Lymphatics Flashcards
Why do lymphatic collecting vessels have lots of valves? [1]
V. low pressure environment: stops back flow
Describe lymph. circulation from lympathic capillary to the lymphatic duct
Lymphatic capillary –> l. collecting vessels –> lymph nodes –> lymph trunk –> lymphatic duct
Lymph travels into the lymph node via [] lymphatic vessels
Lymph leaves via the [] lymphatic vessel
Lymph travels into the lymph node via tha afferent lymphatic vessels
Lymph leaves via the efferent lymphatic vessel
Which two vessels connect at the venous angle? [2]
IJV joins subclavian vein
What is chylothorax? [1]
Why may it occur? [1]
Chylothorax: leakage of lymph into the pleural cavities
Can cccur due thoracic duct damage
Name 3 main superficial lymph nodes xx
Cervical
Axillary
Inguinal
What are the paths for the deep and superficial cervical lymph nodes?
Superficial cervical lymph nodes run down external jugular vein.
Drain to the deep cervical lymph nodes: run down internal jugual vein
What is the cisterna chyli? [1]
The cisterna chyli is the abdominal origin of the thoracic duct, and it receives the bilateral lumbar lymphatic trunks. It is located in the retrocrural space, to the right side and behind of the abdominal aorta.
Label A-F of the lymph node
A: afferent lymphatic vessels
B: trabeculae
C: capsule
D: cortex
E: medulla
F; efferent lympahtic vessels
Which of the following is where the lymphocytes are located in the lymph node?
A
B
C
D
E
F
Which of the following is where the lymphocytes are located in the lymph node?
A
B
C
D : cortex
E
F
Lymph from which parts of the body drains into the right lymphatic duct and the thoracic duct? [2]
The right lymphatic duct drains lymph from the right upper limb, right side of thorax and right halves of head and neck
The thoracic duct drains lymph into the circulatory system at the left brachiocephalic vein between the left subclavian and left internal jugular veins from the rest of the body
Label A & B xx
A: Thoracic duct
B: Left venous angle
Where is the primary site of cancer for elevated virchows node? [1]
GI cancer
Which lymph vessels run over the SCM? [1]
Vessels enter superficial cervical lymph nodes along the course of the EJV (over SCM). Efferent vessels→ deep chain
Name the superficial cervical nodes [6]
Parotid
Buccal
Submental
Submandibular
Retroauricular
Occipital
Label A-F
A: Parotid
B: Buccal
C: Submental
D: Submandibular
E; Retroauricular
F: Occipital
What is the difference in lymph node feel when malignant compared to when fighting infection? [2]
Infection: firm, tender, enlarged and warm.
Malignancies: Firm, non-tender, matted (i.e. stuck to each other), fixed (i.e. not freely mobile but rather stuck down to underlying tissue), and increase in size over time
Which are more likely to develop cancer:
Anterior cervical nodes
Deep cervical nodes
Which are more likely to develop cancer:
Anterior cervical nodes
Deep cervical nodes
Which are more likely to develop cancer:
Anterior cervical nodes
Deep cervical nodes
Which are more likely to develop cancer:
Anterior cervical nodes
Deep cervical nodes
What is a radical masectomy vs a modified radiacl masetcomy?
A radical mastectomy involves the removal of all breast tissue, along with the nipple, axillary lymph nodes and a portion of pectoralis major. This is rarely performed today.
A modified radical mastectomy involves **removal of the breast, nipple and most axillary lymph nodes. **
What is a radical masectomy vs a modified radiacl masetcomy?
A radical mastectomy involves the removal of all breast tissue, along with the nipple, axillary lymph nodes and a portion of pectoralis major. This is rarely performed today.
A modified radical mastectomy involves **removal of the breast, nipple and most axillary lymph nodes. **
What is a method for identifying which lymph node a tumour drains into?
Sentinel Lymph node identification:
Insert radioactive dye into the tumour: drains w/ the lymph into lymph node – shows first node
Exactly where are the inguinal lymph nodes located? [1]
of the femoral triangle [1]
What are the two groups of inguinal lymph nodes and where are they located? [2]
Where do they recieve drainage from? [2]
- Vertical – lie along termination great saphenous vein: Majority of superficial lymphatics from leg
-
Horizontal – (run superficial to inguinal ligament)
Superficial lymphatics from anterior abdominal wall, the perineum, and the external genitalia (excl. testes)
What are the two groups of inguinal lymph nodes and where are they located? [2]
Where do they recieve drainage from? [2]
- Vertical – lie along termination great saphenous vein: Majority of superficial lymphatics from leg
-
Horizontal – (run superficial to inguinal ligament)
Superficial lymphatics from anterior abdominal wall, the perineum, and the external genitalia (excl. testes)
Efferents from superficial lymph nodes drain to the [] inguinal nodes
Efferents from superficial lymph nodes drain to the deep inguinal nodes
What is the path of the testes lymphatic drainage?
