Term
| Which lymph nodes are palpable? |
|
Definition
| -mandibular, superficial, axallary (cats), popliteal, superficial inguinal |
|
|
Term
| Which lymph nodes are palpable when enlarged? |
|
Definition
-maxillary
-accessory axillary
-cervical
-femoral
-retropharyngeal-sublumbar
-mesenteric |
|
|
Term
| What are some of the causes of lymphadenomegaly? |
|
Definition
-infection
-inflammation
-neoplasia: metastatic or primary
-systemic disase |
|
|
Term
| When you palpate a lymph node, what are you watching for? |
|
Definition
-painful: infection
-non-painful: lymphoid neoplasia
-fixed: metastatic neoplasia, fungal |
|
|
Term
| What is a fine needle aspiration? Is it sensitive or specific? |
|
Definition
-first-step screening tool used to take a cellular samply
-specific but not sensitive |
|
|
Term
| What are the primary etiologies explored by a fine needle aspirate? |
|
Definition
| -bacterial, fungal, or neoplasia |
|
|
Term
|
Definition
-diagnosis
-disease staging
-develop treatment plans |
|
|
Term
| Which lymph node do we not biopsy if multiple are enlarged? |
|
Definition
|
|
Term
| Describe the Needle (TruCut) biopsy method. Indications? Advantages? |
|
Definition
-aseptic technique with long bore
-indication: larger node in a safe place
-Advantages: easy/quick, expensive |
|
|
Term
| Describe the incisional (wedge) biopsy technique. Indications? |
|
Definition
-aseptic technique where a wedge-shaped incision is cut out and the capsule is sutured closed
-Indications: regional anatomy concern, smaller size of node, more difficult location |
|
|
Term
| Describe an excisional biopsy. Inidcations? |
|
Definition
-aseptic tecnique where the node is removed and hte blood vessels ligated
-indicaitons: smaller node, evaluate for metastasis |
|
|
Term
| True or False: A lymphadenectomy prevents metastasis. |
|
Definition
|
|
Term
| How do we preserve a biopsy sample if we are looking for neoplasia, bacteria, or fungal infection? |
|
Definition
-neoplasia = formalin (1:9)
-bacteria = fresh
-fungal = fresh or frozen |
|
|
Term
| What vessels supply the spleen? |
|
Definition
|
|
Term
| What are some possible causes of diffuse splenomegaly due to congestion? |
|
Definition
-splenic torsion
-right-sided heart failure
-gastric dilatation - volvulus
-drugs
-infection
-immune-mediated
-neoplasia |
|
|
Term
| What are some possible causes of focal splenomegaly? |
|
Definition
-nodular regeneration
-hematoma
-trauma
-neoplasia |
|
|
Term
| What is splenic torsion? What type of animal is predisposed? |
|
Definition
-spleen twists on its vascular pedicle
-large-breed dogs |
|
|
Term
| What are the clinical signs of acute splenic torsion? Chronic? |
|
Definition
-Acute: shock, anorexia, vomiting, diarrhea, abdominal pain, enlarged spleen
-Chronic: anorexia, vomiting, diarrhea, abdominal pain, enlarged spleen, hemoglobinuria |
|
|
Term
| How do we treat a splenic torsion case? |
|
Definition
-CV stabilization
-antibiotics
-electrocardiogram
-splenectomy |
|
|
Term
| Why do we not just untwist a splenic torsion? |
|
Definition
| -necrotic debris can enter systemic circulation |
|
|
Term
| Are neoplasms of the spleen common or rare? In which dogs are the more common? |
|
Definition
-very common
-large breeds > small breeds |
|
|
Term
| What are the clinical signs of an acute splenic neoplasm? Chronic? |
|
Definition
-acute: shock, enlarged abdomen, abdominal mass, fluid wave, lethargic, vomiting, abdominal pain
-chronic: same as acute, but episodic presentation |
|
|
Term
| What does a splenic torsion look like radiographically? |
|
Definition
| -gas bubbles, comma-shaped |
|
|
Term
| What does a splenic neoplasm look like radiographically? |
|
Definition
| -peritoneal effusion, metastasis in throax |
|
|
Term
| What are the major differentials for splenic neoplasms? |
|
Definition
-non-neoplastic: hematoma
-benign neoplasia: lipome/ myelolipoma, hemangioma, fibroma
-malignant neoplasia: hemangiosarcoma, fibrosarcoma, liposarcoma |
|
|
Term
| How do we treat sploenic neoplasia? |
|
Definition
-CV stabilization
-electrocardiogram
-+/- blood transfusion
-splenectomy |
|
|
Term
| What are the advantages of a splenic fine needle aspirate? Indications? Cautions? |
|
Definition
-Advantages: samples obtained percutaneously, cheap, easy
-indications: concern for diffuse disease
-caution: avoid cavitary lesions, major hemorrhage can occur |
|
|
Term
| Describe hte technique used for splenic biopsy. |
|
Definition
-incision into the spleen to remove tissue
-close capsule with suture
-direct pressure for hemostasis |
|
|
Term
| What are the indications for a partial splenectomy? Concerns? |
|
Definition
-indications: preserve splenic function, focal lesion, repair traumatic lesion
-concerned with hemorrhage |
|
|
Term
| Describe the technique used for a partial splenectomy. |
|
Definition
| -ID portion to remove => dissect and ligate vessels => incise spleen => close capsule with absorbable suture |
|
|
Term
| Is a partial or total splenectomy more commonly performed? |
|
Definition
|
|
Term
| What are the indications for a total splenectomy? Concerns? |
|
Definition
-neoplasia, severe trauma, immune-mediated disease
-concerns: large-Vol blood loss, inc sepsis risk |
|
|
Term
| Describe the classical approach to a total splenectomy. |
|
Definition
| -exteriorize and isolate spleen => dissect, ligate, and divide all hilar vessels but do not dame the gastric aa |
|
|
Term
| Describe the alternate approach for a total splenectomy. |
|
Definition
-abdominal exploration
-exteriorize and isolate spleen => ID splenic a and v => ligate splenic a and v distal to gastric aa/pancreatic br/left gastroepiploi a
-quicker |
|
|
Term
| What are some complications associated with splenectomy? |
|
Definition
-hemoabomen prior to surgery
-breakdown of adhesions at surgery
-mass rpture with handling at surgery
-ligature slippage
-blood contained within the spleen itself |
|
|
Term
| What are some postoperative considerations of a splenectomy? |
|
Definition
-blood transfusion
-electrocardiogram
-crystalloid/colloid fluid support
-oxygen therapy
-monitor coagulation profiles (PT/PTT) |
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