Lecture 18

Question 1

What is chyle?

Answer 1

Lymph arising from the GI tract

Question 2

What is lymph really important for transporting?

Answer 2

Fats

Question 3

What helps with lymph movement?

Answer 3

Muscle contraction. Lymph vessels can be superficial and deep and commonly near arteries.

Question 4

How are lymph vessels structured and where do they drain into?

Answer 4

Similar to large veins but with bigger fibrocartilaginous valves. Upper right quadrant of body drains into right subclavian vein from the right lymphatic duct and rest into left subclavian vein from thoracic duct.

Question 5

Where are the most clinically important lymphatic nodes?

Answer 5

Cervical- neck

Inguinal- groin

Armpit- axillae

Question 6

How are lymph nodes structured?

Answer 6

Like a kidney. Many afferent lymphatic vessels and one efferent one which leaves through the hills. Has a cortex and medulla. Has follicles “nodules” filled with dendritic immune cells and capillaries around these nodules.

Question 7

Role of dendritic cells in lymph?

Answer 7

Proliferate B cells and present bacteria to macrophages

Question 8

What cells reside in lymph nodes?

Answer 8

Macrophages, B cells and T cells which work together to activate inflammatory (macrophages and neutrophils) and immune responses (B cells and T cells)

Question 9

What is the term for enlarged lymph nodes?

Answer 9

Lymph adenopathy

Question 10

What is the term for cancer of the lymph nodes?

Answer 10

Lymphoma eg Hodgkins and non Hodgkin’s lymphoma

When cancer metastasises to lymph nodes.

Question 11

What are the lymphatic organs?

Answer 11

Thymus
Spleen
Peters patches
Appendix
Tonsils

Question 12

What is the function of the thymus?

Answer 12

It matures T cells

Starts to turn off as an adult

Changes in thymus associated with myasthenia gravis

Question 13

Spleen?

Answer 13

Inferior to stomach

Separated into white pulp and red pulp.

White pulp= lymphatic function… B and T lymphocyte activation, removal of macro molecular antigens from blood

Red pulp= haemopoeitic function…… removal of old red blood cells and platelets, stores erythrocytes also, removes iron from haemoglobin

Question 14

Clinical significance of spleen?

Answer 14

Very dangerous if ruptured, severe bleeding.

Splenectomy= liver and bone marrow take over RBC function

Splenomegaly= enlargement due to infection

Question 15

Tonsils?

Answer 15

Nodules reside behind surface invagination known as crypts

Pharyngeal tonsil (adenoid)

Palatine tonsil

Lingual tonsil

Clinically tonsils swell due to T and B cell proliferation

Question 16

Vermiform appendix? (Full name for appendix)

Answer 16

Crypts which trap pathogens. Inferior and attached to caecum.

Question 17

Peyer’s patches?

Answer 17

Inferior and side of ileum

Nodules inferior to surface domes

Prevent pathogen ingress through digestion

Question 18

Functions of lymphatic system?

Answer 18

Fluid balance- interstitial fluid removal

Transport of fats and fat soluble vitamins

Defence against invading pathogens and disease

Storage and destruction of aged erythrocytes- spleen

Question 19

What are sentinel nodes and what are their clinical use?

Answer 19

First lymph nodes to which cancer spreads and so can be used for early detection. In breast cancer can axilla or pectoral lymph nodes can be removed. Can perform mastectomy however removal of nodes can lead to secondary lkympoedema

Question 20

What is the difference between primary and secondary lympoedema?

Answer 20

Primary occurs on its own. Secondary occurs due to another cause or condition such as surgery