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DEOH102 > Lymphatics > Flashcards

Lymphatics Flashcards

1
Q

Name 5 structures containing lymphoid tissue

A

Spleen
Thymus
Tonsils
Lymph nodes
Bone marrow

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2
Q

4 functions of the lymphatic system

A

immunity - fight infection/pathogens *main
Maintain fluid balance * main
Fat absorption from small intestine for usage/storage
Haematopoeisis -maturation /formation blood cells

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3
Q

What’s Waldyers ring

A

Collection lymphoid tissue around superior pharynx

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4
Q

Name the structures that contribute to Waldyers ring

A

palatine tonsil
Lingual tonsils
Pharyngeal tonsils
Tubal tonsil

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5
Q

Name 5 superficial head LN and where found

A

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

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6
Q

Name 2 deep LN of head

A

Deep parotid LN-
Retropharyngeal LN-

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7
Q

what does deep retropharyngeal Ln drain

A

Pharynx,palate/paranasal sinuses

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8
Q

Name 4 contributors to facial LN and where found

A

Malar (infraorbital area )
Nasolabial (nasolabial line )
Buccal (corner mouth /superficial to buccinator)
Mandibular ( body mandible anterior to masseter)

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9
Q

Can you palpate the superficial and deep head LN

A

Superficial yes - deep no

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10
Q

where do superficial LN of head drain

A

All to deep cervical LN but. .
(Facial to submandibular LN first then to deep)
Occipital go to upper deep cervical LN

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11
Q

Name 4 area drained by submandibular lymph nodes

A

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

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12
Q

Name 3 common causes submandibular gland enlargement

A

Tooth infections
Cancer in area
Sinus infections

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13
Q

Name 3 areas drained by submental lymph nodes

A

(CLAM )
Chin
Lower lip central part
Apex tongue/anterior floor mouth
Mandibular incisors

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14
Q

Name 3 common causes enlargement submental LN

A

Infection viral –cmv
dental incisor infection
Cancer in area

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15
Q

Where does mandibular incisors and tissues around them drain( and flow back to heart )

A

submental LN __> submandibularLN–>superior deep cervical LN–>inferior deep cervical LN __> jugular trunk__> Right lymphatic or thoracic duct–> subclavian vein–>brachycephalic Vein–>SVC>heart

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16
Q

Where does maxillary 3rd molar and tissues around drain

A

Superior deep cervical LN->Inferior deep cervical –>jugular trunk->lymphatic/thoracic duct(L) -> subclavian vn->brachiocephalic Vn->SVC->HEART

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17
Q

All teeth drain into what LN group ( and what are the 2 exclusions)

A

Submandibular except mandibular incisors ( submental LN) and ,3 rd max molar -> superior deep cervical LN

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18
Q

What is the lymphatic drainage tongue

A

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 )

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19
Q

What’s lymphadenitis and how does the LN feel

A

Infection of 1 or more lymph nodes
tender ,mobile and softish

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20
Q

Name the 4 superficial cervical (neck ) LN and where found

A

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 )

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21
Q

Name the 2 deep cervical (neck ) LN groups and where found

A

Superior deep cervical LN
Inferior deep cervical LN
Run along internal jugular vein and divided Ito 2 groups in relation to omohyoid muscle )

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22
Q

Can you palpate the superficial and deep cervical LN

A

Yes both

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23
Q

what tooth drains directly into the upper deep cervical LN

A

Maxillary 3rd molar

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24
Q

Where are the Superior deep Cervical Lymph Nodes found

A

2 inches below the ear -
lateral to the internal jugular vein beneath the anterior border sternocleidomastoid

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25
Q

Where are the Inferior deep Cervical Lymph Nodes found

A

2 inches above the clavicle
lateral to the internal jugular vein beneath the anterior border sternocleidomastoid

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26
Q

What drains into the superior deep Cervical Lymph Nodes

A

Submandibular Lymph noes
Maxillary 3rd tooth and surrounding tissue
Base tongue (posterior 1/3tongue )
Hard-posterior part and soft palate
TMJ

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27
Q

Where is the jugulodigastric Ln found and what does it drain

A

drains tonsils - felt when tonsillitis occurring
posterior triangle upper third 9 deep cervical LN )

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28
Q

What does the jugulo-omohyoid LN drain

A

tongue ( a deep cervical LN half way down neck near IJV)

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29
Q

What are the supraclvicular LN and their significance

A

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 )

