Lymphatic Drainage and Lymph Nodes

Question 1

What makes up the lymphatic system?

Answer 1

nodes

Lymph fluid

Lymphatic vessels

Organs = spleen, tonsils, thymus

Tissue = GALT, MALT

Question 2

What does lymphatics link together?

Answer 2

Link between tissues and blood circulation

Question 3

What parts of the body don’t have lymphatics?

Answer 3

Cornea, lens

Inner ear

Cartilage

Question 4

Does the CNS have lymphatics?

Answer 4

Yes present in the dura

Question 5

How does tissue fluid form?

Answer 5

Arteriole – capillary bed – venule

Arteriole = hydrostatic pressure > oncotic pressure = fluid to interstitial space

Venule = oncotic pressure > hydrostatic pressure = fluid to capillary

Due to small proteins moving to the interstitial space: arteriole net filtration > venule net filtration

Question 6

If the small proteins don’t leave the interstitial space what would occur?

Answer 6

Oedema

Therefore lymphatic capillary takes fluid contain proteins away

Question 7

What carries interstitial fluid away?

Answer 7

Lymphatic capillary

Fluid now termed lymph

Question 8

What is carried in lymph?

Answer 8

Small proteins

Damaged cells

Bacteria

Cancer cells

Chylomicrons (gut)

Question 9

How much lymph does the body produce a day?

Answer 9

3-4L

Question 10

Outline the order of the vessels from the interstitial space to the blood circulation?

Answer 10

Capillaries – vessels – nodes – trunks – ducts – venous system

Question 11

Outlines the characteristics of lymphatic flow?

Answer 11

One directional

Low pressure

No central pump

Valves

Passive constriction: run close to muscle/pulsations of vessels that squashes lymphatics = pushing fluid

Question 12

Where does the lymph drain into?

Answer 12

R duct = junction between R jugular vein + R subclavian vein

L thoracic duct = junction between L internal jugular vein + L subclavian vein

Question 13

Most of the lymphatic join where?

Answer 13

L thoracic duct

Question 14

What is lymphoedema?

Answer 14

Abnormal amounts of protein-rich fluid causing swelling due to compromised lymphatic system

Causes = removal of nodes, infect, cancer treatments, no movement

Question 15

Why do we have lymph nodes?

Answer 15

Contain highly organised centres of T/B cells, macrophages

Immune surveillance and defence

Question 16

What is lymphadenopathy?

Answer 16

Enlarged lymph nodes

Why = infection (tender, mobile) OR malignancy (hard, non-tender)

Question 17

Lymph nodes can be classified into what 2 groups?

Answer 17

Regional = drain specific areas, very superficial

Terminal = receives drainage from number of regional nodes, deeper

Question 18

Where are the lymph nodes of the neck found?

Answer 18

Superficial = sit in superficial cervical fascia

Deep = deep to the investing layer of deep cervical fascia, most are close to IJV

Question 19

What are the superficial lymph nodes of the head and neck?

Answer 19

Submental (below chin) = drain chin

Submandibular (below mandible) = drain face

Pre-Auricular (in front of ear) = drain side of scalp and eye

Post-Auricular = drain side of scalp

Occipital = drain back of scalp

Neck = superficial, posterior, anterior

Question 20

What are the deep lymph nodes of the head and neck?

Answer 20

Jugulo-digastric

Jugulo-omohyoid

Supraclavicular

Question 21

Where does the lymphatics from the tonsils drain to?

Answer 21

Retropharyngeal nodes

Question 22

What is waldeyers ring?

Answer 22

Annular collection of lymphatic tissue (nodules surrounding the entrance to aerodigestic tract

Pharyngeal tonsil, tubal tonsils, palatine tonsils, lingual tonsils

Question 23

What is the function of waldeyers ring?

Answer 23

Acts as a first line of defence against microbes that enters the body via the nasal and oral routes

Each tonsil consists of a network of crypts (pits) that store cells used to fight infection