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SA Sx > Spleen Sx-Exam 2 > Flashcards

Spleen Sx-Exam 2 Flashcards

1
Q

Where does the spleen lie?

A

Greater omentum- L side

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2
Q

What is the spleen attached to?

A

The stomach through the gastrosplenic ligament

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3
Q

What is the method of blood flow into the spleen?

A

Celiac a. –> splenic a.

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4
Q

What is the method of blood flow out of the spleen?

A

Splenic v. –> gastrosplenic v. –> portal v

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5
Q

What is the purpose of red vs. white pulp?

A

White pulp: site of immune response

Red pulp: stores RBC/traps Ag

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6
Q

Spleoniss

A

Seeding of cells after sx or trauma

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7
Q

What are siderotic plaques made up of?

A

Ca/Fe deposits

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8
Q

What is the stimulator of macrophages?

A

Tetrapeptid tuftsin

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9
Q

What is considered symmetric enlargement of the spleen?

A

Splenomegaly

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10
Q

What is considered an asymmetric enlargement of the spleen?

A

Mass

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11
Q

What % of blood is sequestered to the spleen during anesthesia?

A

5-40%

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12
Q

What type of enlargement does splenic infarction have on the spleen?

A

Symmetrical- splenomegaly

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13
Q

What should be palpated when evaluating a splenic infarction to make sure the organ is adequately perfued?

A

Vasa recta

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14
Q

This may be caused by stretching of the gastrosplenic ligament during previous GDV sx?

A

Splenic torsion

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15
Q

What is the signalment for splenic torsion?

A

Large/Giant breed dogs

Great dane, greater swiss mountain dog, GSD, english bulldog

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16
Q

What are CS seen with acute splenic torsion?

A

Acute abdominal pain/shock
Abdominal distension
CV collapse

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17
Q

What CS are seen with chronic splenic torsion?

A

Vague/intermittent signs for up to 2 weeks

18
Q

What does a splenic torsion look like on rads?

A

C-shaped spleen

19
Q

What is the only treatment for splenic torsion?

A

Splenectomy

20
Q

Why should you not derotate the spleen prior to splenectomy?

A

Vessels are thrombosed- helping control the hemorrhage intraop

21
Q

What percentage of patients survive to discharge?

A

91%

22
Q

T/F: Neoplasia is a cause of splenic torsion

A

FALSE

23
Q

Nodular hyperplasia are sites of extramedullary hematopoiesis made up of single or multiple ____ nodules

A

Subcapsular

24
Q

What is the diagnostic dilemma for diffuse/nodular hyperplasia?

A

Can look like cancer

FNA/Cytology=poor sensitivity

25
Q

T/F: diffuse/nodular hyperplasia is incidentally found and most commonly benign

A

TRUE

26
Q

What is the most preferred and successful management for splenic trauma?

A

Conservative managment

Compression bandage, supportive care and transfusion if needed

27
Q

What is the most common splenic neoplasia in dogs and cats?

A

Dogs: HSA, sarcomas
Cats: MCT

28
Q

What is the rule of 2/3 in relation to splenic neoplasia?

A

2/3 of dogs w/ splenic mass=malignant

2/3 of those w/ malignancies will be HSA

29
Q

Presence of what increases malignancy of HSA to 80%

A

Hemoperitoneum

30
Q

T/F: Wheaten terriers are predisposed- but in small dogs hemoperitoneum is NOT associated w/ malignancy

A

TRUE- only true for large dogs

31
Q

T/F: Bigger splenic mass=more likely B9

A

True

32
Q

What is the prognosis for the following situations of HSA
Sx
Sx + chemo
Sx + CT + Immunotherapy

A

Sx: 3 months
Sx + CT: 6 months
Sx + CT + immunotherapy: 425 days

33
Q

What are alternative tx used for HSA?

A

C versicolor mushroom

eBAT- bispecific urokinase angiotoxin designed to inhibit EGFR

34
Q

Sx + CT + eBAT MST is what

A

> 450days

35
Q

What are the two splenectomy techniques?

A

Ligation of individual hilar vessels- most common and preferred
Ligation of splenic & short gastric a.

36
Q

Which technique has less risk for PO hemorrhage?

A

Ligation of individual hilar vessels

37
Q

Hilar dissection is when you isolate and double ligate vessels at the hilus- what does this preserve?

A

Branches to pancreas & stomach

38
Q

Where is the primary blood supply of the pancreas?

A

Left limb of pancreas

39
Q

What is the maximum diameter size that hemostatic clips can be used for in terms of ligation?

A

< 4 mm

40
Q

Ligasure allows ligation up to what size vessel?

A

7 mm

41
Q

What is the most common complication of splenectomy?

A

Hemorrhage

42
Q

If this is present- the risk of death is increased by 2x in HSA patients

A

Arrhythmias (ventricular)

SA Sx (22 decks)

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