What is the path of the scrotum lymphatic drainage?
What is the path of the ovaries lympahtic drainage?
What is the path of the testes lymphatic drainage?
Testes –> preaortic aorta
What is the path of the scrotum lymphatic drainage?
Scrotum –> superficical inguinal nodes
What is the path of the ovaries lympahtic drainage?
Ovaries –> preaortic aorta
What is the path of the testes lymphatic drainage?
What is the path of the scrotum lymphatic drainage?
What is the path of the ovaries lympahtic drainage?
What is the path of the testes lymphatic drainage?
Testes –> preaortic aorta
What is the path of the scrotum lymphatic drainage?
Scrotum –> superficical inguinal nodes
What is the path of the ovaries lympahtic drainage?
Ovaries –> preaortic aorta
FYI
Deep lymphatics accompany arteries and receive drainage from internal organs.
Lymph from the internal and external iliac nodes drains into the [] nodes and then the [] nodes.
Lymph from the GI tract drains into the [] lymph nodes ([], [] and [] nodes)
Intestinal + right and left lumbar trunks drain to []
Lymph from the internal and external iliac nodes drains into the common iliac nodes and then the lumbar nodes.
Lymph from the GI tract drains into the pre-aortic lymph nodes (celiac, superior mesenteric and inferior mesenteric nodes)
Intestinal + right and left lumbar trunks drain to cisterna chyli (beginning of thoracic duct)
Label A-C
A: Cisterna chyli
B: Pre-aortic
C: Iliac
deep drainage of the thorax xx
The spleen is a site of:
[] proliferation
[] filtration, destruction and storage.
The spleen is a site of:
lymphocyte proliferation
RBC filtration, destruction and storage.
Label A-D
A: Palatine
B: Lingual
C: Pharyngeal
D: Tubal tonsils
What is waldeyers ring? [4]
Waldeyer’s ring consists of four tonsillar structures:
- pharyngeal
- tubal
- palatine
- lingual
As well as small collections of lymphatic tissue disbursed throughout the mucosal lining of the pharynx (mucosa-associated lymphoid tissue, MALT).
Where do you find each of the following tonsils?
Palatine [1]
Lingual [1]
Pharyngeal [1]
Tubal [1]
Palatine: between palatoglossal & palatopharyngeal
Lingual: back of tongue
Pharyngeal adenoids if enlarged: top of nasopharynx
Tubal tonsils: opening of eustachian tube
What is lymphatic filariasis?
Roundworm infection of lymph nodes blocking the lymphatic drainage so interstitial fluid builds up in the tissues.
From the breast:
- 75% drains into [] nodes
- 25% goes to [] nodes
Clinically important because of relationship to breast
75% of lymph drains into axillary node from breast
25% goes to parasternal nodes
What are the axillary lymph nodes? [4]
Where do they drain lymph from? [4]
Ddescribe their path to to L / R venous angle [2]
Humeral lymph nodes drain from upper limb
Pectoral lymph nodes drain from anterior chest wall (majority drains into here)
Subscapular lymph nodes drain from** posterior chest wall** (rotator cuffs etc)
Together: go to central –> apical –> supraclavicular –> left / right venous angle
Describe the path of deep drainage of the thorax lymphatics
Sub pleural plexus –> interlobal lymph vessels –> interpulmnarry lobes –> inferior trachea bronchiol nodes –> superior trachea bronchiole lobes –> bronchomediastinal trunks –> L / R venous angle
Which of the following recieves lymphatric drainage from the heart?
Interpulmonary nodes
Superior tracheobronchial nodes
Inferior tracheobronchial nodes
Bronchomediastinal trunks
Interlobar lymph vessels
Which of the following recieves lymphatric drainage from the heart?
Interpulmonary nodes
Superior tracheobronchial nodes
Inferior tracheobronchial nodes
Bronchomediastinal trunks
Interlobar lymph vessels
Which of the following is located around the hilum of the lung?
Interpulmonary nodes
Superior tracheobronchial nodes
Inferior tracheobronchial nodes
Bronchomediastinal trunks
Interlobar lymph vessels
Which of the following is located around the hilum of the lung?
Interpulmonary nodes
Superior tracheobronchial nodes
Inferior tracheobronchial nodes
Bronchomediastinal trunks
Interlobar lymph vessels
The thoracic duct enters the thorax through the [] and travels in the [] mediastinum between the [] and the [] vein.
The thoracic duct enters the thorax through the aortic hiatus and travels in the posterior mediastinum between the aorta and the azygos vein.
Where do you find each of the following is called the adenoids if enlarged?
Palatine
Lingual
Pharyngeal
Tubal
Where do you find each of the following is called the adenoids if enlarged?
Palatine
Lingual
Pharyngeal
Tubal
