Lymphatics Flashcards

1
Q

Name 3 functions of the lymphatic system

A

1) Drain excess interstitial fluid
2) Transport dietary lipids from GI tract to blood
3) Protects against invasion through immune responses

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2
Q

How many litres of interstitial fluid circulates?

A

3

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3
Q

Where is most extracellular fluid reabsorbed

A

Capillaries

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4
Q

What are lymphatic vessels

A

Larger capillaries that drain into ducts in venous system

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5
Q

What is the function of lymph nodes

A

Filter the lymph along the way

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6
Q

Define lymphati filariasis

A

Failure of lymph to drain back into the venous system so vessels swell up

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7
Q

Main worldwide cause of lymphatic filariasis

A

Roundworm which is transmitted by a mosquito

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8
Q

Is pressure high or low in lymphatic system

A

Low

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9
Q

How is flow in the lymphatic system aided? (5)

A
  • Milking action of skeletal muscle
  • Valves to prevent backflow
  • Pressure changes in thorax
  • Lymph vessels close to arteries and arteries are pulsatile
  • Smooth muscle in walls of trunks and ducts contracts
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10
Q

What lymphatic trunks drain the legs?

A

Right and left lumbar

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11
Q

What does the intestinal duct drain?

A

Intestines and liver into thoracic duct

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12
Q

Name the 9 lymphatic trunks

A
Intestine
Right and left lumbar
Right and left subclavian
Right and left jugular
Right and left bronchomediastinal
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13
Q

Where does the right lymphatic duct drain?

A

Junction of IVJ and subclavian vein (same as the left)

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14
Q

What does the right lymphatic duct drain

A

Right upper quadrant

RIde side of head,neck, thorax and right arm

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15
Q

What does the thoracic duct drain

A

Left side and rest of body

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16
Q

Where does the thoracic duct begin and end?

A

Begins at cisterna chyle in abdomen

Ends at left venous angle

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17
Q

How do lymph nodes filter lymph

A

Macrophages remove and destroy microorganisms and debris

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18
Q

How do lymph nodes activate the immune system

A

Lymphocytes strategically located to monitor for presence of antigens

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19
Q

How many lymph nodes are there in the body

A

600

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20
Q

What do superficial components drain

A

The skin

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21
Q

Where do cervical nodes drain

A

Above the clavicle

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22
Q

Where do axillary nodes drain

A

Between clavicle and umbilicus

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23
Q

Where do inguinal nodes drain

A

Below umbilicus

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24
Q

Where do vessels enter the superficial lymph nodes to drain the head and neck

A

Along the course of the external jugular vein (over sternocleidomastoid)

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25
Q

Where do you find the deep cervical nodes

A

Vertical chain along internal jugular vein

26
Q

What do the efferent vessels of the deep cervical nodes form

A

Right jugular trunk

27
Q

Which lymph nodes are palpabale

A

Superficial lymph nodes

28
Q

Which of the axillary nodes are palpable

A

Central node

29
Q

Where do humeral nodes come from

A

Arm

30
Q

Which of the axillary nodes are most anterior

A

Pectoral

31
Q

Where are subscapular nodes found

A

Under the scapula

32
Q

What are sentinel lymph nodes

A

First nodes that tumour arrives at

33
Q

In which 2 directions do the 2 groups of inguinal lymph nodes run

A

Horixonal- superficial to the inguinal ligament

Vertical- lie along termination of great saphenous vein

34
Q

What vessels make up horizontal lymph nodes

A

Superficial lymphatics from anterior abdominal wall, perineum, and external genitalia exlucing testes

35
Q

What vessels make up vertical lymph nodes

A

Majority of superficial lymphatic from legs

36
Q

Where do efferents from superficial lymph nodes drain to

A

Deep inguinal nodes

37
Q

Name the nodes responsible for deep drainage of the thorax

A
Interpulomonary nodes
Superior trachebronchila nodes
Inferior tracheobronchial nodes
Interlobar lymph vessels
Sub pleural plexus
Paratrachael 
Bronchomediastinal trunks
38
Q

Where do the lymphatics of the post abdominal wall lie?

A

Aorta, inferior vena cava, iliac vessels

39
Q

Where do external and iliac ndoes drain to

A

Lumbar lymph nodes

40
Q

What forms the lumbar trunk

A

Efferents from lumbar lymph nodes

41
Q

Where do intestinal and right and left lumbar trunk drain to

A

Cisterna Chyle

42
Q

What vessels come from the abdomen

A

Pre aortic lymph nodes

Intestinal lymph trunk

43
Q

What is Trosiers’ sign?

A

Hardened lump in supraclavicular nodes- abdominal cancers may metastasise to left supraclavicular lymph nodes

44
Q

How can lymph nodes differentiate between cancer and infection

A
Cancer= hard lymph ndoes
Infection= tender lymph nodes
45
Q

Is lymph node distribution the same or different in children and adults

A

Same

46
Q

How does lymphoid tissue size change during childhood

A

Increases to twice adult mass between 6-9 years

Regresses to adult levels by puberty

47
Q

Are tonsils larger and smaller in childhood?

A

Larger

48
Q

How does lymph system change in older adults?

A

Number and size decreases with age
Some elements are lost (thyroid)
More fibrotic and fatty

49
Q

Name all of the lymph nodes accessible to examination in head and neck (11)

A
Preauricular
Postauricular
Occipital
Tonsillar
Submandibular
Submental
Superiro anterior cervical
Deep cervical
Posterior cervical
Supraclavicular
Infraclavicular
50
Q

Name all of the lymph nodes accesible to examination in the arm

A
Axillary nodes (anterior axillary/pectoral, lateral/ brachial, mid axillary/ central, posterior/ subscapular)
Epitrochlear
51
Q

Name all of the lymph nodes accessible to examination in the legs

A

Superficial superior inguinal
Superficial inferior inguinal
Popliteal (sometimes)

52
Q

Do lymphoid organs filter lymph

A

No- just the lymph nodes do this

53
Q

Do organs typically have afferent lymphatics, efferent lymphatic or both

A

Efferents

54
Q

Functions of the spleen (5)

A
Site for lymphocyte proliferation
Immune surveillance
Cleanses blood
Stores and releases breakdown products of RBC
Erythrocyte production in foetus
Stores platelets
55
Q

How does the spleen drain the blood?

A

Extracts aged and defective blood cells and platelets

Macrophages remove debris and foreign matter

56
Q

What does thymus secrete

A

Thymopoietin and thymosins

57
Q

Descibe anatomical positioning of thymus

A

Inferior neck and superior thorax

Deep to the sternum

58
Q

Name the 4 tonsils

A

Palatine
Lingual
Pharyngeal
Tubal

59
Q

What are pharyngeal tonsils called if they’re enlarged

A

Adenoids

60
Q

Functions of tonsils

A

Gather and remove some pathogens entering pharynx in food or inhaled air

61
Q

Define payers patches

A

Large isolated clusters of lymphoid tissue located in wall of distal small intestine

62
Q

Functions of peyers patches

A
  • Destroy bacteria and prevent pathogens breaching intestinal wall
  • Generate memory lymphocytes for long term immunity