Lymphattics of the Head and Neck Flashcards
1
Q
What are the functions of the lymphatic system?
A
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
2
Q
Leukocytes are made in the __________.
A
Bone marrow
3
Q
Types of leukocytes
A
- Monocytes
- Lymphocytes
- B-lymphocytes (plasma cell)
- T-lymphocytes
4
Q
Largest leukocyte
A
Monocyte
5
Q
50% of monocytes are stored in the __________.
A
Spleen
6
Q
Which immune system are monocytes a part of?
A
The innate immune system
7
Q
Monocytes can can form into ______ and __________.
A
Macrophages; dendritic cells
8
Q
T Cells obtain maturity in the __________
A
Thymus
9
Q
T- cells are apart of the _________ immune system.
A
Adaptive
*Play a role in cell-mediated response
10
Q
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.
A
Cytokines
11
Q
T cells differentitate into which two cell types?
A
T-helper and Cytotoxic T cells
12
Q
B cells are apart of a ______ or ________ response.
A
Humoral; antibody
13
Q
B cells mature in the __________
A
Bone marrow
14
Q
What is the function of antibodies?
A
They neutralize the pathogen
15
Q
What are the two primary lymphatic organs?
A
Bone marrow
Thymus
16
Q
What are the secondary organs of the lymphatic system?
A
- S. A. L. T.
- M. A. L.T.
- Lymph Nodules
- Pharyngeal tonsils
- Palatine tonsils
- Lingual tonsils
- Lymph Nodes
- Superficial nodes
- Deep nodes
- Spleen
17
Q
What is found in the red marrow?
A
RBCs
WBCs
Platelets
18
Q
What is found in yellow marrow?
A
Made up of fat cells
19
Q
The thymus is dimished after puberty and then replaced by _____________
A
Adipose tissue
20
Q
Which type of lymphatic system is exposed to the environment?
A
S.A.L.T
*Immunologically important
21
Q
What kinds of immune cells reside in the skin?
A
•dendritic cells (DCs), T cells and macrophages reside in the skin
22
Q
Which type of lymph organs are usually found in absorbtive areas?
A
M.A.L.T
23
Q
Which types of immune cells rise in M.A.L.T?
A
• T cells and B cells, as well as plasma cells and macrophages
24
Q
How may tonsils are found in the body?
A
- 5 tonsils in body
- 2 lingual
- 2 palatine
- 1 pharyngeal
25
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**
26
Pharyngeal tonsil a.k.a \_\_\_\_\_\_\_
Adenoid
27
The pharyngeal tonsil is located in the \_\_\_\_\_\_\_\_\_\_\_
Nasopharynx
\*This is the area between the nose and pharynx
28
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.
29
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
30
31
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**
32
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.
33
Tonsilititis
Inflammation of the tonsils most commonly caused by viral or bacterial infection (Symptoms may include sore throat and fever)
34
Which is worse viral infection or bacterial infection in the tonsils?
Bacterial
35
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
36
Where are lingual tonsils located?
At the posterior root of the tongue near the pharynx
\*Protects from inhaled/ingested substances
37
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
38
Where the spleen located?
**Left** side of abdominal cavity beneath the diaphragm
39
What's the structure of the spleen?
* Fibrous capsule
* Trabeculae
* Red pulp (RBCs and macrophages)- Outer
* White pulp (lymphocytes)- Inner
40
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
41
\_\_\_\_\_\_\_\_\_\_\_\_ divide the lymph nodes into nodules.
Trabeculae
42
The \_\_\_\_\_\_\_\_\_\_\_, of the lymph node, stores B and T cells to fight infection.
Cortex
43
The _______ stores macrophages and plasma cells to attack infections?
Medulla
44
What is the path of lymph flow through a lymph node?
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 **subscapular space**, a meshwork of reticular fibers, macrophages, and dendritic cells. Dendritic cells are involved in the initiation of the immune response.
