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Bodylog 2023 > Lymphatic System > Flashcards

Lymphatic System Flashcards

1
Q

Describe the organisation of the lymphatic system

A

Lymph - lymphatic vessels - lymphoid tissues/organs - cells within tissues and organs

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2
Q

Describe lymph and how much is produced each day

A

Serum like, thin fluid (ph7.4)

3-5 litres and then recycled

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3
Q

What is chyle

A

Lymph from GI tract
Contains chylomicrons (fat)
And fat soluble vitamins

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4
Q

Vessel ordering in lymphatic system

A

Capillary, vessel, node, trunk, duct

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5
Q

Structure of lymphatic vessel

A 
Capillaries Blind ended
No basement membrane
Endothelial cells and reticulin cells 
Contain valves
One direction of flow
Reticulin fibres hold in place
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6
Q

Lymph flow order

A 
Tissue fluid from capillaries and cells goes to 
Capillary
Vessel
Node
Trunk 
Duct
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7
Q

Lymph flow control

A 
Vessels lie adjacent to veins and arteries, compression from these expanding can propel lymph
Superficial and deep
Contraction of muscles 
Smooth muscle cells in their walls
Breathing
Valves
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8
Q

Where is lymph not present

A

CNS (brain and spinal cord)

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9
Q

Lymphatic capillary vs Vein

A

Both have:
Valves
Low pressure

Lymph:
No cells present unless infection

Veins:
Lots of cells

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10
Q

Lymphatic trunks and ducts structure

A

Similar to larger veins
Larger valves (fibrocartilage)
Smooth muscle
Skeletal muscle and organ movement for flow

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11
Q

What is cisterna Chyli

A

Contains chyle from GI tract (central body region)

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12
Q

Where does upper right quadrant lymphatic drain to

A

Right lymphatic duct to the right subclavian vein/internal jugular vein

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13
Q

Where does the rest of the body drain to

A

Thoracic duct to the left subclavian vein/internal jugular vein

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14
Q

How many lymph nodes are there

A

600-700 in the body

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15
Q

3 most important lymph nodes

A

Armpit (axillae)
Groin (inguinal)
Neck (cervical)

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16
Q

Lymph node structure

A

Shaped like kidney
Multiple afferent vessels to enter (convex side)
1 single efferent vessel to leave (concave)
Each node has feeding artery and draining vein
Artery and vein run alongside efferent vessel
Capsule
Medulla (mature T lymphocytes)

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17
Q

What do lymph nodes contain

A

Follicles that contain immune cells (macrophages, dendritic, B cells, T cells and plasma cells)
Contain reticulin for connective tissue (made by reticular cells)

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18
Q

Follicular dendritic cells

A

In germinal centres of follicle
Antigen-antibody complex adhere to them
Cause proliferation of B cells and memory B cells

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19
Q

Lymph node draining an infection

A

Dendritic cell carries bacteria to lymph node
Macrophage engulfs + presents antigens
T cells activated
B cells activated
Plasma cells formed which produce antibodies
Antibodies go to blood

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20
Q

Difference between APC’s

A

B lymphocytes recognise antigens
Attacks invaders outside cells

T cells have to have foreign antigens presented to them by bodies own cells
Attacks invaders inside cells

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21
Q

Summary of lymph filtering

A

Traps antigen
Macrophage engulfs
Presents antigen
T lymphocytes activated

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22
Q

What do efferent vessels leave via

A

The hilum (indentation in node)

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23
Q

Where do the feeding artery and draining vein leave

A

Via the hilum

24
Q

How do lymphocytes usually enter lymph nodes

A

Via feeding artery and leave via draining veins

25
Q

How do dendritic cells enter nodes

A

Attached to pathogens via afferent lymph and leave via efferent lymph

26
Q

What cells are responsible for inflammatory and immune response

A

Inflammatory - macrophages and neutrophils

Immune - B cells, T cells, plasma cells

27
Q

What is the medical term for enlarged lymph nodes

A

Lymphadenopathy

28
Q

What can cause lymphadenopathy

A

Infection (high number of lymphocytes to fight infection)
Cancers (can metastasise to lymph nodes via afferent lymph)
Lymphoma (malignancy of lymphoid tissue)

