Lymphatic Drainage of the Upper Limb Flashcards

1
Q

What does the lymphatic system function to do?

A

Drain tissue fluid, plasma proteins and other cellular debris back into the blood stream. Involved in immune defence

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2
Q

What is the collection of substances known as once it’s entered the lymphatic vessels?

A

Lymph

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3
Q

What happens to lymph?

A

It is filtered by lymph nodes and directed into the venous system

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4
Q

What do the superficial lymphatic vessels of the upper limb arise from?

A

Initially the lymphatic plexuses in the skin of the hand

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5
Q

What are lymphatic plexuses?

A

Networks of lymphatic capillaries beginning in the extracellular spaces

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6
Q

Where to the superficial lymphatic vessels of the arm ascend?

A

Up the arm, in close proximity to the major superficial veins

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7
Q

Where do the vessels shadowing the basilic vein go?

A

They enter the cubital lymph nodes

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8
Q

Where are the cubital lymph nodes found?

A

Medially to the vein, and proximally to the medial epicondyle of the humerus

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9
Q

What happens to vessels carrying on from the cubital lymph nodes?

A

They continue up the arm, terminating in the lateral axillary lymph nodes

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10
Q

Where do the vessels shadowing the cephalic vein go?

A

Generally, they cross the proximal part of the arm and shoulder to enter the apical axially lymph nodes, though some exceptions instead enter the more superficial deltopectoral lymph nodes

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11
Q

What do the deep lymphatic vessels of the upper limb follow?

A

The major deep veins- radial, ulnar and brachial

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12
Q

How do the deep lymphatic vessels of the upper limb terminate?

A

In the humeral axillary lymph nodes

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13
Q

What do the deep lymphatic vessels of the upper limb function to do?

A

Drain lymph from joint capsules, periosteum, tendons and muscles

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14
Q

Where may some additional lymph nodes be found?

A

Along the ascending path of deep vessels

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15
Q

Where are the majority of upper lymph nodes located?

A

In the axilla

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16
Q

What groups can the axillary lymph nodes be divided into?

A
Pectoral (anterior)
 Subscapular (posterior)
 Humeral (lateral)
 Central
 Apical
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17
Q

How many pectoral lymph nodes are there?

A

03-May

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18
Q

Where are the pectoral lymph nodes located?

A

In the medial wall of the axilla

19
Q

Where do the pectoral lymph nodes receive lymph from?

A

Primarily the anterior thoracic wall, including most of the breast

20
Q

How man subscapular lymph nodes are there?

A

06-Jul

21
Q

Where are the subscapular lymph nodes located?

A

Along the posterior axillary fold and subscapular blood vessels

22
Q

Where do subscapular lymph nodes receive lymph from?

A

The posterior thoracic wall and scapular region

23
Q

How many humeral lymph nodes are there?

A

04-Jun

24
Q

Where are the humeral lymph nodes located?

A

In the lateral wall of the axilla, posterior to the axillary vein

25
Q

Where do the humeral lymph nodes receive lymph from?

A

Receive the majority of lymph drained from the upper limb

26
Q

How many central lymph nodes are there?

A

03-Apr

27
Q

How big are the central lymph nodes?

A

Large

28
Q

Where are the central lymph nodes located?

A

Near the base of the axilla (deep to the pectoralis minor, close to the 2nd part of the axillary artery)

29
Q

Where do the central lymph nodes receive lymph from?

A

Via efferent vessels, from the pectoral, subscapular and humeral axillary lymph node groups

30
Q

Where are the apical lymph nodes located?

A

In the apex of the axilla, close to the axillary vein and 1st part of the axillary artery

31
Q

Where do the apical lymph nodes receive lymph from?

A

Efferent vessels of the central axillary lymph nodes, therefore from all axillary lymph node groups
From those lymphatic vessels accompanying the cephalic vein

32
Q

Where to efferent vessels from the apical axillary nodes travel?

A

Through the cervico-axillary canal

33
Q

What happens onceefferent vessels from the apical axillary nodes have gone through the cervico-axillary canal?

A

They converge to form the subclavian lymphatic trunk

34
Q

What does right subclavian lymphatic trunk do?

A

Continues to form the right lymphatic duct, and enters the right venous angle directly

35
Q

What is the right venous angle?

A

Junction of the internal jugular and subclavian veins

36
Q

What does the left subclavian lymphatic trunk do?

A

Drains directly into the thoracic duct

37
Q

What can cause enlargement of axillary lymph nodes?

A

Infection of the upper limb, resulting in lymphangitis
Infections of the pectoral region and breast
Metastasis of breast cancers

38
Q

What is lymphangitis?

A

Inflammation of lymphatic vessels with tender, enlarged lymph nodes

39
Q

What is usually affected first in lymphangitis?

A

The humeral group of lymph nodes

40
Q

What can be seen in lymphangitis?

A

Red, warm and tender streaks visible in the skin of the upper limb

41
Q

What is often a vital tool for staging breast cancers?

A

Removal and analysis of the axillary lymph nodes

42
Q

What can interruption of lymphatic drainage from the upper limb result in?

A

Lymphoedema

43
Q

What is lymphoedema?

A

A condition whereby accumulated lymph in the subcutaneous tissue leads to painful swelling of the upper limb

44
Q

What is at risk of damage during an axillary lymph node dissection?

A

The long thoracic nerve or thoracodorsal nerve