Lecture 26: Venous, Portal, and Lymphatic Systems Flashcards
organs and tissues of lymphatic system
thymus, lymph nodes, spleen, tonsils, lymphoid follicles
functions of lymphatic system organs/tissues
immunity, defense
lymph system vessels, in increasing diameter
capillaries, vessels, trunks, ducts (thoracic, right lymphatic), sac (cisterna chyli)
functions of lymphatic vessels
drain and transport lymph (including transport of fat absorbed by small intestine)
what is lymph
fluid, formed in extracellular spaces of tissues and organs
where is lymph
flows in lymphatic vessels, adds to venous blood circulation
what does lymph contain
plasma proteins, antigens, antibodies, fat, lymphocytes
2 classifications of lymphatic vessels
deep, superficial
deep lymphatic vessels location
beneath deep fascia, accompany main arteries
deep lymphatic vessels function
drain lymph from skeletal muscle, internal organs
superficial lymphatic vessels location
superficial fascia of skin - camper’s fascia
superficial lymphatic vessels function
drain lymph from skin and its associated structures
lymph nodes’ location
along the course of lymphatic vessels
size/shape of lymph node
a kidney bean or green pea
what do all lymphatic vessels have?
valves
where does thoracic duct pass
through aortic hiatus of diaphragm; along vertebral column; through thoracic cavity; to upper part of thorax
lacteals
lymphatic capillaries of the small intestine
chyle
milky lymph, result of chylomicrons released into lacteals that form chyle
where are lacteals
the center of the villi of lymphatic capillaries
where does intestinal lymphatic trunk drain lymph
into cisterna chyli
which organs’ lymph drains into cisterna chylia, via intestinal lymphatic trunk?
stomach, pancreas, spleen, liver
where does SVC return venous blood?
from all structures SUPERIOR to the DIAPHRAGM
where does IVC receive blood from?
all structures INFERIOR to the DIAPHRAGM, except the: stomach, small intestine, large intestine, pancreas, spleen, gall bladder
do portal veins/its tributaries have valves?
NO
does lymph enter the venous or arterial system?
ONLY VENOUS
where is lymph transported to
lymphatic capillaries > lymphoid cells
where do lymphoid cells drain into
afferent lymph vessel
what does lymph exit lymph node through?
efferent lymphatic vessel
what are the largest lymphatic vessels
cisterna chyli, thoracic duct
vertebral level of cisternal chyli
L1-L2
L side lymphatic duct
thoracic duct
R side lymphatic duct
R lymphatic duct
where is chyle transported from
small intestine > thoracic duct
where does fat go for absorption
jejunum
what do chlyomicrons do
process fat absorbed by jejunal cells; then release it into lymphatic system to produce chyle
what drains into cisterna chyli from below
intestinal lymph trunk, lumbar lymph trunk
what drains into cisterna chyli from above
descending thoracic lymph trunk
where does thoracic duct empty lymph into venous circulation?
venous angle: where internal jugular vein - subclavian vein meet
where does thoracic duct receive lymph from, in thorax region?
L jugular trunk, L subclavian trunk, broncho-mediastinal trunk
where does right lymphatic duct receive lymph from?
R jugular trunk, R subclavian trunk, broncho-mediastinal trunk
what body area drains to the right lymphatic duct?
right upper quadrant (R side head, neck, thorax, R lung, R side of heart, R upper limb)
what body area drains to thoracic duct?
L side of head, beck, thorax, L lung, L side heart, trachea, esophagus, L upper limb
where do scrotum/labium majus drain lymph to?
superficial inguinal lymph nodes
where does testis drain lymph to?
lateral aortic (lumbar) lymph node, preaortic lymph node, then to cysterna chyli and thoracic duct
where does 75% of breast lymph drain to?
axillary lymph node
where does remaining 25% of breast lymph drain to?
clavicular lymph node, parasternal lymph nodes, abdominal lymph nodes
where is the SVC
superior mediastinum
SVC function?
returns venous blood from all structures superior to diaphragm to the heart
where do L and R common iliac veins join, what do they form?
form the IVC at L4 vertebral level
how many lumbar veins?
5
where do lumbar veins drain?
IVC
where does testicular vein drain?
L2-L3 level of IVC
where do L testicular and orvarian veins drain?
L Renal vein
comparison of L to R Renal vein?
left is 2x longer than right
location of right suprarenal v?
vertebral level L1-L2
where does L suprarenal vein go?
L Renal V
where is the R inferior phrenic vein, what does it do?
drains diaphragm, to IVC
T12-L1
which structures inferior to the diaphragm DO NOT drain into the IVC?
stomach, small intestine, large intestine, pancreas, spleen, gall bladder
how does venous blood from stomach, small intestine, large intestine, pancreas, spleen, gall bladder get to the IVC?
via portal vein, liver, hepatic veins
azygos vein system function?
form collateral pathway between IVC and SVC
on R side, azygos vein system?
azygos vein
on L side, azygos vein system parts?
hemiazygos vein, accessory hemiazygos vein
where are lumbar veins
posterior abdominal wall
what does ascending lumbar vein connect?
L5, 4, 3, 2, 1
azygos system of veins drain (3)
posterior abdominal and thoracic walls, esophagus, lungs
posterior abdominal wall vein?
lumbar veins
thoracic wall vein?
posterior intercostal veins
esophagus vein?
esophageal veins
lung vein?
bronchial veins
definition of hepatic portal circulation
vein between 2 capillaries
artery > capillaries > portal vein > liver capillaries (sinusoids) > hepatic veins > heart
where are 2 sets of capillaries of hepatic portal system
first in abdominal viscera, second in liver
what kind of blood does hepatic portal system carry
venous blood, low in oxygen, rich in nutrients
portosystemic anastomoses
- left gastric v (portal) - esophageal branch (systemic)
- superior rectal v - middle rectal v (lower part of rectum)
- superficial epigastric v - paraumbilical v (in camper’s fascia)
do portal vein/ its tributaries have valves?
no!
fibrotic nodules
develop on cirrhotic liver
sinusoids inside liver compromised/blocked; blood can’t flow to liver; blood goes through anastomosis of porto-hepatic system, esophageal branch of L gastric v - azygos v
