Chapter 13 Lymphatics Anatomy Flashcards
Which lobe of the lung does NOT drain into the right (minor) duct?
Left upper lobe
What drains into the right (minor) duct?
Right UE, right hemicranium, heart and lobes of lung (except left upper lobe)
Where does the right (minor) duct drain into?
Right brachiocephalic vein OR junction of right IJV and subclavian vein
Where does the left (major) duct drain into?
Junction of left IJV and subclavian veins
Where does the thoracic duct traverse?
Sibson’s fascia of the thoracic inlet up to the level of C7 before turning around and empyting into the left (major) duct
Where does the right (minor) duct traverse?
Only traverses the thoracic inlet once
Infection of the right toe would drain where?
Left (major) lymphatic duct
What drains directly into the thoracic duct and bypasses LNs?
1) Thyroid
2) Esophagus
3) Coronary and triangular ligaments of liver
What has prelymphatics?
Superficial skin, deep portions of peripheral nerves, endomysium, and bones (Haversion canals)
2/3 of lymphatic fluid is produced where?
Liver and intestines
What is the de facto lymph of the CNS?
CSF
What level is the cisterna chyli?
L2
Where does the thoracic duct cross the diaphragm?
Aortic hiatus (T12)
When is the lymphatic system developed in utero?
By the 3rd month
What has more valves, lymphatics or veins?
Lymphatics–semilunar
What has “flap valves”?
Terminal lymphatic capillaries–allows fluid to enter
How does interstitial fluid enter the terminal lymphatic vessels?
Micropinocytosis
What is the lymphatic return to the heart in a day?
Entire volume of serum of body
How much extracellular fluid is carried from interstitium to the blood per day?
10-20% or 3 liters
What do the intestinal lymphatics absorb?
Long chain fatty acids, chylomicrons, and cholesterol
What are the main cells found in lymph?
Lymphocytes
What is the innervation of lymphatics?
SNS (just like vasculature)
What does SNS stimulation do the lymphatics?
Initially causes increased peristalsis, long term hyperSNS tone decreases overall mvt of lymph
What is the SNS control to the lymphatic duct?
Intercostal nerves
What innervates the cisterna chyli?
T11
What is interstitial fluid pressure and flow rate?
-6.3mmHg, rate of 120cc/hr
What if interstitial pressure increases (closer to 0mmHg)?
Increased absorption into lymphatics
What happens if pressure gets above 0mmHg?
Lymphatics collapse–decrease in lymphatic drainage
What factors increase interstitial pressure above 0mmHg?
1) Systemic HTN
2) Cirrhosis (decreased plasma protein synthesis)
3) Hypoalbuminemia assoc with starvation
4) Toxins such as rattlesnake poisoning
