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Year 1: 2019 OS I Final > Lecture 3: Lymphatic Lecture > Flashcards

Lecture 3: Lymphatic Lecture Flashcards

1
Q

What are the three anatomic components of the lymphatic system?

A

Lymph fluid
Lymphatic vessels
Lymphatic organs

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2
Q

What are lymphatic organs or tissues?

A 
Spleen
Liver
Thymus
Tonsils
Appendix
Visceral lymphoid tissue
Lymph nodes
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3
Q

What is the physiologic function of the lymphatic system?

A 
Plays a major role in homeostatic mechanisms of:
Immune system
Digestive system
Fluid balance
Waste
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4
Q

What is embryological layer do most lymph tissue arise from?

What are the exceptions?

A

Mesoderm

Thymus and part of tonsils from endoderm

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5
Q

What is the role of lymphatic function?

A

Maintain fluid balance
Tissue cleaning/purification
Defense
Nutrition

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6
Q

How does the lymph fluid purify and cleanse the body?

A

Cleanses extracellular spaces

-gets rid of toxins, bacteria, waste products, etc

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7
Q

Where does lymph fluid travel to from the vessel?

What is the function of this structure?

A

Travels to lymph node, which acts as a purifying filter

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8
Q

Describe lymph nodes.

A

Contains high concentrations of immune cells to combat toxins, bacteria, waste products, etc from lymph fluid

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9
Q

How does the lymphatic system play a role in fat absorption?

A

Chylomicrons travel via lacteals into larger lymph vessels, thoracic duct, and eventually venous system

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10
Q

What tissues do not have lymph tissue?

A

Epidermis
Endomysium of muscle
Cartilage
Bone marrow

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11
Q

In what direction do lymph travels?

A
  1. Collecting vessels
  2. Afferent lymph vessels
  3. Lymph nodes
  4. Efferent vessels
  5. Lymphatic trunks
  6. Thoracic duct or right lymphatic duct
  7. Venous system
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12
Q

Where does lymph formation begin?

A

Interstitial space of tissues w/ initial lymphatics

  • lined by leaky endothelium
  • coalesce into collecting vessels
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13
Q

What are collecting vessels primarily made up of?

A

Lymphangions: chains of muscular units possessing a bicuspid valve

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14
Q

Where are superficial lymph nodes found?

A

Within subcutaneous tissue

Ex: cervical, axillary, and inguinal

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15
Q

Where are deep lymph nodes found?

A

Beneath fascia, muscle, and organs

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16
Q

What is the pathway of lymph through a lymph node?

A
  1. Afferent lymphatics
  2. Subscapular space
  3. Outer cortex: rich in B cells
  4. Deep cortex: rich in T cells
  5. Medullary sinus: rich in B cells
  6. Efferent lymphatics
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17
Q

From where does the lumbar lymphatic trunk drain?

A

Lower limbs and pelvic organs

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18
Q

From where does the intestinal lymphatic trunk drain?

A

Abdominal viscera

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19
Q

From where does the bronchomediastinal lymphatic trunk drain?

A

Portions of thorax

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20
Q

From where do the subclavian lymphatic trunk drain?

A

Upper limbs

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21
Q

From where do the jugular lymphatic trunk drain?

A

Portions of neck and head

22
Q

What is cisterna chyli?

A

Drains lymphatic trunks of lower body and gives rise to thoracic duct
-Level of L1/L2

23
Q

What is the function of the thoracic duct?

A

Receives all drainage from the body except right upper portion

24
Q

What does the right lymphatic duct drain?

A 
Right head/neck
Right UE
Right thorax
Heart
Lungs (except LUL)
25
Q

What is Virchow’s node?

A

left-sided supraclavicular lymph node

26
Q

Where is the spleen?

A

Beneath ribs 9-11 on the left

27
Q

What is the function of the spleen?

A

Destroys damaged/deformed RBC
Synthesizes immunoglobulins
Clear bacteria

28
Q

Where is the liver?

A

Right Upper Quadrant of abdominal area

29
Q

What is the lymphatic function of the liver?

A

Half of lymph formed

Clears bacteria

30
Q

Where is the thymus?

A

Anterior mediastinum

31
Q

What is the function of the thymus?

A

Maturation site for T-cells in children

32
Q

Where are the tonsils?

A

Palatine: lateral pharynx
Lingual: posterior portion of tongue
Pharyngeal: adenoids at nasopharyngeal border

33
Q

What is the function of tonsils?

A

Helps build immunity early in life

34
Q

Where is the appendix?

A

Proximal end of large intestine

35
Q

What is the function of appendix?

A

Part of gut-associated lymphoid tissue (GALT)

36
Q

What is GALT?

A

Lymphoid tissue which works in the immune system to protect the body from invasion in the gut

37
Q

What is the normal interstitial fluid pressure of lymph vessels?

A

-6.3 mmHg (negative)

38
Q

What happens if interstitial fluid pressure of lymph vessels is positive?

A

Lymph capillaries collapse and flow stops

39
Q

How does increased sympathetic tone effect lymph nodes?

A

Tighter valves, meaning less flow into venous system

40
Q

How does increased sympathetic tone effect lymphatic smooth vessels?

A

Less peristalsis and more lymphatic congestion

41
Q

What is a major symptom of a poorly functioning lymphatic system?

A

Edema

42
Q

What are some systematic effects of edema?

A
  1. Decreased delivery of oxygen, nutrients, hormones, etc
  2. Decreased sensation and pain
  3. Shortness of breath*
  4. Decreased tissue waste removal
  5. Decreased pathogen clearance and immunity
43
Q

What is the goal of OMT when treating lymphatic system?

A

Balanced, well-functioning system (no edema)

  1. Remove any impediments
  2. Enhance respiratory-circulatory homeostasis
  3. Augment flow of lymph and immune system elements
  4. Help decongest local tissues
44
Q

What are some indications for lymphatic OMT?

A 
Lymphatic congestion (edema)
Minor CHF
Upper/lower respiratory infections
Asthma
COPD
Sprains/strains
Pregnancy
45
Q

What are absolution contraindications of lymphatic OMT?

A

Anuria: Failure of the kidneys to produce urine
Necrotizing fasciitis
Patient cannot tolerate or refused treatment

46
Q

What are relative contraindications of lymphatic OMT?

A 
Inability to tolerate excessive preload
COPD
Acute asthma exacerbation
Unstable cardiac conditions
Untreated coagulopathies or patients on anticoagulants 
Cancer
Osseous fracture
Bacterial or chronic infections
Diseased organ
Pregnancy
Circulatory disorders
47
Q

What are the principles of diagnosis from a lymphatic approach?

A
  1. Evaluate risk-benefit ratio
  2. Evaluate fascial patterns of Zink
  3. Evaluate diaphragms/fascia
  4. Evaluate for somatic dysfunction
  5. Evaluate tissue congestion
48
Q

What is a compensatory pattern?

A

Main: L/R/L/R

R/L/R/L

49
Q

What are some transverse restrictors?

A

Tentorium Cerebelli
Thoracic Inlet
Thoracolumbar Diaphragm
Pelvic Diaphragm

50
Q

What must you always do when performing lymphatic OMT?

A

Thoracic inlet

Year 1: 2019 OS I Final (12 decks)

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