Lymph Flashcards

1
Q

what is lymph

A

clear watery, slightly yellow fluid lost from the capillary beds that collects in the surrounding tissues

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2
Q

describe the course of lymph

A

fluid lost from capillary beds is taken up by lymphatic plexuses (network of lymphatic capillaries)

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3
Q

lymph is drained from the lymphatic capillaries to

A

lymphatic vessels (lymphatics)

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4
Q

lymphatics have abundant ____

A

valves

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5
Q

multiple lymphatic vessels join to form

A

lymphatic trunks

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6
Q

do lymphatics occur in the brain

A

no - excess tissue fluid of the CNS drains into the CSF

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7
Q

how is lymph filtered

A

lymph nodes occur along the course of lymphatic vessels

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8
Q

what are the circulating cells of the immune system

A

lymphocytes

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9
Q

superficial lymphatic vessels follow

A

venous drainage

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10
Q

deep lymphatic vessels follow

A

arteries

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11
Q

describe the course of lymph from the superficial lymphatic vessels

A

follow venous drainage then eventually drain into deep lymphatic vessels which follow arteries and also receive drainage from internal organs

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12
Q

superficial and deep lymphatic vessels become ____ as they merge with vessels draining adjacent regions

A

larger

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13
Q

large lymphatic vessels enter

A

lymphatic trunks

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14
Q

lymphatic trunks unite to form

A

either the right lymphatic duct or thoracic duct

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15
Q

where does the right lymphatic duct drain

A

body’s right upper quadrant - right side of head, neck, and thorax and right upper limb

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16
Q

where does the right lymphatic duct join the venous system

A

junction of right internal jugular vein and right subclavian vein - right venous angle

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17
Q

where does the thoracic duct drain

A

rest of the body - lower limbs, abdomen, left side of thorax head and neck and left upper limb

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18
Q

the lymphatic trunks draining the lower half of the body merge in the abdomen sometimes forming a dilated collecting sac called the

A

cisterna chyli

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19
Q

where does the thoracic duct join the venous system

A

left venous angle at the junction of the left internal jugular and left subclavian veins

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20
Q

what is chyle

A

milky lymph containing lipids and lipid soluble vitamins absorbed from the small intestine

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21
Q

lymphatic vessels have a similar structure to

A

very small veins

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22
Q

what is contained in the lymph nodes

A

lymphocytes and macrophages

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23
Q

where are lymphocytes formed

A

in bone marrow

24
Q

after forming in the bone marrow where do lymphocytes mature

A

either in bone marrow (B cells) or thymus (T cells)

25
Q

what are 2 primary lymphoid organs

A

bone marrow and thymus

26
Q

name some other concentrations of lymphoid tissue in the body (secondary lymphoid organs - seeded from primary)

A
spleen
tonsils
lymph nodes
Peyer's Patches
GALT, BALT, MALT
27
Q

what do GALT, BALT and MALT stand for

A

Gut
Bronchiolar
Mucosa
Associated Lymphoid Tissue

28
Q

what are Peyer’s patches

A

small groups of lymphoid tissues in the walls of the small intestines (GALT)

29
Q

how do plasma proteins, bacteria, cellular debris and whole cells e.g. lymphocytes readily enter lymphatic capillaries

A

highly attenuated endothelium which lacks a basement membrane
and have a surplus of tissue fluid

30
Q

lymph node swelling indicates

A

a problem

31
Q

slow lymph flow through a node can lead to what

A

cancer cells forming secondary tumours within nodes

32
Q

describe healthy nodes

A

small, soft, bean shaped

difficult to see in dissection and difficult to palpate

33
Q

what are 2 ways lymph can be visualised

A

lymphogram - older method

surgery

34
Q

what is the sentinel node

A

first node that the structure drains to

35
Q

lymph from lower limbs and pelvis drain to the _____ trunks

A

lumbar trunks

36
Q

where does the thoracic duct pass

A

posterior mediastinum of thorax between the aorta and azygous vein

37
Q

is the right lymphatic duct always present

A

no

38
Q

what 3 trunks drain to the junction of the RSCV and RJV

A

right jugular trunk
right subclavian trunk
right bronchomediastinal trunk

39
Q

the right jugular trunk drains

A

the right side of the face and neck

40
Q

right subclavian trunk drains

A

right upper limb and superficial structures of the upper part of the thorax and abdominal walls on RHS

41
Q

the right bronchomediastinal trunk drains

A

deep thoracic structures on the right

42
Q

what is an anatomical variant seen in the trunks draining

A

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
43
Q

are there the equivalent 3 trunks on the left

A

yes

44
Q

the foregut drains where

A

coeliac nodes

45
Q

the midgut drains where

A

superior mesenteric nodes

46
Q

the hindgut drains where

A

inferior mesenteric nodes

47
Q

the coeliac, SM and IM nodes are also known as

A

pre-aortic nodes (anterior surface)

48
Q

renal nodes are

A

para-aortic

49
Q

the cisterna chyli is seen very close to the _____ on dissection

A

diaphragm

50
Q

where are the axillary nodes found

A

in axilla in fat surrounding the brachial plexus and axillary vessels

51
Q

axillary nodes drain what

A

upper limb

lateral sides of breast and thoracic wall

52
Q

there are also small nodes where in the arm

A

cubital fossa

53
Q

testes and ovaries drain where

A

para-aortic nodes

54
Q

what are some nodes of the pelvis

A

superficial and deep inguinal

common, external and internal iliac

55
Q

describe the lymph drainage of the lower limb

A

popliteal and femoral
to inguinal
to iliac

56
Q

name the lymph nodes in the head and neck

A

parotid, sublingual, submental, auricular, jugular, cervical