Lymph Flashcards
what is lymph
clear watery, slightly yellow fluid lost from the capillary beds that collects in the surrounding tissues
describe the course of lymph
fluid lost from capillary beds is taken up by lymphatic plexuses (network of lymphatic capillaries)
lymph is drained from the lymphatic capillaries to
lymphatic vessels (lymphatics)
lymphatics have abundant ____
valves
multiple lymphatic vessels join to form
lymphatic trunks
do lymphatics occur in the brain
no - excess tissue fluid of the CNS drains into the CSF
how is lymph filtered
lymph nodes occur along the course of lymphatic vessels
what are the circulating cells of the immune system
lymphocytes
superficial lymphatic vessels follow
venous drainage
deep lymphatic vessels follow
arteries
describe the course of lymph from the superficial lymphatic vessels
follow venous drainage then eventually drain into deep lymphatic vessels which follow arteries and also receive drainage from internal organs
superficial and deep lymphatic vessels become ____ as they merge with vessels draining adjacent regions
larger
large lymphatic vessels enter
lymphatic trunks
lymphatic trunks unite to form
either the right lymphatic duct or thoracic duct
where does the right lymphatic duct drain
body’s right upper quadrant - right side of head, neck, and thorax and right upper limb
where does the right lymphatic duct join the venous system
junction of right internal jugular vein and right subclavian vein - right venous angle
where does the thoracic duct drain
rest of the body - lower limbs, abdomen, left side of thorax head and neck and left upper limb
the lymphatic trunks draining the lower half of the body merge in the abdomen sometimes forming a dilated collecting sac called the
cisterna chyli
where does the thoracic duct join the venous system
left venous angle at the junction of the left internal jugular and left subclavian veins
what is chyle
milky lymph containing lipids and lipid soluble vitamins absorbed from the small intestine
lymphatic vessels have a similar structure to
very small veins
what is contained in the lymph nodes
lymphocytes and macrophages
where are lymphocytes formed
in bone marrow
after forming in the bone marrow where do lymphocytes mature
either in bone marrow (B cells) or thymus (T cells)
what are 2 primary lymphoid organs
bone marrow and thymus
name some other concentrations of lymphoid tissue in the body (secondary lymphoid organs - seeded from primary)
spleen
tonsils
lymph nodes
Peyer’s Patches
GALT, BALT, MALT
what do GALT, BALT and MALT stand for
Gut
Bronchiolar
Mucosa
Associated Lymphoid Tissue
what are Peyer’s patches
small groups of lymphoid tissues in the walls of the small intestines (GALT)
how do plasma proteins, bacteria, cellular debris and whole cells e.g. lymphocytes readily enter lymphatic capillaries
highly attenuated endothelium which lacks a basement membrane
and have a surplus of tissue fluid
lymph node swelling indicates
a problem
slow lymph flow through a node can lead to what
cancer cells forming secondary tumours within nodes
describe healthy nodes
small, soft, bean shaped
difficult to see in dissection and difficult to palpate
what are 2 ways lymph can be visualised
lymphogram - older method
surgery
what is the sentinel node
first node that the structure drains to
lymph from lower limbs and pelvis drain to the _____ trunks
lumbar trunks
where does the thoracic duct pass
posterior mediastinum of thorax between the aorta and azygous vein
is the right lymphatic duct always present
no
what 3 trunks drain to the junction of the RSCV and RJV
right jugular trunk
right subclavian trunk
right bronchomediastinal trunk
the right jugular trunk drains
the right side of the face and neck
right subclavian trunk drains
right upper limb and superficial structures of the upper part of the thorax and abdominal walls on RHS
the right bronchomediastinal trunk drains
deep thoracic structures on the right
what is an anatomical variant seen in the trunks draining
in most individuals the 3 trunks drain independently into RSC and RJ junction
- 20% population, the jugular and subclavian trunks unite to form right lymphatic duct that drains to junction instead
- bronchomedistinal trunk usually drains independently
are there the equivalent 3 trunks on the left
yes
the foregut drains where
coeliac nodes
the midgut drains where
superior mesenteric nodes
the hindgut drains where
inferior mesenteric nodes
the coeliac, SM and IM nodes are also known as
pre-aortic nodes (anterior surface)
renal nodes are
para-aortic
the cisterna chyli is seen very close to the _____ on dissection
diaphragm
where are the axillary nodes found
in axilla in fat surrounding the brachial plexus and axillary vessels
axillary nodes drain what
upper limb
lateral sides of breast and thoracic wall
there are also small nodes where in the arm
cubital fossa
testes and ovaries drain where
para-aortic nodes
what are some nodes of the pelvis
superficial and deep inguinal
common, external and internal iliac
describe the lymph drainage of the lower limb
popliteal and femoral
to inguinal
to iliac
name the lymph nodes in the head and neck
parotid, sublingual, submental, auricular, jugular, cervical
