Lymphatics Flashcards
Name 5 structures containing lymphoid tissue
Spleen
Thymus
Tonsils
Lymph nodes
Bone marrow
4 functions of the lymphatic system
immunity - fight infection/pathogens *main
Maintain fluid balance * main
Fat absorption from small intestine for usage/storage
Haematopoeisis -maturation /formation blood cells
What’s Waldyers ring
Collection lymphoid tissue around superior pharynx
Name the structures that contribute to Waldyers ring
palatine tonsil
Lingual tonsils
Pharyngeal tonsils
Tubal tonsil
Name 5 superficial head LN and where found
Superficial Parotid - superficial to parotid
Pre auricular LN (anterior to tragus ear )
Post auricular LN (also known as retroauricular )-posterior to ear
Occipital LN -( occipital area scalp)
Facial LN- depends on which part -along facial vein
Name 2 deep LN of head
Deep parotid LN-
Retropharyngeal LN-
what does deep retropharyngeal Ln drain
Pharynx,palate/paranasal sinuses
Name 4 contributors to facial LN and where found
Malar (infraorbital area )
Nasolabial (nasolabial line )
Buccal (corner mouth /superficial to buccinator)
Mandibular ( body mandible anterior to masseter)
Can you palpate the superficial and deep head LN
Superficial yes - deep no
where do superficial LN of head drain
All to deep cervical LN but. .
(Facial to submandibular LN first then to deep)
Occipital go to upper deep cervical LN
Name 4 area drained by submandibular lymph nodes
All teeth and gingiva/periodontum EXCEPT 3rd molar and mandibular incisors
Submandibular/sublingual glands
Anterior body tongue
Anterior hard palate
Posterior floor mouth
Upper lip
Name 3 common causes submandibular gland enlargement
Tooth infections
Cancer in area
Sinus infections
Name 3 areas drained by submental lymph nodes
(CLAM )
Chin
Lower lip central part
Apex tongue/anterior floor mouth
Mandibular incisors
Name 3 common causes enlargement submental LN
Infection viral –cmv
dental incisor infection
Cancer in area
Where does mandibular incisors and tissues around them drain( and flow back to heart )
submental LN __> submandibularLN–>superior deep cervical LN–>inferior deep cervical LN __> jugular trunk__> Right lymphatic or thoracic duct–> subclavian vein–>brachycephalic Vein–>SVC>heart
Where does maxillary 3rd molar and tissues around drain
Superior deep cervical LN->Inferior deep cervical –>jugular trunk->lymphatic/thoracic duct(L) -> subclavian vn->brachiocephalic Vn->SVC->HEART
All teeth drain into what LN group ( and what are the 2 exclusions)
Submandibular except mandibular incisors ( submental LN) and ,3 rd max molar -> superior deep cervical LN
What is the lymphatic drainage tongue
Posterior 1/3–> Deep cervical LN
Middle and anterior thirds ( excluding tip) -submandibular LN
Apex tongue-> submental
( Note : middle section along medial lingual sulcus drain bilaterally into both left and right side LN - sides only to side they are on Ln )
What’s lymphadenitis and how does the LN feel
Infection of 1 or more lymph nodes
tender ,mobile and softish
Name the 4 superficial cervical (neck ) LN and where found
Submental ( below chin submental triangle
Submandibular (submandibular triangle superficial to submandibular gland )
Anterior jugular ( infra hyoid neck area above sternclavicular notch)
External jugular ( along external jugular vein )
Name the 2 deep cervical (neck ) LN groups and where found
Superior deep cervical LN
Inferior deep cervical LN
Run along internal jugular vein and divided Ito 2 groups in relation to omohyoid muscle )
Can you palpate the superficial and deep cervical LN
Yes both
what tooth drains directly into the upper deep cervical LN
Maxillary 3rd molar
Where are the Superior deep Cervical Lymph Nodes found
2 inches below the ear -
lateral to the internal jugular vein beneath the anterior border sternocleidomastoid
Where are the Inferior deep Cervical Lymph Nodes found
2 inches above the clavicle
lateral to the internal jugular vein beneath the anterior border sternocleidomastoid
What drains into the superior deep Cervical Lymph Nodes
Submandibular Lymph noes
Maxillary 3rd tooth and surrounding tissue
Base tongue (posterior 1/3tongue )
Hard-posterior part and soft palate
TMJ
Where is the jugulodigastric Ln found and what does it drain
drains tonsils - felt when tonsillitis occurring
posterior triangle upper third 9 deep cervical LN )
What does the jugulo-omohyoid LN drain
tongue ( a deep cervical LN half way down neck near IJV)
What are the supraclvicular LN and their significance
Above clavicle and spread of cancer from breast /lung/oesophagus will feel here (important as next stop for spread thoracic duct so entering blood stream and rapid spread )
