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SBO5 > Lymphatics > Flashcards

Lymphatics Flashcards

1
Q

Primary lymphoid organs? functions?

A

Red bone marrow & Thymus: sites of B & T cell maturation

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2
Q

Secondary lymphoid organs?

A

lymph nodes, spleen, tonsils, appendix, intestinal follicles:
where mature lymphocytes first encounter their antigens (toxins/foreign bodies) and become activated

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3
Q

What structures filter lymph?

A

lymph nodes

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4
Q

gross structure of a lymph node?

A
  • dense fibrous capsule
  • trabeculae (for compartmentalising)
  • stroma of reticular CT
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5
Q

Lymph node functions?

A
  • House lymphocytes and macrophages
  • site of immune system activation
  • Filtering of lymph (micro organisms and debris)
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6
Q

Nodal circulation?

A

Lymph flows into the node through numerous afferent lymph vessels (convex side)

Lymph moves through the subcapsular sinus towards the medulla

Flow occurs through medullary sinuses

Exits via efferent lymph vessels
Located at hilum (indented region on concave side)

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7
Q

Spleen intraperitoneal or retroperitoneal?

A

intraperitoneal - surrounded by visceral peritoneum except for the hilum (entro of splenic aa & vv)

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8
Q

4 x splenic compressions?

A

stomach, kidney, colon, pancreas

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9
Q

2 peritoneal ligaments attaching to the hilum of the spleen?

A

gastrosplenic & splenorenal ligaments

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10
Q

What sits anterior to the spleen?

A

stomach (connected via gastrosplenic ligament

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11
Q

What sits posterior to the spleen?

A

diaphragm

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12
Q

What sits inferior to the spleen?

A

left colic flexure

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13
Q

What sits medial to the spleen?

A

left kidney (connected via the splenorenal ligament)

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14
Q

Red pulp?

A

Where old RBC’s and bloodborne pathogens are destroyed

- lots of RBC’s and macrophages that engulf them

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15
Q

White pulp?

A

site of immune functions:

mainly lymphocytes suspended in reticular fibres

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16
Q

Spleen arterial supply?

A

splenic artery (celiac trunk)

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17
Q

Spleen venous drainage?

A

splenic vein (formed by several branches emerging from the hilum and joined by the IMV before uniting with the SMV to form the portal vein

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18
Q

Spleen nerve supply?

A

SYMP: abdominopelvic splanchnic

PARA:

19
Q

Pathway of lymphatic flow?

A
  • lymphatic capillaries drain interstitial spaces (once fluid enters these it is termed lymph
  • lymphatic collecting vessels (sup vessels drain into deep vessels, which follow arteries)
  • lymphatic trunks (formed by large collecting vessels)
  • lymphatic ducts: (thoracic & Rt lymphatic ducts)
20
Q

Where does the thoracic duct enter the venous system?

A

Junction of the Lt IJV & Lt subclavian vein

21
Q

Where does the Rt lymphatic duct enter the venous system?

A

At the junction of Rt IJV and Lt subclavian veins

22
Q

location of cisterna chyli?

A

inferior end of the thoracic duct, in the retrocrural space to the Rt of the abdominal aorta

23
Q

3 factors influencing the flow of lymph?

A
  • smooth muscle contractions
  • pressure on vessels by skeletal muscle and movement of viscera
  • pressure changes in thorax during respiration
24
Q

different types and functions of lymphocytes?

A

T cells: ~75% - cellular adaptive immunity

B cells: humoral adaptive immunity

Natural killer cells: innate immunity

25
Q

Types and functions of auxillary immune cells?

A

Macrophages: widely distributed in lymphoid organs.

Dendritic cells (mobile antigen-presenting cells)

26
Q

Macrophage functions?

A
  • phagocytosis,
  • enhancement of inflammatory response
  • presentation of of antigens to T cells
27
Q

Dendritic cell functions?

A

mobile antigen-presenting cells, possess cellular extensons (hence dendritic name) that capture antigens and engulf them (phagocytosis). They also migrate to lymph nodes and present antigens to naïve lymphocytes which initiates an adaptive immune response

28
Q

Reticular cells?

A

supporting cells tha are fibroblast-like that produce CT stroma for lymphoid tissue

29
Q

function of lymphoid tissue?

A
  • proliferation site for lymphocytes

- surveillance point for lymphocytes and macrophages

30
Q

Differentiate diffuse lymphoid tissue from lymphoid follicles?

A

Diffuse lymphoid tissue
• Loose arrangement of lymphoid cells & reticular fibres
• Occur in most organs of the body
• e.g. lamina propria of the GIT

Lymphoid follicles
• Solid, spherical bodies consisting of tightly packed lymphoid cells & reticular fibres
• Have germinal centres of proliferating B lymphocytes
• Form part of lymphoid organs

31
Q

differentiate the roles of primary and secondary lymphoid organs

A

Primary: provide sites for T and B cell maturation

Secondary: are where lymphocytes encounter their first antigens and become activated

32
Q

Differentiate the terms lymphadenopathy and lymphadenitis

A

Lymphadenopathy: the palpable enlargement of a lymph node, generally due to infections (75%) the other 25% due to significant underlying diseases such as glandular fever, lymphoma, leukameia, HIV

Lymphadenitis: lymphadenopathy with pain and other signs of inflammation

33
Q

classification of lymphadenopathy:

A

Localised: present in 1 body area
- Usually reflect pathology in region of drainage

Generalised: present in 2 or more non-contiguous nodal groups
- Generally due to significant underlying disease

34
Q

5 causes of splenomegaly

A
  • Infection: glandular fever, TB, syphilis
  • Portal HTN: cirrhosis, cardiac failure
  • Lymphoid disorders: leukameia, lymphoma, multiple myeloma
  • RBC disorders: thalassaemia
  • Inflammatory conditions: rheumatoid arthritis
35
Q

Clinical features associated with splenomegaly

A

swelling/asymmetry of the abdominal contour

dragging sensation in the LUQ

increased feelings of fullness after eating

36
Q

What is glandular fever?

A

an acute infection of B lymphocytes with the EBV (epstein Barr virus)

37
Q

How is Glandular fever transmitted?

A

saliva and human contact

38
Q

Clinical features of glandular fever

A

30-50 day incubation period,

  • fever, sore throat, cervical lymphadenopathy, fatigue
  • long term/progression: generalised lymphadenopathy, splenomegaly, hepatomegaly
39
Q

What is leukaemia?

A

proliferation of malignant leucocytes in the bone marrow, in which overcrowding causes malignant cells to spill into the blood

40
Q

signs of leukamia

A

rapid onset: <3 months:

anaemia, decreased WBC, bleeding tendencies, bone pain

41
Q

what is lymphoma?

A

proliferation of malignant lymphocytes in the lymphatic system and the formation of discrete tumours

42
Q

what is multiple myeloma?

A

proliferation of malignant plasma cells in the bone marrow

43
Q

What name is given to the tumour formed in multiple myeloma?

A

Plasmacytomas: discrete tumours within the bone, which release osteolytic cytokines which destroy the overlying cortical bone

44
Q

What type of cells are targeted by HIV? What implications does this have for the normal functioning of the body?

A

T cells: these are immune cells which are responsible for making 75% of the circulating lymphocytes, which reduces our cellular adaptive immunity.
HIV predisposes life-threatening infections and malignancies as the bodies ability to fight infections ids depleted

SBO5 (11 decks)

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