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IMED2002 UWA > Lymphatics and the Spleen > Flashcards

Lymphatics and the Spleen Flashcards

1
Q

What tissues make up the reticuloendothelial system?

A

Monocyte/Macrophage system = Mononuclear phagocytic system

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2
Q

What is the purpose of the reticuloendothelial system?

A

It is a network of phagocytic cells that forms part of the immune system (humoural and cell mediated immunity)

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3
Q

What is the purpose of the lymphatic system?

A

Immune functions (lymphoid cell actions)

Lymphatic fluid (involved in circulation)

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4
Q

What determines what macrophages are called?

A

Their location

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5
Q

What are macrophages located in tissue called?

A

Histiocytes

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6
Q

What are macrophages in the CNS called?

A

Microglia

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7
Q

What are sinus histiocytes?

A

Lymph node macrophages

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8
Q

Where are lymph nodes located?

A

They are typically clustered in regions around joints

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9
Q

Basic principles of lymphatic system:

A

Lymph nodes cluster in regions

Lymph fluid is resorbed interstitial fluid and white blood cells

Lymphatics are similar to capillaries in structure

Lymphatics generally follow veins and fluid is returned to CVS through veins in a generally predictable pathway (Right lymphatic duct draining into right sublavian vein and thoracic duct into left subclavian vein)

Lymph nodes:
Filter lymph
Receive antigen from circulating cells
Stimulate B cells to produce antibodies

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10
Q

What blood vessels do lymphatics typically follow?

A

Veins

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11
Q

What blood vessels are lymph vessels structurally similar to?

A

Capillaries

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12
Q

What is the name of the lymph vessel that drains lymph from the abdomen?

A

Cysterna Chyli

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13
Q

Where are efferent vessels of lymph nodes located?

A

At the hilum

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14
Q

Where are afferent vessels of lymph nodes located?

A

They enter at various points of the capsule

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15
Q

What are the structures of the lymph node cortex?

A

in the cortex:

Follicles (B cells and Dendritic cells located here)

Mantle and Marginal zones

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16
Q

What are the types of follicles in a lymph node?

A

Primary (Quiescent)

Secondary (Active, have germinal centers)

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17
Q

What are the structures of the lymph node medulla?

A

Cords (plasma cells and mature B cells accumulate here where they are matured and able to be released via efferent vessels)

Sinuses

18
Q

Where in the lymph nodes are T cells located?

A

In the paracortex

19
Q

Where are mantle and marginal zones located?

A

Around follicles within cortex.

20
Q

What are the types of diseases of lymph nodes? Which ones are most important?

A

MIDNIGHT

Metabolic

*Inflammatory

Degenerative

  • Neoplastic
  • Infectious

Genetic/congenital

Haemodynamic

Trauma

21
Q

What is lymphadenopathy?

A

Multiplication of cells within the node (lymphatic malignancy)

Draining of an increased number of cells

Infiltration of cells from outside the node such as malignant cells

22
Q

What is reactive lymphadenitis?

A

Inflammation of the lymph nodes

23
Q

What are the changes seen in acute lymphadenitis?

A

Short time-course and tender nodes

Follicular hyperplasia (B cells) [bacterial infection and some autoimmune disorders]

Paracortical hyperplasia (T cells) [viral infections including glandular fever or shingles]

Sinus histiocytosis [nodes draining chronic infections, abscesses, or cancers]

24
Q

What are the features of a chronic lymphadenitis?

A

Longer time-course; non-tender

Often non-specific

Can reflect a condition that is chronic (chronic infection for example)

Can also occur idiopathically or in immune mediated disorders

25
Q

What are the types of neoplastic disorders that can affect the lymph nodes?

A

Primary (haematolymphoid)

Secondary (Metastases)

26
Q

What are lymph nodes used for with cancer patients?

A

They provide diagnostic and prognostic information (they are useful for staging via the TNM method)

27
Q

Where is the spleen located?

A

Left upper quadrant and size of fist just under ribcage.

28
Q

What is the shape and size of the spleen?

A

Fist sized and shaped (12cm long and 150 - 200 grams)

29
Q

What surrounds the spleen?

A

Flexible, fibroelastic capsule

30
Q

What are the relations of the spleen?

A

Anteriorly (posterior wall of the stomach)

Posteriorly: Left part of the diaphragm

Inferiorly: Splenic flexure of left colon

Medially: Left kidney

Hilum is usually in contact with tail of the pancreas

31
Q

How is spleen connected to the stomach and the kidney?

A

Connected to greater curve of the stomach by the gastrosplenic ligament and to the left kidney by the splenorenal ligament

32
Q

Where does the spleen get its blood supply and how is that important in clinical practice?

A

The splenic artery goes over the tail of the pancreas to supply the spleen and so removal of the pancreas often means the spleen must also be removed.

33
Q

What are the 4 major functions of the spleen?

A

Filtering the blood (removing damaged RBCs and bacterial particles via red pulp macrophages)

Antibody production (in the white pulp there is presentation of antigens to T lymphocytes)

Haematopoiesis (Compensatory in settings where increased haematopoiesis is needed and important for foetal haematopoiesis)

Sequestration of blood (in cases of splenomegaly can store a huge amount of blood and platelets to release them when the time is right)

34
Q

What are the 2 functionally and histologically distinct parts of the spleen?

A

White pulp: Lymphoid aggregates and macrophages

Red pulp: Sinusoids and cords of Billroth.

35
Q

What makes up the red pulp?

A

Sinuses which build up to a major sinus and cords of Billroth.

36
Q

What makes up the white pulp?

A

Lymphoid aggregates and macrophages

37
Q

What are the types of diseases the spleen can encounter?

A

Congenital (accessory spleen [common] or hypoplasia/aplasia [uncommon])

Acquired (splenomegaly, trauma, infarct, neoplasms)

38
Q

What are the causes of splenomegaly?

A

Passive enlargement

Secondary to infection or inflammation

Hypersplenism [overactive spleen leading to cytopaenias of RBCs and platelets]

Growth disorders and tumours [neoplasms, amyloidosis, sarcoidosis]

Malaria most common cause

Sickle cell disease

39
Q

What kind of neoplasms affect the spleen?

A

Leukemia

Myeloma

Lymphoma

Also haemangioma/angiosarcoma

40
Q

What are accessory spleens and where are they typically located?

A

Functional extra spleens located within mesentery. If a patient has hypersplenism then this accessory spleen must also be removed.

41
Q

What happens as a result of hypersplenism?

A

Overactive spleen

Peripheral cytopaenia

Primary (idiopathic)

Secondary to infection, alcohol, portal hypertension, systemic inflammatory disorders

IMED2002 UWA (29 decks)

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