30
Q

Where does the submental Lymph node drain into

A

submandibular LN and upper deep cervical LN

31
Q

Where does the submandibular LN drain

A

into superior deep cervical LN

32
Q

What helps lymphatic lymph flow

A

Valves -and movement and respiration
there is no pump

33
Q

How is fluid balance of the body maintained

A

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

34
Q

What are the 2 main functions of the lymphatic system

A

Immunity
Maintaining fluid balance

35
Q

How does the lymphatic system filter organisms

A

2 mechanisms- phagocytosis ( by macrophages)
-mechanical filtration

36
Q

What would happen if the interstitial fluid did not enter the lymphatics

A

swelling ( oedema ) of area- leads eventually to tissue destruction or tissue death

37
Q

name 3 main components of the lymphatic system

A

Lymph fluid
Lymphatic vessels - capillaries/vessels/trunks Lymphoid tissues

38
Q

Describe lymph ( lymphatic fluid )

A

clear watery - like vblood plasma but less protein

39
Q

Does lymph clot

A

No so if leaks needs surgery to repair

40
Q

Describe lymphatic vessels compared to veins

A

similar but lymph vessels thinner walled and more valves with Lymph nodes along the way

41
Q

Where are lymphatic capillaries found

A

Between blood cells and blood capillaries in the intercellular space

42
Q

What’s important about the structure of lymphatic capillaries

A

single cell endothelium that allow large molecules ( like proteins ) to pass

43
Q

Name the 2 main thoracic trunks

A

Thoracic duct
Right lymphatic duct

44
Q

Where is the thoracic duct found

A

Arises abdomen ( main channel) and ends between the Left internal jugular and left subclavian veins

45
Q

What lymphatic drains into the left subclavian vein

A

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)

46
Q

What does the right jugular lymphatic trunk drain

A

Right side head and neck

47
Q

What does the right subclavian lymphatic duct drain

A

Right upper limb

48
Q

What does the left subclavian lymphatic duct drain

A

Left upper limb

49
Q

What does the left jugular lymphatic trunk drain

A

Left side head and neck

50
Q

What are lacteals

A

specialised lymphatic capillaries found in intestinal mucosa-drain chyle ( fatty lymph)

51
Q

What is chyle

A

A milky lymph due to the absorption of fat by lacteals

52
Q

Does lymphatic have a muscular pump

A

No

53
Q

Lymphatic pump is due to what and how much a day

A

steady slow continuous flow 3L/day due to one way valves a and skeletal movement and respiration support flow

54
Q

What is the largest lymphoid tissue called

A

Spleen

55
Q

What’s is function spleen

A

Immunity - ( phagocytosis )
Blood reservoir
Haematopoeisis

56
Q

What are lymph nodes

A

Main lymphoid organ - contains lymphocytes and filters lymph of toxic products so not enter blood stream

57
Q

Where are lymph nodes found

A

Along lymphatic vessels -

58
Q

Sometimes lymph nodes are in clusters - name 3 common places this happens

A

Neck
Groin
Axilla ( armpit )

59
Q

Whats the main function lymph nodes

A

defence- filtrate and phagocytosis foreign bodies
Haematopoeisis

60
Q

What does a normal Lymph node feel like

A

Soft , mobile , non tender, small

61
Q

Tp examine a Lymph node on a patient what steps must you take

A
  1. Explain procedure
  2. Consent
  3. Use a systemic approach - size
    -single vs multi
    - tender vs not
    - inflamed (hot/red)?
    -soft/firm/rubbery
  4. record findings
  5. refer if concerns
62
Q

What does a infected Lymph node feel like

A

Soft, warm, mobile ,tender

63
Q

What does a cancerous Lymph node feel like

A

bony hard, non tender, maybe fixed

64
Q

What’s a lymphoma ( cancer of lymph node feel like)

A

firm , multi, rubbery and large

65
Q

Where are the tonsils found

A

Back mouth in oral cavity and pharynx

66
Q

What is waldeyers ring job

A

First defence against external environment toxins entering the body

67
Q

Where does waldeyers ring drain

A

Into jugulodigastric LN ( superior deep cervical LN )

68
Q

Name the tonsils and their location

A

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 )

69
Q

What is lymphadenopathy

A

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

70
Q

What’s lymphoma and how does the LN feel

A

A cancer of the LN -firm rubbery and multi nodular LN (MUST DOCUMENT AND refer )

71
Q

What do cancer spread LN feel like

A

Bony hard ,non tender fixed to area

72
Q

What’s lymphoedema

A

Swollen limb due to blockage lymph vessel so lymph stays out in tissues

DEOH102 (25 decks)

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