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Y1 - LEA Quiz- 9/10 > 10-4 Lymphatics/Autonomics of Lower Limb > Flashcards

10-4 Lymphatics/Autonomics of Lower Limb Flashcards

1
Q

What is the function of lymphatics? (relevant to LEA, don’t go to deep here)

A

To drain interstitial fluid rich in protein, which must be removed, or swelling (edema) will occur.

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2
Q

What is lymphedema?

A

When the drainage function of the lymphatics is disturbed and serious swelling occurs.

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3
Q

What are the major lymph nodes of the lower limb?

A

Iliac
Inguinal (largest aggregate)
Popliteal
Anterior Tibial (inconstant)

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4
Q

What are the two categories of the lymphatic system?

A

Superficial and Deep groups (similar to the venous system)

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5
Q

What do the superficial lymph vessels accompany?

A

Superficial veins

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6
Q

What do the deep lymph vessels accompany?

A

Deep veins and arteries

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7
Q

Where do the superficial and deep systems converge and unite?

A
  • Popliteal fossa

- Femoral triangle

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8
Q

How can the superficial lymphatic system be divided?

A

Medial and Lateral parts

The medial part is the more extensive of the two

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9
Q

Which vein does the medial part of the superficial lymphatic system follow? What is the common termination?

A

Vein: great saphenous vein

Common termination: superficial inguinal nodes

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10
Q

Which vein does the lateral part of the superficial lymphatic system follow? What is the common termination?

A

Vein: small saphenous vein

Common termination: popliteal nodes

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11
Q

What is the territory of drainage for the medial part of the superficial lymphatic system?

A

Medial dorsum of foot, medial leg, thigh

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12
Q

What is the territory of drainage for the lateral part of the superficial lymphatic system?

A

Lateral dorsum of foot, posterior leg

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13
Q

What do the lymphatics from the deep system accompany?

A
  • Dorsalis pedis/anterior tibial vessels
  • Medial and lateral plantar/posterior tibial vessels
  • Fibular vessels
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14
Q

Where do the lymphatics from the deep system terminate?

A

Popliteal nodes

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15
Q

Where does deep lymph from the popliteal nodes drain to?

A

Deep inguinal nodes

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16
Q

What are the two groups of superficial inguinal nodes?

A

Two groups distributed along the lines of a lop-sided “T”

  • proximal/horizontal group
  • distal/vertical group
17
Q

Where does superficial lymph from the inguinal nodes drain to?

A

Most drains into the external iliac lymph nodes and a smaller amount goes into the deep inguinal nodes.

18
Q

Why are the superficial inguinal nodes relevant to podiatry?

A

Enlargement can occur from the presence of an infection or tumor in the foot or leg.

19
Q

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?

A
  • lower limb
  • gluteal region
  • lower abdominal wall
  • external genitalia and perianal region
20
Q

What are the deep inguinal lymph nodes comprised of?

A

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
21
Q

What is the territory of drainage of the deep lymph nodes?

A

Deeper tissues of lower extremity (deep leg, deep foot, posterolateral calf) and the popliteal nodes

22
Q

Where does lymph from the deep inguinal nodes drain to?

A

External iliac lymph nodes

23
Q

How do the sympathetic and parasympathetic divisions of the ANS differ from each other, functionally?

A

Sympathetic:

  • fight/flight
  • fear, strength, endurance
  • cutaneous/visceral vasoconstriction

Parasympathetic

  • rest/digest
  • homeostatic, protective, vegetative
  • secretomotor
24
Q

Why is the sympathetic division often called the thoracolumbar part of the ANS?

A

The cell bodies of the preganglionic neurons are located in spinal cord segments T1-L2

25
Q

True or false:

The autonomic supply to the limbs is exclusively sympathetics?

A

True

26
Q

From what spinal levels do sympathetics to the lower limb originate?

A

T10-L2

27
Q

What are the possible courses/terminations of the preganglionic sympathetic axons after they enter the sympathetic trunk? (relevant to podiatry)

A
  1. Synapse in the symp. trunk at the level of entry

2. Descend in the symp. trunk to a lower level and then synapse

28
Q

What is the fate of sympathetic fibers leaving the sympathetic trunk (relevant to podiatry)?

A

Post ganglionic fibers leave the sympathetic trunk at all levels via gray communicating rami to travel in spinal nerves to smooth muscle and glands in the limbs and body wall.

29
Q

Gray rami communicans along what portions of the sympathetic chains distribute postganglionic fibers to the lower limb?

A

Lumbar and sacral ventral rami

Ventral rami then join to form nerves

30
Q

After first travelling with peripheral nerves, what do the post-ganglionic sympathetics then join?

A

Blood vessels

31
Q

What do post ganglionic sympathetic fibers innervate in the lower limb?

A
  • veins & arteries
  • arrector pili muscles (pilomotor fibers)–> in turn affect sebaceous gland function
  • sweat glands (sudomotor fibers)
32
Q

How would autonomic neuropathy affect the foot?

A
  • keratin cracks and ulcerations due to sweat gland dysfunction and lack of oil production
  • small fissures are created as keratin builds
  • fissures create an entrance for infection causing bacteria
33
Q

What ventral rami compose the lumbar plexus?

A

T12-L4

34
Q

What muscle groups would likely be affected by a lesion to the lumbar plexus?

A
  • Hip flexors
  • Knee extensors
  • Adductors of the thigh
35
Q

What areas of skin would likely be affected by a lesion to the lumbar plexus?

A
  • anterior and medial thigh
  • anteromedial and posteromedial leg
  • medial plantar aspect of foot (including hallux)
36
Q

A lesion to the lumbar plexus, in addition to sensory and motor defects, would also cause what type of presentation in a patient?

A
  • vasodilation of superficial vessels (increased warmth/flushing of affected foot)
  • anhidrosis (lack of sweating in affected foot)

Y1 - LEA Quiz- 9/10 (13 decks)

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