Lymphatics Flashcards by gina de cleene

Name 5 structures containing lymphoid tissue

Spleen
Thymus
Tonsils
Lymph nodes
Bone marrow

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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

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What’s Waldyers ring

Collection lymphoid tissue around superior pharynx

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Name the structures that contribute to Waldyers ring

palatine tonsil
Lingual tonsils
Pharyngeal tonsils
Tubal tonsil

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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

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Name 2 deep LN of head

Deep parotid LN-
Retropharyngeal LN-

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what does deep retropharyngeal Ln drain

Pharynx,palate/paranasal sinuses

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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)

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Can you palpate the superficial and deep head LN

Superficial yes - deep no

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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

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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

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Name 3 common causes submandibular gland enlargement

Tooth infections
Cancer in area
Sinus infections

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Name 3 areas drained by submental lymph nodes

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

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Name 3 common causes enlargement submental LN

Infection viral –cmv
dental incisor infection
Cancer in area

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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

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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

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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

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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 )

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What’s lymphadenitis and how does the LN feel

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

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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 )

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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 )

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Can you palpate the superficial and deep cervical LN

Yes both

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what tooth drains directly into the upper deep cervical LN

Maxillary 3rd molar

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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

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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

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

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

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