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Anatomy and Physiology of Lymphoedema > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Name the components of the lymphatic system

A
  1. Lymph vessels
  2. Lymph nodes
  3. Spleen (produces lymphocytes)
  4. Thymus gland
  5. Bone marrow of long bones
  6. Lymph nodules (tonsils and peyers patches)
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2
Q

What are the functions of the lymphatic system?

A
  1. Return protein and water from the interstitium to the cardiovascular system
  2. Absorb fat and fat soluble vitamins
  3. Immune defense: recognises and responds to foreign cells/ microbes. Produces lymphocytes (white blood cells)
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3
Q

The lymphatic system is multilayered and divided into 3 parts. Name the 3 layers.

A
  1. Superficial system which lies just below the skin
  2. Deep system in the muscles, joints and organs
  3. Visceral system in the intestines
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4
Q

Describe the process of lymphatic transport

A

Transport begins in the interstitial space

  1. Fluid and proteins enter the lymphatic capillary
  2. It passes through pre-collectors
  3. To the collector
  4. Into the lymph nodes
  5. To the lymphatic ducts and trunks
  6. To join with the venous system in the cervical region
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5
Q

Why can lymph capillaries absorb larger molecules such as proteins than blood capillaries?

A

Lumen is larger

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6
Q

Describe the cell wall of a lymph capillary

A

Made up of flat endothelial cells. It’s basement membrane has anchoring filaments which anchor to tissues and open flaps. There is no muscular component

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7
Q

Where does interstitial fluid enter the lymph capillaries?

A

Though the endothelial gaps to become lymph

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8
Q

What does lymph consist of?

A

Fat

Cells (red blood cells, white blood cells and lymphocytes)

Proteins

Water

Waste products and foreign objects

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9
Q

How do lymph capillaries opens?

A

Fluid pressure increases in the interstitium, anchor filaments are stretched and allow junctions between the endothelium cells to open and fluid poors in

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10
Q

What is the role of pre collectors?

A

Pre collectors gather lymph from the capillary area and move fluid towards the collectors

Pre collectors are located just below the surface of the skin in the du dermal tissue

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11
Q

Where are collecting vessels located?

A

Within both superficial and deep systems

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12
Q

Collecting vessels collect what percentage of lymph load from the initial lymphatics? And transport in which direction through the regional nodes?

A

80%

Distal to proximal

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13
Q

What is each section of a collecting vessel called and what is it bordered by?

A

Each section is called a lymphangion and is bordered by proximal and distal bicuspid valves. It is the smallest unit of a lymph collector

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14
Q

What nervous system innervates lymphangion activity?

A

Automatic

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15
Q

How many intrinsic contractions will a lymphangion produce each minute?

A

6-10

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16
Q

What extrinsic factors influence lymphangion contractions?

A

Diaphragmatic breathing

Muscle movement

Arterial pulsation

Negative pressure in the central veins

External compression

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17
Q

What propels fluid movement?

A

Compulsion from behind, constant production of lymph

Lymphangion activity caused by the autonomic nervous system

Negative pressure in central veins

18
Q

What extrinsic factors propel fluid movement?

A

Breathing; changes in intra thoracic and intra abdominal pressure during respiration ( provides pressure to cisterna chyli

Arterial pulsation which causes pulsation to lymphatic system

External stretch and pressure (MLD and garments)

Passive and active limb movements due to muscle pump. The muscle squeezes lymphangion

19
Q

How many lymph nodes are in the body?

A

600-700

20
Q

How big and what shape is a lymph node?

A

2-30mm long and shaped like a kidney bean

21
Q

What are the functions of lymph nodes?

A

Filtering station for noxious matter

Production of white blood cells

Regulate the concentration of proteins in the lymph

22
Q

Where are the main groups of lymph nodes in the body?

A

Cervical lymph nodes

Axillary lymph nodes

Iliac lymph nodes

Inguinal lymph nodes

Popliteal lymph nodes

23
Q

Where do the upper extremity and upper trunk drain in to?

A

Axillary lymph nodes

24
Q

Where do the lower extremity, lower trunk and external genitalia drain to?

A

Inguinal lymph nodes

25
Q

Describe where the thoracic duct is located?

A

Starts at the 2nd lumber vertebrae

Pierces through the diaphragm

Moves along the spinal column

To left venous angle where it joins to the subclavian vein

26
Q

The thoracic duct is the largest lymph vessel? True or false

A

True. It is 40cm long and 5mm wide

27
Q

What are the three parts of the thoracic duct

A

Cervical

Thoracic

Abdominal

28
Q

The thoracic duct receives fluid from all but which quadrant of the body?

A

Right upper quadrant

29
Q

Where is the cisterna chyli located and what does it collect?

A

Beginning of the thoracic duct. It collects fluid from the lower extremity, abdomen and intestinal areas

30
Q

The lymphatic trunks of the lower body are?

A

Right and left lumber trunks. From the inguinal and pelvic nodes the lymph fluid is transported to the cisterna chyli

Intestinal trunk- from the small intestines to the cisterna chyli. Absorbs fatty acids

31
Q

Where does the right upper quadrant and head and neck drain to?

A

Right lymphatic duct which connects to the right subclavian vein

32
Q

The lymphatic trunks of the upper body are?

A

Right and left jugular trunk: from the cervical lymph nodes which drain the head and neck

Right and left subclavian trunk: from the axillary lymph nodes to the thoracic duct (left quad) and the right lymphatic duct (right upper quad)

Right and left broncho mediastinal trunk: from the bronchi, lungs and mediastinum to the thoracic duct and right lymphatic duct

33
Q

What is a lymphatic territory?

A

Specific superficial lymphatic drainage areas which drain lymph to specific lymph nodes

34
Q

What is a watershed?

A

A dividing line between any two territories

35
Q

Name the lymphatic watersheds

A

Median saggital (divides left and right territories)

Transverse (divides upper and lower territories)

Clavicular (separates head and neck from upper trunk quadrants)

Gluteal

Chaps (only goes to knee)

36
Q

Name the two anastomoses?

A

Axillo axillary

Axillo inguinal

Anastomoses connect tributory regions

37
Q

Name the watersheds of the trunk?

A

Upper right quadrant
Upper left quadrant
Lower right quadrant
Lower left quadrant

38
Q

Names the anastomoses we use for treating unilateral upper limb lymphoedema?

A

Axillo axillary anastomoses

Axillo inguinal anastomoses

39
Q

Name the anastomosis we can use when treating unilateral lower limb lymphoedema?

A

Inguinal axillary anastomosis

40
Q

What is the function of the lymphatic system?

A
  1. Return protein and water from the interstitium back to the cardiovascular system
  2. Intestinal lymph vessels absorb fat and fat soluble vitamins
  3. Immune defense - recognises and responds to foreign cells/microbes. Produces lymphocytes
41
Q

What is the enriched lymph originating in the lymphatics of the small intestine called?

A

Chyle which is a milk bodily fluid consisting of lymph and fats. It is formed in the small intestine during digestion

42
Q

Define lymphoedema

A

Lymphoedema is a high protein oedema which develops when a reduced lymphatic transport capacity is overwhelmed by a normal lymphatic load resulting in stagnation of a protein rich fluid in the interstitial tissues.

Anatomy and Physiology of Lymphoedema (2 decks)

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