Lec 26 - Venous Portal System

Question 1

function of lymphatic system

Answer 1

immunity and defense

Question 2

organs and tissues in lymphatic system

Answer 2

thymus, lymph nodes, spleen , tonsils, and lymphoid follicles

Question 3

vessels in increasing diameter

Answer 3

capillaries, vessels, trunks, ducts (thoracic and R lymphatic) and sac (cisterna chyli)

Question 4

what is lymph

Answer 4

fluid formed in extra cellular spaces of tissues and organs

Question 5

where does lymph flow

Answer 5

in lymphatic vessels and then adds to venous blood circulation

Question 6

what does lymph contain

Answer 6

plasma proteins, antigens, antibodies, fat, and lymphocytes

Question 7

where are the deep lymphatic vessels

Answer 7

beneath deep fascia and accompany the main arteries

Question 8

what do the deep lymphatics do

Answer 8

drain lymph from skeletal muscles and internal organs

Question 9

what are the superficial lymphatics

Answer 9

drain lymph from skin and associated structures

Question 10

where are superficial lymphatics

Answer 10

on superficial fascia of skin

Question 11

is there communication between deep and superficial lymphatics

Answer 11

yes

Question 12

where are lymph nodes

Answer 12

found along lymphatic vessels (shape and size of kidney bean or green pea!)

Question 13

what does a lymphnode contain and what does it do

Answer 13

contains lymphocytes, plasma cells, and macrophages. filters the lymph

Question 14

what separates the lymph nodes from afferent and efferent lymphatic vessels

Answer 14

valves

Question 15

meaning of cisterna chyli

Answer 15

cisterna = tank for water, chylie = chyle or milk, creamy lymph due to presence of fat

storage of fatty lymph

Question 16

normal appearance of lymph

Answer 16

clear water

Question 17

where is the cisterna chyli

Answer 17

L1/L2 vertebrae and passes through aortic hiatus of diaphragm

Question 18

how is chyle transported from SI to thoracic duct

Answer 18

lymphatic capillaries to lymphatic vessels to intestinal lymphatic trunk to cisterna chylie to thoracic duct which brings it to venous circulation

Question 19

lymphatic capillaries of the small intestine are called

Answer 19

lacteals

Question 20

how is fat absorbed in the SI processed

Answer 20

by chylomicrons released into lacteals for form chyle

Question 21

where are lacteals found

Answer 21

in center of villi

Question 22

what drains lymph into cisterna chyli

Answer 22

the intestinal lymphatic trunk

Question 23

where does lymphatic trunk get its lymph from

Answer 23

stomach, pancreas, spleen, and liver

Question 24

where does cisterna chylie get lymph from (3)

Answer 24

instestinal lymph trunk, lumbar lymph trunk, and descending thoracic lymph trunk

Question 25

where is lymph ultimately returned to and who returns it

Answer 25

returned to venous circulation by thoracic duct and right lymphatic duct

Question 26

what is the venous angle

Answer 26

junction of subclavian and internal jugular where thoracic duct drains into venous system

Question 27

what does the thoracic duct drain

Answer 27

all quadrants except upper R

Question 28

what does the R lymphatic duct drain

Answer 28

R upper quadrant ( r side of head, neck, and thorax), rt lung and rt side of heart, rt upper limb

Question 29

major lymph nodes

Answer 29

superficial inguinal, lateral aortic/lumbar, preaortic, parasternal, axillary, clavicular

Question 30

how is lymphography accomplished

Answer 30

with injection of contrast dye

Question 31

systemic/caval circulation comprised of

Answer 31

SVC, IVC, azygous

Question 32

how is venous blood in abdomen and thorax drained

Answer 32

by 3 systemic and 1 portal circulation

Question 33

where does SVC return blood from

Answer 33

all structures superior to diaphragm to the heart

Question 34

main tributaries of IVC

Answer 34

L and R renal, gonadal, suprarenal, inferior phrenic, hepatic

Question 35

where does IVC received venous blood directly from

Answer 35

all structures inferior to diaphragm EXCEPT stomach, SI, large intestine, pancreas, spleen and gall bladder. *gets from these indirectly via portal vein, liver, and hepatic vein

Question 36

the hemiazygous comes off of the

Answer 36

L renal of IVC and azygous

Question 37

the accessory hemiazygous comes off of the

Answer 37

azygous

Question 38

what does the azygous system of veins drain

Answer 38

posterior abdominal wall, thoracic wall, esophagus, and lungs

Question 39

how does azygous drain posterior abdominal and thoracic walls

Answer 39

posterior abdominal is via lumbar veins | thoracic walls is via posterior intercostals

Question 40

how does azygous drain esophagus and lungs

Answer 40

via esophageal veins and bronchial veins

Question 41

what happens when there is an obstruction at the IVC

Answer 41

the azygous returns blood from lower limbs to SVC

Question 42

path of systemic circulation

Answer 42

artery - capillary-vein - heart

Question 43

hepatic portal circulation

Answer 43

artery - capillaries (GI tract, pancreas, spleen, gall bladder) - portal vein - liver capillaries (sinusoids) - hepatic veins - heart

Question 44

where are the two sets of capillaries in the portal system

Answer 44

abdominal viscera and in the liver

Question 45

what does hepatic portal system carry

Answer 45

venous blood rich in nutrients but low in oxygen to from abdominal viscera to liver via portal vein and tributaries

Question 46

veins of hepatic portal system

Answer 46

cystic, superior mesenteric, inferior mesenteric, celiac (l and r gastric, splenic)

Question 47

where are the portosystemic anastemoses

Answer 47

umbilicus, rectal plexus, esophageal plexus

Question 48

what anastemoses at esophageal plexus

Answer 48

esophageal/ L gastric (portal) | Azygous/esophageal (systemic)

Question 49

what anastemoses at umbilicus

Answer 49

``` paraumbilical vein (portal) superficial epigastric (systemic) ```

Question 50

what anastemoses at rectal plexus

Answer 50

``` superior rectal (portal) middle/inferior rectal (systemic) ```

Question 51

do portal veins have valves

Answer 51

NO

Question 52

cirrhotic liver

Answer 52

brownish yellow and bumpy, granular with fibrotic nodules

Question 53

what happens with liver cirrhosis in terms of portal system

Answer 53

portal hypertension which gives dilated esophageal veins (called esophageal varices)

Question 54

huge stomach in liver cirrhosis caused by

Answer 54

caput medusae and ascites - varicose veins look like small snakes radiating from umbilicus (serpents on medusaes head)

Question 55

what is a hemmroid

Answer 55

dilation of blood vessel in rectum