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HEMATOLOGY > Lymphoid system > Flashcards

Lymphoid system Flashcards

1
Q

What are lymph nodes?

A
  • small, oval bodies (2.5cm)

- found along the COURSE of lymphatic vessels

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2
Q

What do LNs do?

A
  • blind-ending vascular channels COLLECT fluid from TISSUES and returns to blood stream
  • PASSIVE movement of fluid
  • valves
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3
Q

LNs found in the intestinal wall are called ______

A

PEYER’s PATCHES

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4
Q

What is the function of lymph nodes?

A
  1. filter blood

2. assist the immune system in building an immune response

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5
Q

Describe the flow of lymph through the lymph nodes.

A
  • the AFFERENT channels drain lymph through the CAPSULE into the PERIPHERAL sinus

> lymph then moves towards the HILUM of the lymph node

> concave area in the node that drains lymph into the EFFERENT channels = FILTERED lymph

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6
Q

Name the lymphatic trunks.

A
  1. 2 lumbar trunks
  2. 2 bronchomediastinal trunks
  3. 2 jugular trunks
  4. 2 subclavian trunks
  5. 1 intestinal trunk
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7
Q

What are the 2 major ducts of the lymphatic system?

A
  1. Thoracic Duct

2. Right lymphatic duct - drains lymph from the Right arm, right side of HEAD and chest

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8
Q

What does the right lymphatic duct then do?

A
  • drain blood into the jxn of the RIGHT JUGULAR vein and the RIGHT subclavian vein
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9
Q

Where does the thoracic duct dump lymph into?

A
  • same jxn on the left side of body

- —–jxn of the Left subclavian and left jugular vein

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10
Q

What cells does the lymphoid system house?

A
  • cells of the INNATE immune system
    1. Lymphocytes: B-cells/ T-cells/ NK-cells
  1. Mononuclear phagocytes (macrophages/ Antigen presenting cells and dendritic cells)
  2. endothelial cells
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11
Q

Where are the plasma cells located in the lymph node?

A
  • in the MEDULLA
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12
Q

What are forms of lymphadenopathy?

A
  1. local inflammation
  2. systemic inflammation
  3. malignancy
  4. others: Sarcoidosis/ catslemans disease/ IgG4-related disease
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13
Q

What are causes of local inflammation?

A
  1. infection (TB or Toxoplasma)

2. vaccination/ dermatopathic

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14
Q

What are causes of systemic inflammation?

A
  1. viral infections

2. autoimmune

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15
Q

WHat is sarcoidosis?

A
  • a granulomatous condition
  • WIDE DDX; no histological dx
  • –may mask malignancy in a LN
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16
Q

what is lymphangitis?

A
  • superficial infection (RED lines EXTENDING form an inflamed lesion)
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17
Q

What may be the first sign of UNDERLYING malignancy?

A
  • superficial lymphadenopathy
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18
Q

What could it be if pt presents with GENERALIZED lymphadenopathy?

A
  • inflammatory process

- widespread malignancy (lymphoma/ leukaemia) —FBC check!

19
Q

Name a IIary lymphoid organ.

A

SPLEEN

(normally 150-200g) —usually NOT palpable !

20
Q

What is contact with the spleen’s visceral surface?

A
  • left kidney
  • gastric fundus
  • tail of pancreas
  • splenic flexure of colon
21
Q

What is the spleen supplied by?

A 
splenic artery (br. of the coeliac axis)
---drained by the splenic vein ----SMV forms the portal vein
22
Q

What is a diseased spleen prone to ?

A

RUPTURE

- why it’s an emergency

23
Q

What is the fxn of the spleen?

A

FILTER for the blood
- detects, retains and eliminates UNWANTED, foreign/ damaged material

  • facilitates immune responses to blood borne antigens!
24
Q

Describe the morphology of the spleen.

A

-encapsulated organ with parenchyma, including RED PULP and WHITE pulp

25
Q

What makes up the red pulp in the spleen?

A 
contains SINUSOIDS (fenestrated, lined by endothelial cells 
and supported by reticulin)

CORDS containing macrophages and some fibroblasts and cells (RBCs/ WBC/ PC and some CD8+ T cells) in transit

26
Q

Why should splenic rupture always be considered in abdominal injuries?

A
  • it only has a thin capsule and it is a well-vascularized organ
27
Q

What is the white pulp of the spleen?

A

LYMPHATIC tissue of the spleen:

  • periarteriole lymphatic sheath (lymphoid organ- T-cells and marcophage)
  • marginal zone (macrophages)
  • follicles (B-cells)
28
Q

Describe the circulation of blood within the spleen.

A
  • splenic artery> central arterioles> end arterie s
29
Q

What % of the spleen makes up 25% of it?

A

White matter

30
Q

How does blood return with the venous system in the spleen?

A
  • through the sinus system; found all around the capillaries (which have fevenstrations)

> v.sinus > collecting vein> splenic vein

31
Q

What % if the spleen is made up by the red pulp?

A

75%

- resp. to screen for abnormal RBCs, OLD rbc

32
Q

WHat may be a sign of splenectomy/ hyposplenism?

A
  • presence of abnormal red cells in the peripheries.

(Howell-Joly bodies- remnants of

33
Q

What is seen in the peri-arteriolar lymphoid sheath?

A
  • CD4+ lymphoid cells

- –PALS is explanded by lymphoid follicles

34
Q

How does splenomegaly present as?

A
  • LUQ DRAGGIN sensation
  • discomfort with EATING
  • pain if infarction
  • HYPERSPLENISM
35
Q

What occurs with hypersplenism?

A

TRIAD

  1. splenomegaly
  2. FALL in 1/more cellular components
  3. correction of CYTOPENIAS by splenectomy
36
Q

What infection may cause splenomegaly?

A 
EBV 
TB
Malaria 
Typhoid 
Brucellosis 
Leichmaniasis 
trypanosomiasis
37
Q

What inflammatory conditions results in splenomegaly?

A

RA

- SLE

38
Q

Name congestive causes of splenomegaly.

A

portal (hepatic cirrhosis/ splenic vein thrombosis. cardiac failure)

39
Q

Name haematological diseases leading to splenomegaly.

A
  1. lymphoma/leukaemia
  2. Haemolytic anaemia
  3. ITP
  4. Myeloproliferative d.o
40
Q

Storage causes of splenomegaly.

A

Gaucher’s

Niemann-Pick disease

41
Q

When may hypersplenism occur?

A

with conditions a.w splenomegaly

42
Q

Apart from splenectomy, what are other causes of hyposplenism?

A
  1. coeliac disease
  2. sickle cell disease
  3. sarcoidosis
  4. iatrogenic (non-surgical)
43
Q

Hyposplenism occurs with loss of fxn of which pulp?

A

RED pulp

HEMATOLOGY (20 decks)

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