Lecture 22: lymphatic system Flashcards
How much lymph is produced and returns to the venous circulation each day?
> 3-5L produced
3-5L returned to venous circulation
How are lymphatic vessels and veins similar in structure?
Both have valves to prevent backflow.
Both use a low pressure system.
Which transport system do the lymphatic vessels share with veins?
They both use MSK contractions to move lumen contents.
A 63yrs man with lymphadenopathy develops cellulitis in his left leg where his lymphatics have been infected with bacteria.
What normally happens to bacteria in the lymphatic system?
Macrophages engulf that bacteria and become APCs. They present themselves to T cells for inflammation and immune response.
A 63yrs man with lymphadenopathy develops cellulitis in his left leg where his lymphatics have been infected with bacteria.
Aside from bacteria, what other cell types are screened for in the lymphatic system?
Cancer cells as these cells can metastasise so they can move to other parts of the body via the lymphatic system.
A GP notices a patient’s left leg, ankle and foot are swollen when compared to the RHS. They also know that this individual has lymphadenopathy due to lymphatic bacterial infection.
How would you be able to tell the difference between lymphoedema and peripheral oedema due to congestive heart failure?
Lymphoedema = non-pitting oedema
Congestive heart failure = pitting oedema
A 15yrs girl has a cold and her younger sister has influenza A. Their GP examines both girls by looking for swollen lymph nodes.
Which part of the girls’ body would the GP palpate?
The side of the neck and under the jaw as this is where the cervical nodes are.
Which part(s) of the body have the highest concentration of lymph nodes and which of the nodes is not worth being palpated in patients with ‘colds’ and ‘flu’?
Armpits (Auxiliary lymph nodes)
Groin (Inguinal lymph nodes) - not worth if has a flu or cold as these would not be as swollen if head, neck and nose area are affected.
Lymph from the right side of the body and the head drain into the…
Right subclavian vein
Where does the lymph from everywhere but the right side of the body and head re-enter the venous circulation?
Left subclavian vein
A 67yrs woman has a suspected metastatic breast cancer. Whilst undergoing surgery, she has a sentinel needle biopsy taken.
What is a sentinel needle biopsy with breast cancer used for?
Whether or not the breast cancer has metastasised to another area of the body.
What is a sentinel node?
The first set of nodes that will swell if a cancer has metastasised.
Do all types of cancer have sentinel lymph nodes?
No as non/metastatic cancers (CNS) won’t drain into lymphatic system.
Why would cancers in areas like the CNS not have sentinel lymph nodes?
Organs like the brain are very sensitive to oedema therefore, swollen sentinel lymph nodes near the brain could damage it.
When a female patient was 52yrs, she underwent a radical hysterectomy for endometrial cancer, so her lymph nodes were removed. Now at 67yrs, she has suspected metastatic breast cancer.
Which would be her sentinel lymph nodes during the 1st operation and during her 2nd operation?
1st = Inguinal lymph nodes 2nd = Auxiliary lymph nodes
