Lymphatics System Flashcards

1
Q

When are the lymphatics developing?

what dermal layers and what things are part of it?

A

begins during 5th week. significantly there by week 20

Mesoderm –> vessels, nodes, spleen, myeloid

Endoderm –> thymus and tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lymhoid tissue increases when?

what happens during geriatric stage?

A

birth until puberty. immune system continues to mature but regresses and then levels off

declines and patients may not mount a fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the main functions of the body?

A

Immune
Digestive
Fluid Balance
Waste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Spleen is where?

why is it called “pressure sensitive”?

A

beneath ribs 9-11 on the left

it’s normally not palpable

movement of the diaphragm drives splenic fluid movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What organ has the most lymphoid tissue?

what is its function?

A

spleen

synthesize Ig’s, clear fluid, and synthesize RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Liver is found where?

why is it pressure sensitive?

A

RUQ. right costal margin

like the spleen, movement of the diaphragm for the homeostatic movement of hepatic fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the liver’s lymphatic function?

A

half of the body’s lymph is formed here.

clears bacteria

gate keeper of shared hepatic-biliary-pancreatic venous and lymphatic drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thymus is found where?

what’s good to know about adults vs kids?

function?

A

Anterior Mediastinum

large in infancy, size peaks at 2 y/o. after puberty it becomes fat.

maturation for T cells, little to no fn in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tonsils?

A

3 of them.

most visible 6-9 mo, enlarged through childhood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Appendix?

A

proximal portion of the cecum

lymphoid pulp in it.

part of the GALT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Visceral Lymphoid Tissue?

A

GALT

these have large chylomicrons that we need to move around and they can’t travel through blood so need to go through lymphatic system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is lymphatic fluid?

A

substances that leak out of the capillaries into the interstitium. (fluids, proteins, electrolytes, and cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does lymphatics help with fluid balance?

what if you overload that?

A

30L of fluid move from capillaries to interstitial space each day

90% to capillaries, 10% to lymphatic system.

2nd or third spacing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

where does most of the lymphatic drainage happen/

what is this spot associated with?

A

thoracic duct.

respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how do you start lymphatic treatment?

A

clearing the thoracic duct (inlet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What tissues do not have lymphatic vessels but use d direct diffusion?

A

epidermis, endomysium, cartilage, bone marrow

17
Q

lymph tubes are what type?

A

blind endothelial tubes or capillaries.. they’re leaky

18
Q

starting from lymphatic capillaries, what’s the pathway?

A

lymphatic capillaries –> collecting lymphatics –> afferent lymphatic vessels –> efferent lymphatic vessels –> thoracic duct or R lymphatic duct –> venous system

19
Q

What are Lymphangions?

A

muscular units or “chains” that are two-leaflet bicuspid valves that make sure there isn’t back flow.

20
Q

Lymph node types? function?

A

Superficial + Deep

filter fluid, maturation of lymphocytes, phagocytosis

21
Q

pathway of the lymph node from afferent lymphatics?

A

Afferent lymphatics –> sub capsular space –> outer cortex –> deep cortex –> medullary sinus –> efferent lymphatics through Hilum

22
Q

Malignancy in the neck, what node are you going to look at? where is it at?

A

Virchow’s node. L supraclavicular space

23
Q

What lymph node is associated with secondary syphilis?

A

Epitrochlear Nodes

24
Q

Where does the Thoracic duct originate from?

Where does it terminate?

A

Cisterna Chyli as a dilation at L1-L2 level

terminates by piercing Sibson’s fascia at superior inlet, U-turns to empty into L subclavian/IJ veins

25
What is the thoracic duct major function?
master lymph vessel and drains L UE, L head/neck, L thorax, abdomen, everything inferior to belly button.
26
what does lymph fluid do to organs?
bathes organs cleanses EC spaces of bad shit. travels from vessel --> node node is the purifying filter
27
What's the primary way we move lymph? (flow) what pressure allows movement of lymph? what pressure collapses lymph capillaries
Interstitial fluid pressure (Pif) negative greater than 0
28
Pelvic diaphragm works how?
works with the thoracic diaphragm. helps move fluids from lower to the thoracic duct.
29
SNS on the lymph valves? SNS on the lymphatic smooth muscle? What does OMT do?
higher tone == tighter valves = lower flow higher tone = lower peristalsis = lymphatic congestion lowers the SNS activity
30
What is the consequence of a poorly functioning lymphatic system?
edema.. third spacing out into different place. imbalance of starting forces.
31
What are the effects of edema on vascular? neuronal? SOB?
lower delivery of O2, nutrients, meds lower sensation, pain, or paresthesia pulmonary SOB
32
How does edema effect the body if chronic?
fibroblast recruitment and activation is affected.. leading to fibrosis / contraction
33
Indications for Lymphatic OMT? chronic conditions?
edema, tissue congestion, lymphatic stasis infection inflammation be careful
34
Absolute Contraindications for lymphatic OMT?
Anuria (no urine at all) Necrotizing fasciitis in treatment area (spreads easy) can't tolerate treatment patient consent
35
Relative Contraindications for Lymphatic OMT?
COPD, acute asthma exacerbation, unstable cardiac conditions. bacterial/chronic infections. Cancer is up in the air.
36
What are the 5 principles of diagnosis from a lymphatic approach?
1. evaluate risk-benefit ratio 2. evaluate fascial patterns of Zink 3. Evaluate diaphragms/fascia 4. evaluate SD 5. Evaluate tissue congestion
37
Zink's patterns
L/R/L/R compensatory R/L/R/L (less common)
38
What is the sequence of treatment?
1. open pathways to remove restriction to flow 2. maximize diaphragmatic function 3. increase pressure differentials or transmit motion (fluid pumps) 4. Mobilize targeted tissue fluids
39
Zink's compensatory pattern
look at the 4 junctions (cranial cervical, cervicothoracic, thoracolumbar, lumbosacral) LRLR pattern through rotation or uncommon or uncompensated compensatory