(2.2) Lymphatics Flashcards
Describe an overview of the lymphatic drainage system.
Lymphatic capillaries -> Afferent Lymphatic Vessels -> Lymph Nodes -> Efferent Lymphatic Vessels -> Lymphatic Trunks -> Collecting Ducts -> Subclavian Veins
Describe the structures within a lymph node.
- Afferent lymphatic vessels going in & Efferent lymphatic vessel going out
- Lymphatic sinuses
- Parenchyma = Cortex (outer) & Paracortex (middle) & Medulla (centre)
What are the roles of lymph nodes?
- Phagocytic cells act as a filter of micro-organisms and particles
- Antigen presenting to activate adaptive and innate immune system
Name 2 Primary Lymph organs.
- Bone marrow
- Thymus (under sternum)
Name some Secondary lymph organs. Suggest some places where they can be found.
- Spleen
- Lymph nodes
- Lymphoid follicles
- Tonsils
- MALTs
- GALTs (Adenoid, Peyer’s patches)
Suggest some places where there is a high concentration of lymph nodes.
- Head and Neck
- Axilla
- Groin
What cells can be found in the 3 layers of a parenchyma of a lymph node?
- Cortex: B cells
- Paracortex: T cells & activated B cells
- Medulla: Macrophages & Plasma cells & B memory cells
How do you distinguish a Lymphadenopathy caused by an infection and a malignancy anatomically? What symptoms do they both cause?
- Infection: tender & smooth
- Malignancy: non-tender & craggy
- Sore throat & Dysphagia
What is the most common malignancy in head and neck? What symptoms does it cause?
- Squamous cell carcinoma
- Lymphadenopathy
- Sore throat
- Dysphagia
What is the most common virus cause of Glandular fever? What symptoms does it cause?
- Epstein Barr Virus
- Lymphadenopathy
- Sore throat
- Dysphagia
- Fever & fatigue
Describe the organisation and drainage of the lymph nodes in H&N.
- Regional group x12 groups
- Terminal group x3 groups
- All lymph nodes drain into Jugular Trunks either directly or via Terminal lymph nodes
Give some examples of the regional lymph nodes.
- Occipital
- Post-auricular (Mastoid)
- Pre-auricular (Parotid)
- Buccal (Facial)
- Submental
- Submandibular
- Anterior & Posterior Cervical
- Superficial Cervical - along the External Jugular Vein
What are the three groups of Terminal Lymph Nodes? Where are they found?
- Internal Jugular
- Supraclavicular
- Spinal Accessory
- Found along the Internal Jugular Vein e.g. deep within Carotid Sheath
Tonsillitis causes lymphadenopathy of?
Lymphadenopathy of Jugulo-Digastric node associated with?
Oral cancer causes lymphadenopathy of?
Lymphadenopathy of Jugulo-Omohyoid Node associated with?
Gastric carcinoma causes lymphadenopathy of?
Lymphadenopathy of Virchow’s node associated with?
Where does the Right Jugular Lymph Trunk drain into? Which areas of the body also drain it?
- Right Lymphatic Duct
- Right H&N
- Right Upper Limb
- Right Upper Trunk
Where does the Left Jugular Lymph Trunk drain into? Which areas of the body also drain it?
- Thoracic Duct
- Left H&N
- Left Upper Limb
- Left Upper Trunk
- The rest of lower trunk & limbs
Which areas of the body drain into Thoracic Duct? Where does it then drain into?
- Left H&N
- Left Upper Limb
- Left Upper Trunk
- The rest of lower trunk & limbs
- Left Subclavian/Brachiocephalic Vein at Left Venous Angle
Which areas of the body drain into Right Thoracic Duct? Where does it then drain into?
- Right H&N
- Right Upper Limb
- Right Upper Trunk
- Right Subclavian Vein at Right Venous Angle
How long is the Left Jugular Lymph Trunk?
- 38-45cm, whereas the right is only 1cm
What is lymph? What is it called if the drainage comes from the intestines?
- An interstitial fluid that conduit between blood and cells
- Chyle
Suggest how may an infection in the scalp spread to the skull and intracranial structures?
- The scalp drains into intracranial Dural Venous Sinuses via valveless Emissary veins
- The skull drains into intracranial Dural Venous Sinuses via valveless Diploic veins
- The Dural Venous Sinuses provide connections to them
What is a Malar flush?
Redness on the skin covering Zygomatic bone, indicating various conditions e.g.
- Fevers e.g. TB infection
- Mitral Stenosis
- Systemic Lupus Disease
