Lymphattics of the Head and Neck Flashcards
What are the functions of the lymphatic system?
Functions
A.Drains interstitial fluid
B.Recycles blood plasma into
cardiovascular system
C. Filtration
D.Transportation
- Fatty acids
- Hormones
- Steroids
- Vitamins
E.Natural defense of the body
- Phagocytosis
- Cytotoxic reactions
- Antibody production
Leukocytes are made in the __________.
Bone marrow
Types of leukocytes
- Monocytes
- Lymphocytes
- B-lymphocytes (plasma cell)
- T-lymphocytes
Largest leukocyte
Monocyte
50% of monocytes are stored in the __________.
Spleen
Which immune system are monocytes a part of?
The innate immune system
Monocytes can can form into ______ and __________.
Macrophages; dendritic cells
T Cells obtain maturity in the __________
Thymus
T- cells are apart of the _________ immune system.
Adaptive
*Play a role in cell-mediated response
T cells become mobilized once they encounter an antigen. When they are mobilized, signaling proteins known as ________ will dertemine what will happen to the T- cell.
Cytokines
T cells differentitate into which two cell types?
T-helper and Cytotoxic T cells
B cells are apart of a ______ or ________ response.
Humoral; antibody
B cells mature in the __________
Bone marrow
What is the function of antibodies?
They neutralize the pathogen
What are the two primary lymphatic organs?
Bone marrow
Thymus
What are the secondary organs of the lymphatic system?
- S. A. L. T.
- M. A. L.T.
- Lymph Nodules
- Pharyngeal tonsils
- Palatine tonsils
- Lingual tonsils
- Lymph Nodes
- Superficial nodes
- Deep nodes
- Spleen
What is found in the red marrow?
RBCs
WBCs
Platelets
What is found in yellow marrow?
Made up of fat cells
The thymus is dimished after puberty and then replaced by _____________
Adipose tissue
Which type of lymphatic system is exposed to the environment?
S.A.L.T
*Immunologically important
What kinds of immune cells reside in the skin?
•dendritic cells (DCs), T cells and macrophages reside in the skin
Which type of lymph organs are usually found in absorbtive areas?
M.A.L.T
Which types of immune cells rise in M.A.L.T?
• T cells and B cells, as well as plasma cells and macrophages
How may tonsils are found in the body?
- 5 tonsils in body
- 2 lingual
- 2 palatine
- 1 pharyngeal
What importance do tonsils that become inflammed play?
Tonsils often become inflamed in respone to an infection. It acts a a barrier, to that it doesn’t spread to other places
Pharyngeal tonsil a.k.a _______
Adenoid
The pharyngeal tonsil is located in the ___________
Nasopharynx
*This is the area between the nose and pharynx
Why is the inflammation of the pharyngeal tonsil so problematic?
If an infection occurs and these adenoids get enlarged they can block the respiratory path. If the adenoids get too big they can block the Eustracheal tube and you can get ear infections becuase the drainage is there is being blocked.
Where are the palantine tonsils found?
Near the oropharynx. They are located at the entrance to the upper respiratory and GI tracts to protect the body from inhaled/ injested pathogens
Tonsillectomy
Procedure performed in response to:
- repeated occurrence of acute tonsillitis
- sleep surgery for obstructive sleep apnea
- nasal airway obstruction
- snoring
- takes place in the tonsillar bed
Tonsillectomies take place in the tonsillar bed. Why can this pose a problem?
There are numeruous important structures in the tonsillar bed such as CN IX, the stylopharyngeus muscle, and huge arterial anastomoses.
*So a person can bleed to death if they have this procedure.
Tonsilititis
Inflammation of the tonsils most commonly caused by viral or bacterial infection (Symptoms may include sore throat and fever)
Which is worse viral infection or bacterial infection in the tonsils?
Bacterial
What are the symptoms are a bacterial infection of the tonsils?
- White spots
- Swollen uvula
- Layers of musus on the tongue known as the gray fomy tongue
- Redness
Where are lingual tonsils located?
At the posterior root of the tongue near the pharynx
*Protects from inhaled/ingested substances
What are the three functions of the spleen?
- Three functions:
- Removes worn out or defective RBC by macrophages
- Site of RBC production in fetus
- Stores platelets
Where the spleen located?
Left side of abdominal cavity beneath the diaphragm
What’s the structure of the spleen?
- Fibrous capsule
- Trabeculae
- Red pulp (RBCs and macrophages)- Outer
- White pulp (lymphocytes)- Inner
What’s the structure of the spleen?
- Capsule surrounds node and its connective tissue fibers extend into node
- Trabeculae formed from the extended capsule fibers and compartmentalize the node
- Afferent vessels bring lymph into node, pass through cortex
- Medullary cords extend inward and contain both types of lymphocytes
- Efferent vessel in the hilus transports filtered lymph toward venous circulation
____________ divide the lymph nodes into nodules.
Trabeculae
The ___________, of the lymph node, stores B and T cells to fight infection.
Cortex
The _______ stores macrophages and plasma cells to attack infections?
Medulla
What is the path of lymph flow through a lymph node?
- 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
- The afferent vessels deliver lymph to the subscapular space, a meshwork of reticular fibers, macrophages, and dendritic cells. Dendritic cells are involved in the initiation of the immune response.
- Lymph next flows into the outer cortex, whcih contains B cells within germinal centers that resemble those of lymphoid nodules
- Lymph then flows through lymph sinuses in the deep cortex, which is dominated by T cells.
