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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
How do dendritic cells enter nodes
Attached to pathogens via afferent lymph and leave via efferent lymph
26
What cells are responsible for inflammatory and immune response
Inflammatory - macrophages and neutrophils | Immune - B cells, T cells, plasma cells
27
What is the medical term for enlarged lymph nodes
Lymphadenopathy
28
What can cause lymphadenopathy
Infection (high number of lymphocytes to fight infection) Cancers (can metastasise to lymph nodes via afferent lymph) Lymphoma (malignancy of lymphoid tissue)
29
What are the primary lymphatic organs and where
``` Thymus (mediastinum, behind sternum and above heart) bone marrow (red marrow) ```
30
What are the secondary lymph organs and where
Spleen (left abdomen, behind stomach) Tonsils (oropharynx and nasopharynx) Appendix (lower right quadrant) Payers patches (under mucosa of small intestine)
31
Thymus from birth
Fully formed and functional at birth | Involutes after puberty and becomes fat tissue
32
Function of Thymus
Maturation of T lymphocytes via thymic cell education
33
Thymus structure
Lobules seperated by septa Capsule and septa made of reticulin fibres Dense extra cellular matrix
34
What can changes in thymus lead to
Myasthenia Gravis and then Myasthenia crisis - inability to swallow due to weakened muscles
35
Function of spleen
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
Splenomegaly
Enlarged spleen from localised or systemic infection | At higher risk of rupturing and then internal bleeding
37
Splenectomy
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
Waldeyers ring
Tonsils - adenoid (nose), palatine (ones everyone refers too), lingual (behind tongue)
39
Structure of tonsils
Nodules inferior to invaginations
40
Function of tonsils
Prevent pathogen ingress from oral, nasal and aural routes | Crypts increase SA
41
Why does swelling of tonsils occur
Contain microfold cells Act as antigen presenting cells Swelling from B and T lymphocyte proliferation
42
Appendix structure
Nodules inferior to surface invaginations | Lots of microfold cells
43
Function of appendix
Prevent pathogens from GI and ileum | Crypts increase SA
44
Payers patches structure
Nodules inferior to surface domes | Lots of microfold cells
45
Function of payers patches
Prevents pathogens from digestion
46
Functions of lymphatic system
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
What are sentinel lymph nodes
First node to receive lymph from primary tumour
48
Primary lymphoedema
Congenital (Milroys disease, missing endothelial cells in vessel) Praecox Tarda
49
Secondary lymphoedema
``` Swelling Neoplasia (cancer) Surgery Auto immune Infections (cellulitis and filariasis) ```
50
How can cancer cells travel
Via newly produced vascular system Interstitial space Through lymph
51
3 types of cancers where metastasis often occurs
Malignant melanoma, breast cancer, endometrial cancer
52
Old way to detect cancer
Axilla or pectoral are sentinel lymph nodes in breast cancer Frozen section taken whilst in theatre Checked and presence of malignant cells = mastectomy
53
New modern way to detect cancer
Flurography using radioactive dye Only shows sections which are affected so not all lymph has to be removed Reduces change of lymphoedema
54
Two infections that can cause lymphoedema
Cellulitis - obstruction of vessel | Filariasis - parasitic worm
55
Treatments for lymphoedema
Surgical stockings | Lympha press system (electronics massage system that pushes lymph up to be drained)

Bodylog 2023 (6 decks)

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