cranial sternal LN’s (8)
Dorsal: aortic thoracic LN’s (1)
What lymph nodes & how many are present in the visceral group of the thorax?
Mediastinal lymph center: cranial mediastinal LN’s (6)
Bronchial lymph center: pulmonary & tracheobronchial LN’s (5)
What lymph nodes are present within the parietal group of the abdomen & pelvis?
- Lumbar lymph center: Lumbar aortic & renal LNs
- Iliosacral lymph center: medial iliac, internal iliac, sacral LNs
- Iliofemoral lymph center: distal femoral LN, external iliac LN
What lymph nodes are present within the visceral group of the abdomen & pelvis?
- celiac lymph center: hepatic, splenic, gastric, pancreaticoduodenal LNs
- cranial mesenteric lymph center: jejunal & colic LN’s
- caudal mesenteric lymph center
What are the main lymph centers in the pelvic limbs and what lymph nodes are contained within each?
- Popliteal lymph center: superficial popliteal LN
- iliofemoral lymph center: distal femoral LN, external iliac LN
- Inguinofemoral lymph center: superficial inguinal LNs
What are abnormalities that can appear within the haemolymphatic system?
Lymphadenomegaly, lymphedema
Lymphadenomegaly occurs in…
- reactive hyperplasia
- infection
- neoplasia (primary vs mets)
Lymphedema is the accumulation of
fluid in the interstitial space
What are the 3 types of biopsy sampling lymph nodes?
- TruCut/Core Bx
- Incisional Bx (wedge Bx)
- Excisional Bx (lymphadenectomy)
What are the functions of the spleen?
Extra-medullary haematopoiesis
Reservoir for RBCs and platelets
Immune defense (B & T cells)
Generalized splenomegaly may be caused by…
- inflammation/infection (splenitis)
- immune rxn or cellular hyperplasia
- congestion
- infiltration
Localized or focal splenomegaly may be caused by…
- nodular hyperplasia
- hemangioma
- neoplasia
- abscess
What are normal consequences of splenic disease?
- splenic deposits (fibrin, siderotic plaques)
- accessory spleen/splenosis
- splenic fissures
- size changes (congestion, contraction - anemia, blood loss, stress)
What are pathological consequences of splenic disease?
Focal lesions - hematoma, extramedullary hematopoiesis, neoplasia
Diffuse changes - torsion, neoplasia, IMTP/IMHA, infection
What is the arterial supply to the spleen?
splenic artery which comes off the coeliac artery & has short gastric arteries and left gastroepiploic arteries that come off it.
What are acute signs of splenic disease?
weakness/collapse, pale MM, tachycardia, poor pulses, abdominal distension, +/- fluid wave
What are chronic, nonspecific signs of splenic disease?
decreased appetite, anorexia, decreased weight, PD, lethargy, vomiting, cardiac arrhythmias
What results on bloods might you see with splenic disease?
CBC: anemia, mature neutrophilic leukocytosis
Biochem: non-specific
Clotting, typing
Splenectomy is warranted in what 3 causes?
Benign masses, neoplasia, torsion
Trauma to the spleen can be considered…
life-threatening
How would you approach treating a spleen that had undergone trauma?
Conservative treatment which may progress to a splenectomy, partial splenectomy, splenorrhaphy/repair
What are indications for a splenectomy?
- ruptured splenic neoplasia
- suspected primary splenic neoplasia
- splenic torsion
- trauma (if irreparable, life-threatening)
- adjunctive txt for immune-mediated disease (rare)
What are contraindications for splenectomy?
- physiologic or drug-induced splenomegaly
- BM hypoplasia
- Metastatic/systemic neoplasia
- Clotting disorders
What are some pre-operative considerations with a splenomegaly?
anemia, BP (hypotension), ECG (ventricular arrhythmias)
What are intra-operative considerations with a splenic disease/conditions?
Risk of hemorrhage
Metastasis
torsion
Prophylactic gastropexy?
If torsion of the spleen is discovered, what are your major concerns?
Do not untwist as it will cause death
Watch out for the pancreas
What are some post-op complications following a splenectomy?
Hemorrhage
Ventricular Arrhythmias
Vascular compromise
SIRS/DIC
General complications of coeliotomy
What is the prognosis following a splenectomy due to benign lesions?
good to excellent post-op
What is the prognosis following splenectomy due to trauma?
Good to excellent if survives immediate perioperative period
What is the prognosis following splenectomy due to torsion?
Guarded to good
Chronic torsion has a better prognosis
What is the prognosis following splenectomy due to neoplasia?
Depends on tumor and staging of the neoplasia
What are common splenic neoplasias in dogs?
Hemangiosarcoma, hemangioma, hematoma
What are common splenic neoplasias in cats?
HSA, MCT, lymphoma
What breeds are pre-disposed to splenic torsion?
large to giant breeds
Deep chested dogs
What are acute signs of splenic torsion?
hypovolaemic/toxic shock
What are chronic signs of splenic torsion?
vague signs –> lethargy, anorexia, dysorexia
What are disorders of the tonsils?
tonsillar inflammation/tonsilitis
tonsillar neoplasia
What are common tonsillar neoplasias?
SCC and lymphoma
What are complications of a tonsillectomy?
Hemorrhage
Pharyngeal swelling
Aspiration blood/fluid