29
Q

What are the primary lymphatic organs and where

A 
Thymus (mediastinum, behind sternum and above heart) 
bone marrow (red marrow)
30
Q

What are the secondary lymph organs and where

A

Spleen (left abdomen, behind stomach)
Tonsils (oropharynx and nasopharynx)
Appendix (lower right quadrant)
Payers patches (under mucosa of small intestine)

31
Q

Thymus from birth

A

Fully formed and functional at birth

Involutes after puberty and becomes fat tissue

32
Q

Function of Thymus

A

Maturation of T lymphocytes via thymic cell education

33
Q

Thymus structure

A

Lobules seperated by septa
Capsule and septa made of reticulin fibres
Dense extra cellular matrix

34
Q

What can changes in thymus lead to

A

Myasthenia Gravis and then Myasthenia crisis - inability to swallow due to weakened muscles

35
Q

Function of spleen

A

Filters blood
Immune:
Antigen presenting
Activation and proliferation of B and T lymphocytes
Produce antibodies
Removal of antigens from blood (by macrophages)

Haemopoetic:
Recycles iron from erythrocyte Haemoglobin
Stores erythrocytes
Destruction of old, damaged or abnormal erythrocytes and platelets

36
Q

Splenomegaly

A

Enlarged spleen from localised or systemic infection

At higher risk of rupturing and then internal bleeding

37
Q

Splenectomy

A

Removal of spleen
Liver and bone marrow take over removal and destruction of old RBC
But more susceptible to infection from encapsulated bacteria
(Streptococcus pneumoniae, Neisseria meningitidus, Haemophilus Influenzae)

38
Q

Waldeyers ring

A

Tonsils - adenoid (nose), palatine (ones everyone refers too), lingual (behind tongue)

39
Q

Structure of tonsils

A

Nodules inferior to invaginations

40
Q

Function of tonsils

A

Prevent pathogen ingress from oral, nasal and aural routes

Crypts increase SA

41
Q

Why does swelling of tonsils occur

A

Contain microfold cells
Act as antigen presenting cells
Swelling from B and T lymphocyte proliferation

42
Q

Appendix structure

A

Nodules inferior to surface invaginations

Lots of microfold cells

43
Q

Function of appendix

A

Prevent pathogens from GI and ileum

Crypts increase SA

44
Q

Payers patches structure

A

Nodules inferior to surface domes

Lots of microfold cells

45
Q

Function of payers patches

A

Prevents pathogens from digestion

46
Q

Functions of lymphatic system

A

Fluid balance (interstitial fluid back to circulation
Transports of fats and fat soluble vitamins (chyle)
Defence against pathogens and disease (filter lymph)
Storage and destruction of old erythrocytes (spleen/liver if no spleen)

47
Q

What are sentinel lymph nodes

A

First node to receive lymph from primary tumour

48
Q

Primary lymphoedema

A

Congenital (Milroys disease, missing endothelial cells in vessel)
Praecox
Tarda

49
Q

Secondary lymphoedema

A 
Swelling
Neoplasia (cancer)
Surgery
Auto immune 
Infections (cellulitis and filariasis)
50
Q

How can cancer cells travel

A

Via newly produced vascular system
Interstitial space
Through lymph

51
Q

3 types of cancers where metastasis often occurs

A

Malignant melanoma, breast cancer, endometrial cancer

52
Q

Old way to detect cancer

A

Axilla or pectoral are sentinel lymph nodes in breast cancer
Frozen section taken whilst in theatre
Checked and presence of malignant cells = mastectomy

53
Q

New modern way to detect cancer

A

Flurography using radioactive dye
Only shows sections which are affected so not all lymph has to be removed
Reduces change of lymphoedema

54
Q

Two infections that can cause lymphoedema

A

Cellulitis - obstruction of vessel

Filariasis - parasitic worm

55
Q

Treatments for lymphoedema

A

Surgical stockings

Lympha press system (electronics massage system that pushes lymph up to be drained)

Bodylog 2023 (6 decks)

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