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ANAT3004 > Lymphatic System > Flashcards

Lymphatic System Flashcards

1
Q

What are the main functions of lymph vessels? (2)

A
  1. Collection of tissue fluid and its return to the systemic circulation.
  2. Transport of lymphocytes and other cells.
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2
Q

What is tissue fluid comprised of? (3)

A
  1. Water
  2. Proteins
  3. Lipids
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3
Q

Where do the lipids extruded from blood capillaries go?

A

Into connective tissue matrix.

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4
Q

Approximately what percentage of tissue fluid is returned to the main systemic circulation via lymph vessels? What percentage is removed via blood capillaries and perspiration?

A

20%

80%

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5
Q

Under what conditions does lymphoedema result?

A

When fluid/protein return is compromised.

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6
Q

What is lymphoedema associated with? (2)

A
  1. Long-term inflammation

2. Connective tissue and immune changes

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7
Q

What is believed to be the primary cause of lymphoedema?

A

Protein retention in connective tissue, especially high molecular weight proteins, which are not readily absorbed by blood capillaries.

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8
Q

What part of the body is lymphoedema usually associated with?

A

Limbs, but can occur in any part of the body including head and neck if the lymph drainage is interrupted.

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9
Q

What are the most common causes of lymph drainage interruption?

A

Surgical interventions to remove lymph node metastases, blockage or interruption of vessels by tumour, injury or parasites.

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10
Q

Where is the majority of lymph returned to? (2)

A

Venous system in two places:

At junction of SUBCLAVIAN and INTERNAL JUGULAR VEINS.

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11
Q

Where are there additional connections into the venous system?

A
  1. IVC
  2. Renal
  3. Suprarenal
  4. Azygous
  5. Iliac veins
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12
Q

What type of tubes are lymph capillaries? Where are they located?

A

Blindly ending tubes

In connective tissue

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13
Q

Where do lymph capillaries start as and what do they come to form?

A

Initially a plexus then anastomose to form larger vessels.

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14
Q

Blood capillaries are more permeable than lymph capillaries. True or False.

A

False.

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15
Q

Lymph vessels can be very large. True or False.

A

False.

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16
Q

What is the largest lymph vessel?

A

Thoracic duct. Diameter: 2-5mm

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17
Q

All lymph vessels are very thin walled. True or False.

A

True

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18
Q

Lymph vessels do NOT form many anastomoses. True or False.

A

False.

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19
Q

How is lymph fluid transported?

A

Similar to veins:

  1. Gravity
  2. Muscle in walls (only in larger lymph vessels)
  3. External pressure
    a) movement of adjacent viscera and muscles
    b) suction
  4. Numerous valves - pockets of vessel lining - usually in pairs
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20
Q

What do lymph vessels usually follow? What characteristic?

A

Larger blood vessels as a plexus.

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21
Q

Lymph vessels are always associated with lymph nodes. True or False.

A

False.

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22
Q

Where are lymph vessels not found? (3)

A
  1. CNS
  2. Bone marrow
  3. Avascular tissue (e.g. cornea, epidermis, cartilage)f
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23
Q

What are the functions of lymph nodes? (2)

A
  1. Immunoserveillance of lymph

2. Production of lymphocytes and other immune cells

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24
Q

How big are lymph organs?

A

1 - 25 mm long. Many are tiny.

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25
Q

What is a lymph node enlargement called? What is it a result of?

A

Lymphadenopathy

The result of infection or a tumour.

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26
Q

Lymph nodes are always associated with lymph vessels. True or False.

A

True.

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27
Q

Most lymph vessels pass through at least one node on its way back to the circulation. True or False.

A

True.

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28
Q

How many lymph nodes do we have?

A

Approximately 300-400.

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29
Q

Where are most of the lymph nodes located?

A
  1. Neck
  2. Thorax
  3. Abdomen
  4. Pelvis
  5. Groin
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30
Q

There are relatively few lymph nodes in limbs and none on the thoracic duct. True or False.

A

True.

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31
Q

What are some lymph organs?

A
  1. Spleen
  2. Thymus
  3. Tonsils
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32
Q

What is the thoracic duct formed by on the left side and lower body? Where?

