Lymph Flashcards
When does lymphatic development begin?
5th week
What tissues form from the mesoderm?
lymphatic vessels, lymph nodes, spleen, and myeloid tissue
What tissue forms from the endoderm?
thymus and parts of the tonsils
What is the general timeline of lymphoid tissue maturation?
Lymphoid tissue is immature at birth and increases until puberty.
Lymphoid tissue regresses with age making it difficult to even fight off a a fever
What are the 3 components of the lymphatic system?
- organized lymphatic tissues/organs (spleen, tonsils, liver, thymus, appendix, visceral lymphoid tissue, lymph nodes)
- Lymph fluid
- Lymph vessels
What are the physiological functions of the lymph system?
Immunity, Digestion, Fluid balance, Waste
Spleen: Where is it located? What is its function? What other important characteristics are there?
Beneath ribs 9-11 on the left side (next to stomach)
Destroy damaged/deformed RBCs, Synthesize immunoglobulins, clear bacteria
Largest single mass of lymphoid tissue; is pressure sensitive (diaphragm movement)
Liver: Location? Lymphatic function? Other Characteristics?
Right upper quadrant, right costal margin
Half of body’s lymph formed in liver, clears bacteria, “gate-keeper” of shared hepato-biliary-pancreatic venous and lymphatic drainage.
Pressure sensitive (diaphragm movement)
Thymus: Location? Lymphatic function? Other Characteristics?
Anterior mediastinum
Maturation site for T cells, little to no function in adults
Large in infancy (peaks at 2 y-o), after puberty replaced by fat
Tonsils: Location? Lymphatic function? Other Characteristics?
3 types: all in posterior oropharynx
- Palatine - lateral pharynx (traditional tonsil)
- Lingual - posterior 1/3 of tongue
- Pharyngeal - adenoids at nasopharyngeal border
Provide cells to influence and build immunity early in life, nonessential to adult immune function
Most are not visible until 6-9 months, remain enlarged through childhood
Appendix: Location? Lymphatic function? Other Characteristics?
Proximal end of the large intestine
Part of gut-associated lymphoid tissue
Contains lymphoid pulp, lymphoid tissue atrophies with age
What are the two forms of Visceral Lymphoid Tissue?
Gastrointestinal Associated Lymphoid TIssue
Pulmonary lymphoid Tissue
What is the function of pulmonary lymphoid tissue?
It is scattered throughout the lungs and removes toxins from the tissue
What is the function of Gastrointestinal Associated Lymphoid Tissue?
Carries large Chylomicrons from the GI tract through Lacteals (lymphatic capillaries) to the thoracic duct, then to the venous system because they are too large to enter the circulatory capillaries in the GI tract
Peyers Patches in the ileum protect against pathogenic bacteria in the gut
How are lymphatic vessels organized?
Lymphatic capillaries -> collecting lymphatics -> afferent lymphatics -> efferent lymphatics -> thoracic duct OR right lymphatic duct -> venous system
How does lymph flow through a lymph node?
Afferent lymphatics -> subscapular space -> outer cortex -> deep cortex -> medullary sinus -> efferent lymphatics
What tissues does the thoracic duct drain and where does it empty the lymph fluid?
Generally drains the entire left side and everything umbilicus and down.
Left head/neck, left upper extremity, left thorax/abdomen, everything below umbilicus, lumbar lymphatics
Empties into left subclavian vein/internal jugular junction
What tissues does the right lymphatic duct drain and where does it empty the lymph fluid?
Generally drains the right side of the body above the umbilicus
Right head/neck, Right upper extremity, right thorax, heart, lungs (except left upper lobe)
How do sympathetics affect lymphatics?
SNS causes valves to “tighten” which decreases lymph flow to veinous system
SNS also causes a decrease in peristalsis causing lymph congestion
What are the absolute contraindications for lymphatic treatments?
Anuria: failure of kidneys to produce urine. Need kidneys functioning to process the extra fluid return
Necrotizing Fasciitis: flesh eating disease. Contraindication only in affected area
Patient unable to tolerate treatment
Patient refuses treatment
What are the relative contraindications?
- Inability to tolerate excessive preload (CHF)
- COPD
- Acute asthma exacerbation
- Unstable cardiac onditions
- Untreated coagulopathies or Pts on anti-coagulants
- Cancer
- Bone fracture (area involved)
- Bacterial infection
- Chronic infection
- Diseased organ
- Pregnancy
- Circulatory disorders
What is the common compensatory pattern?
LRLR (80% healthy people)
What us the uncommon compensatory pattern?
RLRL (20% of healthy people)
What are the uncompensated patterns?
LLLL, LRRL, RRLL, etc
Usually symptomatic, usually trauma is invovled
Where are the transition zones of the spine?
OA, C1, C2
C7, T1
T12,L1
L5, sacrum
What are the transverse restrictors?
Tentorium Cerebelli (neck)
Thoracic Inlet
Thoracolumbar diaphragm
Pelvic Diaphragm
