Lymph Flashcards
What are the 3 functions of the lymphatic system?
1) Vascular function one-way drainage of interstitial fluid from tissues to venous circulation. 2) digestive function by absorbing fats and fat-soluble vitamins from the digestive system to venous circulation. 3) immune function by defending against invading microorganisms and disease
What basic thing does lymph flow follow?
pressure
What basic components are in lymph?
proteins, minerals, nutrients, damaged cells, cancer cells, pathogens
Where do both lymphatic ducts enter into?
subclavian veins
What are the 6 key lymph organs?
tonsils/adenoids, thymus, spleen, peyer’s patches, appendix, bone marrow
Where is waldeyer’s ring of MALT?
mucosal tissue of the posterior oropharynx
What is a common cause of lymphangitis?
a distal bacterial infection, commonly Group A beta-hemolytic streptococci
What thing causes cat scratch fever/disease?
bartonella henselae
Features of cat-scratch disease/fever?
onset days-2weeks, non-painful bump at the site, fatigue, painful lymphadenopathy, headache, fever, often is self-limited
What do enlarged/hardened mediastinal/hilar nodes show up as on a CXR or CT?
mediastinal mass
What are the 2 regions of lymph nodes in the abdomen?
intra-obdominal and retroperitoneal (drains testes)
What are the 2 division of superficial inguinal lymph nodes?
horiztonal (below inguinal ligament: drains superficial lower back, butt, external genitalis, perianal region) and vertical groups (near saphenous vein, drains most of the leg except the heel and outer aspect of foot)
Where does the heel and outer foot drain to?
deep to the popliteal space, so no visible lymphadenopathy
What are the 4 broad categories of causes of lymphadenopathy?
infection, inflammatory, malignancy, medication
What are the 4 basic infectious disease causes of lymphadenopathy?
viral, bacterial, fungal/mycobacterial, spirochetal (syphilis or lyme disease)
What is mononucleosis? What causes it? What are the classic triad of symptoms?
~80% caused by Epstein Barr Virus, triad of fever, tonsillar pharyngitis, lymphadenopathy
What are the symptoms of HIV/AIDS in early/acute infection? in latent/chronic? in late-stage progression to AIDS?
early - fever, chills, fatigue, malaise, sore throat.
latent/chronic - usually none
late stage progression to aids - night sweats, fever, unintentional weight loss, fatigue, mouth sores,
generalized lymphadenopathy with all?
Describe lymphoma and it’s presenting sxs?
it is a malignancy of the lymphocytes. most common presentation is painless enlargement of the lymph nodes. B-symptoms include fatigue, fevers, night sweats, unintentional weight loss
What is leukemia?
it is a malignancy of a single white blood cell line, with out of control growth to the bone marrow and/or lymph system.
What are the common sxs of leukemia?
fatigue, SOB, abnormal bleeding, bruising, petechiae
What is the difference between acute and chronic leukemia?
acute is a rapid increase in immature WBC cell line, ill-appearing. chronic is a mature WBC cell line that develops over years and is found incidentally in lab work
What is needed to make a metastatic solid tumor diagnosis?
biopsy
What is the name of the node dubbed “the seat of the devil? Where is it located?
Virchow’s node is in the left-sided supraclavicular region, junction of thoracic duct and left subclavian vein.
What sign is associated with an enlarged Virchow’s node? What does it signal?
Trosier’s sign, metastatic gastric of abdominal cancer
What medications can cause lymphadenopathy?
anti-epileptics, antibiotic, anti-hypertensives, anti-gout
What inflammatory or immunologic diseases can cause lymphadenopathy?
systemic lupus erythematous, rheumatoid arthritis
What is lymphedema?
lymph load is greater than the transport capacity, causing an abnormal accumulation of interstitial lymph fluid
What are the primary (1) and secondary (4) causes of lymphedema?
congenital abnormality; fluid volume overload, obesity, pregnancy, cancer, inflammatory disorders
What are the primary descriptor words for the 4 stages of lymphedema?
1 - asymptomatic with abnormal flow but no fluid, 2 - swelling and pitting, 3- permanent swelling non-pitting, 4- lymphostatic elephantiasis very deformed
What are the 4 grades of edema?
1: 2mm barely detectable
2: 4mm deep pit with few seconds to rebound
3: 6mm deep pit 10-12 seconds to rebound
4: 8mm very deep pit >20 seconds to rebound
What 4 steps are there to lymph inspection?
neck symmetry, visible enlargement of nodes, unilateral/bilateral extremity swelling, sacral and peripheral areas
What are the 4 best practices of palpation of lymph areas?
no creepy finger (use finger pads), small circular motions, remove skin tension, move skin over underlying tissues
What are the 5 areas to palpate for the lymph assessment?
cervical, epitrochlear, axillary, inguinal, pre-tibial pressure
