Lymphatic drainage Flashcards
what is the lymphatic system?
Network of drainage vessels throughout the body that returns fluid that has leaked from the blood vascular system back to the blood.
“Security system that runs background checks, processes foreigners and presents illegal immigrants to the police”
how many liters of interstital fluid does it collect per day?
3L
what does the lymphatic system consists of?
• Fluid
– Lymph
• Vessels
– Lymphatics
• Cells
– Lymphocytes (B cells, T cells and Natural Killer (NK) cells)
– Supporting cells, in particular follicular dendritic cells and macrophages
• Tissues
• Organs
where do u find lymphatics
whereever there is bv there is lymphatics!
except for eyeball (cornea, lens), inner ear, cartilage
r there lymphatics in the CNS?
yes! in relation to meninges
Explain the concept of formation of tissue fluid
all depends on hydrosataic p & oncotic p
at the arterial end, hydrostatic pressure is higher in the capillaries rather than oncotic, this make thes fluid wanna leave the capillaires and go to intersitial space
in venous, hydrostatic p. drops in capillaries cuz half the fluid left! and proetins r left inthe venules, making oncotic P now higher!
why does
Net filtration of fluid ≠ Net reabsorption of fluid
at the different ends of the capillary bed?
bc small proteins can be sneaky at leak into the interstital space! so we do have a little bit of protein there,
therefore in the venule end there is a bit of oncotic p in the interstitial fluid caused by these stupid tiny proteins. so not all fluid is reabsorbed and some r left behind (retained)
how is lymph fluid formed?
but we dont want these little sneaky proteins in our interstitial….
THAT WHERE THE LYMPHATIC COMES IN!
the lymphatic capillary walls r much more porous, and its easier for the small proteins to get into the lymphatic space rather than the regular capillaries
as soon as that fluid gets into the lymph…
we can now call it LYMPH FLUID!!!
what does lymph fluid contain
- Tissue fluid
- Small proteins
- Damaged cells
- Bacteria
- Cancer cells
- Lipids (chylomicrons from gut lymphatics
why does Cancer cells in lymph be a problamo?
cuz the lymphatic system can act as a portal for those cancer cells >> lymphadenopathy!
function of lymphatic vessels
- Continuous removal of remaining tissue fluid from the extracellular space back to blood circulation
BUT
- also route for spread of infection and malignant disease
what things helps propel lymph along?
they also have the ability to constrict automatically themsekves, as soon as they feel they r stretching-its an inner sense they have
coolio
what r the 2 major ducts that drains lymph into the venous circulatio, and what does each section drain?
Lymphoedema
Abnormal collection of protein-rich fluid causing tissue swelling due to compromised lymphatic system
chronic condition
then what r lymph nodes? why cant we usually see them? fucntions?
principal lymphoid organ of the body, which cluster along the lymphatic vessels.
cuz theyre embedded in connective tissue!
- filtration- macrophages in the nodes kill em!
- Immune system activation!
strcuture of a lymph node?
Connective tissue structures
– Tough fibrous outer capsule
– Reticular connective tissue inside (“candy floss”) >> lymphocytes love candyfloss, ao u’ll definitly find them there chilling
- Germinal centers: houses B cells*
- Cortex: T cells*
- dentricitc cells, encapsulate the follicules*
If you see an enlarged lymph node, what options could it be? How would you know?
how can lymph nodes of the body be organised?
where r the Specific regions in body where collections of lymph nodes may be palpable
how many lymph nodes in the body, how many in the neck?
800 lymph nodes in body
– 300 are in the neck!
Enlarged cervical lymph nodes most common cause of swelling in the neck!
– Enlarged lymph node = lymphadenopathy
The lymph nodes of the head and neck can be divided into 2 groups
regional lymph nodes in the head and neck can be readily palpated, why is this so? (think anatomic location)
bc they lie superficially within the superficial cervical fascia
Where r the deep cervical lymph nodes embedded?
closely related to the carotid sheath, & in particular to the IJV.
what r are 2 specific lymph nodes within the deep cervical group?
they r closely related to which structure?
jugulo-digastric & jugulo-omohyoid
which lmyph node can be often swollen and tender in tonsillitis?
The jugulo-digatric node (also called the tonsillar node)
is located just below and behind the angle of the mandible
concerned with lymph drainage of the palatine tonsil, oral cavity and the tongue
he jugulo-omohyoid node is mainly associated with the lymph drainage of
tongue, oral cavity, trachea, oesophagus and the thyroid gland
Infection or diseaseaffectingthesestructuresmaythereforepresentwithanenlargedjugulo- omohyoid lymph node.
know the superficial lymph nodes of the head and neck
receive lymph from the scalp, face and neck.
They are arranged in a ring shape;
what do supraclavicular nodes drain?
know the deep lymph nodes of the head and neck (3)
indicate where the superficial lymph nodes are found
virchow’s node: refers to an enlarged left supraclavicular lymph node(s), which may not necessarily be pathologic
Trosier’s Sign : is an enlarged, hard, left supraclavicular lymph node secondary to metastatic abdominal malignancy.
- this node hey receive the lymph from the thorax & abdomen before it drains via the thoracic duct into the venous circulation. (hence the symtoms)*
- rawan likes abdomen and she has a clavicle peircing>*
describe the superficial and deep lymph nodes in relation to the cervicsl fascia’s
**make sure u know what each lymph node drains ok?
Mouth ulcer
submental
whic lymph nodes affected
conjuctivits>> preauricular
tonsilitis>> palatine tonsil>> juglar diagastric
were r Follicular dendritic cells located?
Located in the germinal centres
Explain the purpose of Waldeyer’s Ring and describe the structures that form it.
Waldeyer’s ring is a ring of lymphoid tissue located in the nasopharynx and oropharynx at the entrance to the aerodigestive tract.
he ring acts as a first line of defence against microbes that enters the body via the nasal and oral routes.
Describe the location of the lymphatic structures of Waldeyer’s Ring and be able to identify their general location when viewing the head and neck in a sagittal plane.
Identify which structures of Waldeyer’s ring are readily visible on inspection of a patient’s oropharynx
What are the names of the ‘tonsils’ which form Waldeyer’s Ring?
Which of the lymphoid tissue forming Waldeyer’s Ring can you most readily view when performing a routine examination of a patient?
where does the lymphoid tissue of waldeyers ring drain into?
drain into deep cervical nodes
Which tonsil is affected by tonsillitis? how do u treat it?
The palatine tonsils can become inflamed due to a viral or bacterial infection
Chronic infection of the palatine tonsils can be treated with their removal, a tonsillectomy
Which tonsil of Waldeyer’s ring is also known as the “adenoids”;
where are these found and why might enlargement of the adenoids cause middle ear problems?
Pharyngeal tonsil – also called the nasopharyngeal/adenoid tonsil, located in the roof of the nasopharynx, behind the uvulva and forms the postero-superior part of the ring.
