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OS1 Final > Lymphatics System > Flashcards

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

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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

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3
Q

What are the main functions of the body?

A

Immune
Digestive
Fluid Balance
Waste

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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

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5
Q

What organ has the most lymphoid tissue?

what is its function?

A

spleen

synthesize Ig’s, clear fluid, and synthesize RBC

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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

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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

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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

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9
Q

Tonsils?

A

3 of them.

most visible 6-9 mo, enlarged through childhood.

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10
Q

Appendix?

A

proximal portion of the cecum

lymphoid pulp in it.

part of the GALT.

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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

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12
Q

What is lymphatic fluid?

A

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

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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.

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14
Q

where does most of the lymphatic drainage happen/

what is this spot associated with?

A

thoracic duct.

respiration

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15
Q

how do you start lymphatic treatment?

A

clearing the thoracic duct (inlet)

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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
Q

What is the thoracic duct major function?

A

master lymph vessel and drains L UE, L head/neck, L thorax, abdomen, everything inferior to belly button.

26
Q

what does lymph fluid do to organs?

A

bathes organs

cleanses EC spaces of bad shit. travels from vessel –> node

node is the purifying filter

27
Q

What’s the primary way we move lymph? (flow)

what pressure allows movement of lymph?

what pressure collapses lymph capillaries

A

Interstitial fluid pressure (Pif)

negative

greater than 0

28
Q

Pelvic diaphragm works how?

A

works with the thoracic diaphragm. helps move fluids from lower to the thoracic duct.

29
Q

SNS on the lymph valves?

SNS on the lymphatic smooth muscle?

What does OMT do?

A

higher tone == tighter valves = lower flow

higher tone = lower peristalsis = lymphatic congestion

lowers the SNS activity

30
Q

What is the consequence of a poorly functioning lymphatic system?

A

edema.. third spacing out into different place. imbalance of starting forces.

31
Q

What are the effects of edema on vascular? neuronal? SOB?

A

lower delivery of O2, nutrients, meds

lower sensation, pain, or paresthesia

pulmonary SOB

32
Q

How does edema effect the body if chronic?

A

fibroblast recruitment and activation is affected.. leading to fibrosis / contraction

33
Q

Indications for Lymphatic OMT? chronic conditions?

A

edema, tissue congestion, lymphatic stasis

infection

inflammation

be careful

34
Q

Absolute Contraindications for lymphatic OMT?

A

Anuria (no urine at all)

Necrotizing fasciitis in treatment area (spreads easy)

can’t tolerate treatment

patient consent

35
Q

Relative Contraindications for Lymphatic OMT?

A

COPD, acute asthma exacerbation, unstable cardiac conditions.

bacterial/chronic infections.

Cancer is up in the air.

36
Q

What are the 5 principles of diagnosis from a lymphatic approach?

A
  1. evaluate risk-benefit ratio
  2. evaluate fascial patterns of Zink
  3. Evaluate diaphragms/fascia
  4. evaluate SD
  5. Evaluate tissue congestion
37
Q

Zink’s patterns

A

L/R/L/R compensatory

R/L/R/L (less common)

38
Q

What is the sequence of treatment?

A
  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
Q

Zink’s compensatory pattern

A

look at the 4 junctions (cranial cervical, cervicothoracic, thoracolumbar, lumbosacral)

LRLR pattern through rotation or uncommon or uncompensated compensatory

OS1 Final (7 decks)

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