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INTERNAL MED FINAL > LYMPHATIC SYSTEM > Flashcards

LYMPHATIC SYSTEM Flashcards

1
Q

What is the lymphatic system responsible for carrying back to blood?

A

Capillary ultrafiltrate fluid volume & escaped plasma proteins.

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2
Q

What type of diuresis is the lymphatic system based on?

A

Osmotic diuresis.

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3
Q

What are the four functions of the lymphatic system?

A
  • Absorb macromolecules (proteins & FAs)
  • Maintain fluid balance in tissue
  • Fight infection
  • Remove cell debris & waste products from extracellular spaces.
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4
Q

What happens if normal lymphatic transport mechanisms are disrupted?

A

Lymphedema (latent, acute, or chronic).

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5
Q

What are the other organs & tissues in the lymphatic system besides superficial & deep lymph vessels & nodes?

A
  • Thymus
  • Bone marrow
  • Spleen
  • Tonsils
  • Peyer patches of small intestine.
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6
Q

True or False: Both superficial & deep lymph drainage is symmetric.

A

False (deep is asymmetric).

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7
Q

Where do right upper extremity & thoracic lymphotome drain into?

A

Right lymphatic duct.

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8
Q

Where do left upper extremity, left thoracic lymphotome, both lower extremities, external genital areas, & abdominal lymphotomes drain into?

A

Left subclavian.

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9
Q

True or False: 3/4 of total flow drains to the left subclavian vein.

A

True.

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10
Q

What enhances flow in trunks & ducts?

A

Respiratory efforts.

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11
Q

Which lymph vessels rely on interaction of oncotic & hydrostatic pressures, muscle contraction, arterial pulsation, & gentle movement of skin to absorb & transport lymph fluid?

A

Superficial lymph vessels.

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12
Q

Deeper lymph vessels are generally parallel to which system?

A

Venous system.

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13
Q

What are the smallest lymph vessels called?

A

Initial lymphatics or lymphatic capillaries.

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14
Q

What powers initial lymphs?

A

Variations in total tissue pressure caused by movement & muscular contraction.

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15
Q

What external pressures affect initial lymphs?

A

Stretch, gravity, & change in position.

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16
Q

What happens without changes in total tissue pressure?

A

Fluid will accumulate in interstitium, leading to edema.

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17
Q

What is the term for each segment of collecting lymphatic vessels between valves?

A

Lymphangion.

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18
Q

What do lymph valves prevent?

A

Backflow.

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19
Q

What increases the pumping actions of lymph valves?

A
  • Extrinsic muscle contraction
  • Autonomic stimulation
  • Manual lymph drainage.
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20
Q

True or False: Collecting lymphs form a plexus with several connections between them.

A

False (does not form plexus, some connections).

21
Q

Lymph trunks have a gradual increase in what?

A

Diameter size of collecting lymphatics.

22
Q

True or False: Muscle in collecting lymph walls contract arrhythmically.

A

False.

23
Q

What do smooth muscle cells around the endothelial cell layer of the lymph vessel network face?

A

Lumen of vessel.

24
Q

How many times per minute does the lymph vessel network contract at rest on average?

A

5-10 times per minute.

25
Q

What does the pressure inside the vessel reach if many lymphangions contract at once and outflow is obstructed?

A

100 mm Hg or more.

26
Q

What does sustained high intravascular pressure lead to?

A
  • Ineffective smooth muscle contraction
  • Vessel failure.
27
Q

What do lymph vessel network walls dilate to prevent closure to?

A

Valve flaps.

28
Q

What does backflow of lymph distal to the site of obstruction cause?

A

Lymphedema.

29
Q

Deep lymph vessels are embedded in what type of tissue?

A

Fatty tissue.

30
Q

What are the four functions of lymph nodes?

A
  • Filter to clean lymph of waste products & cell debris
  • Adjust fluid concentration
  • Produce lymphocytes & macrophages
  • Destroy foreign bacteria, viruses, & cancer cells.
31
Q

Why are lymph nodes often at the sites of obstruction in lymph dysfunction?

A

Nodes offer 100x normal resistance to flow of lymph within vessels themselves.

32
Q

What is the term for separate territories of lymph?

A

Watersheds.

33
Q

What are the smaller divisions in territories that designate areas specific to certain regional nodes called?

A

Lymphotomes.

34
Q

What are the four trunk quadrants?

A

Left & right:
- Axillary territories
- Inguinal territories.

35
Q

What are some characteristics of suspicious nodes?

A
  • Changes in size (> 2 cm)
  • Immobile
  • Firm or hard
  • Painless & enlarged.
36
Q

What is lymphangitis?

A

Inflammation of lymph vessel.

37
Q

What is lymphadenitis?

A

Inflammation of 1 or more lymph nodes.

38
Q

What is lymphedema?

A

Increased amount of lymph fluid in soft tissues leading to swelling.

39
Q

What is lymphadenopathy?

A

Enlargement of lymph nodes.

40
Q

Lymphedema is accompanied by tissue ____________ secondary to chronic inflammation with prolonged swelling.

A

Fibrosis.

41
Q

What are the stages of lymphedema?

A

0 (latent) - III (lymphostatic elephantiasis).

42
Q

What do the following causes increase the risk for lymphedema?
- Individuals who undergo lumpectomy with ALND or SLND & radiation therapy
- Inguinal lymph node dissection to treat melanoma
- Prostate cancer after pelvic node dissection
- Gyne cancers

A

Lymphedema.

43
Q

Which type of lymphedema are these etiologic factors associated with?

A

Primary lymphedema.

44
Q

What is the most common cause of secondary lymphedema worldwide (not in the US)?

A
  • Filariasis
  • Parasitic worm introduced by mosquito bite in endemic region.
45
Q

What is the most common cause of secondary lymphedema in the US?

A

Invasive procedures used in diagnosis & treatment of cancer.

46
Q

What are some clinical manifestations of lymphedema?

A
  • Full, heavy, tight sensation in affected body part
  • Numbness, burning, aching, pain
  • Decreased flexibility in hand, wrist, or ankle
  • Loss of skin integrity.
47
Q

Which type of lymphadenitis is characterized by enlarged, tender, warm, & reddened lymph nodes?

A

Acute lymphadenitis.

48
Q

Which type of lymphadenitis is characterized by scarred lymph nodes with fibrous connective tissue replacement?

A

Chronic lymphadenitis.

49
Q

What is the term for acute inflammation of subcutaneous lymphatic channels that occurs as a result of strep or staph entering a wound?

A

Cellulitis.

INTERNAL MED FINAL (6 decks)

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