Lymphatics

Question 1

What’s the function of the lymph vessels?

Answer 1

Tissue drainage
Return of plasma and plasma proteins
Transport of absorbed fat from the gut
Immunity

Question 2

Describe how the lymphatic system, regarding the vessels in particular, provide a mechanism for immune response.

Answer 2

Most pathogens, apart from viruses, live in the extravascular space. Therefore when there is an infection there will be an accumulation of proteins (antigens) in the extracellular fluid, increasing the osmotic flow of fluid from the extravascular space into the lymph capillaries. This provides a way for the antigens to be transported to a part in the body i.e. nodes, where it will produce an immune response.

Question 3

what does the flow of the lymph fluid rely on?

Answer 3

Gravity, muscle contraction and pressure changes (osmotic)

Question 4

what makes the flow of lymph unidirectional?

Answer 4

The presence of valves

Question 5

where are the groups of lymph nodes located?

Answer 5

The bases of major anterior trunk

Question 6

How much of the daily lymph produced is reabsorbed in lymph nodes?

Answer 6

Half (4 litres)

Question 7

where in the lymph nodes does the lymphocytes mature and carry out their activity?

Answer 7

The cortex

Question 8

what is the mesenteries and what is it made of?

Answer 8

It is a layer made of peritoneum which surrounds the gut tubes

Question 9

Deep lymphatic drainage follows which route?

Answer 9

Deep lymphatic drainage follows routes of arterial supply.

Question 10

where do the 2 large lymph nodes empty at?

Answer 10

They empty into the venous system at the Jugular/subclavican junction

Question 11

What duct drains 3/4 of the lymph?

What duct drains 1/4 of the lymph?

Answer 11

Left thoracic duct drains 3/4

Right lymphatic duct drains 1/4

Question 12

what is the largest lymphatic organ?

Answer 12

The spleen

Question 13

where is there no lymphatic drainage from?

Answer 13

Epithelium, bone and cartilage, the brain, spinal cord and inner ear.

Question 14

name the major groups of lymph nodes at each location:

1) in axilla
2) in inguinal region
3) around the pectorals major muscle
4) at purification of trachea
5) around root of arteries in abdomen and pelvis
6) superficial and deep groups of neck

Answer 14

1) axillary
2) superficial and deep inguinal
3) pectoral
4) tracheobronchial
5) lumbar and pelvic
6) superficial and deep cervical

Question 15

where are the 6 locations of the major groups of lymph nodes?

Answer 15

axillary, inguinal region, around pectoralis major muscle, at bifurcation of trachea, around root of arteries in abdomen and pelvis, superficial and deep groups in neck.

Question 16

From the groups of lymph nodes, afferent/efferent lymph vessels arise which lead to the ……. or …….. lymphatic duct which in turn carry the lymphatic fluid back to the anterior/venous circulation.

Answer 16

efferent lymph vessels
thoracic or right lymphatic duct
venous circulation

Question 17

where does the right and thoracic lymphatic ducts carry the lymph fluid back to?

Answer 17

the venous system

Question 18

where is the thoracic duct located?

Answer 18

between the azygos vein and the aorta in the right side the posterior thoracic wall below vertebra T4.

Question 19

the thoracic duct starts at what vertebral level?

Answer 19

L1

Question 20

the thoracic duct starts at L1 as what?

Answer 20

Cisterna chyli

Question 21

the thoracic duct drains into what?

Answer 21

the medial end of the subclavican vein

Question 22

at which bone does the spinal cord begin?

Answer 22

the occipital bone

Question 23

what does the spinal cord form at its distal end where it terminates?

Answer 23

conus medullaris

Question 24

the spinal cord terminates in a fibrous extension known as what?

Answer 24

the filum terminale

Question 25

the spinal cord shows enlargement at the distal and proximal ends.
this results from enlargement of what?
and why is it necessary for?

Answer 25

enlargement of the grey matter which is necessary to supply the brachial plexus to arms and the lumbosacral plexus to lower limbs.

Question 26

what is the structure called that supply the lumbar and sacral nerves?

Answer 26

cauda equina

Question 27

how does the spinal cord attach to the coccyx?

Answer 27

the pia extends and forms a fibrous extension called the fillum terminale which attaches to the coccyx.

Question 28

what is the innermost meningie layer?

Answer 28

pia matter

Question 29

what is between the archanoid and pia matter?

Answer 29

the subarachnoid space which is filled with cerebrospinal fluid.

Question 30

the dural and arachnoid matter extend to which vertebrae and what do they form?

Answer 30

they extend to S3 and form the dural sac

Question 31

what is the intervertebral canal the site of?

Answer 31

it is the site where the nerves come out of the vertebral canal.

Question 32

where is the lateral horn present?

Answer 32

between T1-L2/3 and S2-S4

Question 33

the dorsal horn contains the …. of the somatic sensory neurones.

Answer 33

axons

Question 34

where are the cell bodies of the somatic sensory neurones present if they are not in the dorsal horn?

Answer 34

they are present in the dorsal root ganglia.

Question 35

where do the sympathetic fibres originate from?

Answer 35

the originate in the lateral horn cells between spinal levels T1-L2.

Question 36

to which vertebral level does the dura mater descend?

Answer 36

S3

Question 37

where is the subdural space found?

Answer 37

between the dura and the arachnoid matter

Question 38

where is the epidural space found?

Answer 38

between the dura matter and the periosteum covering the vertebral bodies.

Question 39

where is the vertebral venous plexus found?

Answer 39

the plexus is found in the fatty tissue between the dura matter and the vertebrae (the epidural space)

Question 40

how does the vertebral venous plexus provide a possible route of communication for the metastasis of cancer?

Answer 40

the veins in the vertebral venous plexus have no valves, and because of the communication between the vertebral bodies and the CNS, it provides a possible route of communication for metastasis of cancer cells.

Question 41

the somatic fibres in the spinal nerves supply involuntary/voluntary muscles and skeletal structures.

Answer 41

somatic fibres provide voluntary movement.

Question 42

does spinal nerve contain sensory, motor or autonomic signals?

Answer 42

spinal nerves carry sensory, motor and autonomic signals.

Question 43

where do sympathetic nerve fibres exit the spinal cord? and at what vertebrae can these segments be found?

Answer 43

from the lateral horn cells.

found between T1 and L2

Question 44

What are the 6 groups of lymph nodes?

Answer 44

Superficial and deep cervical 
Axillary 
Tracheobrachial 
Pectral 
Lumbar and pelvic
Superficial and deep inguinal