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SF3- EXAM 2 > Lymphatics Draining of the Thorax > Flashcards

Lymphatics Draining of the Thorax Flashcards

1
Q

What is the function of the lymphatic system?

A
  • Drains interstitial fluid
  • Recycles blood plasma into cardiovascular system
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2
Q

What is the path of lymph flow through a lymph node?

A
  1. Afferent lymphatics carry lymph to the lymph node from peripheral tissues. The afferent lymphatics penetrate the capsule of the lymph node on the side opposite the hilum
  2. The afferent vessels deliver lymph to the subcapsular space, a meshwork of reticular fibers, macrophages, and dendritic cells
  3. Lymph next flows into the outer cortex, which contains B cells within germinal centers that resemble those of lymphoid nodules
  4. Lymph then flows through lymph sinuses in the deep cortex, which is dominated by T cells
  5. Lymph continues into the medullary sinus at the core of the lymph node. This region contains B cells and plasma cells
  6. Efferent lymphatics leave the lymph node at the hilum. These vessels collect lymph from the medullary sinus and carry it toward the venous circulation.
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3
Q

What are the 5 lymphatic trunks and what areas of the body do they drain?

A
  • Lumbar
    • ​Drain lower limbs, kidney, pelvis, abdominal wall
  • Intestinal
    • ​Drain stomach, intestines, spleen, pancreas, liver
  • Bronchomediastinal
    • ​Drain thoracic wall, lungs, heart
  • Subclavian
    • ​Drain upper limbs
  • Jugular
    • ​Drain head and neck
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4
Q

There is asymmetry of lymphatic drainage. What does the right lymphatic duct drain? What about the thoracic duct?

A
  • Right lymphatic duct
    • ​Right upper arm
    • Right side of the head and thorax
  • Thoracic duct
    • ​Lymph from the rest of the body
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5
Q

Right lymphatic duct and thoracic duct drain at the _____________.

A

Angulus venosus

NOTE: The angulus venosus is the junction of the inferior and superior vena cava

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6
Q

At which spinal level do the following structures pass through the diaphragm?

Vena Cava

Esophagus

Aortic hiatus

A

Vena Cava : T8

Esophagus: T10

Aortic hiatus: T12

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7
Q

What are the primary lymphatic organs?

A

Thymus

Bone marrow

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8
Q

Where do T lymphocytes mature?

A

In the thymus

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9
Q

In which mediastinum is the thymus located?

A

Anterior mediastinum

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10
Q

What is the nerve sumply of the thymus?

A

Parasympathetic: CN X

Sympathetic: Sympathetic trunk

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11
Q

Blood supply to the thymus

A

internal thoracic artery

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12
Q

Which nodes drain the thymus?

A

–Parasternal nodes

–Anterior mediastinal nodes

–Tracheobronchial nodes

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13
Q

How do the parasternal, anterior mediastinal and tracheobronchial nodes drain from the thymus?

A

Right side: Node-> Right brochomediastinal trunk-> Right lymphatic duct

Left side: Node-> Left brochomediastinal trunk-> Thoracic duct

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14
Q

Symptoms of thymoma

A

Persistent cough

Chest pain

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15
Q

Thymoma

A

Tumor in the epithelial cells of the thymus gland

*Linked with myastenia gravis and other autoimmune disease

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16
Q

What are the characteristics of superior vena cava syndrome?

A
  • Edema of the face and arms
  • Swolen collateral veins on nech and chest wall
  • Shortness of breath, coughing, difficulty swallowing
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17
Q

Lymph from the axillary lymph nodes drain into the ____________ trunks.

A

Subclavian

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18
Q

Axillary lymph nodes drain lymph vessels from which areas of the body?

A
  • Superficial regions of the thoracic wall
  • Lateral breast
  • Vessels of upper limb
  • Superficial regions of abdomen above navel
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19
Q

______________ lymph nodes receive efferent lymph vessels from all axillary nodes.

A

Apical

20
Q

Where does breast cancer develop?

A

In acini, lactiferous ducts and lobules of breast

21
Q

Which lymph nodes can drain the breast?

A

Axillary

Supraclavicular

Parasternal

Abdominal

22
Q

Lymphatics of the thoracic wall drain mainly into which nodes?

