lymph and autonomics

Question 1

the lymph system is a ______ network

Answer 1

one way network that parallels the venous system

Question 2

What is one function of the lymph system

Answer 2

to drain interstitial fluid rich in protein, which must be removed or swelling will occur

Question 3

Lymphedema

Answer 3

when the drainage function of the lymph is disturbed, serious swelling occurs.

Question 4

What are the major lymph nodes

Answer 4

iliac , inguinal-largest aggregate, popliteal, anterior tibial -not consistant

Question 5

Where do the superficial and deep systems converge and unite

Answer 5

popliteal fossa and femoral triangle

Question 6

The superficial system can be divided into what two parts

Answer 6

medial and lateral

Question 7

Medial part includes:

Answer 7

follows the great saphenous vein, territory of drainage: superficial medial dorsum of foot, medial leg, thigh. common termination: superficial inguinal nodes

Question 8

Lateral part includes:

Answer 8

small saphenous vein, superficial: lateral dorsum of foot, posterior leg. common termination: popliteal nodes

Question 9

Lymph from the deep system accompany what vessels

Answer 9

dorsalis pedis/ant tib, med and lat plantar/post tib, fibular vessels and terminate at popliteal nodes

Question 10

From the popliteal nodes, lymph primarily drains into what nodes ?

Answer 10

deep inguinal nodes

Question 11

How are inguinal nodes grouped

Answer 11

superficial= 2 groups distributed along the lines of a lop-sided T 4-25 nodes, proxim/horizontal/ superior group and distal/vertical/inferior group most lymph drains into the ext illiac lymph nodes and a smaller amount goes into the deep inguinal nodes.

Question 12

horizontal

Answer 12

superficial inguinal lymph nodes, proximal group

Question 13

vertical

Answer 13

superficial inguinal lymph nodes, distal group

Question 14

What could occur at superficial inguinal nodes?

Answer 14

enlargement can occur from the presence of an infection or tumor in the foot or leg.

Question 15

Enlargement of the superficial inguinal lymph nodes can also indicate disease in which areas?

Answer 15

Lower limb , gluteal region , lower abdominal wall, external genitalia and perianal

Question 16

Deep nodes-

Answer 16

1-3 nodes within femoral sheath , medial to femoral vein 1st- located in the femoral ring and is called gland of cloquet or node of rosenmuller 2nd and 3rd-located within the femoral canal. Receive lymph from deeper tissues of lower extremity and from popliteal nodes. Lymph then drains into the external iliac lymph nodes.

Question 17

What is the course of lymph from external iliac nodes

Answer 17

external iliac nodes, common illiac nodes, lumbar nodes, cisterna chyli, thoracic duct, venous system near brachiocephalic vein

Question 18

Lymph from superficial medial side of foot leg and thigh follow GSV—>

Answer 18

superficial inguinal —> external iliac nodes

Question 19

Lymph from superficial lateral sides of foot and posterior lateral leg follow SS—>

Answer 19

popliteal nodes—> deep inguinal nodes—> external iliac nodes

Question 20

lymph from deep foot and deep leg follow deep veins and arteries—->

Answer 20

popliteal nodes—> deep inguinal —> external iliac nodes

Question 21

sympathetic

Answer 21

cutaneous /visceral vasoconstriction

Question 22

parasympathetic

Answer 22

secretomotor

Question 23

Why is the sympathetic division often called the thoracolumbar part of ANS?

Answer 23

The cell bodies of the preganglionic neurons are located in spinal cord segments T1-L2

Question 24

the automatic supply to the limbs is exclusively

Answer 24

sympathetic

Question 25

From what spinal levels do sympathetics to lower limb originate

Answer 25

T10-L2

Question 26

What are the possible courses and terminations of the preganglionic sympathetic axons after they enter the sympathetic trunk

Answer 26

1. synapse in sympathetic trunk at level of entry, 2. ascend in the symp trunk to a higher level and then synapse 3. descend in the sympathetic trunk to a lower level and then synapse 4. leave the sympathetic trunk in a splanchnic nerve and synpase in collateral ganglion

Question 27

What are the fates of sympathetic fibers leaving the sympathetic trunk

Answer 27

1. post ganglionic fibers leave the sympathetic trunk at all levels via gray communicating rami to travel in spinal nerves to smooth muscle and glands in the limbs and body wall.

Question 28

Gray rami communicans along what portions of the sympathetic chains distribute postganglionic fibers to the lower limb?

Answer 28

lumbar and sacral ventral rami , ventral rami then join to form nerves.

Question 29

after first traveling with peripheral nerves, post-ganglionic sympathetics then join what

Answer 29

blood vessels

Question 30

How do pre ganglionic sympathetics from SC enter the sympathetic chain

Answer 30

white communicating rami

Question 31

Post ganglionic fibers pass along ____________

Answer 31

grey communication rami to enter l2-l4 mixed spinal nerves and then to their respective ventral rami

Question 32

What do the postganglionic fibers travel to

Answer 32

femoral nerve /artery/branches

Question 33

What do postganglionic sympathetic fibers innervate in the lower limb

Answer 33

veins and arteries, arrector pilli muscles, sweat/sebaceous glands

Question 34

Keratoderma plantaris

Answer 34

keratin cracks and ulcerations due to sweat gland dysfunction and lack of oil production, fissures create an entrance for infection causing bacteria

Question 35

lumbar plexus ventral rami

Answer 35

T12-L4

Question 36

What muscle groups would likely be affected with damage to the lumbar plexus

Answer 36

right hip flexors, right knee extensors, right adductors of the thigh

Question 37

What area of skin would be affected by a lesion to the lumbar plexus

Answer 37

anterior and medial thigh, anteromedial and posteromedial leg, medial plantar aspect of the foot including hallux

Question 38

If sympathetics were affected by a lesion to the lumbar plexus, what presentation of the patient would you see

Answer 38

vasodilation of superficial vessels, increased warmth/flushing of right foot) anhidrosis (lack of sweating of the right)

Question 39

the femoral ring is also known as the

Answer 39

gland of cloquet or node of rosenmuller- deep