A

The confluence of 5 major tributaries in the posterior abdomen:

  1. 2 lumbar lymph trunks
  2. 1 gastrointestinal lymph trunk
  3. 2 descending intercostal (thoracic) lymph trunks
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33
Q

What do the lumbar lymph trunks drain?

A
  1. Lower abdominal and pelvic walls
  2. Lower limbs
  3. Pelvic viscera
  4. Parts of the large intestine, kidneys and suprarenals.
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34
Q

What does the gastrointestinal lymph trunk drain?

A
  1. Liver
  2. Spleen
  3. Pancrease
  4. Stomach
  5. Small intesting and much more of large intestine
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35
Q

What does the descending intercostal lymph trunk drain?

A

Lower thoracic regions on both sides

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36
Q

Where does the descending thoracic lymph trunk pass?

A

Through the diaphragm to the start of the thoracic duct.

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37
Q

Where does the thoracic duct receive lymph from?

A

A large range of lymph vessels in the thorax.

38
Q

What are the main tributaries for the thoracic duct? (3)

A
  1. Left subclavian lymph trunk
  2. Left jugular lymph trunk
  3. Left bronchomediastinal lympg trunk
39
Q

Where does the left subclavian lymph trunk come from?

A

L upper limb

40
Q

Where does the left jugular lymph trunk come from?

A

L head and neck

41
Q

Where does the left bronchomediastinal lympg trunk come from?

A

Upper left throax

42
Q

Where is the termination of the left subclavian, jugular and bronchomediastinal trunks?

A

Left jugulosubclavian junction

43
Q

What is the thoracic duct formed by on the right side of the body? Where do each of these come from?

A
  1. R jugular (R head and neck)
  2. R subclavian (R arm)
  3. R bronchomediastinal (upper R thorax)
44
Q

What do 20% of individuals have?

A

Right lymphatic duct formed by the right jugular, subclavian and bronchomediastinal trunks.

45
Q

Where does the right lymphatic duct drain?

A

Into the right jugulosubclavian junction

46
Q

What type of valves exist in lympg vessels?

A

Bicuspid valve

47
Q

Where do we find the lymph valves?

A

At the junction of the venous system

48
Q

What is the purpose of these valves?

A

Prevent or reduce regurgitation of blood in life

49
Q

When are the valves non-functional? Where does it occur?

A

After death.

Terminal portion of the thoracic duct

50
Q

The subclavian and bronchomediastinal trunks have valves at their termination, whereas, the jugular trunks do not. True or False.

51
Q

In the head and neck where does lymph from superficial tissues drain into? What is an alternative? Provide an example.

A

Superficial groups of nodes and then into deep nodes.

Alternatively, some drainage may be into deep nodes directly. (e.g. some of the drainage of the tongue)

52
Q

Where do the deep chain of vessels and nodes eventually drain into?

A

Jugular lymph trunk

53
Q

What are the superficial nodes of the head? (4)

A
  1. Occipital
  2. Retroauricular
  3. Parotid
  4. Buccal
54
Q

What are the skin and superficial tissues drained by roughly? Provide an example.

A

Vertically disposed vessels to the nodes inferior to the tissues in questions. e.g. temporal region and lateral forehead drain into parotid nodes.

55
Q

How many deep nodes are there in the head?

A

Relatively few

56
Q

What do the deep nodes in the head include?

A
  1. Lingual nodes

2. Retropharyngeal nodes

57
Q

What are the lingual nodes associated with?

A

Root of the tongue

58
Q

Where is the retropharyngeal node?

A

Between upper pharynx and longus capitus (a prevertebral muscle)

59
Q

Where do the deep nodes of the head ultimately drain into?

A

Deep cervical nodes

60
Q

What are the superficial nodes of the neck?

A
  1. Superficial cervical (Over lateral surface of SCM)
  2. Submandibular (Between mandible and submandibular salivary gland)
  3. Submental (Overlie mylohyoid muscle)
  4. Anterior cervical (Over thyroid, larynx, trachea)
61
Q

What may the deep nodes of the neck overlie?

A
  1. Carotid sheath

2. Internal jugular

62
Q

How can the deep nodes be divided?

A

Superior and Inferior by a line marked by omohyoid muscles

63
Q

What doe the superior/upper deep cervical nodes included? Where are they located?

