Sx of the Haemolymphatic System Flashcards

1
Q

What are the main components of the haemolymphatic system?

A

Lymph, lymphatic vessels, LN’s, cisterna chyli, thoracic duct

peripheral lymphatic organs –> spleen, tonsils, thymus, BM, GALT

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2
Q

What are the main lymph nodes in the head?

A

Parotid, mandibular, retropharyngeal

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3
Q

What are the main lymph nodes in the neck?

A

superficial and deep cervical

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4
Q

What are the main lymph nodes in the forelimb?

A

Axillary lymph center (axillary and accessory axillary lymph nodes)

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5
Q

What lymph nodes & how many are present in the parietal group of the thorax?

A

Ventral: cranial sternal LN’s (8)
Dorsal: aortic thoracic LN’s (1)

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6
Q

What lymph nodes & how many are present in the visceral group of the thorax?

A

Mediastinal lymph center: cranial mediastinal LN’s (6)
Bronchial lymph center: pulmonary & tracheobronchial LN’s (5)

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7
Q

What lymph nodes are present within the parietal group of the abdomen & pelvis?

A
  • 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
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8
Q

What lymph nodes are present within the visceral group of the abdomen & pelvis?

A
  • celiac lymph center: hepatic, splenic, gastric, pancreaticoduodenal LNs
  • cranial mesenteric lymph center: jejunal & colic LN’s
  • caudal mesenteric lymph center
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9
Q

What are the main lymph centers in the pelvic limbs and what lymph nodes are contained within each?

A
  • Popliteal lymph center: superficial popliteal LN
  • iliofemoral lymph center: distal femoral LN, external iliac LN
  • Inguinofemoral lymph center: superficial inguinal LNs
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10
Q

What are abnormalities that can appear within the haemolymphatic system?

A

Lymphadenomegaly, lymphedema

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11
Q

Lymphadenomegaly occurs in…

A
  • reactive hyperplasia
  • infection
  • neoplasia (primary vs mets)
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12
Q

Lymphedema is the accumulation of

A

fluid in the interstitial space

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13
Q

What are the 3 types of biopsy sampling lymph nodes?

A
  • TruCut/Core Bx
  • Incisional Bx (wedge Bx)
  • Excisional Bx (lymphadenectomy)
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14
Q

What are the functions of the spleen?

A

Extra-medullary haematopoiesis
Reservoir for RBCs and platelets
Immune defense (B & T cells)

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15
Q

Generalized splenomegaly may be caused by…

A
  • inflammation/infection (splenitis)
  • immune rxn or cellular hyperplasia
  • congestion
  • infiltration
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16
Q

Localized or focal splenomegaly may be caused by…

A
  • nodular hyperplasia
  • hemangioma
  • neoplasia
  • abscess
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17
Q

What are normal consequences of splenic disease?

A
  • splenic deposits (fibrin, siderotic plaques)
  • accessory spleen/splenosis
  • splenic fissures
  • size changes (congestion, contraction - anemia, blood loss, stress)
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18
Q

What are pathological consequences of splenic disease?

A

Focal lesions - hematoma, extramedullary hematopoiesis, neoplasia

Diffuse changes - torsion, neoplasia, IMTP/IMHA, infection

19
Q

What is the arterial supply to the spleen?

A

splenic artery which comes off the coeliac artery & has short gastric arteries and left gastroepiploic arteries that come off it.

20
Q

What are acute signs of splenic disease?

A

weakness/collapse, pale MM, tachycardia, poor pulses, abdominal distension, +/- fluid wave

21
Q

What are chronic, nonspecific signs of splenic disease?

A

decreased appetite, anorexia, decreased weight, PD, lethargy, vomiting, cardiac arrhythmias

22
Q

What results on bloods might you see with splenic disease?

A

CBC: anemia, mature neutrophilic leukocytosis
Biochem: non-specific
Clotting, typing

23
Q

Splenectomy is warranted in what 3 causes?

A

Benign masses, neoplasia, torsion

24
Q

Trauma to the spleen can be considered…

A

life-threatening

25
How would you approach treating a spleen that had undergone trauma?
Conservative treatment which may progress to a splenectomy, partial splenectomy, splenorrhaphy/repair
26
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)
27
What are contraindications for splenectomy?
- physiologic or drug-induced splenomegaly - BM hypoplasia - Metastatic/systemic neoplasia - Clotting disorders
28
What are some pre-operative considerations with a splenomegaly?
anemia, BP (hypotension), ECG (ventricular arrhythmias)
29
What are intra-operative considerations with a splenic disease/conditions?
Risk of hemorrhage Metastasis torsion Prophylactic gastropexy?
30
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
31
What are some post-op complications following a splenectomy?
Hemorrhage Ventricular Arrhythmias Vascular compromise SIRS/DIC General complications of coeliotomy
32
What is the prognosis following a splenectomy due to benign lesions?
good to excellent post-op
33
What is the prognosis following splenectomy due to trauma?
Good to excellent if survives immediate perioperative period
34
What is the prognosis following splenectomy due to torsion?
Guarded to good Chronic torsion has a better prognosis
35
What is the prognosis following splenectomy due to neoplasia?
Depends on tumor and staging of the neoplasia
36
What are common splenic neoplasias in dogs?
Hemangiosarcoma, hemangioma, hematoma
37
What are common splenic neoplasias in cats?
HSA, MCT, lymphoma
38
What breeds are pre-disposed to splenic torsion?
large to giant breeds Deep chested dogs
39
What are acute signs of splenic torsion?
hypovolaemic/toxic shock
40
What are chronic signs of splenic torsion?
vague signs --> lethargy, anorexia, dysorexia
41
What are disorders of the tonsils?
tonsillar inflammation/tonsilitis tonsillar neoplasia
42
What are common tonsillar neoplasias?
SCC and lymphoma
43
What are complications of a tonsillectomy?
Hemorrhage Pharyngeal swelling Aspiration blood/fluid