10-4 Lymphatics/Autonomics of Lower Limb Flashcards
What is the function of lymphatics? (relevant to LEA, don’t go to deep here)
To drain interstitial fluid rich in protein, which must be removed, or swelling (edema) will occur.
What is lymphedema?
When the drainage function of the lymphatics is disturbed and serious swelling occurs.
What are the major lymph nodes of the lower limb?
Iliac
Inguinal (largest aggregate)
Popliteal
Anterior Tibial (inconstant)
What are the two categories of the lymphatic system?
Superficial and Deep groups (similar to the venous system)
What do the superficial lymph vessels accompany?
Superficial veins
What do the deep lymph vessels accompany?
Deep veins and arteries
Where do the superficial and deep systems converge and unite?
- Popliteal fossa
- Femoral triangle
How can the superficial lymphatic system be divided?
Medial and Lateral parts
The medial part is the more extensive of the two
Which vein does the medial part of the superficial lymphatic system follow? What is the common termination?
Vein: great saphenous vein
Common termination: superficial inguinal nodes
Which vein does the lateral part of the superficial lymphatic system follow? What is the common termination?
Vein: small saphenous vein
Common termination: popliteal nodes
What is the territory of drainage for the medial part of the superficial lymphatic system?
Medial dorsum of foot, medial leg, thigh
What is the territory of drainage for the lateral part of the superficial lymphatic system?
Lateral dorsum of foot, posterior leg
What do the lymphatics from the deep system accompany?
- Dorsalis pedis/anterior tibial vessels
- Medial and lateral plantar/posterior tibial vessels
- Fibular vessels
Where do the lymphatics from the deep system terminate?
Popliteal nodes
Where does deep lymph from the popliteal nodes drain to?
Deep inguinal nodes
What are the two groups of superficial inguinal nodes?
Two groups distributed along the lines of a lop-sided “T”
- proximal/horizontal group
- distal/vertical group
Where does superficial lymph from the inguinal nodes drain to?
Most drains into the external iliac lymph nodes and a smaller amount goes into the deep inguinal nodes.
Why are the superficial inguinal nodes relevant to podiatry?
Enlargement can occur from the presence of an infection or tumor in the foot or leg.
You are taking the history of a patient and they tell you about recent enlargement of their superficial inguinal lymph nodes. Of which areas could this be indicative of disease?
- lower limb
- gluteal region
- lower abdominal wall
- external genitalia and perianal region
What are the deep inguinal lymph nodes comprised of?
1-3 nodes within the femoral sheath, medial to the femoral vein
- 1st: located in the femoral ring and is called gland of Cloquet or node of Rosenmuller
- 2nd & 3rd: located within the femoral canal
What is the territory of drainage of the deep lymph nodes?
Deeper tissues of lower extremity (deep leg, deep foot, posterolateral calf) and the popliteal nodes
Where does lymph from the deep inguinal nodes drain to?
External iliac lymph nodes
How do the sympathetic and parasympathetic divisions of the ANS differ from each other, functionally?
Sympathetic:
- fight/flight
- fear, strength, endurance
- cutaneous/visceral vasoconstriction
Parasympathetic
- rest/digest
- homeostatic, protective, vegetative
- secretomotor
Why is the sympathetic division often called the thoracolumbar part of the ANS?
The cell bodies of the preganglionic neurons are located in spinal cord segments T1-L2
