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Unit 3: SXS lab > Week 3 > Flashcards

Week 3 Flashcards

1
Q

blood supply to spleen

A

blood is supplied by the trabecular artery; splits off into central arterioles which go into red pulp; wrap around white pulp (germinal center), diverge into penicillar arterioles, which lead to sheathed capillaries into either a closed circulation passing directly into splenic sinuses (S) or an open circulation, being dumped from the vasculature into the lymphoid tissue of the red pulp’s splenic cords where viable blood cells reenter the vasculature through the walls of the sinuses.

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2
Q

capsule (C) of the spleen

A

connects to trabeculae (T) extending into the pulp-like interior of the organ.

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3
Q

red pulp

A
  • occupies most of the parenchyma,

- filled with blood cells of all types, located both in cords and sinuses

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4
Q

white pulp

A
  • restricted to smaller areas, mainly around the central arterioles
  • lymphoid tissue; large blood vessels and lymphatics enter and leave the spleen at a hilum.
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5
Q

5 components of red pulp

A
  • penicillar arteries
  • macrophage sheathed capillaries
  • splenis sinusoids
  • reticular cells
  • all blood cells
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6
Q

ghost RBC

A

RBCs are phagocytized by macrophages. The only thing that is left behind is the RBC membrane

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7
Q

spleen and sickle cells

A

When sickled cells block the blood vessels leading out of the spleen, blood stays in the spleen instead of flowing through it. This causes the spleen to get bigger. When this happens the blood count (hemoglobin and hematocrit) falls and the spleen gets very large and easy to feel. This is called splenic sequestration crisis (or “spleen crisis”). Splenic sequestration can sometimes be painful

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8
Q

How is peripheral blood smear performed?

A
  1. place drop of blood 1cm from end of slide
  2. place smooth, clean end of a second slide just in front of blood drop
  3. hold spreader slide at 30 degrees and draw it against blood drop, allowing the blood to spread almost to the edge of the slide
  4. push the spread forward with light, smooth, moderate speed; should be a thin film of blood in shape of tongue.
  5. label with patient name, lab id, and date
  6. slide should be rapidly air dried by waving slides or using a fan
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9
Q

anisocytosis

A

different RBC sizes

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10
Q

poikilocytosis

A

different rbc shapes

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11
Q

Schistocytosis

A
  • caused by mechanical damage–> gets sheared.

- Another cause is TTP–> intravascular hemolysis

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12
Q

Thrombotic thrombocytopenic purpura

A 
-shredded RBC
○ Biliruben is high
○ Haptoglobin is low
○ LDH- high
○ DAT/coombs test (direct antiglobulin test)- negative; if it was positive, you would expect to see spherocytes because macrophages take a bite out on first pass--> spherocyte completely engulfed on second pass
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13
Q

Spherocytes

  • due to
  • next step
  • negative DAT
A
  • Round
  • Due to: Hereditary spherocytosis; Autoimmune hemolytic anemia; G6PD deficiency, thalasemia
  • Next step is to do a DAT (should be positive if it is autoimmune)
  • If DAT is negative: Do G6PD screening to rule out/in G6PD deficiency; Do Genetic testing to see if it is hereditary (Eosin-5-maleimide)
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14
Q

Target cell

A
  • looks like target; result of a change in cytosolic to membrane ratio
  • Beta thalasemia
  • Electrophoresis
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15
Q

Pencil cell

A
  • long and skinny

- associated with iron deficiency

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16
Q

Howell Jolly cells

A

-Spleen either sick and not taking them out or the bone marrow is releasing them prematurely

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17
Q

hypochromic cells

A
  • white in the middle
  • caused by not having enough iron–> not enough hemoglobin synthesis–> less red)
  • Iron deficient due to heavy menses
18
Q

Which tests from CBC are measured directly?

A
  • RBC count–> directly measured
  • MCV–> measured direct (can also be calculated)
  • Hgb and Hct usually directly measured (can be calculated depending on machine)
19
Q

Which tests from CBC are measured indirectly?

A
  • MCHC is calculated

- RDW calculated

20
Q

methods used by automated instruments to count cells

A

impedance (counts any particle of given size), optical methods (light scatter), or combination of impedance and light scatter.

21
Q

reticulocyte count

A
  • can be measured manually or by automation.
  • manual method: a blood smear is stained with a supravital dye (e.g., newmethylene blue) that highlights the endoplasmic reticulum that persists within reticulocytes. Red cells and reticulocytes are counted, and the result is given as a percentage (number of reticulocytes per 100 red cells).
  • Automated methods: more accurate, since many more cells can be counted. A blood sample is incubated with a supravital dye, and then passed through an automated counter in which they are exposed to a laser. Light scatter (which will be greatest in stained reticulocytes) is used to enumerate the reticulocytes.
22
Q

6 scapulohumeral muscles

A 
Supra-spinatus
Infra-spinatus
Teres minor
Teres major
Subscapularis
Delotid
23
Q

Rotator cuff

A

Supra-spinatus
Infra-spinatus
Teres minor
Subscapularis

24
Q

Empty can test

-what muscles is it testing?

A

assesses integrity of suprapinatus

25
Q

External rotation can test

-what muscles is it testing?

A

tests for infraspinatus and teres minor

26
Q

Internal rotation can test

-what muscles is it testing?

A

subscapularis and teres major

27
Q

Axillary radiograph

A

arm held out at 90 degree

28
Q

Y view

A

emphasizes view of clavicle, coracoid process, acromion,

29
Q

What is found in the deltopectoral triangle

A

cephalic vein

30
Q

Boundaries of deltopectoral triangle

A

Lateral boundary of deltopectoral triangle: deltoid

Medial boundary: pectoralis major

Superior boundary: clavicle

31
Q

Triangular space

  • contents
  • boundaries
A
  • circumflex scapular branch of subscapular a.

- teres major, teres minor, and subscapularis

32
Q

Quadrangular space

  • contents
  • boundaries
A
  • transmitting axillary n. and posterior circumflex a.

- long head of triceps, deltoid, teres minor, and humerus

33
Q

elevation of scapula

A

trap, levator scapulae, rhomboids

34
Q

depression of scapula

A

gravity, pectoralis major, inferior sternocostal head, latissimus dorsi, trap, serratus anterior, pec major

35
Q

protraction of scapula

A

serratus anterior, pec major, pec minor

36
Q

retraction of scapula

A

trap, rhomboids, lat dorsi

37
Q

arteries involved in scapular anastomosis

A

Several vessels join to form networks on the anterior and posterior surfaces of the scapula: the dorsal scapular, suprascapular, and (via the circumflex scapular) subscapular arteries.

38
Q

importance of scapular anastamoses

A

when ligation of a lacerated subclavian or axillary artery is necessary

39
Q

course of axillary nerve

  • where does it pass?
  • what will it cause?
  • how is it caused?
A
  • passes inferior to the humeral head and winds around the surgical neck of the humerus
  • will cause deltoid and teres minor atrophy when head of humerus fractures or damaged during anterior dislocation of the glenohumeral joint and by compression from the incorrect use of crutches
  • shoulder will loof flattened on affected side and produces a slight hollow inferior to the acromion
40
Q

course of posterior circumflex artery

A

passes medially through the posterior wall of the axilla via thequadrangular spacewith the axillary nerve to supply the glenohumeral joint and surrounding muscles

Unit 3: SXS lab (7 decks)

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