Fluid compartments, Lymph and drainage

Question 1

What does the lymphatic system do?

Answer 1

Drain the interstitial fluid lost from capillary beds as well as pathogens, WBC, hormones and debris from broken cells/microbes back into the vascular system.

Question 2

What are the lymphatic vessels that transport fat from the small intestine, and what is the fluid called?

Answer 2

Lacteals, chyle

Question 3

Where does lymph and chyle end up before returning into venous circulation?

Answer 3

Cisterna Chyli, then thoracic duct

Question 4

Where is the left venous angle?

Answer 4

Junction between the left internal jugular vein and the left subclavian vein.

Question 5

Where does the thoracic duct attach to the vascular system?

Answer 5

Left venous angle

Question 6

Where does lymph from the right upper limb, right thorax and right head & neck drain to and connect with the vascular system?

Answer 6

Right lymphatic duct, right venous angle

Question 7

What is contained within the lymph nodes?

Answer 7

WBC (lymphocytes and macrophages)

Question 8

Describe the difference between afferent and efferent lymph vessels

Answer 8

Afferent=draining into node
Efferent=draining away from node

Question 9

What is the term for enlarged lymph nodes?

Answer 9

Lymphadenopathy

Question 10

Where are metastatic cells from a breast cancer tumour likely to spread first?

Answer 10

Axillary nodes

Question 11

Which lymph node is most likely to metastasise from a primary testicular cancer tumour?

Answer 11

Lateral aortic

Question 12

What are the lymph nodes in the axilla?

Answer 12

Pectoral, subscapular, humeral, central and apical

Question 13

Bone marrow is which type of lymphatic tissue?

Answer 13

Primary

Question 14

Lymph nodes are which type of lymphatic tissue?

Answer 14

Secondary

Question 15

What is the ratio of ICF to ECF?

Answer 15

2/3 ICF to 1/3 ECF

Question 16

What is ECF made up of?

Answer 16

Interstitial fluid and plasma

Question 17

Where is K+ most abundant?

Answer 17

Intracellular fluid

Question 18

Where is Na+ most abundant?

Answer 18

Extracellular fluid

Question 19

Is oncotic pressure higher in plasma or interstitial fluid?

Answer 19

Plasma, because of the proteins

Question 20

Oedema is caused by an increase in which fluid compartment?

Answer 20

Interstitial

Question 21

What two forces promote reabsorption of fluid into the vessels?

Answer 21

Oncotic pressure and interstitial hydrostatic pressure

Question 22

Which forces promote the movement of fluid into the interstitium?

Answer 22

Capillary hydrostatic pressure and interstitial osmotic pressure

Question 23

Where is capillary hydrostatic pressure highest?

Answer 23

At the arterial end of the capillary

Question 24

How much lymph fluid is formed daily under normal conditions?

Answer 24

3L

Question 25

What is net filtration pressure?

Answer 25

The sum of filtration forces minus reabsorption forces

Question 26

Under normal conditions, net filtration pressure is negative at which end of the capillary? What does this mean?

Answer 26

Venous, net fluid is moving into the vessel

Question 27

Under normal conditions, net filtration pressure is positive at which end of the capillary? What does this mean?

Answer 27

Arterial, net fluid is moving out of the vessel into the interstitium

Question 28

What is meant by the TRUE net filtration pressure?

Answer 28

Multiplied by Kf coefficient which factors in the permeability and surface area of the capillaries

Question 29

What is the most abundant type of capillary?

Answer 29

Continuous

Question 30

Where would you find fenestrated capillaries?

Answer 30

Small intestine

Question 31

What are the two types of fluid that can accumulate in oedema? Explain the difference between them.

Answer 31

Transudate- low protein
Exudate- high protein

Question 32

What type of fluid would you see in oedema caused by infection and inflammation?

Answer 32

Exudative

Question 33

Intracellular oedema is primarily caused by what mechanism?

Answer 33

Impaired sodium-potassium pump = cellular swelling

Question 34

What might the body do to reduce oedema?

Answer 34

Increase lymphatic flow

Question 35

What part of the net filtration pressure formula would sepsis affect? What affect would this have?

Answer 35

Capillary coefficient (Kf) because there would be increased permeability. Increase in flow out of the vessels = oedema

Question 36

How would a DVT cause oedema?

Answer 36

Blood cannot get past the clot = pools in lower limb.
Increased capillary hydrostatic pressure = oedema

Question 37

Briefly explain congestion in HF

Answer 37

Poor cardiac output leads to poor renal perfusion causing sympathetic activation. Renin-angiotensin- aldosterone system increases retention of sodium and water. Increased blood volume increases capillary hydrostatic pressure which causes fluid to move into the interstitium.

Question 38

What provides a quick compensatory mechanism for the reduced cardiac output of HF?

Answer 38

Reduced cardiac output = reduced capillary hydrostatic pressure = fluid moves out of interstitial fluid store to increase blood volume and pre-load.

Question 39

Left sided HF can cause what life-threatening pathology?

Answer 39

Pulmonary oedema

Question 40

What side of the heart is involved in peripheral oedema?

Answer 40

Right ventricular failure results in back up of the systemic circulation. However, most commonly, left sided HF comes first and leads to right sided HF.