Module 12 : The Lymphatic System Flashcards

1
Q

the lymphatic system

A
  • drainage system that returns extracellular fluid to the body circulation
  • three types of extracellular fluid
    + plasma
    + interstitial
    + lymph
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2
Q

plasma

A
  • colorless fluid in the blood that seeps through capillary walls
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3
Q

interstitial fluid

A
  • plasma that has seeped through capillary walls and circulates among body tissue
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4
Q

lymph

A
  • interstitial fluid that drains out of the tissue and enters the lymphatic ducts
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5
Q

lymphatic anatomy

A
  • similar to circulatory system but different because
    + lack a pump
    + travel in one direction
    + contains lymph nodes
  • consists of capillaries vessels ducts and nodes
  • course along circulatory system
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6
Q

capillaries

A
  • blind ended structures in interstitial spaces, single endothelial layer
  • join together to form larger vessels
  • valves to control direction of flow
  • superficial drain into deep lymph
  • deep vessels pass through nodes on their way towards chest
  • in chest blood reenters blood stream
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7
Q

lymph nodes

A
  • important component of RE system
  • distributed throughout body
  • bean shaped accumulations o lymph tissue scattered along the lymphatic vessels
  • measure from 1mm to 1-2 cm
  • surrounded by connective tissue capsule
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8
Q

afferent vessels

A
  • drain into node
  • carry lymph through the sinuses (lined with phagocytic cells)
    + filter out and destroy bacteria and malignant cells
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9
Q

germinal centers

A
  • sponge like centres in the node
  • produce lymphocytes
  • empty into lymph prior to leaving the node
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10
Q

efferent vessel

A
  • leave only at hilum
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11
Q

lymph node and disease

A
  • rarely seen as the primary site of disease

- secondary disease may be seen as result of spread

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12
Q

two major node bearing areas in retro peritoneum

A
  • iliac and hypogastric = pelvis
  • para aortic = upper retroperitoneum
    + lymph chain follows the course of the thoracic aorta, abdominal aorta and iliac arteries
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13
Q

other lymph tissue

A
  • tonsils
  • thymus
  • spleen
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14
Q

lymphatic circulation

A
  • deep and superficial drainage
  • groups of nodes at key locations
    + axillary
    + cervical
    + inguinal
    + intestinal (peyers patch)
  • right lymphatic duct drain into right upper quadrant
  • left lymphatic duct (thoracic duct) drains remaining 3/4 of the body
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15
Q

lymph - physiology

A
  • extracellular fluid formation
  • similar to blood plasma - higher albumin (maintain blood volume) ratio
  • low leukocyte count
  • no RBCs
  • digestive enzymes
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16
Q

lymph flow - physiology

A
  • slow under resting conditions
  • depends on the kneading action of skeletal muscle
  • uses valves
17
Q

lymph - function

A
  • phagocytosis
  • immunity
  • tissue drainage
  • excretion - end product of fat digestion
18
Q

ultrasound technique

A
  • midline in supine or decubitus
  • two planes
  • common sites
    + para aortic para caval
    + mesenteric and celiac
    + pancreas, renal hilum
    + splenic hilum porta hépatisations
    +- lilacs
  • gentle pressure to displace bowel
19
Q

ultrasound appearance

A
  • not typically visualized in abdomen
  • abdominal nodes < 1cm in AP
  • homogenous low level echoes
20
Q

scanning pitfalls

A
  • enlarged para aortic lymph nodes may mimic aneurysm
  • bowel gas may obscure our visualization of abnormal nodes
  • enlarged lymph nodes surrounding vessels make it hard to see vessels
  • fluid filled areas obscure nodes