lymph + onocology

Question 1

Functions of lymphatic system

Answer 1

drain excess interstitial fluid
absorption and transportation of dietary lipids
produce lymphocytes - immune response
filter pathogens

Question 2

2 ducts lymph is drained by

Answer 2

right lymphatic duct
thoracic duct

Question 3

where does right lymphatic duct drain lymph from

Answer 3

right side of head and neck
right arm
right side of thorax

Question 4

what is right thoracic duct formed by

Answer 4

right subclavian trunk (upper limb)
right bronchomediastinal trunk (thoracic wall, lung and heart)
right jugular trunk (head and neck)

Question 5

where does the thoracic duct drain lymph from

Answer 5

from rest of body
LHS of thorax and lower extremities

Question 6

what is thoracic duct formed by

Answer 6

lymphatic trunks

Question 7

where does thoracic duct commence

Answer 7

T12 above cisterna chyli

Question 8

location of thoracic duct

Answer 8

runs upwards on RHS of descending aorta
posterior to oesophagus

Question 9

how long is thoracic duct

Answer 9

38-45cms

Question 10

where does thoracic duct end

Answer 10

in right atrium

Question 11

Cisterna chill length

Answer 11

5-7cms

Question 12

cisterna chyli location

Answer 12

inferior to thoracic duct
anterior surface of L2

Question 13

cisterna chyli function

Answer 13

drain lymph from abdomen / pelvis / lower limbs

Question 14

flow of lymph
highest to lowest pressure

Answer 14

blood capillaries
interstitial fluid
lymph capillaries
lymph veins and lymph nodes
lymph ducts
junction of jugular and subclavian veins

Question 15

2 pumps that aid flow of lymph

Answer 15

skeletal muscle pump
respiratory pump

Question 16

skeletal muscle pump - defn

Answer 16

milking action
contractions compress lymphatic vessel forcing lymph toward junction of jugular and subclavian veins

Question 17

respiratory pump - function

Answer 17

pressure changes during inhalation
lymph flows from high to low pressure - abdomen to chest
exhalation - reverse (valve = unidirectional flow)

Question 18

nodes
head and neck

Answer 18

cervical
jugular

Question 19

nodes
axillary

Answer 19

axilla
breast
armpit
subclavian trunk

Question 20

nodes
tracheo-bronchial

Answer 20

trachea
bronchus
heart
lung
thoracic wall

Question 21

location of lymphoid organs and tissues

Answer 21

spleen
thymus
tonsils
Peyer’s patches
appendix

Question 22

lymphatic spread - defn

Answer 22

tumour cells invade local lymphatic vessels and break off to spread throughout the body to regional lymph nodes

Question 23

haematogenous spread - defn

Answer 23

tumour cells invade capillary bed and break off
carried in blood stream and develop as a secondary tumour in other organ

Question 24

trans coelomic spread - defn

Answer 24

tumour cells involving serous membrane become detached and implant in other areas of membrane

Question 25

mechanical transplantation spread - defn

Answer 25

tumour cells dislodge during biopsy or surgery and implant along track of surgical site

Question 26

thymic sail Sign - describe

Answer 26

triangular shape from inferior margin of thymus commonly seen on RHS (can be bilateral)

Question 27

thyme sail sign can be mistaken for what pathology?

Answer 27

spinnaker sail sign - pneumomediastinum

Question 28

spinnaker sail sign - pneumomediastinum

Answer 28

gas/air trapped in pericardial sac in mediastinum

Question 29

spinnaker sail sign shape

Answer 29

large wedge shaped opacity angel wing shape from right hemidiaphragm to superior mediastinum

Question 30

oncology defn

Answer 30

study of neoplasms

Question 31

benign features

Answer 31

slow and progressive growth does not invade other tissues contained in fibrous capsule cells closely resemble tissue of origin mobile when palpable

Question 32

malignant features

Answer 32

rapid and progressive growth invades local tissue irregular shaped fixed when palpable detrimental effect on body

Question 33

4 steps of tumour staging

Answer 33

determine extent of tumour and metastatic spread plan most effective treatment plan predict risk of recurrance predict prognosis

Question 34

TNM classification

Answer 34

T- Primary Tumour N- Regional Lymph Nodes M- Distant Metastasis

Question 35

T1/2/3/4

Answer 35

refers to size or extent of primary tumour

Question 36

T0

Answer 36

no evidence of invasion

Question 37

N1/2/3

Answer 37

degree of lymph node involvement

Question 38

N0

Answer 38

no lymph node involved

Question 39

M1/ M0

Answer 39

distant metastasis present yes/no

Question 40

role of diagnostic imaging

Answer 40

initial diagnosis work-up and staging monitoring and ?response to treatment ?follow -up recurrence