A
  1. Jugulodigastric
  2. Retropharyngeal
    Posterior to the pharynx.
64
Q

What does the inferior/lower deep cervical nodes include?

A

Jugulo-omohyoid

65
Q

Where is the jugulodigastric node located? (2)

A
  1. In the triangular region bounded by the posterior belly of digastric, facial vein and internal jugular.
  2. 1 - 2 cm below the angle of the mandible and are easily palpable especially when inflammed
66
Q

What does the jugulodigastric node comprise of?

A

One large and several small nodes.

67
Q

What does the jugulo-omohyoid node overlie?

A

Intermediate tendon of omohyoid

68
Q

What are both the jugulodigastric and jugulo-omo hyoid concerned with?

A

Lymph drainage of the tongue and tonsils (possibly from both ipsilateral and contralateral)

69
Q

There is an absence of deep lympg nodes between the pharynx and vertebral column and around tracher and larynx.

70
Q

Where do all lymph from head and neck eventually drain into?

A

Jugular Lymphatic trunks

71
Q

In the oral cavity, where does much of the lymph from the floor of mouth and mandibular teeth and gingiva drain into? (2)

A

Submandibular and submental nodes and then into the deep cervical nodes.

72
Q

Where does the hard and soft palate and maxillary teeth and gingiva drain? (2)

A
  1. Retropharyngeal nodes

2. There is also some direct deep drainage.

73
Q

What does the tongue contain and where does it drain?

A
  1. Contains a plexus of lymph vessels
  2. with a wide distribution of drainage to submental, submandibular or to both upper and lower deep nodes via a variety of routes.
74
Q

What is Virchow’s node? Where is it located?

A

Supraclavicular/anterior scalene nodes.
It is the lowest of the deep cervical group of nodes, located in the supraclavicular fossa just lateral to clavicular head of SCM.

75
Q

What does the Virchow’s node consist of?

A

Consist of the group of nodes closest to the jugular trunk.

76
Q

Which node is particularly prone to metastasis from malignancies in many other parts of the body?

A

The left supraclavicular/anterior scalene nodes

77
Q

Where does the jugular trunk drain into?

A

The thoracic duct that in turn receives lymph from most of the body.

78
Q

What is retrograde backflow at the venous termination of the thoracic duct prevent by?

79
Q

Where do the subclavian and bronchomediastinal trunk also have valves at?

A

Junction with the thoracic duct

80
Q

What appears to lack valves?

A

Jugular trunk

81
Q

Where are possible sites of metastases in these nodes?

A
  1. Lungs
  2. Bronchi
  3. Breast
  4. Upper limb
  5. Stomach
  6. Intestines
  7. Prostate
  8. Testis
82
Q

What are the tonsils? (3)

A
  1. 1 pharyngeal
  2. 1 lingual
  3. 2 palatine
83
Q

Where is the pharyngeal tonsils located?

A

Beneath nasopharangeal mucosa in posterior of nasopharynx.

In children it is prominent around the opening of the auditory tube.

84
Q

What are the enlarged pharyngeal tonsils called?

A

adenoids - mouth breathing

85
Q

What are the lingual nodes?

A

A collection of lymph nodule in posterior or pharangeal

86
Q

Where are the palatine tonsils?

A
  1. On lateral side of the oropharynx just behind the oral cavity
  2. Located in the tonsilar fossae between the palatoglossal and palatopharangeal folds.
87
Q

What are the tonsils? (3)

A
  1. 1 pharyngeal
  2. 1 lingual
  3. 2 palatine
88
Q

Where is the pharyngeal tonsils located?

A

Beneath nasopharangeal mucosa in posterior of nasopharynx.

In children it is prominent around the opening of the auditory tube.

89
Q

What are the enlarged pharyngeal tonsils called?

A

adenoids - mouth breathing

90
Q

What are the lingual nodes?

A

A collection of lymph nodule in posterior or pharangeal

91
Q

Where are the palatine tonsils?

A
  1. On lateral side of the oropharynx just behind the oral cavity
  2. Located in the tonsilar fossae between the palatoglossal and palatopharangeal folds.

ANAT3004 (12 decks)

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