A

Parasternal nodes

Intercostal nodes

Diaphragmatic nodes

23
Q

Parasternal nodes travel along the internal thoracic artery and drain to ____________.

A

Bronchomediastinal trunks

24
Q

The upper thorax drains into __________, while the lower thorax drains into the _____________.

A

Bronchomediastinal trunks; thoracic duct

25
Q

Nodes located on different parts of the diaphragm drain to different structures. Where do the different nodes drain?

A
  • Anterior group
    • ​Drain into parasternal nodes then to the brochomediastal trunk
  • ​Lateral group
    • ​Drain into parasternal nodes and/or posterior intercostal nodes
  • ​Posterior group
    • ​Drain into thoracic duct and cisterna chyli
26
Q

What parts of the body are drained by parasternal lymph nodes?

A

Breast, deep abdominal wall above umbilicus, anterior thoracic wall

REMEMBER: Parasternal lymph nodes run along the internal thoracic artery

27
Q

Where are intercostal nodes found?

A

Posterior wall of the posterior mediastinum

28
Q

Where do intercostal nodes drain into?

A

Upper nodes:

  • Bronchomediastinal trunks, then to either the thoracic duct or the right lymphatic duct

​Lower nodes:

  • Thoracic duct or cisterna chyli
29
Q

What parts of the body are drained by intercostal nodes?

A

Deep lymphatics of posterior and lateral chest

30
Q

Where are anterior mediastinal nodes located?

A

In front of the brachiocephalic veins

31
Q

What parts of the body do anterior mediastinal nodes drain and where do they drain to?

A

Afferents: Thymus, thyroid gland, and anterior part of the pericardium

Efferent:Right or left bronchomediastinal trunk

32
Q

Where are posterior mediastinal nodes located?

A

Posterior to the pericardium

33
Q

Where do afferents of posterior mediastinal nodes come from? Where do the efferents go?

A

Afferents: Esophogus and posterior part of the pericardium

Efferents: Thoracic duct

34
Q

Enlargement of the posterior mediastinal nodes may indent the ___________.

A

Esophagus

35
Q

Chylothorax

A

A type of pleural effusion caused by the rupture of the thoracic duct leading to the leakage of lymph into the posterior mediastinum

36
Q

Pancoast Tumor/Syndrome

A

Tumor of the apex of the lung that affects the root of the neck

37
Q

Where does lymph fluid from the visceral pleura drain?

A

Into the subpleural lymphatic plexus and into the bronchopulmonary nodes at the hilum of the lung

38
Q

What are the lymph nodes of the trachea and lungs and where are they located?

A

Pulmonary group- Inside the lung tissue

Bronchopulmonary group- At the hilum

Tracheobronchial group- Alongside primary bronchi

Paratracheal group- On either side of the trachea

39
Q

What are respiratory symptoms of lung cancer?

A

Coughing, coughing up blood, wheezing, or shortness of breath

40
Q

What are systemic symptoms of lung cancer?

A

Weight loss, weakness, fever, or clubing of fingernails

41
Q

The lymphatics of the heart drain into which lymph nodes?

A

Right side: Right tracheobronchial nodes and brachiocephalic nodes

Left side: Left tracheobronchial nodes and brachiocephalic nodes

42
Q

Lymph from the esophagus drains into the ________ and the ____________.

A

Posterior mediastinal nodes; Posterior intercostal nodes

*Lymph then drains into the thoracic duct

43
Q

What are the symptoms of esophageal cancer?

A
  • Difficulty swallowing
  • Weight loss due to reduced appetitie and undernutrition
  • Pain behind the breastbone or in the region around the stomach
  • Unusually raspy or hoarse-sounding cough
  • Nausea, vomiting and regurgitation of food
  • Vomiting of blood
44
Q

Compression of structures due to esophageal cancer can lead to what symptoms?

A

Upper airway obstruction

Superior vena cava syndrome

45
Q

A ______________ is a left-sided supraclavicular lymph node.

A

Virchow’s node

NOTE: Virchow’s node receives lymph from lymph vessels int he avdomial cavity

46
Q
A
47
Q

An enlarged, hard Virchow’s node can indicate what?

A

Abdominal cancer, specifically gastric cancer that has spread through the lymph vessels

SF3- EXAM 2 (11 decks)

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