Where does the submental Lymph node drain into
submandibular LN and upper deep cervical LN
Where does the submandibular LN drain
into superior deep cervical LN
What helps lymphatic lymph flow
Valves -and movement and respiration
there is no pump
How is fluid balance of the body maintained
As Blood flows thru capillaries to provide cells nutrients Plasma filters into interstitial spaces
90% reabsorbed back into tissue cells or blood-venous system
!0% is uptaken by lymphatic capillaries entering the lymphatic system
What are the 2 main functions of the lymphatic system
Immunity
Maintaining fluid balance
How does the lymphatic system filter organisms
2 mechanisms- phagocytosis ( by macrophages)
-mechanical filtration
What would happen if the interstitial fluid did not enter the lymphatics
swelling ( oedema ) of area- leads eventually to tissue destruction or tissue death
name 3 main components of the lymphatic system
Lymph fluid
Lymphatic vessels - capillaries/vessels/trunks Lymphoid tissues
Describe lymph ( lymphatic fluid )
clear watery - like vblood plasma but less protein
Does lymph clot
No so if leaks needs surgery to repair
Describe lymphatic vessels compared to veins
similar but lymph vessels thinner walled and more valves with Lymph nodes along the way
Where are lymphatic capillaries found
Between blood cells and blood capillaries in the intercellular space
What’s important about the structure of lymphatic capillaries
single cell endothelium that allow large molecules ( like proteins ) to pass
Name the 2 main thoracic trunks
Thoracic duct
Right lymphatic duct
Where is the thoracic duct found
Arises abdomen ( main channel) and ends between the Left internal jugular and left subclavian veins
What lymphatic drains into the left subclavian vein
Entire body except the right upper limb and right sided head and neck ( enter the right lymphatic duct that drains into the right subclavian vn)
What does the right jugular lymphatic trunk drain
Right side head and neck
What does the right subclavian lymphatic duct drain
Right upper limb
What does the left subclavian lymphatic duct drain
Left upper limb
What does the left jugular lymphatic trunk drain
Left side head and neck
What are lacteals
specialised lymphatic capillaries found in intestinal mucosa-drain chyle ( fatty lymph)
What is chyle
A milky lymph due to the absorption of fat by lacteals
Does lymphatic have a muscular pump
No
Lymphatic pump is due to what and how much a day
steady slow continuous flow 3L/day due to one way valves a and skeletal movement and respiration support flow
What is the largest lymphoid tissue called
Spleen
What’s is function spleen
Immunity - ( phagocytosis )
Blood reservoir
Haematopoeisis
What are lymph nodes
Main lymphoid organ - contains lymphocytes and filters lymph of toxic products so not enter blood stream
Where are lymph nodes found
Along lymphatic vessels -
Sometimes lymph nodes are in clusters - name 3 common places this happens
Neck
Groin
Axilla ( armpit )
Whats the main function lymph nodes
defence- filtrate and phagocytosis foreign bodies
Haematopoeisis
What does a normal Lymph node feel like
Soft , mobile , non tender, small
Tp examine a Lymph node on a patient what steps must you take
- Explain procedure
- Consent
- Use a systemic approach - size
-single vs multi
- tender vs not
- inflamed (hot/red)?
-soft/firm/rubbery - record findings
- refer if concerns
What does a infected Lymph node feel like
Soft, warm, mobile ,tender
What does a cancerous Lymph node feel like
bony hard, non tender, maybe fixed
What’s a lymphoma ( cancer of lymph node feel like)
firm , multi, rubbery and large
Where are the tonsils found
Back mouth in oral cavity and pharynx
What is waldeyers ring job
First defence against external environment toxins entering the body
Where does waldeyers ring drain
Into jugulodigastric LN ( superior deep cervical LN )
Name the tonsils and their location
Adenoid( pharyngeal tonsil)- posterior wall midline nasopharynx
Tubal tonsils - nasopharynx
Palatine tonsils - between anterior and supeior faucial pillars ( oropharynx)
Lingual tonsil - posterior 1/3 tongue -below mucosa
( all make up Welders ring )
What is lymphadenopathy
Enlarged and consistency change of a LN - causes infection/inflammation/cancer
If a localised area nodes usually infection /inflammation if systemic >1 -lymphoma/viral systemic infection
What’s lymphoma and how does the LN feel
A cancer of the LN -firm rubbery and multi nodular LN (MUST DOCUMENT AND refer )
What do cancer spread LN feel like
Bony hard ,non tender fixed to area
What’s lymphoedema
Swollen limb due to blockage lymph vessel so lymph stays out in tissues
