4: Lymphatics Flashcards

1
Q

3 components of lymph system

A
  1. Lymph fluid
  2. Lymph vessels
  3. Organized lymph tissues/organs
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2
Q

Lymphatic development in embryo

A

Begins during week 5, significant presence by week 20

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3
Q

When does lymphoid tissue stop increasing?

A

Around 6-9 years old

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4
Q

Substances found in lymph fluid

A
  1. Substances that leak out of arteries, like proteins and electrolytes
  2. Immune cells
  3. Foreign Ags, bacteria, and viruses
  4. Clotting factors
  5. Chylomicrons
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5
Q

Four tissues that do not have lymph vessels

A
  1. Epidermis
  2. Endomysium of muscle
  3. Cartilage
  4. Bone marrow
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6
Q

Superficial vs deep LNs

A

Superficial: within subq tissue
Deep: beneath fascia, muscle, and organs

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7
Q

Virchow’s node

A

Left supraclavicular node -> indicated intrathoracic or abdominal cancer

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8
Q

Epitrochlear nodes

A

In elbow region, indicate secondary syphilis

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9
Q

Three tonsils and their locations

A
  1. Palatine: lateral pharynx
  2. Lingual: posterior 1/3 of tongue
  3. Pharyngeal: adenoids at nasopharyngeal border
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10
Q

Normal interstitial fluid pressure (Pif)

A

-6.3mmHg (negative pressure system

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11
Q

What happens if interstitial fluid pressure reaches above 0 mmHg

A

Lymph caps collapse and flow ceases -> increased hydrostatic pressure, decreased plasma colloid osmotic pressure, increased cap permeability

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12
Q

What two forces help lymph move through large vessels

A
  1. Muscle contractions

2. Breathing

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13
Q

What happens with each breath in terms of lymph movement (2 things)

A
  1. Increased negative intrathoracic pressure pulls fluid centrally
  2. Direct force on cisterna chyli, pushes fluid superiorly
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14
Q

Sympathetics effect on lymph valves

A

Increased symps -> tighter valves -> decreased lymph flow into venous system

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15
Q

Sympathetics effect on lymph smooth muscle

A

Increased symps -> decreased peristalsis -> lymph congestion

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16
Q

What happens with a buildup of interstitial fluid?

A

Edema!

17
Q

Four things edema causes

A
  1. Increased arterial pressure
  2. Increased venous pressure
  3. Decreased plasma osmotic pressure
  4. Increased capillary permeability
18
Q

Effects of increased arterial vs venous pressure

A

Arterial: HTN, increased blood volume
Venous: CHF, valvular disease, venous obstruction, dysfunctional valves

19
Q

What does decreased plasma osmotic pressure cause?

A

Cirrhosis, protein malnutrition, DM

20
Q

Local effect of edema compression on structures

A

Vascular: decreased delivery of O2, nutrients, meds, hormones
Neuronal: decreased sensation, pain, or parasthesia

21
Q

Edema and clearing tissues

A

Edema causes decreased waste and pathogen clearance

22
Q

Indications for lymphatic OMT

A
  1. Lymph congestion / edema
  2. Mild CHF
  3. URI or lower RI
  4. Asthma or COPD
  5. Sprains or strains
  6. Acute SD
  7. Pregnancy
23
Q

Four absolute contraindications for lymphatic OMT

A
  1. Anuria: kidneys needed to process extra fluids
  2. Necrotizing fasciitis
  3. Pt unable to tolerate tx
  4. Pt refuses tx
24
Q

Some relative contraindications for lymphatic OMT

A
  1. Inability to tolerate excessive preload in CHF
  2. COPD
  3. Acute asthma exacerbation
  4. Untreated coagulopathy
  5. Cancer (unsure if it could spread it)
  6. Osseous fracture
  7. Bacterial or chronic infection
  8. diseased organ
  9. Pregnancy (dont do uterus or abd work)
  10. Circulatory disorders
25
Q

Four transverse restrictors in the body

A
  1. Tentorium cerebelli
  2. Thoracic inlet
  3. Thoracolumbar diaphragm
  4. Pelvic diaphragm
26
Q

Path of lymph through the body

A
  1. Terminal lymphatics
  2. Collecting vessels
  3. Afferent vessels
  4. LN
  5. Efferent vessels
  6. Lymphatic trunks
  7. Cysterna chyli
    8 Thoracic duct + right lymphatic duct
27
Q

What forms collecting vessels?

A

Lymphangions - chains of SM units with 2-3 leaflet bicuspid valves

28
Q

Level of cisterna chyli

A

L1-2