3. Lymph next flows into the **outer cortex**, whcih 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 sinuses** 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 medullar sinus and carry it toward the **venous** circulation
45
Lymphadenopathy
* Swollen or enlarged lymph nodes
* Arise from infection, autoimmune disease or malignancy
46
How many main lymphatic trunks are there? What are they?
5
* Lumbar
* Intestinal
* Bronchomediastinal
* Subclavian
* Jugular
47
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
48
The beginning of the thoracic duct is known as the \_\_\_\_\_\_\_\_\_\_\_\_
Cisterna chyli
49
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
50
What is the flow of lymph?
Lymphatic capillaries-\> afferent lymph vessels-\> lymph nodes-\> efferent lymph vessels join trunk-\> duct-\> venous system
51
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
52
\_\_\_\_\_\_\_\_\_\_\_\_ & ____________ trunks merge to form the cisterna chyli of the thoracic duct
Intestinal; lumbar
53
Which trunk drains the head and neck?
Jugular trunk
54
Elephantiasis
* Gross enlargement of an area of the body (**commonly limbs and gentalia**)
* Caused by obstruction of lymphatic system, resulting in accumulation of lymph
55
The right lymphatic duct drains in the junction of the _________ and ________ veins, which then drain into the _________ vein.
Right Subclavian; right jugular; brachiocephalic
56
What is the junction of the right internal jugular vein and the right subclavian vein called?
The augulus venous
57
The superior deep cervical nodes (SDCN) are the level of which muscle?
Posterior belly of the digastric muscle
58
The inferior deep cervical nodes (IDCN) are the level of which muscle?
Inferior belly of the omohyoid muscle
59
The deep cervical lymph nodes runs along which vein?
Internal jugular vein
60
The superficial cervical lymph nodes runs along which vein?
External jugular vein
61
What are the components of the carotid sheath?
* Common carotid artery
* Internal jugular vein
* Ansa cervicalis
* CN X
* Deep cervical nodes
62
Lymph from bouth the deep and superficial cervical nodes empty in the _________ trunk.
Jugular
63
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
64
65
Deep cervical lymphatics are located posterior to the \_\_\_\_\_\_\_\_\_\_
SCM
\*You can palpate these closer to the clavicle
66
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
67
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
68
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
69
What is another name for the tonsillar node?
Jugulodigastric node
70
Why is the lymph from the palantine tonsil able to drain directly to the IDCN?
Because it is apart of the SDCN
71
The lymph from the body of the tongue drains to the _________ and it drains __________ (bilaterally/ipsilateral).
IDCN; Bilaterally
72
Aside from the body of the tongue, which structure drains bilaterally?
The middle of the tip of the tongue
73
\_\_\_\_\_\_\_\_\_ in the body of the tonue means that you need to test lymph nodes on both sides.
Tumor
74
Tip of the tongue drains to \_\_\_\_\_\_\_\_\_\_.
Submental nodes
75
Lateral tongue drains to the \_\_\_\_\_\_\_\_\_\_\_\_\_.
submandibular nodes
76
Why is pharynx lymphatic drainage important?
High incidence of cancers
77
What can be found behind the pharyngeal constrictor muscles (superior, middle, and inferior)?
The common carotid artery and the internal jugular vein
78
Where are the paratracheal nodes found?
Just outsuide of the trachea
79
Laryngeal nodes that are located above the vocal fold drain where?
SDCN
80
Laryngeal nodes that are located below the vocal fold drain where?
IDCN or paratracheal nodes
81
Paratracheal nodes drain directly to the \_\_\_\_\_\_\_\_\_\_\_\_
Jugular trunk
82
The __________ becomes diminished at puberty and becomes mostly replaced by adipose tissue.
Thymus
83
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is found in numerous sites of the body, including the GI tract, reporductive tract and eye.
MALT
84
The _________ tonsil is located in the nasopharynx.
Pharyngeal
85
The deep cervical lymph nodes are found within the carotid sheath. True or false.
True
86
The _________ lymph nodes are located near the external jugualr vein.
Superficial cervical
87
The superior and inferior deep cervical lymph nodes lie along what vessel?
Internal jugular vein