- Lymph continues into the medullary sinuses at the core of the lymph node. This region contains B cells and plasma cells
- Efferent lymphatics leave the lymph node at the hilum. These vessels collect lymph from the medullar sinus and carry it toward the venous circulation
Lymphadenopathy
- Swollen or enlarged lymph nodes
- Arise from infection, autoimmune disease or malignancy
How many main lymphatic trunks are there? What are they?
5
- Lumbar
- Intestinal
- Bronchomediastinal
- Subclavian
- Jugular
What are the components of the lymphatic circuit?
Lymphatic Circuit (Vessels)
- Capillaries
- Lymph Vessels
- Lymphatic Trunks
- Jugular Trunks
- Subclavian Trunks
- Bronchomediastinal Trunks
- Intestinal Trunks
- Lumbar Trunks
- Lymphatic Ducts
- Right Lymphatic Duct
- Thoracic Duct (rest of body)
- Cisterna Chyli
The beginning of the thoracic duct is known as the ____________
Cisterna chyli
The high pressure of the capillaries forces water and solutes out of thin wall of the blood capillaries into the interstitial fluid, whatever is then picked up by the lymphatic capillaries is called ___________
Lymph
What is the flow of lymph?
Lymphatic capillaries-> afferent lymph vessels-> lymph nodes-> efferent lymph vessels join trunk-> duct-> venous system
Lymph is delivered to one of two large ducts. What are they and what do they drain?
- Right lymphatic duct drains lymph from the right arm, right thorax & right side of the head and neck
- Thoracic duct receives lymph from the rest of the body
____________ & ____________ trunks merge to form the cisterna chyli of the thoracic duct
Intestinal; lumbar
Which trunk drains the head and neck?
Jugular trunk
Elephantiasis
- Gross enlargement of an area of the body (commonly limbs and gentalia)
- Caused by obstruction of lymphatic system, resulting in accumulation of lymph
The right lymphatic duct drains in the junction of the _________ and ________ veins, which then drain into the _________ vein.
Right Subclavian; right jugular; brachiocephalic
What is the junction of the right internal jugular vein and the right subclavian vein called?
The augulus venous
The superior deep cervical nodes (SDCN) are the level of which muscle?
Posterior belly of the digastric muscle
The inferior deep cervical nodes (IDCN) are the level of which muscle?
Inferior belly of the omohyoid muscle
The deep cervical lymph nodes runs along which vein?
Internal jugular vein
The superficial cervical lymph nodes runs along which vein?
External jugular vein
What are the components of the carotid sheath?
- Common carotid artery
- Internal jugular vein
- Ansa cervicalis
- CN X
- Deep cervical nodes
Lymph from bouth the deep and superficial cervical nodes empty in the _________ trunk.
Jugular
Superficial cervical lymphatics lie anterior to the __________
SCM
*If you turn your head you can actually palpate these, they are found closer to the ear
Deep cervical lymphatics are located posterior to the __________
SCM
*You can palpate these closer to the clavicle
What is the flow of lymph in the facial area?
Facial nodes-> Submandibular nodes-> SDCN-> IDCN->Jugular trunk-> Right lymphatic duct or thoracic duct (depends on side of body)-> Venous circulation
What is the flow of lymph in the nasal cavity?
Nasal cavity-> retropharyngeal nodes-> SDCN->IDCN-> Jugular trunk-> Thoracic or right lymphatic duct (depends on side of body)-> Venous circulation
-OR-
Nasal cavity-> deep parotid nodes-> SDCN->IDCN-> Jugular trunk-> Thoracic or right lymphatic duct (depends on side of body)-> Venous circulation
What is the flow of lymph from the palantine tonsil?
Palantine tonsil->Tonsillar node->IDCN-> Jugular trunk-> Thoracic or right lymphatic duct (depends on side of body)-> Venous circulation
What is another name for the tonsillar node?
Jugulodigastric node
Why is the lymph from the palantine tonsil able to drain directly to the IDCN?
Because it is apart of the SDCN
The lymph from the body of the tongue drains to the _________ and it drains __________ (bilaterally/ipsilateral).
IDCN; Bilaterally
Aside from the body of the tongue, which structure drains bilaterally?
The middle of the tip of the tongue
_________ in the body of the tonue means that you need to test lymph nodes on both sides.
Tumor
Tip of the tongue drains to __________.
Submental nodes
Lateral tongue drains to the _____________.
submandibular nodes
Why is pharynx lymphatic drainage important?
High incidence of cancers
What can be found behind the pharyngeal constrictor muscles (superior, middle, and inferior)?
The common carotid artery and the internal jugular vein
Where are the paratracheal nodes found?
Just outsuide of the trachea
Laryngeal nodes that are located above the vocal fold drain where?
SDCN
Laryngeal nodes that are located below the vocal fold drain where?
IDCN or paratracheal nodes
Paratracheal nodes drain directly to the ____________
Jugular trunk
The __________ becomes diminished at puberty and becomes mostly replaced by adipose tissue.
Thymus
_______________ is found in numerous sites of the body, including the GI tract, reporductive tract and eye.
MALT
The _________ tonsil is located in the nasopharynx.
Pharyngeal
The deep cervical lymph nodes are found within the carotid sheath. True or false.
True
The _________ lymph nodes are located near the external jugualr vein.
Superficial cervical
The superior and inferior deep cervical lymph nodes lie along what vessel?
Internal jugular vein
