Lymphatic Structures And Lymph Flow Flashcards
Describe the anatomical features of lymph nodes
Connective tissue capsule
List 4 important functions of lymph nodes
Removal of
Pre collectors
Precollector is both a transport and collecting vessel
It can absorb LOL in sm amounts and transport lymph from initial LV to to collectors
They are interconnected with skin zones.
They are smaller than collectors and bigger than ILV
Initial lymph vessels
Initial lymph vessels are the smallest vessels and form the beginning of the lymphatic vascular system.
Found in the entire dermis and drain LOL from the connective tissue.
They have a blind origin in the tissue like fingers in a glove.
They cosist of a single layer of endothelial cells that overlap on the edges so they open like shutter valves.
The ILV transports the LOL to the precollectors.
What is a lymphangion?
Any portion of the lymph vessel thats between two valves is a lymphangion.
Name 3 mechanisms which control smooth muscle in collector vessels.
Lymphangiomotoricity=
Autonomous motoricity
Passive distension- from inside ( filling pressure)
from outside ( distension pressure)
Internal and external stimuli
Temperature rise
Muscle and joint pump Arterial pulsation Respiration and peristalsis Negative intrathoracic pressure ( negative pressure in the thorax) External pressure ( mld and bandaging)
What mechanisms allow uptake of fluids by the ILV?
When pressure is low valves are closed, when pressure is up it pulls on the anchoring filaments that are attached to the fibre network ( endothelial cells) which opens the valves so fluid can enter the vessel.
List at least 6 functions of the lymphatic vascular system.
To circulate lymphocytes- immune system
Removal of fluid
Removal of lge proteins and lipids
Removal of organic and inorganic wastes-
Assists in maintaining blood volume
Maintain protein circulation
( waste going into blood ie carbon dioxide)
Name three mechanisms which control smooth muscle in collector vessels
Muscle and joint pump Arterial pulsation Respiration and peristalsis Negative intrathoracic pressure External pressure (MLD and bandaging)
Upper left lobe of lung
Bronchomediastinal trunk to thoracic duct
Contraction of collector smooth muscle is controlled by…
Sympathetic nervous system
What happens when sympathetic activity is high?
Running from the bear!
Stress is high!
It suppresses and flow slows down.
Where are initial lymph vessels found?
In loose connective tissue (where blood capillaries are)
What do B cells do?
They produce plasma cells which manufacture antibodies
Proteins in the tissues attract water. This is known as….
Cotp
Connective tissue contains phagocytic cells known as …
Macrophages
Which cell is stimulated by antigens to produce antibodies?
B lymphocytes
A lymphostatic edema could be…
Primary
Functional
What is meant by the term functional reserve of the lymph vessel system?
The difference between transport capacity and lymph obligatory load.
What characteristic edema locations would indicate a patient has lipedema?
Bilateral symmetrical thighs
How does primary lymphedema differ from secondary lymphodema?
It can be caused by a deficiency of lymph vessels.
What is a characteristic of Dynamic edema?
Lymph system is functioning at capacity.
not damaged
Name three typical skin alterations due to chronic lymphodema…
Hyperkeratosis
Papillomatosis
Lymph cysts
Lymph fistulas
What are some of the forces that encourage fluid movement from the blood capillariy to the interstitium?
Hydrostatic blood pressure Colloid osmotic ( oncotic) tissue pressure ( both encourage water out)
What holds the water in…
Hydrostatic tissue pressure Colloid osmotic ( oncotic) blood pressure
( both hold water in the blood capillary as opposed to encouraging it out nto the interstitium)
What are the intrinsic mechanisms for normal lymph flow?
ANS
Stretch receptor reflex
Automyogenic ( a property no other muscle has 5-7 x p/min)
What are the extrinsic mechanisms for normal lymph flow?
Breathing Pulsation of arteries Skeletal muscle contractions Intestinal peristalsis Gravity
What do the pulsation of arteries do to the Lymph vessels?
The veins, valves arteries are all in a sheath so the Lymph vessels get squeezed a bit.
What does breathing do to Lymph flow?
High pressure area to low pressure area
Diaphragm fills up, thoracic decreases
Hi pressure to low pressure allows the lymph to flow more
What do skeletal muscle contractions do the lymph flow?
By walking around active lymph load increases ( stretches) which then triggers the Stretch receptor reflex
SRR triggers what rate of firing of smooth muscle?
Max 27-30 x per min
What increases lymph flow?
Exercise- activating skeletal muscle pumps
Carbon dioxide and water
Body temperature- LS can only work to max capacity not higher. Only up to 39 degrees C, above that inhibits L/ flow- functional proteins- de nature
Characteristics of Stage 3 lymphoedema
Stemmer sign
What is Lymphostatic ( Lymphoedema) edema?
= low volume insufficiency
=mechanical insufficiency
Its a failure of the lymphatic system
High protein edema (MLD can help)
What are the root causes of Lympostatic edema( lymphoedema)
Direct damage to LS
Lack of movement- sedentary lifestyle, obesity
- reduction of lymphangiomotoricity
- reduction of venous return
Lymph vessel spasm
- pain
- greatly fluctuating stimuli ( electrical current, laser)
- inflammatory processes
Suggested classification for lymphedema
Acute/ chronic
primary/ secondary
Benign/ malignant
Stages 1/2/3
Skin changes in Stage 3
Pachydermia
Papillomatosis- warty growths on skin
Lymphatic cysts- lymph filled cysts on skin
Lymphatic fistulas- hole gets developed in sweat gland or sebaceous gland and leaks out
Hyperkeratosis-
