Lec 26 - Venous Portal System Flashcards
function of lymphatic system
immunity and defense
organs and tissues in lymphatic system
thymus, lymph nodes, spleen , tonsils, and lymphoid follicles
vessels in increasing diameter
capillaries, vessels, trunks, ducts (thoracic and R lymphatic) and sac (cisterna chyli)
what is lymph
fluid formed in extra cellular spaces of tissues and organs
where does lymph flow
in lymphatic vessels and then adds to venous blood circulation
what does lymph contain
plasma proteins, antigens, antibodies, fat, and lymphocytes
where are the deep lymphatic vessels
beneath deep fascia and accompany the main arteries
what do the deep lymphatics do
drain lymph from skeletal muscles and internal organs
what are the superficial lymphatics
drain lymph from skin and associated structures
where are superficial lymphatics
on superficial fascia of skin
is there communication between deep and superficial lymphatics
yes
where are lymph nodes
found along lymphatic vessels (shape and size of kidney bean or green pea!)
what does a lymphnode contain and what does it do
contains lymphocytes, plasma cells, and macrophages. filters the lymph
what separates the lymph nodes from afferent and efferent lymphatic vessels
valves
meaning of cisterna chyli
cisterna = tank for water, chylie = chyle or milk, creamy lymph due to presence of fat
storage of fatty lymph
normal appearance of lymph
clear water
where is the cisterna chyli
L1/L2 vertebrae and passes through aortic hiatus of diaphragm
how is chyle transported from SI to thoracic duct
lymphatic capillaries to lymphatic vessels to intestinal lymphatic trunk to cisterna chylie to thoracic duct which brings it to venous circulation
lymphatic capillaries of the small intestine are called
lacteals
how is fat absorbed in the SI processed
by chylomicrons released into lacteals for form chyle
where are lacteals found
in center of villi
what drains lymph into cisterna chyli
the intestinal lymphatic trunk
where does lymphatic trunk get its lymph from
stomach, pancreas, spleen, and liver
where does cisterna chylie get lymph from (3)
instestinal lymph trunk, lumbar lymph trunk, and descending thoracic lymph trunk
where is lymph ultimately returned to and who returns it
returned to venous circulation by thoracic duct and right lymphatic duct
what is the venous angle
junction of subclavian and internal jugular where thoracic duct drains into venous system
what does the thoracic duct drain
all quadrants except upper R
what does the R lymphatic duct drain
R upper quadrant ( r side of head, neck, and thorax), rt lung and rt side of heart, rt upper limb
major lymph nodes
superficial inguinal, lateral aortic/lumbar, preaortic, parasternal, axillary, clavicular
how is lymphography accomplished
with injection of contrast dye
systemic/caval circulation comprised of
SVC, IVC, azygous
how is venous blood in abdomen and thorax drained
by 3 systemic and 1 portal circulation
where does SVC return blood from
all structures superior to diaphragm to the heart
main tributaries of IVC
L and R renal, gonadal, suprarenal, inferior phrenic, hepatic
where does IVC received venous blood directly from
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
the hemiazygous comes off of the
L renal of IVC and azygous
the accessory hemiazygous comes off of the
azygous
what does the azygous system of veins drain
posterior abdominal wall, thoracic wall, esophagus, and lungs
how does azygous drain posterior abdominal and thoracic walls
posterior abdominal is via lumbar veins
thoracic walls is via posterior intercostals
how does azygous drain esophagus and lungs
via esophageal veins and bronchial veins
what happens when there is an obstruction at the IVC
the azygous returns blood from lower limbs to SVC
path of systemic circulation
artery - capillary-vein - heart
hepatic portal circulation
artery - capillaries (GI tract, pancreas, spleen, gall bladder) - portal vein - liver capillaries (sinusoids) - hepatic veins - heart
where are the two sets of capillaries in the portal system
abdominal viscera and in the liver
what does hepatic portal system carry
venous blood rich in nutrients but low in oxygen to from abdominal viscera to liver via portal vein and tributaries
veins of hepatic portal system
cystic, superior mesenteric, inferior mesenteric, celiac (l and r gastric, splenic)
where are the portosystemic anastemoses
umbilicus, rectal plexus, esophageal plexus
what anastemoses at esophageal plexus
esophageal/ L gastric (portal)
Azygous/esophageal (systemic)
what anastemoses at umbilicus
paraumbilical vein (portal) superficial epigastric (systemic)
what anastemoses at rectal plexus
superior rectal (portal) middle/inferior rectal (systemic)
do portal veins have valves
NO
cirrhotic liver
brownish yellow and bumpy, granular with fibrotic nodules
what happens with liver cirrhosis in terms of portal system
portal hypertension which gives dilated esophageal veins (called esophageal varices)
huge stomach in liver cirrhosis caused by
caput medusae and ascites - varicose veins look like small snakes radiating from umbilicus (serpents on medusaes head)
what is a hemmroid
dilation of blood vessel in rectum
